Management of nonalcoholic fatty liver disease. A 60-year-old man with probable nonalcoholic fatty liver disease: Weight reduction, liver biopsy, or both?

摘要

Dr Libman: Mr T is a 60-year-old man who presented with chronically increased serum transaminase levels. He has worked as a salesman for the past 10 years and before that was a manager in a manufacturing business. He is married with an adult daughter. He has been in generally good health and reports no symptoms of chronic liver disease. He has had intermittent mild transaminase abnormalities since July 2001 that have become more consistent since October 2006. His highest alanine aminotransferase (ALT) level has been 72 U/L, with most values in the range of 40 to 50 U/L; his highest aspartate aminotransferase (AST) level has been 47 U/L. His total bilirubin level has been normal.