2015-07-13

What is the difference between fatty liver disease, AFL, NAFLD, and NASH? What are their treatment options?

Fatty liver is the accumulation of fat in liver cells. Fatty liver can be categorized into two types in general: alcoholic and nonalcoholic. Alcoholic fatty liver (AFL) is caused by excess consumption of alcohol and is usually reversible. [1]

However, unlike alcoholic fatty liver, the cause for nonalcoholic fatty liver disease (NAFLD) is not clear. NAFLD is a spectrum of diseases that ranges from mild to severe. The mild form of NAFLD is also known as simple fatty liver; while the more severe form is called nonalcoholic steatohepatitis (NASH).

NASH is characterized by buildup of fat in the liver, along with inflammation and liver damage. It is a serious condition as it has higher risk of advancing to cirrhosis and liver cancer. On the other hand, simple fatty liver generally does not cause great harm and most people do not have any symptoms. The ALT level of NASH patients are also usually more elevated than those with fatty liver. [2]

Currently, there is no specific treatment for alcoholic fatty liver. But if patients quit drinking and lead a healthy lifestyle, alcoholic fatty liver can usually be reversed. [1] There is also no conventional medical therapy to treat NAFLD or NASH. [2]

However, research papers on PubMed suggest that YHK, a natural alternative therapy, has an inhibitory effect on the development of NASH; it has been proven to effectively stop inflammation in the liver and help liver cells recover. A clinical study shows that NASH patients’ ALT values reduced to normal levels within 2 weeks of using YHK. [3][4][5]

Summary Table

	Alcoholic Fatty Liver	NAFLD	NASH
Diagnosis	Usually diagnosed in asymptomatic patients who are undergoing evaluation for abnormal liver function tests. [6]	Liver biopsy – NAFLD or simple fatty liver is diagnosed if the tissue shows fat without inflammation and damage. [2]	Liver biopsy - NASH is diagnosed if the tissue shows fat along with inflammation and damage to liver cells. [2]
Progression	Alcoholic fatty liver (simple steatosis) Alcoholic hepatitis Alcohol-related cirrhosis	NASH Cirrhosis Liver cancer	Cirrhosis Liver cancer
Treatment	Cease drinking	Reduce weight	YHK

Reference:

Fatty Liver. (2014). Retrieved from http://emedicine.medscape.com/article/175472-overview (accessed 3/11/2015)
Nonalcoholic Steatohepatitis. (2006). Retrieved from http://www.niddk.nih.gov/health-information/health-topics/liver-disease/nonalcoholic-steatohepatitis/Pages/facts.aspx (accessed 3/11/2015)
Chande N, Laidlaw M, Adams P, Marotta P. (2006) “Yo Jyo Hen Shi Ko (YHK) improves transaminases in nonalcoholic steatohepatitis (NASH): a randomized pilot study” Digestive Diseases and Sciences Jul;51(7):1183-9. PMID: 16944007
Stefano JT, de Oliveira CP, Corrêa-Giannella ML, de Lima VM, de Sá SV, de Oliveira EP, de Mello ES, Giannella-Neto D, Alves VA, Carrilho FJ. (2007) “Nonalcoholic steatohepatitis (NASH) in ob/ob mice treated with yo jyo hen shi ko (YHK): effects on peroxisome proliferator-activated receptors (PPARs) and microsomal triglyceride transfer protein (MTP)” Digestive Diseases and Sciences Dec;52(12):3448-54. PMID: 17394061
de Lima VM, de Oliveira CP, Sawada LY, Barbeiro HV, de Mello ES, Soriano FG, Alves VA, Caldwell SH, Carrilho FJ. (2007) “Yo jyo hen shi ko, a novel Chinese herbal, prevents nonalcoholic steatohepatitis in ob/ob mice fed a high fat or methionine-choline-deficient diet” Liver International Mar;27(2):227-34. PMID: 17311618
Alcoholic Liver Disease. (2012). Retrieved from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/alcoholic-liver-disease/ (accessed 3/11/2015)

Disclaimer:

* All research and clinical data should be used as reference purposes only, results may vary.

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