This is an increasingly common finding diagnosed on an ultrasound of the liver. About 10-20% of the adult population have this condition. This condition is associated with obesity.

What is the condition?

This condition is due to to fat(triglycerides) accumulating in the cells of the liver(the hepatocytes). The liver cells can become damaged by the accumulation of the fat leading to cell injury, inflammation and scarring of the liver.

In a mild form, the only finding may be only on ultrasound. The liver appears “bright”(or in radiological terms – show increased echogenecity). Sometimes the liver function tests can show an elevation of the  liver enzyme levels(especially the ALT – aspartate aminotransferase).

In more severe cases, the liver becomes inflammed and one can get hepatitis of the liver. This is called Non-Alcholic Steato-hepatitis(NASH). This can lead to scarring of the liver and the development of chronic liver failure and increases the risk of getting liver cancer.

What other conditions can mimic/cause fatty liver?

Alcoholic liver disease(The AST is usually higher)

Hepatitis from Hepatitis B and  C

Side effects of medications – eg Tamoxifen, Amiodarone

Investigations

Liver function test(Billirubin, ALT, AST, GGT, ALP)

Blood sugar level

Fasting lipid profile

Hepatitis serology

Liver biopsy – to diagnose NASH

Treatment

Lifestyle measures

The treatment is usually the treatment of the obesity – losing weight by both diet and exercise.

Medications

Some agents being studied

Surgery

Laparoscopic gastric banding for the morbidly obese has been shown to be beneficial for patients with NASH.

Author’s note: In my practice, I see this a lot in patients who have had US of the upper abdomen in particular to exclude gallstones.

Disclaimer:

This article does not constitute medical advice

You should see a qualified medical practitioner for a formal opinion.