The liver suffers silently: liver disease, often without symptoms

Serious consequences in the case of fatty liver disease

Very many people suffer from non-alcoholic fatty liver. The diagnosis is commonplace in German medical practices. Almost every 3. Adults in Western countries suffer according to the German center for diabetes research (DZD) to this initially symptom-free disease. Without treatment, severe consequences, such as hypertension and type 2 Diabetes and cirrhosis of the liver and liver cancer to a heart attack and stroke threaten. So a fatty liver can be diagnosed and treated.

Often the fatty liver disease by easy lifestyle Changes can effectively treat, but the prerequisite is that the Problem is recognized as such. Of the Affected know, however, many suffers are not that your liver. Because the symptoms often appear only later in the disease course. In a recent contribution to the journal “The Lancet Diabetes & Endocrinology“ together a team of authors with the participation of scientists of the German center for diabetes research, the current research and shows how personalized Risk assessment and individualized treatments in the future, significant improvements can.

Also, obese children often have a fatty liver

“More and more adults are suffering, but also about 34 percent of the obese children of non-alcoholic fatty liver disease (non-alcoholic fatty liver disease, NAFLD),” the message of the DZD. As common causes, the experts call an “unhealthy lifestyle with little movement and much fat and sugar and fruit sugar-containing food and/or a genetic predisposition.” The course of fatty liver disease could differ in the case of the individual Affected massively, because the NAFLD would be a “complex and heterogeneous disease.”

The Threat Of Secondary Diseases

Among the imminent complications of severe liver damage, type 2 Diabetes and cardiovascular disease, and “to avoid these complications, it must be recognized that the fatty liver in due time, as well as the risk for liver-, metabolic – and cardiac muscle diseases can be accurately evaluated”, says the first author of the current technical contribution, and Professor Norbert Stefan, of the University hospital Tübingen and Institute for diabetes research and Metabolic diseases (IDM) of the Helmholtz Zentrum München.

Research on fatty liver evaluated

Together with Professor Hans-Ulrich Häring, also from the University hospital of Tübingen and the IDM, as well as Professor Kenneth Cusi of the University of Florida (USA) Prof. Stefan evaluated the state of research and in a review article compiled. For example, not only patients with elevated liver enzymes should be screened for fatty liver, but also people with a dysproportionalen fat distribution, i.e., a high proportion of abdominal fat and/or a low percentage of fat around the hips and legs, says Professor Häring, one of the research results.

Specific risk forecasts for the Affected

In addition, the experts also recommend a fatty liver-Screening for people who suffer from insulin resistance or type 2 Diabetes. In General, the use of new diagnostic and therapeutic approaches should be implemented in the clinical routine, in order to enable a specific risk forecast for possible consequential diseases, so the researchers Prof. Stefan and colleagues. For example, a genetically NAFLD-related associated with a higher risk for liver fibrosis and liver cancer. For the Concerned diseases, but a low risk for cardiovascular. In order to take the correct therapeutic measures, “it is important to know whether a fatty liver is genetic,” emphasize the experts.

Diagnosis of fatty liver disease

First of all, the question of how the Fat content in the liver determine, in a General reliable, and liver damage such as inflammation and fibrosis certainly indicate. Here is according to a statement from the physician “in primary care, the use of simple indices or ultrasound examinations.” In addition, the use of other methods of investigation such as, for example, special MRI scans (MRI), specialist doctors, such as Hepatologists, endocrinologists, and radio was in demand lied.

Lifestyle changes are often sufficient

It was found in the studies a fatty liver, could often achieve a life style changes already significant positive effects. For example, the weight of the fat content is reduced with a decrease of about five percent in the liver by up to 30 percent, so the message of DZD. The goal should be a weight reduction of around ten percent, in order to reduce the risk for liver inflammation and Fibrosis.

Drug Treatment

“If such a reduction in weight cannot be achieved or is not sufficient to improve NAFLD, should be considered a pharmacological treatment is considered,” says Professor Cusi in the press release of the DZD. Although approved for up to today no drug for NAFLD, but under certain conditions such as the Occurrence of non-alcoholic fatty liver disease in combination with Diabetes or obesity, the use of specific drugs is possible, “the different effects on hepatic fat content, inflammation and fibrosis,” says Professor Cusi. With the help of the new concepts in the future a personalized risk prediction and individualised treatment of non-alcoholic fatty liver disease will possible. (fp)