Klinika

Komplikace

• K prosté steatóze může přidat zánětlivá složka a nemoc může přes obraz NASH (nealkoholové steatohepatitidy) a jaterní fibrózy vyústit až v jaterní cirhózu a hepatocelulární karcinom [2]

Portal venous pyer

• May begin to rise in the earliest stages of NAFLD when fibrosis is far less advanced or absent.
• Early changes in sinusoidal homeostasis remains unclear
• Sinusoidal space restriction due to hepatocellular lipid accumulation and ballooning may impair sinusoidal flow
• Generate shear stress,
• Increasingly disrupting sinusoidal microcirculation.
• Sinusoidal endothelial cells, hepatic stellate cells, and Kupffer cells
• Key partners of hepatocytes affected by NAFLD in promoting endothelial dysfunction
• Through enhanced contractility,
• Capillarization,
• Adhesion
• Entrapment of blood cells,
• Extracellular matrix deposition,
• Neovascularization.
• Biomechanical and rheological changes are aggravated by
• Dysfunctional gut-liver axis
• Splanchnic vasoregulation,
• Culminating in fibrosis and clinically significant portal hypertension
• Increased portal venous pressure is an essential element of the pathogenesis across the entire spectrum of NAFLD.
• Improved methods of noninvasive portal venous pressure monitoring
• Will hopefully give new insights into
• pubmed.ncbi.nlm.nih.gov/29368124/

Klinika

• Asymptomatic +++
• Abdominal cramps
• Meteorism
• Fatigue [1]

Symptoms from NASH may include:

• Severe tiredness
• Weakness
• Weight loss
• Yellowing of the skin or eyes
• Spiderlike blood vessels on the skin
• Long-lasting itching

Serum uric acid to creatinine ratio

• Is associated with higher prevalence of NAFLD detected by FibroScan in the United States
• www.researchgate.net/publication/361888984_Serum_uric_acid_to_creatinine_ratio_is_associated_with_higher_prevalence_of_NAFLD_detected_by_FibroScan_in_the_United_States?_tp=eyJjb250ZXh0Ijp7ImZpcnN0UGFnZSI6Il9kaXJlY3QiLCJwYWdlIjoiX2RpcmVjdCJ9fQ