Fatty liver is the way in which non-alcoholic fatty liver disease is commonly referred to, as one of the most common liver diseases: it is estimated that over 40% of the population suffers from it. Those who suffer from it risk that steatosis evolves into important pathologies, such as liver fibrosis and cirrhosis.
We talk about it with Professor Alessio Aghemo, Head of the Operative Unit of Hepatology in Humanitas and professor at Humanitas University.
What Is Hepatic Steatosis?
Fatty liver disease is a disease characterized by an accumulation of fat in the liver cells in the form of triglycerides. Its causes include diabetes, a sedentary lifestyle, and a high-calorie diet; therefore among the subjects most at risk, we find overweight people, those who lead a life that is too sedentary, and those who have a body mass index higher than 30.
What Are The Symptoms Of Fatty Liver Disease?
Those who suffer from it are not always aware of it, because steatosis is almost completely asymptomatic. Steatosis does not prevent the liver from performing its functions, but it can lead to liver fibrosis, an inflammation of the liver that causes injury, which in turn causes the formation of fibrous tissue. The latter interferes with the proper functioning of the liver and can lead to the development of cirrhosis. In this case, the symptoms manifested are ascites, swollen legs, anemia, fatigue, skin bleeding, and jaundice. Cirrhosis is a chronic and degenerative disease that can give rise to liver tumors.
What Tests For The Diagnosis Of Fatty Liver?
Steatosis can be suspected on a physical examination that takes the patient’s abdominal circumference into consideration. Furthermore, steatosis is often associated with metabolic syndrome, ie the concomitance of at least three factors including obesity, diabetes and pre-diabetes, hypertension, and excess triglycerides.
There is still no clarity on the reasons that can lead to steatosis in fibrosis: there is certainly a genetic component, but also nutrition, and in particular the excess of red meats and sausages, industrial sugars, trans and polyunsaturated fats.
The fact that this pathology is asymptomatic means that clinical controls are fundamental tools for prevention: blood tests, which allow for evaluating the level of liver enzymes, and tests performed by means of diagnostic images. Today you can also undergo fibroscan, a special test capable of recognizing the presence of liver fibrosis. Finally, the visit with the specialist allows us to focus on the health of the liver as a whole.
Treatment Of Fatty Liver Disease: The Role Of Lifestyle
To prevent liver diseases, it is necessary to avoid a sedentary lifestyle, practice physical activity and follow a correct diet, consisting of whole grains, vegetable proteins, fish, and white meats. It is also important to limit the consumption of red meat and avoid sweets and alcohol. Following the Mediterranean diet has proved effective in achieving weight loss and therefore reducing the amount of steatosis.
There are currently no drugs on the market that can stop the degenerative process of non-alcoholic steatosis into hepatic fibrosis. The most important intervention that can be implemented is therefore lifestyle, through an improvement in nutrition, abstention from alcohol, and the integration of physical activity into daily life.
Research In Humanitas
The research in Humanitas for hepatic steatosis follows two main lines:
- Spontaneous studies are dedicated to identifying the best dietary/nutritional profile.
- Pharmacological studies to identify drugs that can reduce steatosis, inflammation, and fibrosis in the liver.
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