Dear Doctors: My father passed away due to unexplained liver problems that we only now know was fatty liver disease. It’s 20 years later, and a CT scan shows some fat in my own liver. My liver readings are normal, but I’m the same age as my father was when his issues began. Should I be concerned?
Dear Reader: Fatty liver disease refers to a range of liver disorders not caused by alcohol consumption, autoimmune disease, drug use or virus.
It’s the most common liver disease in the United States, estimated to affect up to 30% of the population. Once known as nonalcoholic fatty liver disease, the condition is now more accurately called metabolic-associated fatty liver disease or MAFLD.
Your father’s health problems arose when this type of fatty liver disease was in the early stages of being understood. Though alcohol-induced changes to the liver were first described in the 1840s, it wasn’t until the 1980s that a metabolic cause for fatty liver disease began to emerge.
Fatty liver disease is just as it sounds — an abnormal buildup of fat in the liver. While a healthy liver contains some fat, when the amount begins to exceed 5% to 10%, it is considered to be fatty liver disease. This excess fat triggers an inflammatory response that, over time, leads to liver damage.
That means the liver’s hundreds of metabolic functions — which include filtering toxins, aiding in digestion, blood-sugar management and creating and storing nutrients — are adversely affected. The condition is linked to being overweight or obese, high blood-lipid levels, high blood pressure and prediabetes and diabetes.
There is some evidence of a higher risk of developing MAFLD when the condition runs in a family. But lifestyle and environmental factors appear to play a more significant role.
The condition has few symptoms, which makes it challenging to diagnose. Some people describe feeling tired. Some experience discomfort or pain in the upper right abdomen.
Abnormal results of liver-enzyme tests can be an indicator. So can a stiff or enlarged liver as well as jaundice.
Imaging tests can assess the amount of fat in the liver. A biopsy might be done to check for abnormal amounts of scar tissue in the liver, known as fibrosis.
Tell your doctor you have a family history of fatty liver disease.
To reduce your risk, stay away from alcohol, maintain a healthy weight, eat a diet rich in fresh, plant-based foods and exercise regularly.
Dr. Eve Glazier and Dr. Elizabeth Ko are internists at UCLA Health.
