Nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease

A condition in which fats are accumulated in the liver are known as nonalcoholic fatty liver disease (NAFLD). This disease is caused by metabolic disorders and is not associated with negative impact of alcohol.

NAFLD is diagnosed when mass of accumulated fat is equal to or greater than 5% of the liver weight. Further fat accumulation leads to more severe diseases, such as nonalcoholic steatohepatitis (NASH) and cirrhosis.

Previously, NAFLD was considered a rare disease, but recent statistics paint an alarming picture. Over the past 25 years, the number of patients diagnosed with NAFLD has doubled.

According to some estimates, too much fat in the liver has accumulated in every fifth person in the world. Scientists are talking about NAFLD epidemic, which has no signs of weakening in the near future.

The main reasons for NAFLD are as follows:

  • obesityobesity
  • type 2 diabetes
  • dyslipidemia

Obesity is the most common cause of NAFLD. If obesity is severe and accompanied by high level of lipids and / or sugar in the blood, risks of NAFLD are significantly increased.

NAFLD is a multifactorial disease. It is difficult to diagnose, and it is rapidly progressing as a result of a number of factors:

  • insulin resistance
  • abdominal obesity
  • increased blood pressure
  • impaired glucose toleranceimpaired
  • increased level of triglycerides and cholesterol in the blood
  • increased uric acid level in the urine

If NAFLD is suspected, a medical examination and tests are recommended.

In general, these are magnetic resonance imaging and ultrasound of the abdominal cavity.

Liver biopsy (taking a small tissue sample) is the most reliable way to diagnose NAFLD. If the diagnosis is confirmed, treatment is prescribed.

Currently, there is no standard treatment of NAFLD. It is generally accepted that treatment should begin with nonpharmacological intervention:

  • decrease in daily calorie intake;
  • increase in level of physical activity. 

It is proven that consumption of about 2500 calories a day in combination with exercise at least 1 hour per day:

  • improves biochemical and histological indicators;
  • increases sensitivity of receptors to insulin.

During NAFLD treatment, weight loss should not be too fast. This may cause the disease progression. A stable decrease in the amount of fat in the liver is observed when losing 500 to 1000 g of weight per week.

Currently, there are no drugs approved for NAFLD treatment. Nevertheless, studies and clinical trials are conducted in this direction. In pilot study, it was used a variety of drugs, including:

Statins – reduce lipid level in tissues and body fluids;

Antioxidants (vitamin E) – demonstrate a significant improvement in steatosis;

Metformin – reduces blood sugar level;

Anorectics – suppress appetite and reduce fat deposits in the body and in the liver.

NAFLD is a disease that needs to be cured as soon as possible. Given that today there are no drugs approved to reduce fat in the liver, further search for approaches to diagnosis and treatment of NAFLD is needed.