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Impact of obesity on the liver – Part 1

• Several data have accumulated suggesting that obesity may be associated with liver disease and disease progression.
• Accordingly, the worldwide epidemic of obesity is likely to become a relevant source of morbidity and mortality in the general population.

Study of impact of obesity on liver

We reviewed the literature on two main issues:
1) The evidence that obesity carries out an increased risk of liver disease, both in the general population and in selected cohorts.
2) The evidence that obesity is a risk factor for nonalcoholic fatty liver disease and its progression in a series observed in liver units.

Evidence Synthesis:
• The presence of obesity increases the risk of elevated liver enzymes by a factor of two to three.
• The risk of steatosis at ultrasonography is increased by a factor of 3 in the presence of overweight.
• It peaks at a factor of approximately 15 in the presence of obesity.
• Both cirrhosis (cryptogenic cirrhosis) and hepatocellular carcinoma are also associated with obesity in the general population.
• In patients with nonalcoholic fatty liver disease obesity and weight gain are systematically associated with advanced fibrosis and fibrosis progression.

Conclusion

• Liver disease of metabolic origin, associated with obesity, is now recognized as the most prevalent liver disease.
• Strategies are needed to approach obesity-associated liver disease by behavior programs.
• This shall motivate people to adopt a healthier lifestyle.
• Such programs should be coupled with public policies at a societal level to obtain the maximum effects in lifestyle changes.
• The obesity epidemic is likely to put a very high number of patients at risk for advanced liver disease.
• The disease is the product of an altered substrate metabolism and has obesity as a pivotal pathogenic component.
• This is excluding the cases due to excessive alcohol intake.
• Liver fat deposition may either be isolated (pure fatty liver or steatosis) or associated with a variable degree of necroinflammation and fibrosis [nonalcoholic steatohepatitis (NASH)], progressing to advanced fibrosis and cirrhosis (cryptogenic cirrhosis) and finally to hepatocellular carcinoma (HCC).
• The evidence that obesity carries out an increased risk of liver disease, both in the general population and in selected cohorts.
• The evidence that in subjects referred to liver units, obesity is a risk factor for NAFLD and NAFLD progression.
• The two groups of studies will be analyzed separately.
• A brief section was also dedicated to the role of obesity as a risk factor for liver diseases of other well-defined etiology.
• This constitutes an important source of obesity-related morbidity.

Nonalcoholic Fatty Liver Disease Fatty Liver You Can Reverse It The Liver Cleansing Diet

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