Fatty Liver Disease is a group of Hepatic Diseases, which is characterized with the buildup of excess fats in the liver.
There are two type of FLDs, Non-alcoholic Fatty Liver Disease and Alcoholic Liver Disease.
Regarding Alcoholic Liver Disease, the manifestations of hepatitis and cirrhosis are brought to the liver due to consumption of alcohol.
Non-Alcoholic Fatty Liver Disease is the excess buildup of fats in liver, not related to the consumption of alcohol. It is a direct manifestation of obesity, diabetes type 2, high serum triglycerides, etc.
NAFLD is of two types:
- Non-alcoholic Fatty Liver
- Non-alcoholic Steatohepatitis – with the additional hepatitis (liver inflammation)
Although initially no signs or symptoms are seen, as the disease may progress, some symptoms that can be seen are:
- Unexplained Fatigue
- Pain in the upper right abdomen
- Enlarged Spleen
- Abdominal swelling (Ascites)
- Yellowing of the skin & eyes (Jaundice) due to excess biliary secretions by the liver.
Some primary causes that can be narrowed down are:
- High blood sugar (Hyperglycemia)
- Type-2 Diabetes
- Obesity/Being Overweight
- Insulin resistance that can lead to buildup of sugars in the blood.
- Presence of high serum triglycerides (Fats)
RISK FACTORS (NAFLD)
There are various comorbidities or risk factors that can contribute to:
- Consumption of Fatty diet
- High blood cholesterol
- Metabolic syndrome
- Hypothyroidism (Thyroid hormone not secreted at the required levels)
- PCOS (Polycystic Ovary Syndrome)
- As the disease (NAFL) gradually progresses, it develops to NASH, which leads to inflammation of the liver cells (Hepatitis).
- NASH, being an aggressive form has a higher rate of development of Liver Cirrhosis (scarring of the Liver) which slowly progresses to Liver Cancer.
- Further complications can result in comorbidities like high blood pressure, Coronary Artery Disease, Steatorrhea, etc.
- Primary diagnosis is on the basis that NAFLD is caused due to factors other than excess alcohol consumption, drug related complication or Hep-C.
- Blood tests are done to rule out possibility of EBV, Hepatitis (A,B or C), autoimmune diseases, etc.
- Imaging, like Ultrasounds, MRI, CT scan are done to diagnose steatosis, which can be linked to NAFLD.
- Liver biopsy is the gold standard method for effectively diagnosing and distinguishing NAFLD (including NAFL and NASH) from other forms of liver disease.
- NAFL can be differentiated from NASH, on the basis that, in the latter, hepatocyte injury and lobular inflammation is existent.
TREATMENT & PREVENTION
- Medications like Statins, Pioglitazone & Omega-3 Fatty acid supplements.
- Bariatric Surgery for obese person, can reduce and even cure individuals with fatty liver.
- NAFLD is a leading cause for Liver Transplant.
- Calorie restriction and low fat/lipid consumption is the key to prevention of NAFLD and the related comorbidities.
- More consumption of Coffee, in certain scientific studies has shown preventive action on the liver.
- Increased physical activity that promotes fat loss and liver health.
- Moderate consumption or completely cutting off alcohol consumption and over or unnecessary popping of drugs like aspirin, which are bad for hepatic health.