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There is currently a move towards renaming non-alcoholic fatty liver disease to metabolic dysfunction-associated steatohepatitis (MASLD), with health experts also calling for non-alcoholic steatohepatitis to be renamed metabolic dysfunction-associated steatohepatitis (MASH). Is recommended. Steatosis is a medical term for fat accumulation, therefore, steatotic liver disease means excessive fat accumulation in the liver and SLD is the new epidemic.
The prevalence of SLD ranges between 30–40% worldwide, while in India, various studies have reported a prevalence of 31–38%. Its prevalence is even higher in diabetic patients.
Reason:
In an interview with HT Lifestyle, Dr. Adarsh CK, Chief Consultant Gastroenterologist and Hepatologist at Gleneagles BGS Hospital, shared, “The causes/risk factors for SLD other than alcohol are diabetes, overweight/obesity, thyroid disease, high cholesterol/triglyceride levels , have high blood pressure. , Sedentary lifestyle, wrong eating habits (excessive sweet/oily consumption), certain medicines and some genetic diseases.”
Dr. BV Sriram, DM, Gastroenterology, Manipal Hospital, Goa, bringing his expertise to the fore, said, “Experts do not know exactly why fat builds up in some livers and not others. They also don’t fully understand why some fatty liver turns into NASH.” According to them, both NAFLD and NASH are linked to:
- genetics
- overweight or obese
- insulin resistance, which happens when your cells don’t take up sugar in response to the hormone insulin
- Type 2 diabetes, sometimes called high blood sugar or hyperglycemia
- High levels of fats in the blood, especially triglycerides.
These combined health problems can contribute to fatty liver. However, some people get NAFLD even if they have no risk factors.
symptoms:
Dr. Adarsh CK reveals, “Abnormal fatty liver disease is usually asymptomatic or sometimes manifests with abdominal discomfort or fatigue. However, once they suffer from cirrhosis, they may have abdominal pain, jaundice, swelling in the legs and abdomen, vomiting blood or black stools, altered behavior, weight loss, and other problems.
Dr. BV Sriram said SLD often has no symptoms but when it does, it may include:
- Tiredness
2. Not feeling well, or being unwell
3. Pain or discomfort in the upper right side of the abdomen
risk:
Dr BV Sriram highlighted that several diseases and health problems can increase the risk of NAFLD, including:
- Family history of fatty liver disease or obesity
- Growth hormone deficiency, which means the body doesn’t make enough hormone to grow
- high cholesterol
- high levels of triglycerides in the blood
- insulin resistance
- metabolic syndrome
- Obesity, especially when fat is concentrated around the waist
- polycystic ovary syndrome
- obstructive sleep apnea
- type 2 diabetes hypothyroidism
- hypopituitarism
What are the complications?
Dr. Adarsh CK said, “About 10-20% of SLD patients may develop fibrosis in the liver and eventually end up in a condition called liver cirrhosis, which is irreversible. Some of them may also develop liver cancer later on. If SLD can be detected and monitored early, these complications can be prevented, and fatty liver can be cured.
Dr. B.V. Sriram cautioned that if nothing is done to prevent the lesions, cirrhosis can lead to a number of complications:
- A build-up of fluid in the abdominal area, called ascites
- swollen veins in your esophagus, or different parts of the esophagus, which may burst and cause bleeding
- confusion, drowsiness, and slurred speech, also called hepatic encephalopathy
- overactive spleen, or hypersplenism, which can cause too few platelets in the blood
- liver cancer
- End-stage liver failure, meaning the liver has stopped working.
What tests are necessary? How is it diagnosed?
Dr Adarsh CK replied, “Simple ultrasound can detect fatty liver. Once detected, other tests like liver function test and fibroscan are also done to see the severity of the fatty liver. FibroScan is a relatively accurate test for this and is a non-invasive test. Other blood tests will also be done to find out the cause of fatty liver. Rarely, a liver biopsy or CT/MRI scan is required.”
Talking about who needs fatty liver test, he said, “All patients with diabetes, hypothyroid, overweight/obesity, high cholesterol, high blood pressure, family history of liver disease need fatty liver test “
Prevention and treatment:
To reduce the risk of SLD, Dr. BV Sriram suggests:
- Eat a healthy diet that is rich in fruits, vegetables, whole grains, and healthy fats.
- Limit alcohol, simple sugars and portion sizes. Avoid sugary drinks like soda, sports drinks, juice and sweet tea. Drinking alcohol can damage your liver and should be avoided or reduced.
- Maintain a healthy weight. If you are overweight or obese, work with your health care team to lose weight slowly. If your weight is healthy, try to maintain it by eating a healthy diet and exercising.
- Exercise. Be active most days of the week. If you are not exercising regularly, get consent from your health care team first.
He further added, “Now, with a medical test called ‘FibroScan’, the extent of fat deposits in the liver and the extent of fibrosis can be diagnosed and reviewed again after three to six months to find out whether It can be determined whether the fat level has increased or decreased.
According to Dr. Adarsh CK, the mainstay of treatment is lifestyle modification which includes:
- Calorie restriction (eat 30% less)/intermittent fasting to lose weight
- Low sugar with fat, <30% calories compromised
- Exercise 30-45 minutes a day, 5 days a week
- Avoid aerated drinks/junk food
- sum
He concluded, “In addition to the above steps, some medications like Vitamin E, metformin and a recently launched drug called saroglitazar may be beneficial. Once liver cirrhosis occurs, liver transplantation may be the only treatment. Since fatty liver can be cured in its early stages, its early detection with appropriate lifestyle changes and medicines at the right time is a simple mantra for a healthy life.”
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