Fatty Liver Disease
Fat in the liver (steatosis) can be caused by a variety of factors such as diabetes, alcohol, certain medications and the metabolic syndrome. It is very common occurring in up to 5% of the population.
In some individuals the fat is associated with inflammation (steatohepatitis). In such cases inflammation may lead to progressive scarring and even the development of cirrhosis.
Fat in the liver is predictive of an increased risk of developing diabetes, heart disease and strokes.
Recognition of fatty liver and its health consequences at an early stage can lead to prevention of future cardiovascular disease.
As with other forms of liver disease, it is often asymptomatic until substantial damage has been done to the liver.
Investigations
Fatty liver is often picked up incidentally as abnormal liver function tests on health screening, or during ultrasound examination of the abdomen.
Measures of pre-diabetic states using markers of insulin resistance, and of serum cholesterol and lipids are important in addressing risks of developing diabetes or cardiovascular disease.
Liver biopsy helps to confirm the diagnosis and assess the degree of scarring (fibrosis) in the liver.
Non-invasive tests of liver fibrosis such as 'fibroscan' and blood test markers of fibrosis will be used with increasing frequency in the future.
Treatment
Diet, exercise and lifestyle issues are the main focus of treatment and prevention of associated complications.
Lipid lowering drugs and tablet treatments for insulin resistance may have a role in preventing progressive liver disease.
Antioxidants may have a role in treatment.