Hepatic steatosis occurs due to an excessive accumulation of fat in the hepatocytes (liver cells). Healthy liver tissue is partially replaced by unhealthy areas of fat, resulting in an enlarged and heavier liver.
A comparison to the human situation is the famous paté de foie gras (goose liver); to obtain the paté, the geese are subjected to an extremely high-calorie diet which accumulates in the liver resulting in a liver full of fat.
In humans, this accumulation may be due to metabolic alterations or the liver’s response to a malfunction. That is, it can be a symptom of a liver disease (such as hepatitis C or alcoholic disease) or it could be related to a metabolic disease (diabetes, obesity, metabolic syndrome), leading in this case to the so-called non-alcoholic fatty liver disease.
This condition, in most people, is a liver disorder that can regress once the metabolic problem is eliminated or controlled. However, in about 30% of cases, it may progress to hepatic steatosis or steatohepatitis, with a silent (no symptoms) and slow progression (over the years) which can lead to cirrhosis of the liver and, less frequently, to liver cancer.
In addition to the deficiencies caused to the liver, all patients with hepatic steatosis (fatty liver) are at an increased risk of developing diabetes and cardiovascular diseases (coronary heart disease and stroke). Based on the diagnosis of steatosis and the factors associated with it, it is crucial to change lifestyles.
Diagnosis of hepatic steatosis includes measuring blood pressure, circumference of the waist (visceral obesity is often associated with steatosis), medical examination of the liver and undergoing ultrasound. Blood tests are necessary to obtain results of liver enzymes (ALT, AST, GGT and alkaline phosphatase) including metabolic tests to obtain levels of glucose, insulin, cholesterol, triglycerides, glycosylated haemoglobin, in addition to others such as uric acid and ferritin. A liver biopsy may also occasionally be necessary, especially in cases where there is doubt concerning the source of the problem.
In cases of secondary steatosis, elimination or correction of the cause, when possible, solves the problem, while treatment of an existing liver disease and abstention from alcohol can eliminate liver steatosis. In fatty liver disease, treatment is primarily aimed at changes in lifestyle habits that involve healthier diets and increased physical activity. Insulin sensitizing drugs, antioxidants and cell protectors can also be used.
Adopt a diet containing additional fibre, fruits and vegetables; reduce the amount of fats and carbohydrates (sweets, sugar, white bread, rice); include whole wheat food; avoid alcohol and be careful with medication and teas purchased without a doctor’s prescription. Exercise for at least 30 minutes a day for a total of 150 minutes a week. If necessary, reduce weight; losing about 10% of your body weight is already enough to significantly improve steatosis and metabolic and liver alterations.
Article submitted by the HPA Group
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