First of all, you have to make sure that there are many types of fatty liver. Here I introduce nonalcoholic fatty liver disease (NAFLD). It refers to the presence of hepatic steatosis without other causes (e.g., heavy drinking) leading to secondary hepatic lipid deposition. NAFLD may progress to cirrhosis and may be an important cause of cryptogenic cirrhosis.
NAFLD has hepatic steatosis with or without inflammation and fibrosis. In addition, there is no secondary cause of hepatic steatosis. It is subdivided into non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). NAFL refers to hepatic steatosis without obvious evidence of inflammation, while NASH refers to hepatic steatosis accompanied by hepatic inflammation, which may not be histologically distinguishable from alcoholic steatohepatitis. Other terms used to describe NASH include pseudoalcoholic hepatitis, alcoholic hepatitis, fatty hepatitis, fat necrosis and diabetic hepatitis.
Most NAFLD patients have no symptoms, but some NASH patients may complain of fatigue, discomfort and vague discomfort in the right upper abdomen. Patients are more likely to seek medical attention because of elevated aminotransferase levels in the liver during laboratory tests or incidental hepatic steatosis on abdominal imaging.
Physical examination revealed that NAFLD patients may have enlarged liver at the time of physical examination. Liver enlargement is the first sign. In NAFLD patients, the reported incidence of hepatomegaly varies widely: patients with cirrhosis may have chronic liver disease characteristics (e.g., palm of liver, spider nevus, ascites). AST and ALT may increase slightly or moderately in patients with NAFLD, but normal aminotransferase levels do not exclude NAFLD. Because many patients are diagnosed with NAFLD because of the discovery of abnormal aminotransferase, the true prevalence of abnormal aminotransferase in NAFLD patients is not clear. When AST and ALT are elevated, they are usually 2-5 times the normal upper limit, and the
