With increasing incidence of diabetes and other lifestyle diseases in the Indian population, incidence of fatty liver disorders is also increasing. Nonalcoholic fatty liver disease (NAFLD) is an broad term for a range of liver conditions with too much fat stored in liver cells in people who drink little or no alcohol.
in my experience of running an ultraound clinic in Agra for over 16 years now, one in every 4 patients suffers from non alcoholic fatty liver disease (NAFLD). Most of these patients are asymptomatic and had incidental detection of NAFLD on ultrasound done for any other purpose like abdominal pain, menstrual problems etc. it is prevelant in both genders in equal proportion.
Some individuals with NAFLD can develop nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease, in which the deposited fat in liver cells initiates marked inflammation and may progress to advanced scarring (cirrhosis) and liver failure. This damage is similar to the damage caused by heavy alcohol use.
NAFLD affects 25%of world population
7-30% NAFLD may progress to NASH
10% NASH may progress to cirrhosis
Tests done to pinpoint the diagnosis and determine disease severity include:
Blood tests
Complete blood count
Liver enzyme and liver function tests
Tests for chronic viral hepatitis (hepatitis A, hepatitis C and others)
Fasting blood sugar & Hemoglobin A1C, which shows how stable your blood sugar is
Lipid profile, which measures blood fats, such as cholesterol and triglycerides
Imaging procedures
Imaging procedures used to diagnose NAFLD include:
Abdominal ultrasound, which is often the initial test when liver disease is suspected.
Fatty liver quantification by latest ultrasound techniques using hepato-renal index.
Computerized tomography (CT) scanning or magnetic resonance imaging (MRI) of the abdomen. These techniques lack the ability to distinguish NASH from NAFLD, but still may be used.
Transient elastography / shearwave elastography, an enhanced form of ultrasound that measures the stiffness of your liver. Liver stiffness indicates fibrosis or scarring.
Magnetic resonance elastography, works by combining MRI imaging with sound waves to create a visual map (elastogram) showing the stiffness of body tissues.
Liver biopsy
The tissue sample is examined in a laboratory to look for signs of inflammation and scarring. This procedure is performed by a needle insertion through the abdominal wall and into the liver.
A liver biopsy can be uncomfortable, and it does have small complication rate.
What to do next once you have been diagnosed fatty liver disease ?
You should consult a physician or a gastroenterologist, who will then offer some further blood tests to know whether this deposited fat is causing some form of inflammation in the liver cells or not, after which some medication can be prescribed.
NAFLD and NASH in early stages is completely reversible with lifestyle modification, healthy diet and medication.
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