Fatty livers are on the rise

According to a study, one in every three adults in urban and semi-urban areas has a morbidly fatty liver, which increases the risk of life-threatening diseases associated with the liver. A fatty liver not only affects the liver but also the heart, the kidneys and the pancreas. The excess fat in the liver increases the production of glucose, unfavourable fats and proteins which get released in the blood stream and enter other organs of the body, triggering an unhealthy reaction.

Scientists have dubbed this behaviour of the fatty liver as ‘organ cross talk’, wherein the damage is seen in many other organs.

Dr Madhusudhan C.H., a senior liver specialist in the city, explains that fatty liver is one of the causes of cardiovascular diseases and has a debilitating effect on diabetic patients as well.

How does a fatty liver affect other organs of the body?
A fatty liver weakens and causes harmful effects on the body. Hence, it impacts a lot of systems and organs like steatohepatitis and cirrhosis of the liver, insulin resistance, loss of appetite, discolouration of the skin, acute and severe back pain, liver cancer, high triglyceride levels and high risk of heart disease.

What is the importance of the liver in the body?
The main functions of the liver are producing bile, absorbing and metabolising bilirubin, assisting in creating blood-clotting bodies called coagulants, metabolising fat and carbohydrates, storing vitamins and minerals, helping in metabolising proteins, filtering the blood, producing albumin and synthesising angiotensinogen — a hormone that raises blood pressure.

Alpha-fetoprotein, which is produced by the liver, affects the pancreas. How does it create problems for the body?
Alpha-fetoprotein, a secreted glycoprotein, is known to affect inflammation and insulin resistance in obese humans. It can damage pancreatic ß cells, hastening the onset of diabetes.

What are the causes of fatty liver and what are the different grades of the condition?
The most common causes of fatty liver are alcoholism, obesity, high lipid levels in the blood, genetic inheritance, rapid weight loss, diabetes and side effects of certain medications among others.

The stages of the fatty liver disease are — fatty liver or steatosis, non-alcoholic steatohepatitis, fibrosis and cirrhosis. The grades of fatty liver are grade 1, grade 2 and grade 3 fatty liver as per radiological classification.

What do grade 1, grade 2 and grade 3 of fatty liver mean?
This classification of fatty liver is essentially a radiological indication seen during ultrasound.

When the echogenicity has just increased, it is grade 1; when the echogenic liver obscures the echogenic walls of the portal vein branches, it is grade 2; and, when the echogenic liver obscures the diaphragmatic outline, it is grade 3 fatty infiltration.

Can a damaged liver function better if the patient improves his or her lifestyle?
The liver is the only visceral organ with the capacity to regenerate. The liver can regenerate completely as long as a minimum of 25 per cent of the tissue remains.

What is the exact incidence of fatty liver in India? Why is it important to control the condition?
The incidence of fatty liver in India varies from 30 to 35 per cent across different states. A fatty liver should be controlled at an early stage to stop the disease’s progression and to avoid serious complications like cirrhosis which may later require multidisciplinary intervention and, later, transplantation.

What is the treatment schedule for fatty liver?
Fatty liver requires a lifestyle modification — it is very important to cut down on fats and also control the cholesterol levels in the body. Hence, the first step is controlling one’s weight. Weight control is an important aspect and if it is carried out zealously, the fatty liver issue is sorted out in grade 1 and grade 2 cases. But it also requires medication in cases where the individual has other co-morbid conditions such as heart disease or diabetes.