Nonalcoholic Fatty Liver Disease: All Too Common

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Nonalcoholic fatty liver disease (NAFLD) describes a group of conditions affecting the liver which are not prompted by alcohol consumption. One of these, nonalcoholic steatohepatitis, can lead to liver scarring and other irreversible damage similar to the damage caused by heavy drinking.

In the U.S. alone, where it is the most common form of chronic liver disease, NAFLD affects between 80 and 100 million people. It is especially prevalent in people in their 40s and 50s who are at high risk of heart disease because of such risk factors as obesity and type 2 diabetes. In fact, up to 80 percent of obese people will suffer from it. It has been estimated that NAFLD will become the main cause of liver transplants in the country, with demand continuing to out-pace supply.

NAFLD typically strikes without symptoms, only getting onto a doctor's radar when examinations scheduled for other reasons reveal a liver problem. Usually the revelation is as a result of an ultrasound or a liver enzyme test.

Once your doctor has identified NAFLD, he is likely to perform numerous blood tests to fine tune his diagnosis and determine your condition's severity. These may include the following:

  • Complete blood count
  • Liver enzyme and liver function tests
  • Tests for chronic viral hepatitis
  • Celiac disease screening test
  • Fasting blood sugar
  • Hemoglobin A1C
  • Lipid profile

Your doctor may also schedule you for additional imaging scans, including computerized tomography (CT) scanning or magnetic resonance imaging (MRI) of the abdomen; transient elastography, an enhanced form of ultrasound that measures the stiffness of your liver; and magnetic resonance elastography, which combines magnetic resonance imaging with patterns formed by sound waves bouncing off the liver to create a visual map showing gradients of stiffness throughout the liver reflecting fibrosis or scarring.

Ultimately, your doctor may take a sample of your liver to look for signs of inflammation and scarring. This is accomplished by inserting a needle through the abdominal wall and into the liver.

There is currently no FDA-approved drug to ameliorate or control NAFLD. The only approach is to lose weight. You will be asked to shed at least 10 percent of of your body weight, but an improvement in the risk factors associated with the disease may be obtained with a weight loss of even 3 to 5 percent.

Sources: The Mayo Clinic