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Nonalcoholic Fatty Liver Disease: Diagnosis and Treatment
Diagnosis
- The evaluation begins with a medical history and a physical examination.
- Blood testing to assess liver function will be performed.
- Ultrasound,
CT scan, or MRI may make the diagnosis. These tests can identify
fatty liver and evaluate for other disorders, including gallstones,
hepatitis, and cirrhosis.
- Liver biopsy may be recommended if the
cause of fatty liver is unclear.
Treatment
- Weight loss is essential in overweight patients. Even modest
weight loss (about 5 percent of body weight) may have significant
beneficial effects by reversing diabetes and hypertension.
- Exercise
may be beneficial, with or without associated weight loss.
- Severely
obese patients (BMI more
than 35) may consider surgical options, such as “stomach stapling.”
- Diabetes
mellitus should be treated as appropriate. Insulin–sensitizing
drugs (e.g., metformin and pioglitazone) may be especially useful
and are also under investigation for use in nondiabetic patients
with fatty liver.
- Treatment of high cholesterol
and triglycerides may also be beneficial. Rarely,
patients with advanced disease may require liver transplantation.
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