{"id":22280,"date":"2021-10-25T23:33:14","date_gmt":"2021-10-26T04:33:14","guid":{"rendered":"https:\/\/saluddigital.com\/?p=22280"},"modified":"2025-10-21T11:48:18","modified_gmt":"2025-10-21T17:48:18","slug":"nonalcoholic-fatty-liver-statpearls","status":"publish","type":"post","link":"https:\/\/saluddigital.com\/en\/resumen-de-cursos\/nonalcoholic-fatty-liver-statpearls\/","title":{"rendered":"Nonalcoholic Fatty Liver \/ StatPearls"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"22280\" class=\"elementor elementor-22280\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6f34e246 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-equal-height-no\" data-id=\"6f34e246\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-51e1960a\" data-id=\"51e1960a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5139b4eb elementor-widget elementor-widget-text-editor\" data-id=\"5139b4eb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Key points<\/strong><\/p><p><strong>INTRODUCTION<\/strong><\/p><ul><li>Non-alcoholic fatty liver disease (NAFLD\/NAFLD) encompasses a spectrum of conditions characterized by evidence of hepatic steatosis on imaging or histology and secondary absence of hepatic steatosis, such as alcohol consumption or chronic medication use<\/li><li>Non-alcoholic fatty liver disease is a silent disease.<ul><li>It has several phases of progression: simple steatosis, steatohepatitis, fibrosis, cirrhosis and could progress to hepatocellular carcinoma<\/li><\/ul><\/li><li>The presence of liver injury with inflammation + with or without fibrosis constitutes non-alcoholic steatohepatitis (NASH\/NASH)<\/li><\/ul><p><strong>ETIOLOGY<\/strong><\/p><ul><li>Obesity, diabetes, dyslipidemia, insulin resistance and metabolic syndrome, associated with the appearance of NAFLD<ul><li>Therefore, they present cardiovascular risk factors.<\/li><\/ul><\/li><\/ul><p><strong>EPIDEMIOLOGY<\/strong><\/p><ul><li>Incidence is on the rise in Western countries<\/li><li>NAFLD prevalence<ul><li>80% \u2013 90% in obese adults<\/li><li>30% \u2013 50% in adults with Diabetes Mellitus<\/li><li>90% or higher in adults with dyslipidemia<\/li><li>40% to 70% in children with obesity<\/li><\/ul><\/li><\/ul><p><strong>PATHOPHYSIOLOGY<\/strong><\/p><ul><li>Environmental and genetic factors intervene<ul><li>first degree relatives<\/li><li>SIRT1 activation<\/li><\/ul><\/li><li>Insulin resistance causes:<ul><li>Accumulation of triglycerides in the cytoplasm of hepatocytes<\/li><li>Accumulation of fatty acids and triglycerides in the liver due to an excessive supply of them<\/li><li>Sinusoidal collagen deposition and portal fibrosis develops NASH<\/li><\/ul><\/li><li>Accumulation of fatty acids makes the liver more vulnerable to injury<\/li><li>Excess of CHOs stimulates hepatic synthesis of fatty acids<\/li><li>Obesity releases inflammatory mediators that damage hepatocytes<\/li><\/ul><p><strong>HISTOPATHOLOGY<\/strong><\/p><ul><li>In NAFLD, liver biopsy shows more than 10% from hepatocytes with fat droplets<\/li><\/ul><p><strong>CLINICAL PRESENTATION<\/strong><\/p><ul><li>NAFLD:<ul><li>Most asymptomatic, some with nonspecific symptoms<ul><li>Fatigue is one of the most common symptoms<\/li><li>Upper abdominal pain, thirst, bloating, and sleep disturbances<\/li><\/ul><\/li><li>Moderate hepatomegaly is the most common clinical sign.<\/li><\/ul><\/li><\/ul><p><strong>EVALUATION <\/strong><\/p><ul><li>Slightly elevated serum aminotransferases (main biochemical data), although they may appear normal.<\/li><li>GGT elevation, marker of increased mortality<\/li><li>Ultrasound, routine method<\/li><li>Liver biopsy, gold standard for NAFLD diagnosis<\/li><li>\u201cNAFLD in metabolic syndrome score\u201d, is a non-invasive score to predict the development of NAFLD, it includes:<ul><li>BMI &gt; 25<\/li><li>AST\/ALT &gt; or = 1<\/li><li>DM2<\/li><li>Obesity<\/li><\/ul><\/li><\/ul><p><strong>DRIVING<\/strong><\/p><ul><li>Changes in lifestyle<\/li><li>With simple steatosis, weight loss of 3% \u2013 5%<\/li><li>Before NASH, weight loss from 7% \u2013 10%<ul><li>Control of risk factors (Statins in dyslipidemias, control SAH and DM)<\/li><\/ul><\/li><li>multidisciplinary