Dear Doctors: My father passed away due to unexplained liver problems which we only now know were fatty liver disease. It’s 20 years later, and a CT scan shows fat in my own liver. My liver readings are normal, but I’m the same age as my dad when his problems started. Should I be worried?
Dear reader: The term fatty liver disease refers to a range of liver disorders that are not caused by alcohol consumption, autoimmune disease, drug use, or a virus. It is the most common liver disease in the United States and is estimated to affect up to 30% of individuals. Once known as non-alcoholic fatty liver disease, the condition is now more accurately called metabolism-associated fatty liver disease, or MAFLD.
Your father’s health problems arose when this type of fatty liver disease was in its infancy. Although alcohol-induced liver changes were first described in the 1840s, it was not until the 1980s that a metabolic cause of fatty liver disease began to emerge. A series of studies conducted throughout the decade found that metabolic abnormalities unrelated to alcohol consumption can also cause fatty liver disease. All these years later, with a better understanding of MAFLD, you are in a better position to understand and monitor your own liver health.
Fatty liver disease is what it sounds like: an abnormal buildup of fat in the liver. Although a healthy liver contains some fat, when the amount begins to exceed 5-10%, it is called fatty liver disease. This excess fat triggers an inflammatory reaction which, over time, leads to liver damage. This means that the liver’s hundreds of metabolic functions, which include filtering out toxins, aiding digestion, managing blood sugar, and creating and storing nutrients, are negatively affected. The condition is linked to overweight or obesity, high blood lipid levels, high blood pressure, prediabetes, and diabetes.
There is evidence of a higher risk of developing MAFLD when the disease runs in a family. However, the lifestyle and environmental factors we mentioned earlier seem to play a bigger role.
The condition has few symptoms. Some people describe feeling tired and others feel discomfort or pain in the upper right part of the abdomen. This makes the disease difficult to diagnose. Abnormal liver enzyme test results can be an indicator. The same goes for a stiff or enlarged liver, as well as jaundice, which is a condition that causes the skin and whites of the eyes to turn yellow.
When fatty liver disease is suspected, imaging tests may be used to assess the amount of fat in the liver. A biopsy to check for abnormal amounts of scar tissue in the liver, called fibrosis, may also be ordered.
It is important that in the future you tell your health care providers that you have a family history of fatty liver disease. In the meantime, you can take steps to reduce your risk. These include staying away from alcohol, maintaining a healthy weight, choosing a healthy diet rich in fresh, plant-based foods, and exercising regularly.