Possibility of Steatosis without Fibrosis to Induce Portal Hypertension in Patients of Nonalcoholic Fattyliver Disease

Abstract

NAFLD affects a substantial portion of the general population and is associated with metabolic syndrome, which includes obesity, insulin resistance, hyperlipidemia, and hypertension. Patients with NAFLD not only frequently suffer from insulin resistance but also have increased overall mortality. Although simple fatty liver seems to be a benign condition, it can progress to NASH and ultimately to cirrhosis in some patients. The diagnosis of NAFLD should prompt management of metabolic risk factors. Weight loss regimens are believed to be helpful, and numerous drugs have been investigated in small studies. Large randomized clinical trials are necessary to determine the real benefit of these agents. Finally, studies on the pathogenesis of NAFLD may not only improve our understanding of the mechanisms involved in NAFLD progression but also may lead to novel therapeutic strategies to treat this condition. Portal hypertension (PH) is a severe complication of liver cirrhosis leading to a higher risk of development of gastro-esophageal varices, ascites, hepatorenal syndrome, and hepatic encephalopathy. Among patients with NASH, the portal hypertensive syndrome appears only in those with advanced cirrhosis.