Serious consequences in fatty liver disease
Many people suffer from non-alcoholic fatty liver. The diagnosis is made every day in German medical practices. Almost every third adult in Western countries suffers from this initially asymptomatic disease, according to the German Center for Research on Diabetes (DZD). Without therapy, serious consequences such as hypertension and type 2 diabetes, liver cirrhosis and liver cancer, as well as heart attacks and strokes, may be at risk. Thus, a fatty liver can be diagnosed and treated.
Often, fatty liver diseases can be treated effectively by small changes in lifestyle, but the condition is that the problem is recognized as such. However, many of the affected do not know that the liver is suffering. Because the symptoms usually appear only at the end of the illness. In a recent article in The Lancet Diabetes & Endocrinology, a team of authors with the participation of scientists from the German Center for Research on Diabetes summarizes the current state of the research and shows how personalized risk predictions and individualized treatments can contribute to improvements in the future.
Obese children also tend to have a fatty liver
"More and more adults but also about 34 percent of obese children suffer from non-alcoholic fatty liver disease (NAFLD)," according to the DZD. As frequent causes, experts call it "unhealthy lifestyle with little exercise and lots of fat, as well as sugar and fructose foods and / or a genetic bias." The course of fatty liver disease may be very different for each individual, because NAFLD is very "complex and heterogeneous disease".
Complications include severe liver damage, type 2 diabetes and cardiovascular disease and "to prevent these sequels, fatty liver should be detected in a timely manner and the respective risk of liver, metabolic and cardiac diseases be accurately assessed," says the first author. of the current article, Professor Norbert Stefan, University Hospital Tübingen and the Institute for Research in Diabetes and Metabolic Diseases (IDM) Helmholtz Zentrum München.
Status of the research evaluated for fatty liver
Together with Professor Hans-Ulrich Häring, also from Tübingen University Hospital and IDM, as well as Professor Kenneth Cusi from the University of Florida (USA), Prof. Stefan evaluated the state of the research and put it together in a review article. For example, not only patients with elevated liver enzymes should be screened for fatty liver, but also individuals with disproportionate fat distribution, i. a high proportion of fat in the belly and / or a small amount of fat around the hips and legs, emphasizes Professor Häring as one of the results of the research.
Specific risk forecasts for those affected
In addition, experts also recommend a fatty liver test for people suffering from insulin resistance or type 2 diabetes. In general, the use of new diagnostic and therapeutic approaches should be implemented in daily clinical practice in order to allow a prognosis of specific risk for possible secondary diseases, according to the researchers. Stefan et al. For example, a genetic NAFLD is associated with an increased risk of liver fibrosis and liver cancer. However, those affected have a low risk of cardiovascular disease. To take the right therapeutic measures, "it's important to know if a fatty liver is genetically determined," the experts emphasize.
Diagnosis of fatty liver disease
First, the question arises as to how fat levels in the liver can be safely determined and how liver damage, such as inflammation and fibrosis, can be safely detected. According to the doctors, "the use of simple indices or ultrasound scans is adequate for primary care." In addition, the use of additional examination methods such as special magnetic resonance imaging (MRI) by medical specialists such as hepatologists, endocrinologists and radiologists is possible.
Lifestyle changes often enough
If a fatty liver has been found in the examinations, often a change in lifestyle can already achieve significant positive effects. For example, with a decrease of about five percent by weight, the fat content in the liver is reduced by up to 30 percent, according to the DZD. The goal, however, should be a weight reduction of about ten percent to reduce the risk of liver inflammation and fibrosis.
"If this weight loss can not be achieved or is insufficient to improve NAFLD, pharmacological treatment should be considered," emphasizes Professor Cusi in the DZD press release. Although there is no approved medicine for NAFLD, under certain conditions, such as the occurrence of non-alcoholic liver disease in combination with diabetes or obesity, it is possible to use specific drugs that have different effects on liver fat content, inflammation, and fibrosis. "Says Professor Cusi. With the help of the new concepts, a personalized risk prognosis and an individualized treatment of non-alcoholic fatty liver will become possible in the future.
Metabolic syndrome and hepatic steatosis usually go hand in hand
Non-alcoholic fatty liver occurs infrequently due to the so-called metabolic syndrome. In this syndrome several unfavorable health conditions come together, which feed each other. These include obesity, high blood sugar, high blood lipid levels and high blood pressure. For more information, see the article: Metabolic Syndrome and Fatty Liver: These everyday risks make our liver suffer. (Fp)