non-alcoholic fatty liver disease:
2018.3.26: summary:
. surprised to learn how many are sick with
something that may be related to dysbiosis;
ie, having the wrong gut germs from a bad diet
or from getting too many antibiotics
such as the pesticide Roundup
(much more common in grains and legumes now).
. Dr.Rinella blames fatty liver on
bad germs or leaky gut and being obese,
but the primary cause is our modern diet
high in fructose (sugar is half fructose).
[J Hepatol. 2008]
Mary E. Rinella, MD:
jama 2015 june 9,
Nonalcoholic Fatty Liver Disease
A Systematic Review
Nonalcoholic fatty liver disease
affects approximately 30% of the US population.
p2266:
high visceral adipose tissue (being obese)
increases pro-inflammatory mediators
and excessive free fatty acids (lipotoxemia)
and insulin resistance;
all that affects the liver:
alterations of glucose and lipid metabolism.
. all that altered metabolism leads to
fatty liver or hepatic steatosis.
2nd stage is steatohepatitis
caused by lipotoxicity from increased free fatty acids
and by inflammation from
obesity releasing pro-inflammatory mediators,
and by intestinal dysbiosis generating portal endotoxin.
. pro-inflammatory mediators and
(endoplasmic reticulum sress
from dysregulated unfolded protein response)
leads to pro-inflammatory signalling
that along with (the vicious circle of
oxidative stress and mitochondrial dysfunction)
causes activation of hepatic stellate cells
and collagen deposition;
that leads to fibrosis
which is a precursor to cirrhosis.
. one symptom of insulin resistance is
acanthosis nigricans
[velvety darkening of the skin.
It is usually found in body folds.]
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