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| ldl c, american surgical association, starvation, fatty fucking , fat girls and feeders , queen fat bottom girls , pleasingly plump , hcv treatments, impaired liver function, plump fuck , plump girls galleries , immunization, refsum disease, poynard, plump buttocks , liverdisease, plump djs , iv drugs, plump teens , steatosis, | Although, insulin resistance syndromes are pegasus common in cases of NASH, other causes for NASH should not be overlooked. These other causes include drugs, surgical procedures, certain metabolic conditions, and environmental toxins. Fatty liver disease owing to these less common causes has a distinctly different pegasus pathogenesis. Clinical Features pegasus The majority (45-100%)5 of patients with NAFLD do not have any signs or symptoms of their liver disease at the time of initial presentation. Although uncommon, some patients may have symptoms of vague right upper quadrant discomfort, fatigue, and malaise. The most common physical sign is hepatomegaly; it is present in up to 75% of the patients with NAFLD. Stigmata of chronic liver disease are rarely seen in patients with NAFLD. Splenomegaly, however, can be noted at the time of presentation in 25% of the patients.2 Usually an incidental finding of elevated transaminase levels or hepatomegaly triggers the initial evaluation leading to a specific diagnosis of NAFLD. |
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| Other common associations are hypertension, hyperuricacidemia, and polycystic ovary syndrome. The prevalence of obesity, type 2 diabetes, and hyperlipidemia in patients liverdisease with NAFLD range from 30% to 100%, 10% liverdisease to 75%, and 20% to 92%, respectively.3 Angulo et al. demonstrated that age greater than 45, obesity, type 2 diabetes, and an aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio > 1 are independent predictors of severe fibrosis liverdisease (septal fibrosis or cirrhosis)4 in cases of NASH. More importantly, individuals with NASH have a 20% prevalence of cirrhosis and an 11% prevalence of liver-related deaths.5 Furthermore, in one recent study, Caldwell et al. noted the presence of obesity and diabetes a decade earlier in 74% of 70 patients with cryptogenic cirrhosis.6 This suggests that NASH may be the most common cause of cryptogenic cirrhosis. There are multiple factors that have been associated with NAFLD (Table 1). A middle-aged obese diabetic female with hyperlipidemia typically defines the primary associative factors with insulin resistance as an essential causative etiology. |
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