There are two types of fatty liver disease, or steatosis: alcohol-induced and nonalcoholic. Both conditions may result in elevated levels of normal liver enzymes in your blood. If your doctor notices high liver enzyme levels, he may investigate fatty liver disease as a possible cause.
Liver Enzymes
Elevated blood levels of normal liver enzymes can indicate damage or inflammation in the cells of the liver. There are two types of liver enzyme that your doctor will look for: alanine transaminase, or ALT, and aspartate transminase, or AST. A moderate increase in liver enzymes is often normal and will usually resolve on its own. However, a number of more serious conditions can be to blame, including alcoholism and alcohol-related liver damage, hepatitis, some prescription medications, obesity and nonalcoholic fatty liver disease.
Alcohol-Induced Fatty Liver Disease
Alcohol-induced fatty liver disease occurs when excessive consumption of alcohol causes fats called triglycerides to accumulate in the cells of the liver. This type of fatty liver disease may be asymptomatic or cause tenderness in the abdomen or the lower back. In advanced stages, you might experience fever, jaundice, spider veins and increased white blood cell count. Alcoholic fatty liver disease is a serious condition. If not identified and treated, it may lead to cirrhosis, a scarring of the liver tissue that can destroy its ability to function. Unfortunately, alcohol-induced fatty liver disease can also cause lower than usual levels of liver enzymes instead of the expected high levels, making the condition more difficult to diagnose.
Non-Alcoholic Fatty Liver Disease
Occasionally, fat builds up in the liver for other reasons. Nonalcoholic fatty liver disease, or NALFD, is often asymptomatic or presents only mild abdominal discomfort. NAFLD is often harmless and temporary, but in some cases can cause inflammation, leading to problems with liver function. Common causes of NAFLD are obesity, diabetes, hepatitis and certain medications. Occasionally, a hereditary metabolic problem may be involved. NALFD is probably the most common of mild to moderately elevated liver enzyme levels.
Diagnosis and Treatment
Diagnosing fatty liver disease starts with a doctor's examination. Many times, doctors will detect an enlarged or sensitive liver by touch, then order blood tests to check liver enzymes or a liver biopsy for confirmation. Treatment for alcohol-induced fatty liver disease requires eliminating its cause: alcohol. Many patients find that fat levels in the liver return to normal after only six weeks of sobriety. Treatment for NAFLD may include weight loss, better control of diabetes or discontinuing any problematic medications.
References
- University of Maryland Medical Center: Liver Disease
- MayoClinic.com; Nonalcoholic Fatty Liver Disease; 2011
- MayoClinic.com; Elevated Liver Enzymes; Mayo Clinic Staff; 2011
- Merck Manual Home Health Handbook; Fatty Liver; Eldon A. Shaffer; 2007
- "Clinical Liver Diseases"; The Asymptomatic Outpatient with Abnormal Liver Function Tests; Michael Krier et al.; 2009
