Non-Alcoholic Fatty Liver Disease.pdf

Non-Alcoholic Fatty Liver Disease What is it? ○ A spectrum of diseases from least severe to most severe ○ Steatosis Causes fat droplets to form and grow on hepatocytes ○ Steatohepatitis ○ Fibrosis ○ Cirrhosis Irreversible scarring of the liver usually caused by inflammation and necrosis Slow, progre...

Non-Alcoholic Fatty Liver Disease What is it? ○ A spectrum of diseases from least severe to most severe ○ Steatosis Causes fat droplets to form and grow on hepatocytes ○ Steatohepatitis ○ Fibrosis ○ Cirrhosis Irreversible scarring of the liver usually caused by inflammation and necrosis Slow, progressive chronic disease Inflammation caused by toxins or disease (ie, hepatitis, drug addiction, alcoholism) Hepatitis C a leading cause of cirrhosis and liver cancer ○ Results from fat deposition in the liver Typically affects individuals with metabolic syndrome which includes a combination of three of the five following diagnoses ○ Obesity: ○ Waist of 40”men, ○ 35” for women ○ HTN: 130/85 or higher ○ Hyperglycemia: Fasting glucose 100 mg/dl ○ Hyperlipidemia: HDL less than 40 mg/dl men, and women less than 50 dl ○ Triglycerides 150 mg/dl on medication Rapidly growing health concern Associated with aging, Type 2 Diabetes, metabolic syndrome ○ Metabolic syndrome is presence of metabolic factors that increase risk of Type 2 DM and CV disease Risk factors ○ Up to 30% of Americans may have NAFLD (American Liver Foundation, 2020) ○ Gene PNPLA3 identified as a risk factor ○ Latinos at highest risk of any ethnic group Secondary Prevention ○ Complete Blood count ○ ALK phosphate ○ Serum bilirubin ○ A1C and fasting glucose ○ Fasting cholesterol ○ AST (aminotransferese) and LDH (Lactate dehydrogenease) Tertiary Prevention ○ Medical follow up for prediabetes, hypertension, metabolic syndrome, NAFLD Possible medications to lower cholesterol/triglycerides ○ Weight loss program ○ Diet: Importance of DASH diet, portion control Who would you involve in teaching? How can this be implemented? ○ Elimination Need stool daily/ Exercise helps with this ○ Exercise: 150 minutes per week ○ Regular wt. and b/p checks ○ Periodic blood work