Fatty liver

YOUR LIVER normally contains some fat, but if more than 10 per cent of the organ is fatty, you probably have fatty liver disease (FLD). There are two main types of FLD: liver disease from alcohol (ALD) and non-alcoholic fatty liver disease (NAFLD).

Many people are unaware that NAFLD is the most common form of liver disorder in developed countries and affects almost a quarter of the American population. The name speaks for itself: an accumulation of fat in the liver, occupying more than 10 per cent of the organ, in people who drink little or no alcohol. In the past, a fatty liver was usually associated with alcohol abuse, but NAFLD is another lifestylerelated disorder.

As the obesity problem accelerates, so does the epidemic of NAFLD. A weakened liver makes you toxic, and a fatty liver dramatically increases your risk of cirrhosis, liver failure, and liver cancer. Although the disease can strike anyone, certain groups are at high risk: The obese: Ninety per cent of obese individuals risk damaging their liver, especially when their excess fat is stored around the waistline. Belly fat (truncal obesity) is not just stored under the skin, but surrounds and infiltrates the abdominal organs, particularly the liver where fat globules actually enter the liver cells and damage them. The diabetic: Fifty per cent of diabetics have NAFLD, and almost all obese diabetics will have this problem. Elevated levels of insulin in the blood and insulin resistance are common features of Type 2 diabetes, and obesity and seems to play a major role in fatty liver disease. High cholesterol: A very high percentage of individuals with elevated levels of bad (LDL) cholesterol and triglycerides have excess fats stored in the liver that damages the organ. The elderly: This condition is more prevalent in the elderly, and studies show that more than 65 per cent of persons over age 80 have NAFLD. Unfortunately, obese children often already have fatty livers. Drug users: NAFLD can occur as a side effect of the long-term use of certain medications, including aspirin, the immunity-suppressing medications methotrexate and steroids; the breast cancer drug tamoxifen; and the antibiotic tetracycline. What to look out for

Like diabetes and high blood pressure, this liver condition is often initially silent, only to cause life-threatening problems many years later.

Some persons may have only non-specific complaints like low energy, fatigue, malaise and mild upper abdominal pain. Laboratory tests for liver function may or may not reveal any abnormality in the early stages. Later in the progression of the disease, signs of inflammation of the liver (hepatitis), cirrhosis, liver failure or liver cancer may develop.