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Steatosis: Co-factor
in Other Liver Diseases
The
prevalence of steatosis
(fatty liver) is rising in association with
the global increase in obesity and
type
2 diabetes. In the past, simple steatosis was
regarded as benign, but the presence of another liver disease
may provide a synergistic combination of steatosis, cellular
adaptation, and oxidative damage that aggravates liver injury.
In
this review, a major focus is on the role of steatosis as
a co-factor in chronic
hepatitis C (HCV), where the mechanisms promoting
fibrosis and the effect of weight reduction in minimizing
liver injury have been most widely studied.
Steatosis,
obesity, and associated metabolic factors may also modulate
the response to alcohol- and drug-induced
liver disease and may be risk factors for the
development of hepatocellular
cancer.
The
pathogenesis of injury in obesity-related fatty liver disease
involves a number of pathways, which are currently under investigation.
Enhanced
oxidative stress, increased susceptibility to apoptosis, and
a dysregulated response to cellular injury have been implicated,
and other components of the metabolic syndrome such as hyperinsulinemia
and hyperglycemia are likely to have a role.
Fibrosis also may be increased as a by-product of altered hepatocyte
regeneration and activation of bipotential hepatic progenitor
cells.
In
conclusion, the authors write, “Active management of obesity
and a reduction in steatosis may improve liver injury and
decrease the progression of fibrosis.”
06/29/05
Reference
E
E Powell, J R Jonsson and A D Clouston. Steatosis: Co-factor
in other liver diseases. Hepatology 42(1): 5-13. July
2005.
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