Fatty liver: A silent threat

 The easy lifestyle most of us enjoy today allows us to shop in convenience stores around the clock, order the foods we like by phone and operate our TVs, stereos and other entertainment centres by remote control. But this couch potato life also has its downside: lack of exercise and unhealthy snacking has pushed obesity levels higher than ever before. Insulin resistance has plummeted, leading to accumulation of fat in the liver and doctors are now seeing an increasing number of people suffering from fatty liver disease.

In the USA, where more than 35 per cent of the population is obese, the accumulation of fat in the liver is a leading cause of chronic liver disease, cirrhosis (scarring of the liver) and liver failure. 

In Taiwan, 32 per cent of residents suffering from chronic liver inflammation due to accumulation of fat in the liver.

Many people associate fatty liver disease with excessive alcohol use but it also occurs in those who never touch a drink. In these cases, it is related to insulin resistance and the metabolic syndrome, a combination of medical disorders that includes obesity, especially belly fat, type 2 diabetes, high blood pressure, and high blood cholesterol levels (HDL level lower than 40mg/dL in men and less than 50 mg/dL in women), and a triglyceride level higher than 150mg/dL.

The major risk factor is obesity, with 70 per cent of obese people having an accumulation of fat deposit in their livers, and especially those with a big belly.

Patients with accumulation of fat in the liver usually show no signs. They appear to be perfectly well, albeit severely overweight.

The accumulation of fat in the liver is divided into 4 pathological types. The first two types involve fatty deposits in the cells of the liver or slight inflammation of the liver while the third and fourth types involve higher inflammation of the liver as well as ballooning degeneration of the cells or hepatic fibrosis.

Patients with fatty liver disease of type 3 and 4 have a 22 to 28 per cent chance of developing cirrhosis within 10 years and liver cancer, which may lead to death. The accumulation of fat in the liver of Type 3 and4 is called Non-Alcoholic SteatoHepatitis (or NASH) and requires treatment as well as monitoring by a physician. 

Fatty liver disease also leads to other diseases. For example, accumulation of fat in the liver will cause patients with Hepatitis C to develop cirrhosis faster and to respond less well to the treatment. Additionally, those with suffering from accumulation of fat in the liver are at risk or developing colon cancer and have a much higher risk of dying from other health-related complications, especially coronary artery disease. 

A recent studied that followed Chinese patients with fatty liver disease for 6 years revealed that 20 per cent of them went on to develop diabetes, 70 per cent had high blood pressure, 39 per cent had high cholesterol and 56 per cent developed more than one disease during the study period.

If your lifestyle is such that you are at risk of fatty liver disease, consult a physician and seek treatment.

 

Dr Teerha Piratvisuth is a Heptologist and Gastroenterologist at Samitivej Sukhumvit Hospital. |Call (02) 711 8822-4 or check out “samitivej” on Facebook.