Fatty liver is an accumulation of fat in liver cells. The condition is caused by an excessive supply of breakdown products of fats. The capacity of the liver, which is usually healthy, then fails to process these breakdown products. Fatty liver is the most common liver disease.
Cause
The liver plays, among other things, a significant role in fat metabolism in the body. If this fat metabolism gets disrupted, fat may accumulate in liver cells. The fat in the liver isn’t harmful in itself. However, because in this situation the liver is sensitive to other harmful influences and thus may damage easily, it’s still important that the cause of the fatty liver is found and the condition is addressed. The most common causes of fatty liver are:
- Excessive alcohol consumption. Prolonged use of alcohol can cause inflammation of liver cells. The inflamed liver cells function less well, causing fat accumulation in the liver.
- Overweight. Especially in people who have a lot of fat around their waist, fat accumulation in the liver may occur. Seventy-five percent of obese people have fatty liver.
- Insulin resistance. People with type 2 diabetes have built up a resistance to insulin. If the body is insusceptible to insulin, sugar metabolism is disrupted and the blood sugar remains high. The excess of sugars is converted in the liver into fats. These fats are stored in the liver, causing fatty liver.
- Medication. Use of certain medications that need to be broken down in the liver, can lead to disturbances in liver function. This may cause fatty liver.
- The metabolic syndrome. This is a combination of five risk factors, which in many cases will lead to diseases where fatty liver is one of them. The risk factors are: elevated blood pressure, a waist size of more than 102 centimeters in men and more than 88 centimeters in women, elevated blood sugar (indicating diabetes), increased triglycerides content (fat-like substances) in the blood and low HDL cholesterol (the so-called ‘good cholesterol’).
- During pregnancy, a rare form of fatty liver can occur, that arises from the twenty-eighth week of pregnancy. It is an acute and severe form of fatty liver, that can be very dangerous for both mother and child. The symptoms usually disappear immediately after childbirth.
Symptoms
Fatty liver usually causes no symptoms. Some people suffer from (vague) pain in the right upper abdomen and fatigue. In rare cases there is jaundice. This is the yellowing of the skin and whites of the eyes.
Diagnosis
Fatty liver is often accidentally determined by abnormal blood values or during an ultrasound. In physical examination, the liver may be slightly enlarged or sensitive, but not necessarily. In blood tests, usually slightly elevated liver values are determined, but sometimes normal values as well. When in doubt, the general practitioner can refer the patient for further examination. Fatty liver can usually be well detected by ultrasound. During an ultrasound, the liver can be imaged using sound waves. Fat accumulation in the liver is usually clearly visible.
The most convincing diagnosis is made by liver biopsy. In the liver, the doctor sucks some tissue away. The biopsy sample is then examined in a laboratory on the amount of fat in the liver cells.
Treatment
There is no treatment that can cure fatty liver. However, fatty liver is a reversible process, the liver has a healing ability. Treatment, therefore, is made up of eliminating the cause. The fat accumulation will usually disappear by itself then. For many people, this means an adjustment of lifestyle and dietary habits: not drinking alcohol, healthy and varied food (low fat) and weight loss. A healthy diet and additional exercise also reduce any existing insulin resistance. Type 2 diabetes needs to be treated with medication.
Prognosis
The prospects are generally good. However, if fatty liver is present for a long time, an inflammation of the liver (hepatitis) can occur. This inflammation can eventually pass into liver cirrhosis. This is a serious disease that may extend even further.
