Fatty Liver Disease

Insulin resistance may be primary cause of NAFLD.

What is it?

Fatty liver is also known as Non- Alcoholic Steatorrhoeic Hepatosis (NASH) or Non-Alcoholic-Fatty-Liver-Disease (NAFLD). NAFLD primarily affects people over 30 years old who are over weight. In the USA about 15 to 20% of people are affected with NAFLD and it can even effect children. It affects a much higher percentage of over weight people.

However, in a recent study looking at the role of insulin resistance in fatty liver disease, there was no significant difference in glucose uptake during the test between normal-weight and overweight NAFLD subjects. This finding rules out the possibility that obesity plays a significant role in fatty liver disease. This test suggests that insulin resistance in NAFLD might be a primary cause of NAFLD, sometimes aggravated by obesity and diabetes associated insulin resistance. In NAFLD patients, the blood sugar level was normal or high-normal in the fasting state. Despite high levels of insulin in the blood stream, the liver did not switch off glucose production in response to insulin infusion, indicating the presence of liver insulin resistance.

The liver is the largest gland in the body. There is evidence that growing older is not a reason for the liver to function any less efficiently. It is estimated that the liver has over 500 different functions.

The function of the liver is to:

• Assist in the digestion of food. It makes bile, which is needed to digest fats.
• It makes many chemicals important for functions all over the body
• It helps to keep the blood clean and well-maintained by removing toxins, dead cells, micro-organisms from the blood stream. It is essentially a filter and cleanser of the blood stream thereby helping the body to fight infections and to get rid of poisons.
• regulates fat metabolism
• major fat-burning organ in the body
• It stores carbohydrates in a form that allows a quick release of energy when it is needed. This is why people with liver damage may lack energy.
• It regulates blood sugar.
• It makes plasma proteins, needed to help the blood to clot

When the liver is not able to filter and cleanse the blood stream it will become overloaded with toxins and fat. A poorly functioning liver can lead to autoimmune conditions and diabetes; and because the liver regulates fat metabolism, if your liver is unhealthy you will have difficulty in controlling your weight. Normally the liver not only burns fat, it dumps extra fat into the intestines. A liver which is fatty is actually storing fat which makes you feel sick and can actually lead to an early death.

Fatty liver, no matter what it’s called, is easy to understand. It means that healthy liver cells are being replaced with fat! Since fat cells weigh more than liver cells, the liver becomes enlarged and heavier. If you could see your liver it would look yellow, instead of red, and greasy. You also have pain in your upper, right abdomen, over the liver. Your doctor can see gallstones and excess fat in an ultrasound scan of the liver.

What are the signs that you might have NAFLD? They are:

• You are over weight and find it hard to loose weight. You probably carry a lot of your weight in your abdomen
• You and your doctor are not happy about your cholesterol. Your cholesterol and triglycerides are elevated in your blood
• You may have Syndrome X (insulin resistance)
• Your blood sugar values are too high. Your doctor calls it type 2 diabetes or Adult Onset Diabetes
• You feel tired most of the time and have very little energy.
• You’re sick all the time because your immune system is weak
• Your liver enzymes are elevated

Fatty liver is the most common cause of abnormal liver function tests in the USA. The elevated liver enzyme results mean that there is damage to the liver cells. Liver enzymes are normally found mostly within liver cells. Only when the cells are damaged or inflamed, do the enzymes leak into the blood stream. This can occur due to:

• a fatty liver
• excessive alcohol consumption
• some medications such as:
  • long term antibiotics or pain killers
  • synthetic Hormone Replacement
• viral infections of the liver such as hepatitis C & B
• auto-immune hepatitis
• hemachromatosis
• primary biliary cirrhosis
• exposure to toxic chemicals such as insecticides, pesticides or organic solvents
• incorrect diet

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