Page 25 - Clinical Biochemistry
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• Grade 1: Up to 33%
• Grade 2: 33%-66%
• Grade 3: >66%
Figure 4: NAFLD
NAFLD
NAFLD is a spectrum of diseases which includes Fatty liver disease and NASH, but only
NASH is known to progress to cirrhosis.
Fatty Liver NASH Cirrhosis
Obese BMI>28 Obese BMI>28 Bright/ small liver on
Centipetal (apple) Bright liver on USS USS + splenomegaly
Bright liver on USS Abnormal ALT Abnormal ALT
Insulin Resistance
Normal ALT
• Simple steatosis: relatively benign “liver” prognosis with a risk of developing clinical
evidence of cirrhosis over 15–20 years in the order of 1%–2%.
• NASH and fibrosis: risk of progress to cirrhosis between 0% at 5 years to 12% over 8 years.
• Cirrhotic: high risk of developing hepatic decompensation and of dying from a liver-related
cause including HCC.
NASH
