Generality
The liver, with its 1500 grams, is the largest gland in our body. Its functions are multiple and largely essential. Among these, a role of primary importance is covered by the sorting and synthesis of fats.
Causes and Incidence
Fatty liver, as we have seen, derives from an alteration in lipid metabolism. This situation can be caused by many ailments and diseases.
Significant risk factors for hepatic steatosis are diabetes, obesity (especially the abdominal one - android or mela-), an unbalanced diet, unbalanced and excessively rich in fat, anemia and acolism. Also some drugs, hormonal imbalances, nutritional (Kwashiorkior), carnitine deficiency, prolonged fasting and excessive exposure to toxic substances can promote the accumulation of triglycerides in the liver. All these factors, in addition to increasing the risk of onset, also increase the risk of complications
- 75% of patients with type 2 diabetes present a picture of hepatic steatosis on ultrasound examination:
- Fatty liver is a frequent condition in obese people (incidence of 70-90%):
- Liver steatosis appears more frequently between the ages of 50 and 60, but the incidence among children is increasing.
Symptoms and Diagnosis
To learn more: Symptoms Fatty liver
About 20-40% of Italian adults "suffer" from fatty liver disease. in itself this disorder is not a real disease but a simple metabolic disadvantage, often asymptomatic. Only when the liver is heavily involved in steatosis can the patient experience a sense of discomfort, of a mild tenderness located in the right quadrant of the abdomen.
The liver, in fact, shows signs of the disturbance only in very advanced stages. What the patient normally refers to as liver pain is, in many cases, a simple intestinal pain or gallbladder (gall bladder).
Precisely because of this asymptomatic nature, more than 90% of people with fatty liver occasionally discover this disorder. Often this discovery occurs during an ultrasound that shows the so-called bright liver or during blood control checks (slight increases in alkaline phosphatase or transaminases may be related to steatosis).
Transaminases are small proteins contained in the hepatic cell that perform a precise metabolic function. When a liver cell suffers and becomes inflamed, a part of these transaminases goes outside and pours into the blood. For this reason, when a person has high transaminases it probably means that his liver is suffering. This suffering is not in any case synonymous with disease: it could in fact be transient and not very relevant from a clinical point of view (extreme exercise, an incongruous diet too rich in calories, pregnancy).
Ultrasound is a relatively simple examination but can diagnose hepatic steatosis only at a fairly advanced stage. In general it is not in fact able to visualize steatosis of small and medium size (ie when fat infiltration affects less than 33% of cells). Only a biopsy can confirm with certainty the degree of steatosis severity and the presence of any complications.
Fatty liver (hepatic steatosis)
X Problems with video playback? Reload from YouTube Go to Video Page Go to Wellness Destination Watch the video on youtubeComplications
When working in conditions of maximum effort, such as a car that always travels at full throttle, the liver cells can go haywire for too much work. This overload results, in the long run, in a cellular degeneration that causes first the inflammation and then the death of the hepatocytes. This complication called steatohepatitis is the natural evolution of untreated steatosis.
In alcoholics the fatty liver can thus degenerate first in steatohepatitis and then in cirrhosis (non-reversible degeneration of liver cells).
To learn more: Steatosis Alcoholic
The risk that a fatty liver of non-alcoholic origin turns into steatohepatitis (accumulation of fat accompanied by phlogosis, fibrosis and necrosis) is quite low (about 5-10% of cases). Dyslipidemias (elevated blood cholesterol and triglycerides), obesity, metabolic syndrome and insulin resistance increase the risk of this complication.
Diet and Care
To learn more: Medications for the Treatment of Fatty Liver
The therapeutic approach of steatosis and non-alcoholic steatohepatitis consists in the modification of lifestyle, while the efficacy of pharmacological treatments is still uncertain.
At the base of fatty liver, as we have seen, very often there are dietary causes. These include: an excessively high fat, alcohol and sugar diet and, especially in underdeveloped countries, vitamin B12 deficiency (contained exclusively in foods of animal origin), biotin and pantothenic acid.
Diet becomes an even more important factor if we consider that two of the main causes of hepatic steatosis (overweight and diabetes) derive in the vast majority of cases from incorrect eating habits.
In the presence of fatty liver it is therefore important to rebalance one's diet paying particular attention to the use of animal fats (including butter and dairy products), red meat, margarine, alcohol and sweets. Although they are preferable to animal ones, it is also good to moderate the use of vegetable fats (olive oil, seeds, dried fruit, etc.).
Replacing meat with fish or legumes can be of great help in detoxifying the liver (as long as the fish does not contain, as unfortunately often happens, toxins or heavy metals).
To further confirm the role of the diet contributes the absence of a specific pharmacological therapy (except for those cases in which the disorder is due to particular diseases).
To further enhance the beneficial effects of a healthy diet we recommend, as always, the combination with a regular program of physical activity. Resistance sports (swimming, cycling, walking and running) are particularly suitable.
See also: Diet and hepatic steatosis and remedies for fatty liver
