What is Fatty Liver or Hepatic Steatosis and why is Type 2 Diabetes a risk factor for developing it?
Hepatic Steatosis or Fatty Liver, is just one of many health problems caused by the lifestyle we currently lead, characterized by excessive consumption of processed and junk foods, a sedentary lifestyle or lack of physical activity, accelerated weight gain, excess waist fat and intense stress, which is part of our daily routine. All of these elements greatly harm our health, and are responsible for the excess weight, obesity and Type 2 Diabetes epidemic, which are the top risk factors that cause Hepatic Steatosis or Fatty Liver. It’s estimated that approximately 76% of all fatty liver cases occur in obese people and 34% to 75% in people with Type 2 Diabetes.
Hepatic Steatosis is liver damage caused by the accumulation of fat, especially triglycerides. Unfortunately, this damage, if not detected and controlled in time, will progress to more severe stages and may even cause Cirrhosis, increasing mortality due to it.
Fortunately, if we stay well informed about any problems that may arise and know how to detect them in their early stages, treat and control them efficiently to prevent, minimize or stop its progression, this damage won’t affect our quality of life.
By Joe Cardozo
Hepatic Steatosis is a condition that occurs when there’s a defined obesity or elevated triglycerides accumulated in the liver, which is why it’s also known as Fatty Liver.
Two of the main causes or risk factors of Hepatic Steatosis or Fatty Liver are obesity (especially morbid obesity) and Type 2 Diabetes. It’s estimated that approximately 76% of obese people have Fatty Liver, as compared to only 16% of those with a normal weight. For people with Type 2 Diabetes, the incidence of Fatty Liver lies between 34% and 75%, where the risk percentage increases proportionally based on excess body weight.
Hypertension, high cholesterol and triglycerides (Dyslipidemia), excess fat in the waist adipose tissue and insulin resistance, compose the X Syndrome, better known as Metabolic Syndrome, which is primarily responsible for the development of Hepatic Steatosis or Fatty Liver.
Other risk factors or causes that can lead to Hepatic Steatosis or Fatty Liver are sudden loss of body weight, certain inherited metabolic diseases, Hepatitis C, malnutrition, excess iron in the body, tuberculosis, human immunodeficiency virus, lipodystrophy, aspirin, cocaine, sleep apnea, endocrine gland disorders (Thyroid and pituitary glands), Polycystic Ovary Syndrome, intestinal diseases, surgical procedures, gastric bypass to treat obesity (bariatric surgery or gastric bypass) and the use of certain anti-inflammatory drugs such as calcium channel blocker (anti-hypertensives) and corticoids, among others. Corticosteroids raise blood glucose levels, facilitate the formation of fat cells or adipocytes in abdominal fat (waist), constrict blood vessels and accelerate heart rate, increasing the risk of excess weight, obesity, dyslipidemia, hypertension, Metabolic Syndrome and Type 2 Diabetes.
It’s normal for body organs to have some fat, but for the liver, when weight increases by 5% to 10% due to fat accumulation, the person is considered to have Hepatic Steatosis or Fatty Liver.
Hepatic Steatosis or Fatty Liver Classification Based on the severity of the damage
Hepatic steatosis is classified based on the degree of injury to the liver, and can be mild (early stage) or severe (advanced stage). Simple Fatty Liver or with inflammation, is considered mild or benign, shows no symptoms and doesn’t pose a significant hazard. In its more advanced stages, Fatty Liver with cellular degeneration, and Fatty Liver with cellular degeneration and fibrosis, several lesions appear which can be dangerous and increase the risk of liver cirrhosis, causing serious damage and even increasing the mortality rate due to this cause.
Fortunately, this situation can be prevented or its progression delayed or halted with a few simple lifestyle changes. Acquiring healthy eating habits, increasing physical activity, reducing alcohol consumption, exercising adequate control of their blood glucose levels and Hemoglobin A1c and maintain lipid levels and blood pressure within normal values, are some of the most important basic recommendations you need to consider to slow down the progression of Hepatic Steatosis to its more severe stages and the onset of liver cirrhosis, especially if you are overweight, obese, have metabolic syndrome or Type 2 Diabetes.
Hepatic Steatosis or Fatty Liver Symptoms
In its initial stage, Hepatic Steatosis shows no symptoms, so a person with Fatty Liver could not know it for many years. As liver damage worsens, it progresses into its most severe stages and when it does, the following symptoms arise: fatigue, general weakness, weight loss for no apparent reason, nausea, loss of appetite, pain in the upper abdomen, yellowing of the skin and eyes (jaundice), dark spots on the neck and armpits (acanthosis nigricans or pigmentosa), confusion, fluid retention (swelling or edema in the legs and abdomen), general itching, gastrointestinal bleeding, liver failure and muscle atrophy, among others.
If you have any of these symptoms, drink alcohol excessively, have obesity, metabolic syndrome, Type 2 Diabetes or suspect you may have Fatty Liver, you should seek medical advice as soon as possible, so you can get tested and diagnosed early to prevent damage from progressing into more severe stages.
How is Hepatic Steatosis or Fatty Liver diagnosed?
In its initial phase, Hepatic Steatosis or Fatty Liver, can be detected with a simple routine examination to check liver function through blood tests which include complete blood count, blood albumin level, function or liver enzymes, which include Bilirubin and transaminases (GOT and GPT), among others. On the other hand, you may also need medical imaging tests such as an Ultrasound, Magnetic Resonance Imaging (MRI) and Computed Tomography (CT), with which you can get a complete picture of your liver and determine if your liver is larger than normal. If at least two risk factors exist, getting a liver biopsy is advisable to look for fat deposits, cellular degeneration and inflamed, fibrous or scarred tissue, with which your doctor will be able to determine the evolution of your liver damage and seek the best treatment to prevent damage from progressing. It’s important to prevent Hepatic Steatosis or Fatty Liver from progressing into its more severe stages, since it has been demonstrated that Cirrhosis, increases by 21% when it evolves over a 10 year period when there’s cellular degeneration and 26% when there’s cell degeneration and fibrosis.
Treatment for Hepatic Steatosis or Fatty Liver
Hepatic Steatosis or Fatty Liver treatment should primarily focus on minimizing the causes or risk factors that can cause it, that is, people with excess weight or obesity need to lose weight, people with Type 2 Diabetes should keep their blood sugar and Hemoglobin A1c levels well controlled and people with metabolic syndrome should reduce their cells’ resistance to insulin and control their blood lipids and hypertension. On the other hand, it’s very important for everyone with risk factors of developing Hepatic Steatosis or Fatty Liver, to decrease their alcohol consumption and stop smoking. All of this can be easily achieved by acquiring healthy eating habits, increasing physical activity and leading a quieter, more relaxed and stress-free life.
There are currently several drugs available on the market which can help treat Hepatic Steatosis or Fatty Liver, although no scientific study has proven the efficiency these drugs have to offer. Among the drugs used to treat Hepatic Steatosis, by protecting liver cells and counteracting the inflammatory reaction, we can mention ursodeoxycholic acid, and vitamin E due to its antioxidant effects, as well as betaine and S-adenosyl-metio-nina (SAMe).
The key is in prevention, which is why the most important recommendation is to minimize the risk factors or causes of Hepatic Steatosis or Fatty Liver and check your liver function regularly as indicated by your doctor.
Staying well informed about any problems that may arise if you are overweight, obese or have Diabetes, is vital to avoid or be able to detect any problems that may be happening so in time they won’t affect your quality of life.
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