Assessment of grade of hepatic fibrosis in non-alcoholic fatty liver disease using shear wave elastography – a one year hospital based cross sectional study

Abstract

1) INTRODUCTION As we enter the period of epidemiological transition, there is gradual shift from the morbidity and mortality related to communicable diseases towards non communicable and man-made diseases. Non-Alcoholic Fatty Liver Disease (NAFLD) has recently emerged as a concerning public health problem. NAFLD is defined as the presence of steatosis in > 5% of hepatocytes in the absence of other competing chronic liver diseases and without significant alcohol consumption (< 20 g/day in women and < 30 g/day in men). Literature suggests that NAFLD will replace Hepatitis C as a major cause of chronic liver disease in the next decade and thus become a major cause of liver transplantation. (5) NAFLD is a global health issue and the spectrum includes (6): 1.NAFL (Non-Alcoholic Fatty Liver or simple steatosis) – excessive fat accumulation in the liver parenchyma with little or no inflammation or liver cell damage. It is a silent disease with no symptoms. 80-90 % of the cases show no progression and have good prognosis. 2. NASH (Non-Alcoholic Steato-Hepatitis)- inflammation and liver cell damage in addition to fat accumulation, setting stage for future complications 3. Advanced fibrosis 4. Cirrhosis NAFLD is silent killer and an important cause of liver disease in India with estimated prevalence of 9-32 % (in general population) (2), 30-90% in overweight and obese and 40-80% in diabetics.(7)