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BVHS Weekend Column: Getting the Skinny on Fatty Liver Disease

Getting the Skinny on Fatty Liver Disease, by Brenda Keller, CNP, Gastroenterology Associates of Northwest Ohio

Brenda Keller, CNP

If you have been told that you have “fatty liver disease,” you are among 25 percent of people in the United States and 24 percent of people worldwide who have this condition. Fatty liver disease occurs when fat is deposited in the liver due to causes other than excessive alcohol use. Non-alcoholic fatty liver disease (NAFLD) is one type of fatty liver. NAFLD is the most common liver disorder in developed countries. Non-alcoholic steatohepatitis (NASH) is the most extreme and fastest progressing subtype of NAFLD.

NASH and NAFLD are the leading causes of chronic liver disease. NAFLD is associated with insulin resistance, increasing body mass index (BMI) and age, and metabolic syndrome (obesity, combined hyperlipidemia, Type II diabetes mellitus and high blood pressure) as well as hypoxia caused by obstructive sleep apnea. Being male might also be a risk factor for NAFLD, as NAFLD has been observed to be more prevalent in men than women.

A liver biopsy is the only test widely accepted as distinguishing NASH from other forms of liver disease and can be used to assess the severity of the inflammation and the fibrosis that results from the disease. Since liver biopsy is associated with risks, and since most NAFLD patients are asymptomatic, other methods of diagnosis are preferred such as liver sonography (ultrasound). Routine liver function (blood) tests are not sensitive enough to detect NAFLD.

For those who have fatty liver with associated inflammatory injury (steatohepatitis), blood tests are usually indicated to rule out viral hepatitis (A, B and/or C), rubella and autoimmune diseases. Low thyroid activity is more prevalent in NASH patients and is detected by determining the thyroid stimulating hormone.

Imaging studies including liver ultrasound, computerized tomography (CT) scan, magnetic resonance imaging (MRI) of the abdomen and magnetic resonance elastography can all be useful, noninvasive methods of detecting fatty liver disease.

Treatment for NAFLD involves treating the underlying cause. Weight reduction, increased activity and control of lipids and blood glucose are all beneficial. Daily vitamin E may also be prescribed for some patients with NAFLD. A diet that is plant-based may reduce symptoms. Patients with NAFLD should consider diets rich in fruits, vegetables, whole grains and healthy fats. Limiting alcohol intake is also recommended. The absorption of alcohol can cause fat to accumulate on the liver and lead to inflammation.

If you feel discouraged because you have been told that you have fatty liver disease, cling to the “better-late-than-never” principle. It is better to lose excess weight, increase physical activity and make the necessary diet adjustments whenever you can, rather than not at all. Even small changes can make a big difference when it comes to your liver health.

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