Fatty Liver Case Study

Fatty Liver

It is a reversible condition wherein large vacuoles of triglycerides (TG) accumulate in liver cells into intracytoplasmic vacuoles.

Fatty Liver Symptoms

1. Fatigue and weakness.
2. Loss of appetite.
3. Slight pain or tenderness in the right or central abdominal area.
4. Increase in SGOT, SGPT, TG, and Insulin.

Read And Learn More: Biochemistry Clinical Case Studies With Answers

Case 1: Complained Of Gastric Pain

A 45 years old obese man complained of gastric pain and was admitted to the hospital due to heavy alcohol ingestion. Blood was taken for an organ function test. Serum looked opalescent and was analyzed for lipids. Serum cholesterol was 310 mg% and serum triglyceride was 690 mg%.

Question 1. What is a probable diagnosis?
Answer: Fatty liver or alcoholic liver disease.

Question 2. Which additional test you will perform?
Answer:

1. HDL and LDL cholesterol.
2. Gamma-glutamyl transferase– specific for alcoholic liver disease.
3. SGPT and SGOT.
4. Liver biopsy.
5. Serum electrophoresis for lipoproteins.
6. USG-Liver.

Fatty Liver Causes

• Increased TG synthesis:
  • DM, alcohol, high-fat diet, and starvation are associated with increased fat mobilization from adipose tissue to the liver.
• Impaired lipoprotein synthesis:
  • Decrease in phospholipid synthesis- deficiency of lipotropic factors.
  • Defect in the formation and secretion of lipoproteins.
  • Toxic injury to the liver– poisoning by CCl4, arsenic, and lead.
  • Alcoholism– is the most common cause of fatty liver in India. Alcohol increases the production of NADH which converts oxaloacetate to malate and decreases oxaloacetate level. Acetyl CoA is not metabolized by the TCA cycle and is utilized for fatty acid synthesis leading to triglyceride deposition in the liver.

Treatment of Fatty liver

1. Limit or avoid alcohol.
2. Take a step to lose weight.
3. Make changes in diet- No excess calories, low saturated and trans fat.
4. Moderate exercise.
5. Medications.
6. Surgery.

Lipotropic Factors

1. These factors are required for the mobilization of fat from the liver.
2. A deficiency of these factors causes the deposition of fat in the liver.

Names

1. Choline
2. Betaine
3. Methionine
4. Inositol
5. B-12, Folic Acid, Vitamin E
6. Selenium
7. Glycine, Serine Etc.