A low blood count or anaemia can lead to tiredness and breathlessness. This is may be due to loss of blood from the gut (especially if there is evidence of low body iron stores)...

Fatty Liver

Yellow appearance of a liver with excess fat

What is fatty liver?

  • Answer : simply what the name suggests - too much fat in the liver!
  • Some important facts:
    • Fatty liver is the accumulation of fat (mainly as triglycerides) within liver cells.
    • This happens when the fat coming into the liver is more than the fat going out (the liver makes and secretes fat).
    • This condition is becoming more common.
    • It is the commonest cause of abnormal liver enzyme tests(blood tests for the liver). This is because fat in the liver may cause some inflammation.

What causes fatty liver?

  • Excess alcohol intake may be the main underlying cause.
    • How much is too much?
    • Refer to section on alcohol and liver.
  • There are an increasing number of people with fatty liver that is NOT caused by alcohol.
    • This condition has an association with being overweight, having diabetes (or pre-diabetes - also called impaired glucose tolerance -  and having raised cholesterol or raised triglyceride levels in the blood.
  • The underlying problem is considered to be "insulin resistance".
    • This means that the body is not responding normally to the insulin hormone.
    • This problem directly relates to the amount of fat tissue in the body.
    • Fatty tissue is not inert. It secretes a range of hormones that control the body's metabolism.
    • Insulin resistance promotes increased rate of delivery of fat to the liver from the tissues.
    • Insulin resistance (and therefore fatty liver) is primarily determined by body weight and also the level of physical activity.
  • Fatty liver is more common some ethnic groups.
    • That is, for a given weight there is more fatty liver in some groups.
    • It is more common with Indian and Chinese compared with European groups. It is also more common in Pacific Islanders.
  • About 10% of people with excess fat in the liver will develop inflammatory in the liver.
    • The medical term is called steatohepatitis.
    • This sometimes abbreviated as NASH - non-alcohol steatohepatitis.
    • Another abbreviation is NAFLD (non-alcoholic fatty liver disease).
  • This inflammatory process, if sustained over a long period of time, can lead to significant liver fibrosis and eventually to cirrhosis (severe liver damage).
    • The risk is low (compared to other causes of liver disease).
    • Overall only 2% will progress to cirrhosis.  This is a much smaller risk than for fatty liver caused by alcohol

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