treatment<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-41e02b5 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"41e02b5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-md\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK541033\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">See more<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Puntos Clave INTRODUCCI\u00d3N La enfermedad del h\u00edgado graso no alcoh\u00f3lico (EHGNA\/NAFLD), abarca un espectro de afecciones caracterizadas por evidencia de esteatosis hep\u00e1tica en im\u00e1genes o histolog\u00eda y ausencia secundaria de esteatosis hep\u00e1tica, como el consumo de alcohol o uso cr\u00f3nico de medicamentos La enfermedad del h\u00edgado graso no alcoh\u00f3lico es una enfermedad silente. Tiene varias fases de progresi\u00f3n: esteatosis simple, esteatohepatitis, fibrosis, cirrosis y podr\u00eda progresar a carcinoma hepatocelular La presencia de lesi\u00f3n hep\u00e1tica con inflamaci\u00f3n + con o sin fibrosis constituye esteatohepatitis no alcoh\u00f3lica (EHNA\/NASH) ETIOLOG\u00cdA La obesidad, diabetes, dislipidemias, resistencia a la insulina y el s\u00edndrome metab\u00f3lico, asociados con la aparici\u00f3n de EHGNA Por ello presentan factores de riesgo cardiovascular EPIDEMIOLOG\u00cdA Incidencia va en aumento en pa\u00edses occidentales Prevalencia de EHGNA 80% &#8211; 90% en adultos con obesidad 30% &#8211; 50% en adultos con Diabetes Mellitus 90% o m\u00e1s en adultos con dislipidemia 40% a 70% en ni\u00f1os con obesidad PATOFISIOLOG\u00cdA Intervienen factores ambientales y gen\u00e9ticos Familiares de primer grado Activaci\u00f3n de SIRT1 Resistencia a la insulina, provoca: Acumulaci\u00f3n de triglic\u00e9ridos en el citoplasma de los hepatocitos Acumulaci\u00f3n de \u00e1cidos grasos y triglic\u00e9ridos en h\u00edgado por un suministro excesivo de los mismos Dep\u00f3sito de col\u00e1geno sinusoidal y fibrosis portal desarrolla EHNA Acumulaci\u00f3n de \u00e1cidos grasos hace m\u00e1s vulnerable al h\u00edgado a presentar lesiones Exceso de CHOs estimula la s\u00edntesis hep\u00e1tica de \u00e1cidos grasos La obesidad libera mediadores inflamatorios que da\u00f1an a los hepatocitos HISTOPATOLOG\u00cdA En EHGNA, la biopsia hep\u00e1tica presenta m\u00e1s del 10% de los hepatocitos con gotitas de grasa PRESENTACI\u00d3N CL\u00cdNICA EHGNA: La mayor\u00eda asintom\u00e1ticos, algunos con s\u00edntomas inespec\u00edficos Fatiga es uno de los s\u00edntomas m\u00e1s comunes Dolor en parte superior del abdomen, sed, distensi\u00f3n abdominal y alteraciones del sue\u00f1o La hepatomegalia moderada es el signo cl\u00ednico m\u00e1s frecuente EVALUACI\u00d3N Aminotransferasas s\u00e9ricas levemente elevadas (principal dato bioqu\u00edmico), aunque pueden aparecer normales. Elevaci\u00f3n de GGT, marcador de aumento de la mortalidad Ecograf\u00eda, m\u00e9todo rutinario Biopsia de h\u00edgado, est\u00e1ndar de oro para el diagn\u00f3stico de EHGNA \u201cNAFLD en la puntuaci\u00f3n del s\u00edndrome metab\u00f3lico\u201d, es un score no invasivo para predecir el desarrollo de EHGNA, incluye: IMC &gt; 25 AST\/ALT &gt; \u00f3 = 1 DM2 Obesidad MANEJO Cambios en el estilo de vida Ante esteatosis simple, p\u00e9rdida de peso del 3% &#8211; 5% Ante EHNA, p\u00e9rdida de peso del 7% &#8211; 10% Control de factores de riesgo (Estatinas en dislipidemias, controlar HAS y DM) Tratamiento multidisciplinario Ver m\u00e1s<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3398],"tags":[],"class_list":["post-22280","post","type-post","status-publish","format-standard","hentry","category-resumen-de-cursos"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/posts\/22280","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/comments?post=22280"}],"version-history":[{"count":0,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/posts\/22280\/revisions"}],"wp:attachment":[{"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/media?parent=22280"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/categories?post=22280"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/tags?post=22280"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}