Pasi Erkkilä and Akseli Koskela Liver Steatosis Pasi Erkkilä and Akseli Koskela

Fatty Liver Caused by accumulated lipids, mainly triacylglycerol in liver Term used when more than 5% of volume of liver tissue is fat There is two types of intracellular lipid accumulations Microvesicular steatosis Small liposomes in the cytoplasm around the nucleus Macrovesicular steatosis Fat vacuoles grows so large that they push nucleus out of it place In normal state liver carries out major lipid metabolism functions, but in fatty liver following mechanism are disturbed Beta-oxidation of fatty acid in mitochondria is decreased Fatty acid synthesis in liver or delivery of fatty acid to liver is increased Transformation of triglycerides to VLDL and its export is deficient

Symptoms you may have are: In most cases fatty liver is symptomless, but over time it may lead to many types of liver diseases, such as cirrhosis, hepatocarcinoma and even liver failure Symptoms you may have are: Feeling tired Loss of weight or appetite Nausea Weakness Confusion, poor judgment or trouble of concentrate You may have also other symptoms like over grown liver, abdominal pain and some skin color changes There is no medical cure for disease but you can prevent or cure your condition by healthy nutrition and physical exercise Treatment of diabetes and alcoholism is critical for the treatment of fatty liver disease

Fatty Liver is most common liver disease Usually more common in middle-aged persons who have overweight and high cholesterol Fatty Liver is most common liver disease Every 4th adult have it in some point of their lives 10-20% of normal weight persons and if obese, especially abdominal obese 70- 80% have it There are two main types of fatty liver disease: Nonalcoholic and alcoholic fatty liver disease

Nonalcoholic Fatty Liver Disease (NAFLD) The most common liver disorder worldwide Main cause is central obesity and Type-2 diabetes Other reasons includes: Malnutrition, Medication, Viral hepatitis, fast weight loss and hereditary reasons Divided in two categories according to their type of formation Type 1, is formed when fatty acids are mobilized from adipose tissue Type 2, is formed when the production of lipoproteins is blocked and triacylglycerol accumulates (in liver) In chronic state may lead to Nonalcoholic steatohepatitis (NASH) NASH state liver has inflammation and scarring in addition to fat accumulation NASH can progress intohepatocarcinoma, liver failure and/or cirrhosis

Alcoholic Liver Disease (ALD) Caused by alcoholism, may occur even after short period of heavy drinking Develops if person consumes more than 60 g of alcohol per day. Eventually leads to cirrhosis (scarring of liver) Accumulation is caused by two factors Impaired fatty acid oxidation Increased lipogenesis Alcohol oxidation leads to excess amount of NADH -> free fatty acids form fats Other risk factors are: Obesity High iron concentration Hepatitis C Heredity factors ( risk of alcoholism and how body breaks down the alcohol)

Acute Fatty Liver of Pregnancy Fats accumulate in mothers liver, can be a risk for mother and baby because may lead kidney or liver failure to either one May cause serious infection or bleeding Cause uncertain, hormones may play a key role of this Fortunately rare cases

Preferences Harper´s illustrated biochemistry 30th edition http://www.nature.com/modpathol/journal/v20/n1s/full/3800680a.html https://en.wikipedia.org/wiki/Steatosis http://emedicine.medscape.com/article/175472-overview http://www.terveyskirjasto.fi/terveyskirjasto/tk.koti?p_artikkeli=dlk00070&p_h akusana=rasvamaksa