Facts About Non-Alcoholic Fatty Liver Disease

While excessive drinking can often lead to fatty deposits in the liver over time (and eventually to liver disease), there are other reasons a patient may end up with a fatty liver. Even if you don’t drink or are a moderate drinker, you can still be affected by nonalcoholic fatty liver disease (NAFLD).

While NAFLD generally isn’t a major concern on its own, if left unchecked it can lead to other more serious health problems and there are some forms of fatty liver disease that can cause major complications. Let’s look closer at some interesting facts about this condition…

1. What is It?

This type of liver disease has nothing to do with drinking or excess drinking, it’s actually a result of a metabolic syndrome. WebMD describes metabolic syndrome as an umbrella term “marked by high blood pressure, high levels of bad cholesterol, [hormone that regulates the amount of glucose in the blood], and large amounts of belly fat.”

The National Institute of Diabetes and Digestive and Kidney Diseases describes nonalcoholic fatty liver disease as a condition that occurs when there is a buildup of fat in the liver. This is not caused by heavy alcohol use, it’s when the body’s excess fat is stored in the liver.

2. There Are Two Types

There are two separate types of non-alcoholic fatty liver disease, the first is called simple fatty liver and the second is nonalcoholic steatohepatitis (NASH). Even though they are both considered to be NAFLD, they are two separate conditions, notes NIH. So what differentiates the two?

Simple fatty liver means “you have fat in your liver, but you may not have any inflammation in your liver or damage to your liver cells,” writes WebMD. This type of NAFLD isn’t as serious as it doesn’t tend to cause any problems with the liver or get any worse as time goes on.

The other type is referred to as NASH and is much more serious. “NASH means you have inflammation in your liver. You may also have damage to your liver cells,” explains the source. The inflammation and liver cell damage can cause other serious problems like fibrosis which is scarring of the liver. It can also lead to cirrhosis, severe scarring that can lead to liver failure and death, as well as liver cancer. WebMD notes that nearly 20-percent of people with non-alcoholic fatty liver disease have NASH.

3. There’s a Potentially Fatal Version

The Mayo Clinic explains that NAFLD is actually an umbrella term for a range of liver conditions that don’t have alcohol as a trigger. One form of the disease that might cause more alarm to patients and doctors is nonalcoholic steatohepatitis, which is characterized by liver inflammation that can lead to scarring and permanent damage, notes the source.

This form of the disease, ironically, is similar to what might occur to a heavy drinker’s liver, explains the clinic. At its worst, this condition can lead to liver failure, which can cause death.

4. It’s Becoming Increasingly Common

The Mayo Clinic explains that the prevalence of NAFLD is increasing around the world, particularly in Western nations like the U.S. In fact, here at home it is the most common form of chronic liver disease, affecting up to 100-million people, according to the source.

It most commonly strikes people in their 40’s and 50’s, especially those who are at a higher risk of heart disease due to obesity or type 2 diabetes, it adds. However, it can occur in people of all age groups, notes the clinic.

5. Genetics Likely Play a Role

The University of California, San Diego explains that NAFLD is “shown to run in families,” and that if you have a child diagnosed with the condition, you should be tested as well during routine medical exams even without symptoms.

The article quotes an expert that states, “As we suspected, NAFLD is not simply about weight, but rather is highly familial and likely genetic.” The source cites a study involving 44-children with or without NAFLD and 152-family members. “Whether or not the child had NAFLD was a major determinant of the amount of liver fat present in the other family members,” the study determined. It found that 59-percent of siblings and 78-percent of parents related to children with NAFLD also had the disease.

6. Metabolic Syndrome Might Be a Link

post on ScienceDirect.com explains there is growing evidence of a connection between NAFLD and metabolic syndrome, the latter which is a “disease composed of different risk factors such as obesity, type 2 diabetes or dyslipidemia.” NAFLD is being recognized as the “liver manifestation” of the syndrome, it adds.

The prevalence of metabolic syndrome is rising as global obesity levels rise, adds the source. A key characteristic linking the liver disease and metabolic syndrome is resistance to the hormone that regulate glucose in the blood, which can lead to high blood sugar and is associated with accumulation of fat in areas such as the liver. The resulting inflammation can further aggravate the resistance, creating a “vicious cycle,” explains the source.

7. There May Be No Symptoms

As we hinted at earlier, often you may not know you have a NAFLD until it develops into something more serious. MedicineNet.com explains that early signs of the disease will show up in routine blood tests, or from ultrasonography when checking for other problems such as gallstones.

