Fatty liver disease (fatty hepatosis, steatosis, steatohepatitis) is one of the most common types of chronic liver disease. However, the public knows very little about it. That’s why we interviewed Zhanat Adibay, a physician at the National Hospital.
“The disease is caused by the accumulation of excess fat in liver cells. This disrupts their normal structure and function. Normally, the liver contains very little fat. If fat mass constitutes 5-15% of the liver’s weight, the patient is considered to have fatty liver disease. This disease most often occurs in people over 40-50 years old, but in recent years it has begun to be diagnosed in younger people, even children,” says Zhanat Oryngaliyevna.
The main characteristic of fatty liver disease is the “hidden” accumulation of fat in the liver. This can eventually lead to inflammation, fibrosis, cirrhosis, and even liver cancer. It’s important to be wary of these hidden liver-damaging activities.
The main risk factors for this disease are a high-calorie diet and excessive alcohol consumption. Prediabetes and type 2 diabetes, along with excessive consumption of sugary foods, lead to weight gain, obesity, and gallstones. Depending on the cause, liver disease is divided into non-alcoholic fatty liver disease (NAFLD/MAFLD) and alcoholic liver disease (ALD).
How does fatty liver disease develop?
The disease progresses through several stages, from an early, asymptomatic stage to severe complications. When the liver ceases to perform its vital functions:
Steatosis: accumulation of fat in hepatocytes; steatohepatitis: accumulated fat causes inflammation and destruction of liver cells; fibrosis: chronic inflammation leads to the formation of scar tissue in the liver, but the liver still functions relatively normally. Cirrhosis: the death of liver cells and their replacement by scar tissue. The final stage of the disease is the development of severe liver failure or liver cancer, which can lead to the patient’s death, says Zhanat Oryngaliyevna.
What is the danger of the disease?
This disease develops slowly in both adults and children. With timely detection and effective treatment, a full recovery is possible. However, in 20% of cases, if the disease is detected at the fibrosis stage, it progresses very rapidly. The danger of CKD lies in the development of liver complications (liver cirrhosis, hepatocellular carcinoma). However, it has been proven that the majority of deaths in patients with CKD are related to cardiovascular disease, as well as the development of malignant neoplasms. This may be due to a common developmental mechanism, as all such cases are characterized by varying degrees of obesity. This significantly reduces the protective function of the immune system, including its antitumor function. Malignant tumors can occur in the gastrointestinal tract (the liver itself, intestines, stomach, and pancreas) as well as in other organs (kidneys, mammary glands, etc.).
Main Symptoms of Fatty Liver Disease
The first symptoms indicate that the disease is at least at the hepatitis stage. The most common complaints are hepatogenic weakness and fatigue, which are observed in over 70% of patients. This is due to the liver’s inability to completely detoxify the body of harmful metabolic products, which negatively affect the central nervous system, causing intoxication. Patients also experience heaviness and discomfort in the right lower quadrant of the abdomen, bloating, and bowel dysfunction.
Tolerance to alcohol and fatty foods decreases. As the disease progresses, the following serious symptoms develop: increasing weakness, sleep disturbances, decreased performance, loss of appetite, nausea, vomiting, yellowing of the skin, mucous membranes, and eyes, pain in the right lower quadrant of the abdomen, weight loss, bloating, ascites (fluid accumulation in the abdominal cavity), swelling of the abdomen and legs, increased bleeding, and bruising.
How to diagnose?
The easiest way to diagnose this pathology is a liver ultrasound. It is recommended for all people over 40-50 years of age, as well as younger people with risk factors such as obesity, metabolic syndrome, diabetes, and fatty liver disease. An ultrasound should be performed once a year. Laboratory signs of pathology include biochemical changes in the blood. Elevated levels of bilirubin and liver enzymes (transaminases (AST, ALT), GGT, alkaline phosphatase, and cholesterol) indicate liver damage. Before making a definitive diagnosis of gallstone disease, it is important to ensure that abnormal test results are not caused by conditions such as viral hepatitis, toxic liver disease, or other liver damage. Therefore, the doctor will order additional tests to confirm the diagnosis: elastometry (determines the amount of scar tissue) liver biopsy – a procedure in which a small piece of liver tissue is removed and examined under a microscope.
Treatment and Prevention
The doctor also notes the importance of strictly following a diet. Dietary recommendations include limiting consumption, eliminating canned foods and high-sugar drinks from the diet. Complete abstinence from alcohol is necessary to prevent the disease from progressing to severe, complicated stages. Weight loss also helps reduce the amount of fat in the liver. Aerobic exercise and appropriate strength training effectively reduce liver fat levels and improve cellular health. As your health improves, you can gradually increase aerobic/strength training under the supervision of a doctor. A gastroenterologist or hepatologist will prescribe individualized medication therapy for each patient, taking into account the underlying factors and the presence of other medical conditions.
