GI lecture 5

Question 1

Metabolic Associated fatty liver disease (MAFLD):
What is the pathogenesis (which is uncertain)?

Answer 1

1) Insulin resistance is key mechanism
2) Gut dysbiosis & genetics play major role

Question 2

Metabolic Associated fatty liver disease (MAFLD):
1) How common is it?
2) What are 3 risk factors?
3) List 3 groups that are at an increased risk
4) What are 3 protective factors?

Answer 2

1) 20-45% US population (includes adolescents & young adults)
2) Obesity, diabetes, hypertriglyceridemia
3) Hispanics, soft drinks, high fat diet
4) Physical activity, strict control of DM, lipids and weight

Question 3

MAFLD:
1) What does it increase risk of?
2) What reduces the risk?

Answer 3

1) CV disease
2) Coffee consumption

Question 4

How do you manage MAFLD?

Answer 4

1) Abstinence from alcohol
2) Vaccination for hepatitis A & B, pneumococcal, influenza, DTP
3) Weight loss
4) Manage diabetes & insulin resistance-diet, exercise, meds
5) Manage dyslipidemia

Question 5

MAFLD vs alcoholic liver disease: What does the management of both have in common?

Answer 5

1) Abstinence from alcohol
2) Manage DM, insulin resistance and dyslipidemia
3) Need Immunizations

Question 6

What are some management differences between MAFLD and alcoholic fatty liver disease?

Answer 6

1) MAFLD patients do not typically become unstable or need admitted to the hospital
2) Alcoholic: replace micronutrients, avoid nephrotoxic drugs
-Methylprednisolone x 1 month in alcoholic hepatitis may reduce short-term mortality

Question 7

Methylprednisolone x 1 month in ___________________ may reduce short-term mortality

Answer 7

alcoholic hepatitis

Question 8

List the epidemiology for MAFLD and AFLD (alcoholic fatty liver disease)

Answer 8

1) MAFLD: Insulin resistant, hyperlipidemia, metabolic syndrome
2) AFLD: Excess alcohol intake; develops in women after shorter duration and with less intake

Question 9

List the pathogenesis for MAFLD and AFLD (alcoholic fatty liver disease)

Answer 9

1) MAFLD: Multifactorial but based on excess fatty acid accumulation in the liver
2) AFLD: Alcohol metabolism induces higher levels of fatty acids and FA signal liver cells to compound to glycerol to form triglycerides. TG accumulate.

Question 10

List the management for MAFLD and AFLD (alcoholic fatty liver disease)

Answer 10

1) MAFLD: No pharmacologic agents. Improve risk factors.
2) AFLD: Steroids only with severe disease

Question 11

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