[From hepatic steatosis due to obesity to cirrhosis, in the absence of alcoholic intoxication].
FROM STEATOSIS TO CIRRHOSIS: Obesity is frequently associated with steatosis. The latter may provoke inflammatory manifestations and steatohepatitis, the clinical biological and histological characteristics of which are identical to lesions of alcoholic origin. A fibrosis may appear after several years, particularly if the obesity is severe, the patient is elderly and suffering from diabetes and that the increase in transaminase exceeds twice the normal value. It is therefore justified to propose a hepatic biopsy in an obese patient when abnormalities in transaminase levels exceed twice the normal values and notably if other fibrosis risk factors exist. THERAPEUTIC ATTEMPTS: Treatment is aimed at correcting the metabolic disorders and the obesity. Other treatments are currently proposed (anti-oxidants, insulin-resistance modulators), but none of them have presently been completely validated.


CONCLUSIONS
With the increase in obesity in industrialised countries, the prevalence of steatosis and steatohepatitis will also increase and there is a risk that they will become, within a few years, one of the principle causes of cirrhosis.
Service d'hépatogastroentérologie et transplantation Hôpital Saint Eloi, 80 rue Augustin Fliche 34295 Montpellier. d-larrey@chu-montpellier.fr
Dominique
D
Larrey
D003937:Diagnosis, Differential; D018450:Disease Progression; D005234:Fatty Liver / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008104:Liver Cirrhosis, Alcoholic / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008111:Liver Function Tests; D009765:Obesity / Q000150:complications* / Q000473:pathology / Q000628:therapy; D012307:Risk Factors