| [ Summary ] |
Recently the number of patients with fatty liver syndrome has been increasing, along with an increase in obesity and alcoholism. Fat deposition in the liver may accumulate through at least five mechanisms. These are : 1) increased delivery of dietary fat or fatty acids to the liver, 2) increased synthesis of fatty acids in the liver, 3) reduced mitochondrial oxidation of fatty acids, 4) impaired export of triglycerides from the hepatocytes, and 5) increased lipid peroxidation. Fatty liver syndrome may be classified into macroveslcular (large droplet) and microvesicular (small droplet) types. Generally the prognosis for the macrovesicular type of fatty liver condition associated with obesity or diabetes mellitus is good, but that for the microvesicular type, associated with drug toxicity or acute fatty liver in pregnancy is poor. Occasionally the liver shows changes in steatosis with inflammation and necrosis in non-alcoholic patients. This is called non-alcoholic steatohepatitis, and progression to fibrosis and cirrhosis has been reported. |