Hepatic steatosis is a common, complex metabolic disease characterized by the buildup of excess fat within liver cells. It is the early state of a condition known as nonalcoholic fatty liver disease (NAFLD) and is the most common liver disorder in industrialized countries with increasing prevalence noted alongside the global epidemic of obesity. An estimated 25-33% of adults in the United States have fatty liver disease. In the adolescent and young adult population, the prevalence of fatty liver is increasing and estimated at 18.5%. NAFLD is often without symptoms and detected only after incidental laboratory or radiology findings. This article will highlight potential consequences and treatment options for NAFLD.
Consequences of NAFLD
1. Inflammation and Steatohepatitis: NAFDL can progress to a more severe condition called non-alcoholic steatohepatitis (NASH) which is characterized by liver inflammation and damage. NASH can lead to fibrosis (scarring of the liver), cirrhosis, and eventually liver failure.
2. Increased Risk of Cardiovascular Disease: NAFLD is closely linked to cardiovascular risk factors such as obesity, high blood pressure, high cholesterol, and insulin resistance. These factors contribute to the development of cardiovascular diseases, including heart attacks and strokes.
3. Type 2 Diabetes: NAFLD and insulin resistance are closely intertwined. Excess fat in the liver can disrupt insulin signaling, leading to elevated blood sugar levels and an increased risk of developing type 2 diabetes.
4. Increased Risk of Dementia: In August 2022, the medical journal Neurology reported a modest association with NAFLD and an increased risk of developing dementia. That risk is even higher with heart disease or stroke being part of the medical history.
5. Increased Risk of Liver Cancer: In severe cases of fatty liver disease, cirrhosis may develop leading to an increased risk of hepatocellular carcinoma (HCC), the most common form of liver cancer. It is important to note that not all individuals with NASH will develop HCC. However, the presence of advanced fibrosis or cirrhosis significantly increases the risk.
Treatment of NAFLD
1. Lifestyle Modifications: The cornerstone of NAFLD treatment involves lifestyle changes. Weight loss through a combination of regular exercise and a balanced, healthy diet is essential. A diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can help reduce liver fat and improve liver health.
2. Alcohol Moderation or Abstinence: For individuals with alcoholic fatty liver disease, it is crucial to significantly limit or eliminate alcohol intake under medical supervision.
3. Medications: In certain cases, medications may be prescribed to manage underlying conditions such as diabetes, high cholesterol, or metabolic disorders. However, no specific medication has been approved for the direct treatment of fatty liver disease.
4. Clinical Trials: Studies are ongoing looking at specific medications to treat NAFLD. Promising studies at several major universities are investigating the roles that the gut microbiome and intestinal inflammation potentially play in liver fat build-up.
5. Ongoing Monitoring: Regular medical check-ups, including liver function tests and imaging, may help monitor the progression of fatty liver disease and detect complications at an early stage. Close collaboration with healthcare professionals is important for personalized guidance and support.
Conclusion
NAFLD poses a significant health risk if left untreated. Long standing and untreated fatty liver may impart a risk of developing liver cancer, even in the absence of cirrhosis. Increasing awareness and understanding of fatty liver disease along with implementing healthy lifestyle changes are key to combating this silent intruder. If you have liver related concerns, please contact your primary care physician.
LifeStyle Medicine Inc. is a Tulsa concierge medical practice committed to promoting prevention and wellness along with treating complex medical conditions. Dr. Mayer is a board-certified Internal Medicine physician. She is an experienced clinician and medical researcher involved in developing clinical trials and protocols for chronic medical conditions including NAFLD. Our practice partners with patients to develop personalized healthcare treatment plans. Patients have access to helpful tools including body composition analysis, radiologic scans, psychological and nutritional resources as well as pharmacologic and nutraceutical support. Increasing awareness and understanding of fatty liver disease along with implementing healthy lifestyle changes are key to combating this silent intruder.
About the author
Dr. Renae Mayer’s passion to incorporate years of advanced training, research and experience prompted the formation of LifeStyle Medicine, Inc. in May of 2016, a practice offering traditional medicine along with selective alternative integrated medical procedures and prescriptions.
LifeStyle Medicine Inc.
5801 E 41st - Suite 600
Tulsa, OK 74135
918-488-9874
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder in industrialized countries with increasing prevalence noted alongside the global epidemic of obesity.
