Non-Alcoholic Fatty Liver Disease (NAFLD)
One of the most common causes of chronic hepatitis is accumulation of excess fat in the liver. This often occurs in those who drink alcohol heavily but may also occur without alcohol ingestion. It is normal for some fat to accumulate in the liver, but if the weight of the liver is made up of more than 10% fat, then it is considered to be a fatty liver. This is most commonly seen in people with metabolic syndrome , a combination of health problems such as obesity (especially too much fat in the belly), hypertension, high triglyceride levels, low HDL cholesterol, and insulin resistance or type 2 diabetes.
Often, a fatty liver does not cause any apparent problems and there may be no obvious signs or symptoms of the condition. It is a condition that develops gradually, typically over several years, with the intake of too many calories. Sometimes, the first sign that there may be liver inflammation is a slightly enlarged liver or abnormal results on routine tests. However, in some cases the fat accumulation leads to severe inflammation and scarring of the liver. This more serious form of hepatitis, sometimes termed non-alcoholic steatohepatitis (NASH), can progress to liver failure. It is one of the three leading causes of cirrhosis of the liver, according to the American Liver foundation.
Signs and Symptoms
Usually there are no apparent signs or symptoms of hepatitis caused by non-alcoholic fatty liver disease. When present, they are generally mild but may also correspond to those of hepatitis in general. See the section on Signs and Symptoms for detailed information.
Tests
A fatty liver may first be detected when routine tests such as a comprehensive metabolic panel (CMP) or a liver panel are performed for other reasons. Abnormal results on these may be the first indication that there is a problem with the liver. Imaging tests such as a CT scan or MRI may detect some fat in the liver. Often, several laboratory tests are done to rule out other causes, such as alcohol or hepatitis C. However, there are no laboratory tests that can make the diagnosis of NAFLD or NASH other than a liver biopsy.
Treatment
There is no specific treatment for non-alcoholic fatty liver disease. There are some things that can be done that often lead to improvement in the condition of the liver:
- Weight loss in those who are obese
- Good glucose control in those who are diabetic
- Lowering of cholesterol and/or triglycerides
- Avoiding alcohol
- Some studies suggest that drugs that decrease insulin resistance may be helpful.
