CAP: a Novel Era to Better Quantitate Fatty Liver?

Hepatic steatosis is one of the most popular findings in patients with liver injury and it has been considered by most textbooks as the first sign of all chronic liver diseases. Fatty liver has long been appreciated as symptomatic for patients who consume alcohol [1] and it is seen more frequently with the epidemic rise of NASH. In the now classical Dionysos study, Bellentani et al. were able to demonstrate that almost all obese people who consumed alcohol had fatty liver [2]. The liver is the central metabolic organ located at the cross roads of many physiological pathways and its response towards environmental, nutritional, hor mona l and me t ab ol i c changes is rather complex (Fig. 1). Theodor Frerichs recognized in his famous classical ‘Klinik der Leberkrankheiten’ in 1858 that liver fat can be stored reversibly upon feeding a high fat diet and that hibernating mammals store fat in the liver during winter periods [3]. It is not widely conceived that the liver responds with fat accumulation both in the fasting state due to peripheral lipolysis and under conditions of excess nutritional fat (Fig. 1). In the 19th century, infectious diseases were the most common causes of fatty liver due to peripheral lipolysis. Today, apart from nutritional causes, toxic conditions due to drugs or viral hepatitis are very common. These conditions typically cause microvesicular EDITORIAL Available from: URL: http://www.jgld.ro/2015/1/1.html DOI: http://dx.doi.org/10.15403/jgld.2014.1121.smu