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Gastrointestinal - Fatty Liver Disease
In this episode, we review nonalcoholic fatty liver disease (NAFLD), a common and often silent condition driven primarily by insulin resistance and metabolic dysfunction. We break down the distinction between simple steatosis (NAFL) and nonalcoholic steatohepatitis (NASH), highlighting key pathophysiologic differences such as hepatocellular ballooning and fibrosis. The discussion covers risk factors including obesity, type 2 diabetes, and dyslipidemia, along with appropriate diagnostic evaluation and when to consider liver biopsy. We also emphasize lifestyle modification as the cornerstone of treatment and review the potential progression to cirrhosis and hepatocellular carcinoma.
References
1) Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2) Antunes C, Azadfard M, Hoilat GJ, et al. Fatty Liver. [Updated 2023 Jan 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441992/
3) Younossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77(4):1335-1347. doi:10.1097/HEP.0000000000000004.
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By Kristopher Maday, PA-C, DFAAPAIn this episode, we review nonalcoholic fatty liver disease (NAFLD), a common and often silent condition driven primarily by insulin resistance and metabolic dysfunction. We break down the distinction between simple steatosis (NAFL) and nonalcoholic steatohepatitis (NASH), highlighting key pathophysiologic differences such as hepatocellular ballooning and fibrosis. The discussion covers risk factors including obesity, type 2 diabetes, and dyslipidemia, along with appropriate diagnostic evaluation and when to consider liver biopsy. We also emphasize lifestyle modification as the cornerstone of treatment and review the potential progression to cirrhosis and hepatocellular carcinoma.
References
1) Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2) Antunes C, Azadfard M, Hoilat GJ, et al. Fatty Liver. [Updated 2023 Jan 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441992/
3) Younossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77(4):1335-1347. doi:10.1097/HEP.0000000000000004.