Do you have a fatty (Steatotic) liver?

NAFLD (pronounced na-ful-dee) or Non-Alcoholic Fatty Liver Disease is the most common type of chronic liver disease and the number 2 cause for needing a liver transplant. 75 to 100 million Americans have NAFLD. It is three times more prevalent than diabetes. It’s caused by a buildup of fat in the liver like alcoholic liver disease but occurs in people who consume little or no alcohol. Having excess body fat increases the risk for NAFLD, but genetics and environmental factors also play a role. 1 in 14 people with a fatty liver will progress to NonAlcoholic SteatoHepatitis or NASH. When this happens, liver cells become injured and inflamed and begin to form scar tissue. Scarring leads to cirrhosis and possible liver cancer in 20% of people with NASH. Early detection and treatment are the only way to prevent a fatty liver from developing into cirrhosis or cancer.

NAFLD (pronounced na-ful-dee) or Non-Alcoholic Fatty Liver Disease is the most common type of chronic liver disease and the number 2 cause for needing a liver transplant. 75 to 100 million Americans have NAFLD. It is three times more prevalent than diabetes. It’s caused by a buildup of fat in the liver like alcoholic liver disease but occurs in people who consume little or no alcohol. Having excess body fat increases the risk for NAFLD, but genetics and environmental factors also play a role. 1 in 14 people with a fatty liver will progress to NonAlcoholic SteatoHepatitis or NASH. When this happens, liver cells become injured and inflamed and begin to form scar tissue. Scarring leads to cirrhosis and possible liver cancer in 20% of people with NASH. Early detection and treatment are the only way to prevent a fatty liver from developing into cirrhosis or cancer. Fatty liver disease is suspected by abnormal liver tests, primarily elevated liver enzymes, low platelets or high ferritin levels. Suspected NAFLD needs to be confirmed with an ultrasound, CT or MRI of the liver. The only way to know if a fatty liver is NASH is through a liver biopsy. A liver biopsy is an outpatient procedure performed using a small needle inserted into the liver to collect a tissue sample. The sample is then analyzed in a pathology laboratory to look for inflammation and scarring.

There are several risk factors that increase the chances of progressing from NAFLD to NASH:

1. Obesity or overweight
2. Excess body fat Increased abdominal fat (central obesity)
3. Age >50 years
4. Diabetes
5. Metabolic syndrome
6. Polycystic ovary syndrome (PCOS)
7. High blood pressure
8. Metabolic dyslipidemia (low HDL cholesterol and high triglycerides)
9. Cushing’s Syndrome
10. Psoriasis
11. Hypothyroidism
12. Obstructive sleep apnea
13. Pituitary disease
14. Low testosterone (in men)

Treating NAFLD means treating the liver disease alongside the associated metabolic conditions such as obesity, diabetes, and abnormal cholesterol. Weight loss with a diet plan has been shown to be highly effective for both NAFLD and NASH. Weight loss improves metabolic conditions and decreases the risk of cardiovascular disease. Fast weight loss programs have proven to be an excellent treatment for fatty liver disease. Although there are no approved drug therapies for NAFLD, several diabetes medications and vitamin E can be helpful. Weight loss medications are also helpful for NAFLD especially when people struggle with losing weight. Bariatric surgery is also a powerful treatment for fatty liver disease. New pharmaceutical agents that directly target NASH are in development. Liver transplantation is a last resort but is more commonly used as a treatment for people with end stage liver disease.