What is Fatty Liver Disease?
Fatty liver disease is a common liver condition where there is a build up of excess fat in the liver cells. Although it is normal for the liver to contain some fat, a fatty liver is classified when fat accounts for greater than 10% of the liver by weight. Fatty liver disease may be linked to alcohol abuse (alcoholic liver disease), whereas non-alcoholic fatty liver disease (NAFLD) is defined as a fatty liver when no other obvious cause such as alcohol is present.
NAFLD is relatively common, and its incidence is increasing, particularly in western societies where other conditions including diabetes and obesity are more prevalent. A report commissioned by the Gastroenterological Society of Australia (GESA) and Australian Liver Association (ALA) indicated that an estimated that 5.5 million Australians, including 40% of all adults aged 50 years and above are affected by NAFLD.
Are there any complications?
Simple fatty liver disease, which defines the accumulation of fat in the liver, is a relatively benign condition, although it is associated with an increased risk of cardiovascular disease. If NAFLD is left untreated it may progress to the development of more serious complications including non-alcoholic steatohepatitis (NASH), which encompasses the accumulation of fat with additional liver inflammation. Furthermore, over time an inflamed liver may become scarred and hardened, a condition known as cirrhosis which can lead to liver failure and liver cancer.
What causes NAFLD?
Fatty liver can develop in anyone, however there are certain factors or other pre-existing conditions that can contribute to fatty liver. Obesity is the most common risk factor, with the majority of patients being overweight or obese. Other obesity-related conditions such as diabetes and elevated triglycerides are also associated with increased risk of NAFLD.
In addition, research also suggests that metabolic syndrome, a cluster of disorders that increase the risk of heart disease, diabetes and stroke and is characterised by abdominal obesity, high blood pressure (hypertension), insulin resistance and abnormal cholesterol levels, is associated with the development of fatty liver.
Although the majority of NAFLD patients are middle-aged, fatty liver disease is the most common cause of liver disease in children, due in large part to the rise in childhood obesity. Obesity aside, other factors which may lead to fatty liver include alcohol abuse, malnutrition or rapid weight loss.
How will I know if I have NAFLD?
Most people experience no symptoms or pain with a fatty liver, and even if the disease progresses to NASH, liver damage can go unnoticed and unchecked for many years, even decades. Often it is only as the disease worsens that a patient may experience symptoms including fatigue, confusion, weight loss,weakness and abdominal discomfort.
For this reason, often people only learn they have fatty liver during a medical test for another condition or during a routine check up. Indications may include an unusual blood test, or a slight enlargement of the liver, and further tests including liver function tests, CT scans , ultrasounds or MRIs may be required to rule out other liver diseases. To confirm diagnosis, the doctor may need to take a liver biopsy – where a needle is used to remove a sample of liver tissue that is examined under a microscope.
What can I do to treat NAFLD?
Currently there are no medical or surgical procedures to effectively treat a fatty liver. Scientists are currently researching whether existing medications, particularly for those for diabetes, can be used to address fatty liver disease.
Current recommendations centre around life style changes to help prevent or reverse some of the damage caused by fatty liver, including maintaining a healthy balanced diet, regular exercise and avoiding alcohol.
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