BOF:
19
An obese 45-year-old female is referred to the clinic by
her general practitioner as she has been found to have a raised alanine
aminotransferase level. She is not on any medication and does not take
alcohol. On examination she is obese. In this patient you would expect:
a)
Type 2 diabetes mellitus
b)
Insulin resistance
c)
Hyperlipidaemia
d)
Acanthosis nigricans
e)
Hepato-splenomegaly
Answer:
b)
This patient has non-alcoholic fatty liver disease. The
metabolic abnormalities leading to accumulation of lipid within hepatocytes
are poorly understood but one of the most reproducible features in the
development of this process is insulin resistance.
Type 2 diabetes mellitus and hyperlipidaemia frequently
co-exist with this condition but not necessarily.
Acanthosis nigricans is a feature of non-alcoholic fatty
liver in children.
Hepatomegaly is a common finding but not
hepato-splenomegaly.
