Fatty liver disease

What is fatty liver disease?

Fatty liver disease is a condition that is increasingly common in New Zealand and around the western world, as larger numbers of people are identified as overweight or obese. It is diagnosed when there is a build-up of fat within liver cells, and this happens when there is more fat entering the liver than there is leaving after processing.    

What causes it?

There are various causes of fatty liver, including:

• Being overweight/obese or having diabetes. These are the most common causes and, if present, are part of the Metabolic Syndrome. In this case, fatty liver disease can also be known as non-alcoholic fatty liver disease (NAFLD)

• Excessive alcohol intake

• Having a diet rich in processed foods and refined carbohydrates

• Hepatitis C

• Raised cholesterol or increased triglyceride levels in the blood. Triglycerides are calories stored in the body

• Occasionally it can be caused by starvation, protein malnutrition or intestinal bypass operations 

• Belonging to a specific ethnic group. Fatty liver is more common in Indians, Chinese, Maori and Pacific Islanders).

Fatty liver can occur in people who are not overweight. This can particularly be seen in people of Asian or Indian ethnicity.

Diagnosis

Fatty liver isn’t always easy to diagnose because it doesn't cause any symptoms for most people. It may just be that the liver is found to be enlarged through a physical examination by your doctor. Therefore you may need several different tests to accurately determine its presence.

Blood tests can detect abnormal liver enzymes. These are usually done after your doctor takes a detailed health history from you and completes a physical exam to detect any inflammation.

Ultrasounds can identify fatty liver, but can miss up to 40 per cent of cases. They can't easily detect scarring of the liver. For assessment of liver scarring a more accurate scan is called a fibroscan. This is available in some regions of New Zealand. 

Often a combination of information from your health history and these test results will determine whether you have fatty liver disease.

Are there long-term effects?

Fatty liver complications range from fat build-up causing inflammation of the liver to scarring of the liver – cirrhosis – that can change the liver’s structure and result in irreversible damage.

In some cases it can also cause severe liver disease, liver failure and liver cancer.

People with non-alcoholic fatty liver disease also have three times the risk of developing type two diabetes and double the risk of heart disease (such as coronary artery disease, which affects more than 170,000 New Zealanders and causes heart attacks and angina).

How can it be treated?

There are no current medications to control fatty liver. Prevention is the best treatment, so if you think you may be at risk or have been diagnosed with fatty liver you should follow these recommended lifestyle changes: