Fatty liver disease. Pathophysiology & assessment

Continuous accumulation of lipid in the liver may result in fatty liver disease (FLD). This can cause damage, such as inflammation, cirrhosis or tumours. FLD is present in 25% to 40% of adults in Western countries. In a large population-based study it was found that FLD is strongly associated with markers for cardiovascular disease. A literature study revealed that the fatty liver overproduces many markers for cardiovascular disease. Weight reduction improves both FLD and markers for cardiovascular disease. Based on the studies in this thesis and the literature three categories of risk factors for FLD are proposed: 1) risk factors for liver fat (e.g., calorie intake, exercise), 2) risk factors for inhibited liver metabolism (e.g., alcohol, specific drugs), 3) risk factors for hepatic inflammation (e.g., hepatitis, Crohn’s disease). Finally, imaging modalities for assessment of FLD were studied. A quantitative method for ultrasonography was developed which is recommended for screening.