One in five Americans has non-alcoholic fatty liver disease. What you should know.

NAFLD is closely associated with obesity and metabolic abnormalities such as hypertension, insulin resistance, and elevated triglycerides. As rates of risk factors such as obesity continue to rise, including in childhood, 100 million people in the US It is projected to become NAFLD by 2030. This condition tends to: run by familyHispanic Americans unfairly affected.

Most people are unaware that they have NAFLD and do not develop serious complications from NAFLD. However, the American Association for Liver Research recommends screening for liver scarring in patients with classic risk factors such as type II diabetes.

There are no approved treatments yet, but some interventions may help. Weight loss and a healthy diet are the most effective and can also help improve NAFLD.

Here are some possible complications and options for diagnosis and treatment.

Methods for diagnosing fatty liver disease

Most people with NAFLD have no symptoms, but some experience fatigue and vague abdominal discomfort. Some people are evaluated for NAFLD when a doctor finds abnormal liver enzymes on a blood test called the Comprehensive Metabolic Panel.

For example, two enzymes produced in the liver, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), are often elevated in patients with NAFLD. Another test that may be abnormal in NAFLD patients is: serum ferritina protein in the blood that rises when the liver is inflamed.

After ruling out other causes of liver damage, NAFLD is usually diagnosed by imaging tests such as ultrasound or CT scan. A doctor can check if there is too much fat in the liver. A liver biopsy is considered the gold standard for making a diagnosis, especially if it’s still not clear what’s going on after imaging. Your doctor may also order other tests, such as: Elastographyto see if there is scarring in the liver that helps the disease progress.

Complications of fatty liver disease

People with fatty liver Increased risk of death from liver cancer and cardiovascular disease.

It is estimated that 1 in 5 NAFLD patients It develops the next stage of the disease, an inflammation of the liver known as non-alcoholic steatohepatitis (NASH).

This inflammation increases the risk of liver scarring. The terminal form of liver scarring is called cirrhosis and is one of the most devastating consequences of NASH.

Liver dysfunction can be life threatening. As a result of cirrhosis, patients may experience massive bleeding due to ruptured esophageal veins, brain dysfunction due to accumulation of toxins in the bloodstream, natural abdominal infections, and kidney failure.

Cirrhosis is the most common reason for liver transplantation. Liver transplantation results are generally good, but extensive surgery is required and lifelong immunosuppressive drugs are often needed to keep the new liver from rejecting.

again, The current process of determining who is eligible for a liver transplant They are highly selective and have an ethical dilemma. Racial and socioeconomic disparities continue to plague the system. for example, Black patients are four times less likely than Caucasian patients undergo liver transplants. Thousands of people are on waiting lists, and many die each year while waiting for new liver donations.

Treatment of fatty liver disease

Treatment options for NAFLD are limited, but effective treatments may exist may be on the horizon. Here are some doctor-recommended ways to manage his NAFLD.

Weight loss: This is the most established recommendation.The goal is to lose on total 3 to 5 percent of body weight (Additionally 7-10% of body weight for NASH patients). According to research, Weight loss with low-calorie diet and exercise Helps reverse fatty liver disease and scarring. However, it is very difficult to achieve and maintain weight loss alone. If your diet and exercise are not working after 6 months, talk to your doctor about other options, such as weight loss medications.

Temperance: Considering that heavy alcohol consumption is associated with the progression of liver disease and that the effects of more moderate drinking are unclear, complete abstinence is generally recommended to avoid the risk of developing disease. .

medicine: Although there are no specific drugs approved by the Food and Drug Administration to treat NAFLD or NASH, there are some potential benefits of certain drugs for appropriate patients. These may include vitamin E supplementation and pioglitazone, which is commonly used to treat diabetes. However, more research is needed and you should discuss the risks and benefits with your doctor. Due to their association with diabetes and cardiovascular disease, patients with these comorbidities should be treated accordingly.

Physician Profile: Trisha S. Pasricha is a gastroenterologist and medical journalist at Massachusetts General Hospital Center for Neuro-Enteral Health.

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