What is hepatic steatosis?

• A. A biliary obstruction
• B. First stage of hepatic insufficiency due to alcohol
• C. A form of viral hepatitis
• D. Normal liver fat deposition

Answer: (B)

Hepatic steatosis is fat accumulation inside liver cells, usually triglycerides stored as fat droplets (often described as macrovesicular steatosis). In the context of alcohol use, this fat buildup occurs because alcohol disrupts normal fat metabolism: fatty acids are mobilized and not efficiently exported as VLDL, so they accumulate in hepatocytes. This makes steatosis the earliest, reversible change in alcohol-related liver disease and a precursor to more severe injury if alcohol use continues.

It’s not caused by biliary obstruction (that would cause cholestasis), nor is it a form of viral hepatitis (viral inflammation affects hepatocytes differently). It’s also not simply “normal” fat deposition; the level and context are pathologic, reflecting liver stress.

So, in alcohol-related liver disease, steatosis is the first stage of alcohol-induced liver injury, which can progress to inflammation, fibrosis, and eventual dysfunction if the insult persists.