Nonalcoholic fatty liver disease Symptoms and causes

Furthermore, many aspects of the disease are still to be unravelled, which has an important impact on the information that is given (or not) to patients. Its management requires a close interaction between patients and their many healthcare providers. It is important for patients to develop a full understanding of NAFLD in order to enable them to take an active role in their disease management. This guide summarises the current knowledge relevant to NAFLD and its management. It has been developed by patients, patient representatives, clinicians and scientists and is based on current scientific recommendations, intended to support patients in making informed decisions.

How common is NAFLD?

MRI is so accurate in assessing the presence of liver fat and in quantifying it,102 that it is considered the reference method (gold standard) for this particular feature, but it is still mainly used for research purposes. The presence of steatosis can be assessed with imaging techniques. As with every investigation in medicine, liver biopsy is not perfect. As mentioned, a classical biopsy represents only about 1/50,000th of the total amount of liver tissue.

What Is the Prognosis for Those with NAFLD?

Some patients will evolve to NASH, wherein steatosis is accompanied by liver cell damage and inflammation. This can go along with the accumulation alcoholic liver disease of scar tissue or fibrosis. In a subset of patients with NASH, more and more scar tissue will accumulate and ultimately result in cirrhosis.

Can children develop fatty liver disease?

Most people with NAFLD only have the early stage – ‘simple fatty liver’. Only a minority will progress to develop inflammation of the liver (called non-alcoholic steatohepatitis, or NASH). And, only a minority of people with NASH will progress to develop cirrhosis.

How common is non-alcoholic fatty liver disease?

Nevertheless, they are not strictly separated but frequently interact. This close entanglement of all these diseases, including psychological and psychiatric conditions, should not be minimised. Ideally, everything should be treated as part of the global management of your health (see also Section 6.g). Your family doctor and other first-line healthcare providers may help you with this and play an important role in keeping an overall view of all your health problems. If one of your health problems and diseases is not taken care of it could have a negative impact on the treatment of NAFLD or your other conditions. As mentioned, there is a strong association between the metabolic syndrome, T2D, CVD and NAFLD (see Section b, c and Table 1).

• A doctor removes a sample of tissue from your liver and sends it to a lab to see if you have liver inflammation or damage.
• As this is a slowly evolving disease, focus should probably lie on picking up the people that are most at risk of developing NAFLD-related problems in the near future.
• You use it as part of a treatment plan that includes exercise and a healthy diet to lose weight.
• This surge has led to a rise in serious health conditions, particularly cardiovascular disease, type-two diabetes, and cancers.

e. Impact of the NAFLD/NASH on health-related quality of life

• We cannot define a cause-and-effect relationship between MASLD and CVD.
• When your excess calories exceed this storage capacity, the fat will need to go somewhere else.
• However, there is a small proportion of NASH patients whose cirrhosis will become more severe, possibly leading to liver cancer or liver failure.
• A percentage of 30% corresponds to very severe steatosis, as it is a percentage of total weight; as such, this percentage cannot be directly compared to observations made on a liver biopsy.

The FDA (U.S. Food and Drug Administration) approved the drug resmetirom (Rezdiffra™) for the treatment of MASH in March 2024. Healthcare providers recommend using this medication in combination with nutritional changes and increased physical activity. Your provider can let you know if resmetirom is right for your situation. Your healthcare provider may suspect MASLD during a routine checkup if your blood panel shows high levels of certain liver enzymes or your liver appears enlarged on an imaging test.

The liver blood tests are usually abnormal, but not always.86,87 If abnormal, they are usually only slightly elevated, which should not be considered as a sign of mild disease. Surprisingly, the degree of abnormality of the blood tests does not reliably predict the severity of liver injury. This means that liver tests may be normal or show only minor elevations and you still can have advanced disease. (A) The fat that is inside the abdominal cavity and in close contact with both the gut and the liver is called intra-abdominal or visceral fat. The intra-abdominal fat tissue is also active in the production of signals that help the body regulate its energy metabolism.