There's only one sure way to determine whether you have fatty liver disease; it involves a long needle piercing your skin to remove tissue from the organ. Before you get to that point, your health care provider may suspect you have fatty liver based on blood tests or an ultrasound. If you have the condition, you may not know it and consequently may not express any concerns to your doctor. Fatty liver disease can go symptomless for years, and even stop progressing and reverse all on its own.
Fatty Liver Disease in the United States
Fatty liver is a spectrum of disorders that range on one end from a simple buildup of fat cells among the various types of cells found in the organ to liver failure on the other. Simple steatosis, or fatty buildup, is a mostly benign condition, but as the disease progresses and those fat cells comprise more than 5 to 10 percent of your liver's weight, you may be diagnosed with fatty liver disease. Fatty liver can be brought about by excessive alcohol intake, but more people are experiencing it as a result of the obesity and diabetes epidemics. The only thing that distinguishes the two is your level of alcohol intake. With additional inflammation and scarring, nonalcoholic fatty liver disease can progress to nonalcoholic steatohepatitis, or NASH. The progress can develop without symptoms for years, and most people feel well as the liver tries to heal itself. You should talk to you doctor about your liver health if you drink alcohol, are overweight or obese, or have diabetes or high cholesterol.
Blood Tests
Your doctor may first suspect you have a fatty liver condition based on the results of routine blood tests. Your results may show an elevation of two enzymes, alanine aminotransferase (ALT) or aspartate aminotransferase (AST). Both are released at higher levels into your bloodstream when your liver is injured or diseased. This step, however, is only an initial assessment that may prompt your doctor to perform a more comprehensive diagnostic review. There are more than 100 known liver diseases, according to the American Liver Foundation, so you're likely to undergo additional testing to rule out other liver diseases.
Ultrasound
Your doctor may also see a buildup of fat in your liver through a scan, such as an ultrasound, CT or MRI. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) states that although each of these methods can detect fat in the liver, none of them can reliably distinguish a simple buildup from the more advanced diseased state.
Liver Biopsy
The only way to confirm a diagnosis of fatty liver disease is through a liver biopsy. With this procedure, your health care provider may remove a sample of tissue from your liver. This portion of tissue is usually extracted through a long needle inserted into your skin. The sample will be inspected in a lab for signs of fat cell buildup, inflammation and scarring. The NIDDK is working on developing less invasive procedures to diagnose fatty liver disease and distinguish its various forms from simple fat to NASH. Blood samples from people with all forms of the disease could provide biomarkers that help improve diagnoses.
References
- American Liver Foundation: Non-alcoholic Fatty Liver Disease
- MayoClinic.com; Nonalcoholic Fatty Liver Disease: Tests and Diagnoses; Feb. 19, 2011
- National Digestive Diseases Information Clearinghouse; Nonalcoholic Steatohepatitis; Nov. 2006
- National Institute of Diabetes and Digestive and Kidney Diseases: Action Plan for Liver Disease Research: Chapter 7: Fatty Liver Disease
