Non-alcoholic fatty liver disease

What is it about ?

Non-alcoholic fatty liver disease is fatty liver disease that is not caused by alcohol. It is strongly correlated with metabolic syndrome.

Metabolic syndrome

Metabolic syndrome is a metabolic disease associated with:

• a deregulation of sugar levels in the blood (blood sugar) ;
• a high cholesterol in the blood ;
• a high blood pressure (hypertension) ;
• a obesity.

This condition is essentially the consequence of a poor lifestyle, marked by a lack of physical activity and poor eating habits.

Steatohepatitis

When fatty liver disease is associated with damage to liver cells, it is referred to as steatohepatitis. A doctor should detect this complication in time, as it can progress to liver cirrhosis or in liver cancer.

What is its frequency?

Non-alcoholic fatty liver disease is the most common liver disease in Western countries. Many of the elevated liver values ​​in people aged 45 to 69 are linked to it.

About 5% of people with fatty liver disease also have steatohepatitis.

How to recognize it?

These conditions usually do not cause any symptoms.

How is the diagnosis made?

Non-alcoholic fatty liver disease is often discovered by chance:

• based on elevated liver values ​​(ALT) in the blood;
• on the occasion of a ultrasound or another imaging test of the belly.

Discussion

The doctor will ask you questions about your alcohol consumption in order to rule out an alcoholic cause for fatty liver disease.

Exams

In parallel, various blood tests may be needed. Based on the results, the doctor may:

• rule out infection or autoimmune disease of the liver;
• assess the risk of metabolic syndrome, of diabetes and steatohepatitis.

To diagnose non-alcoholic fatty liver disease, your doctor may use a liver biopsy or one fibroscan, a test that measures the elasticity of the liver.

What can you do ?

It is very important toadapt your lifestyle.

• Aim for 10% weight loss per year.
• Try to avoid sugars, especially refined ones.
• Try to get enough physical activity.
• Avoid alcohol and drugs.

What can your doctor do?

Nutritional advice and support

The doctor can also give you nutritional advice and possibly refer you to a dietitian. The dietitian can help you eat healthier and lose weight.

Specialist orientation

If he suspects hepatic steatosis, the doctor will refer you to a specialist in the gastrointestinal system (gastroenterologist) for further examinations.

Source

Foreign clinical practice guide ‘Non-alcoholic steatotic liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH)’ (2015), updated on 4.12.2015 and adapted to the Belgian context on 2.03.2019 – www.ebpnet.be