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In patients with
metabolic syndrome, the
presence of type 2
diabetes and obesity is
the best predictor of
severe fibrosis and
disease progression.
PATHOGENESIS (3)
INSULIN RESISTANCE
Insulin resistance results in the accumulation of triglycerides in hepatocytes
by at least three mechanisms:
Impaired oxidation of fatty acids
Increased synthesis and uptake of fatty acids
Decreased hepatic secretion of very-low-density lipoprotein cholesterol
The end result of insulin resistance is steatosis, which can then progress to
steatohepatitis.
Liver Biopsy
Gold standard to assess the degree of inflammation and extent of fibrosis
MANAGEMENT
Non-Pharmacological Treatment
Lifestyle intervention weight loss, diet and physical exercise