The non-alcoholic fatty liver is a pathology of the liver caused by an accumulation of fat on the inside resulting from a sedentary lifestyle and a diet high in calories. This disorder affects especially overweight people, including children, those who are too sedentary and not dedicated to physical activity, and those with a body mass index (BMI) greater than 30.
We spoke with Professor Savino Bruno, Director of the Department of Hepatology and General Medicine in Humanitas.
Non-alcoholic fatty liver is a common problem: “It is estimated that over 60% of the population has fatty liver, mostly without knowing it, because it is a silent disease which remains asymptomatic for years. In the long run however non-drinkers can experience the same liver damage that is found in those that consume large amounts of alcohol.”
Non alcoholic fatty liver can progress to liver fibrosis, “inflammation of the liver resulting in injuries that are saturated by scar tissue, the excess of which restricts the proper functioning of the organ”. Cirrhosis, a liver and chronic degenerative disease that can also lead to cancer is another possible result of chronic non-alcoholic fatty liver. On fatty liver fibrosis you can intervene with a healthy lifestyle and change the course of the disease. On the other hand, cirrhosis has no cure and requires a transplant.
How is it diagnosed?
The presence of steatosis or fatty liver is often diagnosed by objective examination in the presence of a large abdominal circumference. “The problem is associated with metabolic syndrome, ie the simultaneous presence of obesity, diabetes or pre-diabetes, hypertension and hyperlipidemia (excess of triglycerides and bad cholesterol). The combination of at least three of these factors makes the diagnosis of fatty liver almost certain”, says Professor Bruno.
Blood tests such as transaminases and gamma-GT can also provide significant results. Ultrasound cannot contribute to the diagnosis in cases where the fat is less than 20% of the volume of the liver.
How do you fight fatty liver?
Counteract the sedentary lifestyle, devote yourself to physical activity and follow a proper diet. These are essential decisions towards a healthier life and treating fatty liver. Green light to whole grains, fish, white meats and vegetable protein. Red light the consumption of red meat and avoid that of sweets and alcohol, which “quadruple the risk of developing the disease”, says the professor, adding: “The ideal scheme is a good breakfast, a proper lunch and a light dinner”.
There are no available drugs against non-alcoholic fatty liver, although many molecules are being tested. The difficulty lies in the lack of a marker of the disease that can be monitored over the years. The course of steatosis in fact is very long (possibly more than thirty years), and the available studies fail to cover a significant period of time so that it becomes clear whether the drugs being tested are effective.
