Synonyms
Steatohepatitis, fatty liver hepatitis, fatty liver cells
Definition
The excessive storage of fats in the tissue of the liver (parenchyma) is called hepatocellular fatty degeneration (if more than 5% is affected) or fatty liver (if more than 50% is affected). If an inflammatory reaction in the liver occurs concomitantly or during the course of the disease, it is called fatty liver hepatitis (steatohepatitis). However, fatty liver is not a disease in its own right, but rather a symptom that fatty liver can be cured if the underlying disease is treated sufficiently. Depending on the triggering underlying disease, the group of steatohepatitides is divided into an alcoholic (ASH= alcoholic steatohepatitis) and a non-alcoholic (NASH= non-alcoholic steatohepatitis) form, which, however, can only be distinguished by light microscopy.
Causes
There are numerous causes for the development of fatty liver. Biochemically, an excess of fats or a reduced ability of the liver to process these fats leads to an excessive storage of fats. The most common reason for an excess supply of fats in the liver is chronic, increased alcohol consumption.
The alcohol is absorbed (taken up) in the gastrointestinal tract and transported to the liver via the portal vein. The alcohol abuse means that the liver cells can no longer functionally carry out the removal of fatty acids. This leads to the result that the fat remains in the cell.
The more fat the individual cell stores and the more cells are affected, the more the liver swells. Another common reason for the development of a fatty liver is the disease diabetes mellitus (usually diabetes type II; diabetes). The decisive factor is the reduced effect of the hormone insulin on the organism.
As a result, the signal is missing that enough energy is available. The liver therefore constantly tries to provide energy and produces fatty acids (fatty acid synthesis) and sugar (gluconeogenesis). Even in this case, the liver cells do not manage to release all the substances produced into the blood, which leads to swelling of the cell. Other factors for the development of a fatty liver are
- Obesity,
- Malnutrition (too little protein, too much fat)
- Genetic stress (hyperlipoproteinemia),
- Drug side effects (antibiotics from the group of tetracyclines, cortisone) and others.