Fatty Liver Disease

Learn About Fatty Liver Disease

There are two major types of fatty liver disease: One is due to alcohol abuse and dependence; this type will not be covered here as it is a distinct clinical entity. On the other hand nonalcoholic fatty liver disease is a remarkably common condition not occurring in the context of alcohol abuse. Nonalcoholic fatty liver disease refers to the accumulation of fat within the liver cells, or hepatocytes. For most people, it causes no signs and symptoms, and is essentially a benign condition. But there are people for whom the accumulation of fat in the liver cells leads to inflammation and scarring which affect the liver’s ability to function. This more serious form of nonalcoholic fatty liver disease is sometimes called nonalcoholic steatohepatitis, or NASH.

A wide range of diseases and conditions can increase the risk of developing nonalcoholic fatty liver disease, chief amongst these being obesity and disorders of lipid metabolism such as Type II diabetes, elevated serum triglycerides and cholesterol, and the “metabolic syndrome.” The diagnosis is made by a combination of blood tests (“liver function tests”) that measure levels of liver enzymes that are elevated when the liver is stressed by circumstances such as the accumulation of fat in the hepatocytes. Imaging procedures such as ultrasound, computerized tomography (CT) scanning and magnetic resonance imaging (MRI) along with the blood tests are sufficient to make the diagnosis. If it suspected that the disease is NASH and therefore causing inflammation and scarring, a liver biopsy is necessary to make this diagnosis. The liver biopsy is typically accomplished using a long needle inserted through the skin and into the liver (a needle biopsy); sometimes a more invasive, surgical procedure is required (a wedge biopsy).

There is no specific treatment for nonalcoholic fatty liver disease. Controlling the associated conditions can help substantially; for example, weight loss for obesity and avoiding alcohol. Managing the contributing factors can substantially mitigate the potentially harmful course of disease progression, and in some cases bring about a complete remission.

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