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A very recent study has found that patients diagnosed with non-alcoholic fatty liver disease and who have an increased level of waist fat, are at greater risk of developing complications to the disease than those who are obese.

Definitions

NAFLD is defined as fat accumulation around the liver in people who drink little to no alcohol. Consuming more than 20 grams of alcohol per day excludes this condition, as it then becomes known as alcoholic fatty liver disease.

The following are different types of NAFLD:

  • Non-alcoholic fatty liver - although fat deposition on the liver isn't normal, it doesn't necessarily cause any harm. In its simplest form, this condition is very common and causes no complications.
  • Non-alcoholic steatohepatitis - in a small number of people, the fatty deposits on the liver cause inflammation of the organ. This can cause liver dysfunction and may lead to cirrhosis.
  • Non-alcoholic fatty liver disease-associated cirrhosis - Prolonged inflammation leads to cirrhosis which can become severe enough to cause the liver to become dysfunctional, and finally may result in liver failure.

Causes

Certain medications can lead to NAFLD and they can include the following:

  • Corticosteroids.
  • Tetracyclines such as erythromycin.
  • Antiviral drugs such as the nucleoside analogues.
  • Methotrexate.
  • Tamoxifen.
  • Aspirin, as part of Reye's syndrome in children under 12 years of age.
  • Amiodarone.

Sucrose in carbonated soft drinks metabolizes to fructose, and this may cause an increase in fat deposition in the abdomen.

Genetic factors also have a major role to play in the development of this disease in Native American men.

Symptoms

NAFLD usually doesn't cause any signs and symptoms, but when it does it can cause the following issues:

  • Fatigue.
  • Weight loss.
  • Dull upper right abdominal pain.
  • Mild jaundice may be noticed, but this is rare.

Risk factors

There are many conditions and diseases which may be associated with this condition, and these may include the following:

  • As mentioned, increased waist circumference and/or obesity.
  • Increased triglyceride levels.
  • High cholesterol levels.
  • Type 2 diabetes.
  • Metabolic syndrome.
  • Polycystic ovary syndrome.
  • Sleep apnoea.
  • Hypothyroidism.
  • Hypopituitarism.

Diagnosis 

The diagnosis of NAFLD is confirmed with blood tests showing abnormal liver function tests, imaging procedures showing fatty deposits on the liver and inflammation and scarring noted on liver tissue which has been biopsied.

Management 

There is no standard protocol for the treatment of NAFLD, but the condition is managed by addressing risk factors which are associated with this condition. This would include incorporating the following suggestions:

  • Losing weight - patients should reduce their calorie intake and increase their physical activity to improve weight loss.
  • Choosing healthy food choices - the addition of whole grains, fruits and vegetables are suggested.
  • Increased physical activity - a combination of 30 minutes of aerobic exercises and weight training, on most days of the week, has been shown to offer great benefits.
  • Diabetic control - it's very important that diabetic patients should monitor their glucose levels regularly, that their medication should be taken correctly and that they should follow-up with their doctors in an appropriate manner.
  • Lowering cholesterol levels - patients should be controlling high cholesterol levels with medication, diet and exercise.
  • Protecting the liver - avoid things that will cause strain on the liver such as alcohol, as well as certain medications.

Doctors may recommend being vaccinated against Hepatitis A and B to help prevent against contracting these viruses which could cause further damage to the liver.

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