07/07/2023
Non-alcoholic fatty liver disease (NAFLD) is part of the metabolic syndrome characterized by diabetes, or pre-diabetes (insulin resistance), being overweight or obese, elevated cholesterol and triglycerides, as well as high blood pressure.
NAFLD is a very common disorder and refers to an accumulation of excess fat in the liver of people who drink little or no alcohol. The most common form of NAFLD is a non serious condition called fatty liver. In fatty liver, fat accumulates in the liver cells. Although having fat in the liver is not normal, by itself it probably does not damage the liver. A small group of people with NAFLD may have a more serious condition named non-alcoholic steatohepatitis (NASH). In NASH, fat accumulation is associated with liver cell inflammation and different degrees of scarring. NASH is a potentially serious condition that may lead to severe liver scarring and cirrhosis. Cirrhosis occurs when the liver sustains substantial damage, and the liver cells are gradually replaced by scar tissue, which results in the inability of the liver to work properly.
The majority of individuals with NAFLD have no symptoms and a normal examination. On physical examination the liver might be slightly enlarged.
The diagnosis of NAFLD is usually first suspected with mild elevations in their liver tests during a routine blood testing or incidentally detected on abdominal ultrasound or CT scan. However NAFLD can be present with normal liver blood tests. The diagnosis of NAFLD is confirmed by imaging studies, most commonly a liver ultrasound. Fat accumulation in the liver can also be caused by excess alcohol intake, certain medications, viral hepatitis, autoimmune liver disease, and metabolic or inherited liver disease. These need to be excluded as causes of fatty liver disease in order to confirm the diagnosis of NAFLD. Currently, the only reliable way of telling whether a person has NASH or simple fatty liver is by a liver biopsy.
The most important recommendations for people with fatty liver are to lose weight if they are overweight or obese, increase their physical activity, follow a balanced diet and avoid alcohol and unnecessary medications.
