Review article
NON-ALCOHOLIC FATTY LIVER DISEASE
LEONARDO BUKMIR
orcid.org/0000-0002-1980-9665
; University of Rijeka, School of Medicine, Chair of Family Medicine, Department of Family Medicine and Family Medicine Office, Rijeka, Croatia
HELENA SMOKROVIĆ
; Family Medicine Office, Rijeka, Croatia
INES DIMINIĆ-LISICA
; University of Rijeka, School of Medicine, Chair of Family Medicine, Department of Family Medicine and Family Medicine Office, Rijeka, Croatia
ALEKSANDAR LJUBOTINA
; University of Rijeka, School of Medicine, Chair of Family Medicine, Department of Family Medicine and Family Medicine Office, Rijeka, Croatia
BRANKA POPOVIĆ
; University of Rijeka, School of Medicine, Chair of Family Medicine, Department of Family Medicine and Family Medicine Office, Rijeka, Croatia
Abstract
With the increasing prevalence of obesity and metabolic syndrome, non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease in adults and children. Despite the increasing prevalence, NAFLD remains largely undiagnosed and untreated in routine medical practice. Most patients with NAFLD have no symptoms, while only a few feel discomfort in the upper right quadrant of the abdomen or increased fatigue. The diagnosis is usually set during abdominal ultrasound examination, which is done for some other reason, or by elevated liver biochemical test findings. Early recognition is very important for correct and successful treatment. In primary health care, little is known about the processes related to the identifi cation, diagnosis and referral of patients to specialists. Differentiation between steatosis and steatohepatitis by assessing the severity of fi brosis within steatohepatitis is extremely important. Histopathologic analysis of tissue obtained by biopsy remains the gold standard in this fi eld. For family physician, guidelines that should be combined can be of great help in treating patients with suspected NAFLD. The serious consequences of late recognition of NAFLD could be reduced by such guidelines. Recent studies have shown that NAFLD is associated with an increased prevalence and incidence of cardiovascular complications. Because of their complexity, hepatic and extrahepatic complications, heterogeneity in clinical presentation, histologic severity, prognosis and therapeutic outcome, NAFLD requires a multidisciplinary approach with the active role of family physicians in preventive care, diagnosis and treatment, especially in individuals and groups at risk. Greater attention should be focused on lifestyle modifi cations (reduction in body weight and physical activity) and their practical implementation.
Keywords
non-alcoholic fatty liver disease; liver biopsy; family physician
Hrčak ID:
154159
URI
Publication date:
12.3.2016.
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