When the disease progresses, which is referred to as cirrhosis, the symptoms can be a lot more serious: excessive bleeding due to the liver’s inability to produce blood-clotting proteins; jaundice (yellowing of the skin) from the liver’s inability to filter out bilirubin from the bloodstream; and fluid accumulation due to “portal hypertension” that causes fluid leakage from blood vessels, adds the source.

8. Symptoms That Can Exist

While nonalcoholic fatty liver disease often presents no symptoms or warning signs, when they do occur they often come in the form of an enlarged liver, fatigue, or pain in the upper right abdomen, says Mayo Clinic. You might also see elevated levels of liver enzymes, increased levels of the hormone that regulates glucose in the blood, and elevated triglyceride levels.

The Mayo Clinic also includes signs and symptoms of nonalcoholic steatohepatitis and cirrhosis which might present symptoms like “abdominal swelling, enlarged blood vessels beneath the skin’s surface, enlarged breasts in men, enlarged spleen, red palms,” and jaundice which is yellowing of the skin and eyes.

9. Most Common Causes

We already mentioned that non-alcoholic fatty liver disease is not caused by alcohol and that it’s due to a build up of fat in the liver. Why does this happen? According to the Mayo Clinic, experts are still unclear why it happens to some people and not others. There is also little understanding of why there are two separate types of fatty liver — simple fatty liver and NASH. They still cannot find a definitive reason why one fatty liver becomes inflamed and leads to conditions like cirrhosis and why another doesn’t.

What is known is that there are links to both non-alcoholic fatty liver disease and nonalcoholic steatohepatitis. The most common links are overweight or obesity, a resistance to the hormone that regulate glucose in the blood “in which your cells don’t take up sugar in response to the hormone,” as well as high blood sugar or hyperglycaemia that is found in people with prediabetes or type 2 diabetes. It’s also linked to high levels of fat in the blood, particularly triglycerides, says Mayo Clinic.

10. Complications of Fatty Liver Disease

The most common complication of fatty liver disease is cirrhosis which is late-stage scarring of the liver. “Cirrhosis occurs in response to liver injury, such as the inflammation in nonalcoholic steatohepatitis,” writes the Mayo Clinic. “As the liver tries to halt inflammation, it produces areas of scarring (fibrosis). With continued inflammation, fibrosis spreads to take up more and more liver tissue.”

Cirrhosis is a serious condition that can progress and lead to fluid build up in the abdomen, swelling of the veins in the esophagus which can later rupture and bleed, as well as liver cancer, end-stage liver failure, as well as confusion, drowsiness, and slurred speech. The Mayo Clinic notes that 20-percent of people with nonalcoholic steatohepatitis will develop cirrhosis.

11. How to Prevent a Fatty Liver

In order to reduce your risk of developing fatty liver disease, you can make healthier choices when it comes to diet, exercise, and overall lifestyle. The Mayo Clinic suggests eating more plant-based foods like fruits, vegetables, whole grains and healthy fats. At the same time, you should be cutting back on carbs, particularly refined carbs. While researchers report that only 16-percent of people with NAFLD have liver fat from diet, Healthline points to some research which has shown that a diet low in refined carbs can reverse NAFLD.

You should work toward maintaining a healthy weight. If you are obese or overweight, you should be actively trying to lose the weight through a healthy diet and exercise. Healthline notes that weight loss has proven to be effective at promoting liver fat loss in adults with NAFLD.

Lastly, we should all be exercising frequently throughout the week. “Studies have shown that engaging in endurance exercise or resistance training several times a week can significantly reduce the amount of fat stored in liver cells, regardless of whether weight loss occurs,” writes Healthline.

12. Medical Treatments are Lacking

The American Liver Foundation notes there are currently no medically approved treatments in the U.S. for NAFLD. It instead says lifestyle changes are in order. “Eating a healthy diet and exercising regularly may help prevent liver damage from starting or reverse it in the early stages,” it notes.

The source also reminds you to visit a liver specialist regularly to monitor progression, and to lower your intake of cholesterol and saturated fats that can raise levels of triglycerides (which store fat). Oh, and it should go without saying – but try to avoid alcohol too, even though it’s not the root cause of your problem.

Katherine George

Katherine George

Katherine is the Senior Managing Editor of ActiveBeat and Childhood. She is constantly striving to live a more active and healthy life, from eating healthy, exercising, and just spending more time outdoors. She enjoys cooking (with wine), walking her dog, reading, and recently joined a yoga studio!