Nonalcoholic Fatty Liver Disease

Fatty Liver Disease (nonalcoholic) is a condition where the liver has trouble breaking down fats (triglycerides) that build-up in the liver cells (hepatocytes) of patients who do not abuse alcohol. Fatty Liver Disease has become the leading cause of chronic liver disease in children and adolescents in the United States. The cause of fatty liver disease is not clear, but it is thought to be from being overweight and obese. Approximately 90% of children with Fatty Liver Disease are obese (BMI greater than the 95% percentile for their age and gender). Certain diseases and conditions tend to increase the risk of developing fatty liver disease such as family history, high cholesterol, high triglycerides, obesity, metabolic syndrome, and type 2 diabetes. Nonalcoholic fatty liver disease can take several forms:

  • Nonalcoholic fatty liver (NAFLD) – not serious and most common
  • Nonalcoholic steatohepatitis (NASH) – fat causes inflammation in the liver which can impair the liver’s ability to function and lead to complications.
  • Nonalcoholic fatty liver disease-associated cirrhosis – liver inflammation leads to scarring of the liver tissue.

NAFLD is also associated with:

  • Diabetes or pre-diabetes
  • Elevated blood lipids such as cholesterol and triglycerides
  • High blood pressure

Secondary related causes include:

  • Metabolism of fat
  • Some drugs
  • Gastrointestinal operations like bariatric surgery
  • Malnutrition
  • Genetic defects in proteins that process lipids

Symptoms

Most people don’t have any symptoms, especially in the beginning. Children may have abdominal pain, which may be in the center or right upper part of their abdomen. When symptoms do occur, they may include:

  • Tired and weak
  • Weight loss
  • Loss of appetite
  • Nausea
  • Abdominal pain
  • Metal confusion

Testing

If blood tests show high levels of liver enzymes, NAFLD is thought to be the cause but other liver diseases are first ruled. The most common way to determine NAFLD is by a liver ultrasound, which shows fat in the liver.

Treatment

There is no medical treatment for NAFLD. Eating a healthy diet and exercising regularly, and avoiding alcohol and unnecessary medications may help prevent liver damage from starting or reverse it in the early stages. If weight loss is needed, slowly loosing excess weight (approximately 1-2 pounds per week) is best. People who have diabetes, high blood pressure or cholesterol and triglycerides may be prescribed medications to control these conditions.