Fatty liver disease is a growing epidemic related to the increase in obesity rates. The condition was once thought to be only a problem for alcoholics, but people who drink little to no alcohol are now experiencing the same troubles as problem drinkers. If you are overweight or obese, have diabetes, or have a family history of liver problems, consider talking with your health care provider about monitoring your liver health.
Fatty Liver
Fatty liver comes in two major forms: alcoholic and nonalcoholic. Both involve the accumulation of fat in the liver and progressive damage to the organ. After the initial buildup of fat -- called steatosis or nonalcoholic fatty liver disease -- some people experience inflammation and scarring -- called nonalcoholic steatohepatitis, or NASH. At the far end of the spectrum is a liver that is so swollen and hardened that it is unable to do its job. Parts of it shut down, leaving the functioning parts to work harder. This can lead to cirrhosis and liver failure.
Prevalence of Fatty Liver in the United States
About 10 to 20 percent of Americans -- 31 million to 62 million people -- have fatty liver, says the National Digestive Diseases Information Clearinghouse. This statistic includes a growing number of children. Another 2 to 5 percent have the more advanced NASH. According to the National Institutes of Health's "Action Plan for Liver Disease Research," 10 percent of all new cases of chronic liver disease come from NASH diagnoses, and 10 percent of cirrhosis cases can be traced to NASH. The NDDIC suspects that 9 percent of liver transplants in adults may be due to end-stage NASH.
Coexisting Problems
Fatty liver disease is rarely a solitary problem. Various stages of the condition often come with high blood pressure, insulin resistance, diabetes and other metabolic issues. Many NASH patients also have elevated blood lipids, such as cholesterol and triglycerides. Additionally, public health researchers aren't entirely sure what causes fatty liver to progress, but suspect factors such as toxic inflammatory proteins released by fat cells, as well as oxidative stress inside liver cells, contribute to the progression.
Treatment Options
Although there's no known way to cure fatty liver, your health care provider may suggest you lose weight, eat a healthy diet, get more exercise, stop drinking alcohol and eliminate unnecessary medications. Current treatment usually entails trying to prevent the condition from worsening and treating underlying health problems like high cholesterol and diabetes. Several new potential treatment approaches are being investigated. For example, research published in a May 2010 issue of "The New England Journal of Medicine" showed promising improvements in some features of the conditions using the antioxidant vitamin E and a diabetes drug, pioglitazone. New research, published in the September 14, 2010, issue of the "World Journal of Gastroenterology," has also uncovered a link between sleep apnea and nonalcoholic fatty liver disease; so treating the sleeping disorder may one day open a pathway to fatty liver treatment. Furthermore, gastric bypass surgery has dramatically improved fatty liver disease, mostly due to the resulting weight loss, according to research published in the July 2005 issue of "Obesity Research."
References
- "Action Plan for Liver Disease Research"; U.S. Department of Health and Human Services -- The Liver Disease Subcommittee of the Digestive Diseases Interagency Coordinating Committee; December 2004
- National Digestive Diseases Information Clearinghouse; Nonalcoholic Steatohepatitis; November 2006
- "Journal of Clinical Gastroenterology"; The Influence of Nonalcoholic Fatty Liver Disease and Its Associated Comorbidities on Liver Transplant Outcomes; A. Sidney Barritt, IV, et al.; April 2011
- "The New England Journal of Medicine"; Pioglitazone, Vitamin E, or Placebo for Nonalcoholic Steatohepatitis; Arun J. Sanyal, et al.; May 2010
- "World Journal of Gastroenterology"; Obstructive Sleep Apnea Syndrome and Fatty Liver: Association or Causal Link?; Mohamed H. Ahmed and Christopher D. Byrne; September 2010
- "Obesity Research"; Roux-en-Y Gastric Bypass Improves Liver Histology in Patients With Non-Alcoholic Fatty Liver Disease; Jeanne M. Clark, et al.; July 2005
