Non-alcoholic fatty liver disease: an emerging pathological spectrum.
The spectrum of pathological lesions observed in non-alcoholic fatty liver disease (NAFLD) is wide and strongly resembles that of alcohol-induced liver disease. It ranges from fatty liver to steatohepatitis, progressive fibrosis and cirrhosis. Hepatocellular carcinoma is a possible complication of NAFLD, but whether it is related to frequently associated metabolic disorders (e.g., overweight, diabetes) or to underlying cirrhosis is unclear. This disease is the result of a multi-factorial process in which insulin resistance seems to play a major role in the initial accumulation of fat in the liver, whereas multiple causes of mitochondrial dysfunction and oxidative stress can induce the secondary occurrence of necroinflammatory lesions and fibrosis. Genetic factors might explain why only some patients with simple steatosis will develop steatohepatitis and fibrosis. Due to the increasing prevalence of obesity in Western countries, NAFLD will possibly be a public health problem and the liver disease of the future.
Zafrani
Elie Serge
ES
Département de Pathologie, Hôpital Henri Mondor, 94010 Créteil cedex, France. elie-serge.zafrani@hmn.ap-hop-paris.fr
D006528:Carcinoma, Hepatocellular / Q000473:pathology; D016207:Cytokines / Q000096:biosynthesis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005234:Fatty Liver / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D006526:Hepatitis C; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology; D008930:Mitochondria, Liver / Q000502:physiology; D009765:Obesity / Q000150:complications; D018384:Oxidative Stress
D016207:Cytokines