How Does Having a Fatty Liver Impact Your Health?

Fatty liver or nonalcoholic fatty liver disease (NAFLD) now called MASLD - metabolic dysfunction-associated steatotic liver disease is a disorder in which too much fat builds up in the liver. Nonalcoholic steatohepatitis (NASH/MASH) occurs when that extra fat causes inflammation and scarring of the liver. If severe enough, NASH or MASH metabolic dysfunction-associated steatohepatitis can lead to cirrhosis or liver cancer, potentially requiring a liver transplant. In addition, heart-related deaths are one of the main causes of death for people with NAFLD or NASH.

Studies have found that about 25% of people in the world have NAFLD and 2-6% have NASH. NAFLD/NASH can affect people of any age, including children. It is more common in people with obesity type 2 diabetes, prediabetes, PCOS, high blood pressure, or high cholesterol. There are no medications currently approved to treat NASH. Several medications are being tested in clinical trials for approval. Doctors can also prescribe medications for conditions associated with a fatty liver, such as diabetes and obesity. The symptoms of NASH are hard to recognize which is why it is underdiagnosed. Newer noninvasive diagnostic tests offer a safe examination of the liver compared with a liver biopsy that examines a small piece of the liver.

Noninvasive tests include:

  1. Blood tests: A lab analysis to calculate the amount of fat and risk for fibrosis in the liver.
  2. Specific blood tests include AST to Platelet Ratio Index (APRI), Fibrosis-4 Test (FIB-4), Enhanced Liver Fibrosis (ELF), and FibroTest.
  3. Transient Elastography (Fibroscan): Imaging device that uses sound waves to measure liver stiffness.
  4. Shear Wave Elastography: Imaging technology that uses sound waves to measure liver stiffness.
  5. Multiparametric Magnetic Resonance Imaging (LiverMultiScan): Imaging technology that uses magnetic resonance imaging to measure liver fat, iron, fibrosis, and inflammation.
  6. Magnetic Resonance Elastography (MRE): Imaging technology that combines MRI with sound waves to create a visual map or elastogram to assess liver stiffness.

It is possible to stop NASH in the initial stages from progressing to severe liver damage or cancer through weight loss. This can be accomplished with lifestyle change by focusing on physical activity and nutrition. Weight loss medications and weight loss surgery can be added when needed.