| Theme |
Obesity Related Digestive Diseases |
| Title |
Obesity and Liver Disease |
| Author |
Maki Tobari |
Division of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Makiko Taniai |
Division of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Etsuko Hashimoto |
Division of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University |
| [ Summary ] |
With the dramatic increase in the prevalence of obesity in Japan, nonalcoholic fatty liver disease (NAFLD), which is considered to be a hepatic manifestation of metabolic syndrome, has also increased. NAFLD developes primarily in obese individuals, and has become an important public health issue because of its high prevalence. NAFLD consists of 2 entities : simple steatosis, which generally follows a non-progressive clinical course, and nonalcoholic steatohepatitis (NASH), which may progress to cirrhosis and hepatocellular carcinoma. The diagnosis of NAFLD is based on the following three criteria；nonalcoholic, detection of steatosis either by imaging or by histology, and appropriate exclusion of other liver diseases. NASH is histologically characterized by hepatic steatosis associated with evidence of liver cell injury (ballooning degeneration) and inflammation, steatohepatitis, and varying degrees of fibrosis. Alcoholic liver disease is thought to occur when daily alcohol consumption exceeds 20 g for women and 30 g for men. However, there is no internationally accepted upper limit of alcohol consumption for the diagnosis of NAFLD. Although liver biopsy remains the gold standard for making a definitive diagnosis of NASH, noninvasive alternatives are being developed. Reduction of body weight is the most promising treatment option for obesity and NAFLD. |