Steatosis - secondary or independent pathological syndrome characterized by the accumulation of fat in the liver tissue. The cause of this condition is the use of alcohol; diseases accompanied by metabolic disorders (diabetes, thyroid disease, malabsorption, and others look there), as well as taking certain medications. Steatosis has no specific clinical picture and long asymptomatic. Diagnosis is liver biopsy, and imaging studies (MRI liver scintigraphy, ultrasound). Treatment is conservative, a favorable prognosis .
Steatosis - pathological process, which consists in the degeneration of the liver tissue with fatty degeneration of hepatocytes. Morphological changes are characterized by intracellular and / or intracellular accumulation of fat droplets. This pathology occurs in one third of patients with non-alcoholic fatty liver disease, and most patients with alcohol-induced. Steatosis is the initial stage of alcoholic liver disease and can lead to irreversible changes in cirrhotic and death. Currently, steatosis is considered a global problem not only of Gastroenterology, and integrated medicine because the disease is associated with an increased risk of developing liver cirrhosis, cardiovascular disease, endocrine and metabolic disorders, allergies, varicose veins and other serious changes.
The most important factor in the development of fatty liver is alcohol damage to hepatocytes. Intensity of morphological changes and the risk of transition to cirrhosis is directly dependent on the amount and duration of alcohol consumption. In the formation of fatty liver play an important role diabetes. Hyperglycemia with insulin resistance leads to increased levels of free fatty acids in the blood, resulting in enhanced hepatic synthesis of triglycerides. If the rate of their formation exceeds the exchange reactions with the formation of complexes of VLDL-TG, there is deposition of fat in the liver.
We prove the relationship of fatty liver from obesity, the main role is played not by the percentage of body fat, and occurs when insulin resistance and metabolic syndrome. In the study the amount of fat in the liver, determined by proton spectroscopy, depended on the level of fasting insulin.
The causes of fatty liver can be other diseases accompanied by metabolic disorders: myxedema, Cushing's syndrome, hyperthyroidism, chronic gastrointestinal disease with malabsorption (including chronic pancreatitis), Wilson's disease, the pathology of the cardiovascular system ( hypertension, ischemic heart disease), and other chronic diseases that lead to the depletion of the patient (oncopathology, pulmonary and cardiac insufficiency).
By violation of metabolism of fats, carbohydrates and fatty degeneration of hepatocytes and causes the so-called "Western" diet - food high in hydrogenated fats, simple carbohydrates, as well as lifestyle with low physical activity. A separate group of factors that contribute to the accumulation of fat in the liver - hereditary deficiency of enzymes involved in lipid metabolism.
Thus, regardless of the initial cause of the disease, with fatty hepatosis (especially non-alcoholic etiology) holds insulin resistance, in turn, degenerative changes in the liver is one of the pathogenetic links of the metabolic syndrome. The accumulation of fat in hepatocytes, and between them is due to excessive intake of fat due to hyperlipidemia or alcoholic destruction, violation of their utilization in the process of peroxidation and reduced excretion of molecules of fat from cells as a result of violation of the synthesis of apoprotein forming transport form of fat (this explains alipotropnoe fatty liver).
Often a particular patient can not identify the causative factor since there are no pure liver damage a particular origin. Eating disorders, alcohol intake, medication use - the factors that occur almost every patient.
The complexity of this disease is that, despite the significant morphological changes in the majority of patients no specific clinical signs of fatty liver. 65-70% of patients - women, most of them are overweight. In many patients there is a non-insulin dependent diabetes mellitus.
The vast majority of patients have no symptoms typical of liver damage. Perhaps unspecified discomfort in the abdomen, mild aching pain in the right hypochondrium, asthenia. The liver is enlarged, it can be slightly painful on palpation. Sometimes the disease is accompanied by dyspeptic syndrome: nausea, vomiting, a violation of the chair. Maybe some yellowness of the skin.
In diffuse liver damage can occur episodes of hemorrhage, hypotension, fainting, due to release as a result of the inflammatory process tumoronekrotiziruyuschego factor.