What is Fatty Liver?
Fatty liver is the accumulation of fat in liver cells. Another term
used to identify this condition is fatty infiltration of the liver.
What causes Fatty Liver?
Fat
accumulates in the liver, usually in connection with heavy use of
alcohol,
extreme weight gain or type 2 diabetes mellitis (the type which usually
develops later in life).
Fatty liver can also be associated with poor diet and certain illnesses,
such as tuberculosis, intestinal bypass surgery for obesity and certain
drugs such as corticosteroids.
How is Fatty Liver identified?
Fatty liver is usually suspected in a person with the diseases or conditions
mentioned above.
The
patient may have an enlarged liver and/or minor elevation of liver enzyme
tests. Several studies show that fatty liver is one of the most common
causes of isolated minor elevation of liver enzymes found in routine
blood screening.
To find out for certain whether a person has fatty liver requires that
a sample of liver tissue be obtained (a liver biopsy) to be examined
under a microscope. An ultrasound examination or a CT scan can also
suggest the presence of a fatty liver.
How does fat get into the liver?
It is not certain how this happens. A person is said to have fatty
liver when the fat present in the liver increases the weight by 5%
or more.
Possible explanations for fatty liver include the transfer of fat from
other parts of the body, or an increase in the extraction of fat presented
to the liver via the intestine.
Another explanation is that for some reason the liver cannot break
down or remove fat at a fast enough rate and the fat builds up.
People who drink too much alcohol for many years may develop alcoholic
liver damage that includes fatty liver. Fatty liver may also occur in
middle-aged, overweight, and often diabetic patients who do not drink
alcohol.
Although the majority of patients with fatty liver do not have any
significant liver disease, some will develop severe liver inflammation
and scarring. This scarring can develop into cirrhosis.
Non alcoholic steatohepatitis (NASH) is the term given to patients
who do develop liver inflammation in the presence of fatty liver but
where alcohol consumption is negligible or absent. This is an important
condition as some of these patients can develop liver scarring and cirrhosis.
Can fatty liver be treated?
The treatment of fatty liver is related to the cause.
Simple fatty liver does not require treatment since it does not result
in damage to liver
cells or clinical disease.
By losing a substantial amount of weight, obese patients with fatty
liver will have a reduction of excess fat in liver cells as well as
in other cells of the body.
Patients, who are overweight and have fatty liver, can have a high
cholesterol level in the blood and may have glucose intolerance if
not
established diabetes.
This is usually associated with a resistance to
the action of the hormone, insulin. Such patients are at high risk
of stroke or heart attack.
Weight reduction in these patients will not only help the fatty liver
but will substantially decrease the chance of stroke or heart attack.
Patients who drink alcohol to excess will also have a loss of fat in
the liver when alcohol is ceased.
Good control of diabetes mellitus with diet, medication or insulin
will usually decrease the fat content of the liver.
Acknowledgement: Web sites for Hepatitis Central and the Mayo clinic
– research on liver diseases.
