How is hepatic blood flow described in obesity-related liver changes?

• A. Increased
• B. Decreased
• C. Unchanged
• D. Varied depending on the stage

Answer: (A)

In obesity-related liver changes, hepatic blood flow is increased. This reflects a hyperdynamic circulatory state seen with obesity, where increased splanchnic blood flow and higher cardiac output deliver more blood to the portal system and liver. Although the hepatic arterial flow can adjust somewhat via the hepatic arterial buffer response, the net perfusion to the liver tends to be higher than normal in this context. This increased flow supports the liver’s metabolic workload in obesity and NAFLD, though it can also participate in the progression of steatosis and inflammation. Decreased or unchanged flow would not fit the typical obesity-associated pattern, and while perfusion can become more complex at advanced stages, the common teaching point is that hepatic blood flow is increased.