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Liver disease often progresses without discomfort

Severe consequences in fatty liver disease

Very many people suffer from non-alcoholic fatty liver. The diagnosis is made daily in German medical procedures. Almost every third adult in Western countries suffers from this originally asymptomatic disease according to the German Diabetes Research Center (DZD). Severe consequences such as hypertension and type 2 diabetes, liver cirrhosis and liver cancer as well as heart attacks and strokes can be compromised without treatment. Fat can be diagnosed and treated.

Often, fatty liver disease can be effectively treated with mild lifestyle changes, but the condition is that the problem is recognized as such. However, many of those affected do not know that their liver is suffering. Because the symptoms often manifest themselves only in the later course of the disease. In a recent article by The Lancet Diabetes & Endocrinology, a team of researchers from the German Diabetes Research Center summarizes the current state of the art and shows how personalized risk forecasting and personalized treatments can contribute to significant future improvements.

Change in diet and regular exercise are very important for reducing the fatty liver. (Source: therapeutic practice)

Also obese children often have fatty liver

"More and more adults, but also about 34% of obese children suffer from non-alcoholic liver disease (NFLD)," says DZD. As common causes, experts call it "an unhealthy lifestyle with little exercise and plenty of fat, as well as sugar and fructose foods and / or genetic prejudices." The course of fatty liver disease can vary greatly for each individual because NAFLD is a very "complex and heterogeneous disease."

Threatening consequences

Threatening complications include severe liver damage, type 2 diabetes, and cardiovascular disease, and "in order to avoid these consequences, fat must be recognized early and the appropriate risk of liver, metabolic, and heart muscle disease determined," says the first author. Professor Norbert Stefan of University Hospital Tübingen and Institute for Diabetes and Metabolic Disease Research (IDM) Helmholtz Zentrum München.

Research status evaluated for fat liver

Together with Professor Hans-Ulrich Häring, also from the University Hospital Tübingen and IDM, as well as Professor Kenneth Cusi of the University of Florida, USA, prof. Stefan reviewed the state of the research and put it together in a review article. For example, not only patients with elevated liver enzymes should be examined for fatty liver, but also individuals with dysproportional fat distribution, ie. a high proportion of abdominal fat and / or a small amount of fat around the hips and legs, Professor Häring, one of the research results, emphasizes.

Specific risk forecasts for disabled people

In addition, experts also recommend fatty liver screening for those suffering from insulin resistance or type 2 diabetes. In general, the use of new diagnostic and therapeutic approaches should be introduced in everyday clinical practice to allow for a specific risk prediction for potential secondary diseases, said researchers Prof. Günther. Stefan and colleagues. For example, genetic NAFLD is associated with a higher risk of liver fibrosis and liver cancer. Influences, however, have a low risk of cardiovascular disease. To take the right therapeutic measures, "it is important to know if adipose tissue is genetically determined," experts said.

Diagnosis of liver disease

First and foremost, the question arises of how fat levels in the liver can be reliably determined and how liver damage, such as inflammation and fibrosis, can be reliably detected. According to doctors, "the use of simple indexes or ultrasound scans is suitable for primary care." In addition, other investigative methods such as special magnetic resonance imaging (MRI) by medical specialists such as hepatologists, endocrinologists and radiologists can be used.

Lifestyle often changes

If it has been found in the examinations that the fatty liver has been found, the lifestyle change can often produce significant positive effects. For example, with a decrease of about five percent by weight, the fat content of the liver is reduced by up to 30 percent, according to DZD. However, the goal should be to reduce weight by about ten percent to reduce the risk of liver inflammation and fibrosis.

Reducing existing overweight acts against fatty liver disease and at best reduces the risk of further complications. (Picture: Kurhan /

Drug treatment

"If such weight loss cannot be achieved or is insufficient to improve NAFLD, pharmacological treatment should be considered," Professor Cusi points out in a DZD press release. While no drug is approved for NAFLD, specific medicines that have different effects on liver fat, inflammation and fibrosis can be used under certain conditions, such as the presence of non-alcoholic fatty liver in combination with diabetes or obesity. ", Professor Cusi says. With the help of new concepts, individualized prognosis of risk and individual treatment of non-alcoholic fatty liver will be enabled in the future.

Metabolic syndrome and fatty liver often go hand in hand

Non-alcoholic fatty liver rarely occurs due to the so-called Metabolic Syndrome. In this syndrome, there are several adverse health conditions that complement each other. These include obesity, high blood sugar, high blood lipid levels and high blood pressure. For more information, see: Metabolic Syndrome and Oily Liver: These daily risks cause our liver to suffer. (Fp)

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