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Nonalcoholic Fatty Liver Disease

by | Apr 30, 2023 | News Releases | 0 comments

Bay Biosciences provides high quality, clinical grade, cryogenically preserved sera (serum) and matched K3-EDTA plasma and stool specimens from non-alcoholic fatty liver disease (NAFLD) patients.

The sera (serum) and K3-EDTA plasma specimens are processed from non-alcoholic fatty liver disease (NAFLD) patient’s peripheral whole-blood using customized collection and processing protocols.


Nonalcoholic Fatty Liver Disease (NAFLD) Overview

Non-alcohol related fatty liver disease (NAFLD) is a type of steatosis that’s caused by factors other than excessive alcohol use. Nonalcoholic Fatty Liver Disease is the build-up of extra fat in liver cells not caused by alcohol.

NAFLD develops when too much fat builds up in the liver. In the beginning, there may be no symptoms, but it can lead to ongoing liver damage and other issues. It often occurs with obesity and high cholesterol.

Healthcare providers may diagnose non-alcoholic fatty liver disease (NAFLD) if fat represents more than 5–10% of the liver’s weight. The condition often develops alongside obesity, high blood pressure, diabetes, and high cholesterol.

A patient with NAFLD may go on to have nonalcoholic steatohepatitis (NASH), a type of inflammation. This can result in cirrhosis, which is scarring and dysfunction of the liver.

About 24% of adults in the United States may have NAFLD but no inflammation or damage. NASH affects around 1.5% to 6.5% of this adult population.

Fat can build up in the liver for many different reasons, including during pregnancy. Cirrhosis can stem from high alcohol consumption, but NAFLD and NASH do not result from this. Liver function can also decrease depending on how much scarring occurs.

The liver removes toxins from the body. If it does not work correctly, various issues can arise.

If the body produces too much fat or does not metabolize fat correctly, it can accumulate in the liver. This is often referred to as having a “fatty liver.” If fat continues to accumulate, inflammation can result. Eventually, it can lead to cirrhosis and liver failure.

Types of Nonalcoholic Fatty Liver Disease

There are two types of nonalcoholic fatty liver disease: Nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Scientists are not sure why an people develop NAFLD or NASH. It’s possible to be diagnosed with one form first, and then later the other.

Signs and Symptoms of Nonalcoholic Fatty Liver Disease

NAFLD

A doctor may diagnose fatty liver, or NAFLD, if more than 5–10% of the liver weight is fat. This is not healthy, but it does not necessarily cause symptoms or have a severe impact at this stage. For most people, this condition does not progress further.

Many people with fatty liver do not know that they have it. They may find out during routine tests for another condition or if a doctor recommends testing due to risk factors.

About 24% of adults and 10% of children in the U.S. have NAFLD, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

In most NAFLD patients, there are no noticeable symptoms. When symptoms are present, they usually include:


NASH

If fat continues to build up, inflammation can occur in the liver, leading to NASH. This affects around 1.5% to 6.5% of adults in the U.S.

Symptoms may include:

  • Abdominal swelling
  • Behavioral changes
  • Confusion
  • Easily bruising and bleeding
  • Itchiness
  • Jaundice
  • Slurred speech
  • Spider-like veins visible just under the skin
  • Yellowing of the skin and eyes


Cirrhosis and Liver Failure

In time, 10–25% of patients with NASH develop scarring, known as cirrhosis, and liver failure.

Symptoms of cirrhosis include the following:

  • Abdominal swelling and pain, due to a buildup of fluid
  • Confusion difficulty focusing, memory loss, and hallucinations
  • Changes to menstruation
  • Dark urine
  • Easy bleeding and bruising
  • Enlarged breasts in males
  • Itching
  • Jaundice
  • Loss of sexual desire
  • Nausea, vomiting and diarrhea
  • Pale or dark, tarry stools

In severe cases, a patient may need a liver transplant.


Causes of Nonalcoholic Fatty Liver Disease

The exact causes of NAFLD are currently unknown. Researchers believe genes, certain health conditions, diet, and the digestive system may play a role.

While some patients who are diagnosed with NAFLD have no previous risk factors, there are some lifestyle factors that can increase the likelihood of a NAFLD diagnosis.

NAFLD and NASH are both linked to the following:

  • High levels of fats, particularly triglycerides, in the blood 
  • Insulin resistance
  • Hyperglycemia
  • Obesity

The above combined health problems appear to promote the deposit of fat in the liver. For some patients, this excess fat acts as a toxin to liver cells, causing liver inflammation and NASH, which may lead to a buildup of scar tissue in the liver.


Risk Factors of Nonalcoholic Fatty Liver Disease

One of the biggest risk factors for developing NAFLD is living with obesity.

Additional risk factors include health issues that often occur along with obesity, such as type-2 diabetes and metabolic syndrome (a group of traits and conditions linked to living with obesity).

If anyone diagnosed with more than one of these health issues, your chances of developing NAFLD go up.

Risk factors include the following:

  • Any health condition that affects the body’s ability to use or store fat
  • Exposure to certain toxins
  • Fat concentrated in the abdomen 
  • Genetic factors
  • High cholesterol 
  • Type 2 diabetes
  • Sleep apnea
  • Underachieve pituitary gland
  • Smoking
  • High levels of triglycerides in the blood
  • Metabolic syndrome
  • Polycystic ovary syndrome
  • Under-active thyroid NASH is more likely to develop in the following patient groups:
  •  Individuals with diabetes
  • Older people
  • People with body fat concentrated in the abdomen


Diagnosis of Nonalcoholic Fatty Liver Disease

NAFLD usually has no symptoms. The condition is typically diagnosed after a blood test finds higher-than-normal levels of liver enzymes.

High levels of liver enzymes could also suggest other liver diseases. Your healthcare provider will need to rule out other conditions before diagnosing NAFLD.

If NAFLD is suspected, your doctor may look for physical symptoms like signs of insulin resistance (darker skin patches over your knees, knuckles, and elbows), and signs of cirrhosis (ascites and/or muscle loss).

Additional Tests

An ultrasound of the liver can help reveal excess fat in the liver. Another type of ultrasound, called transient elastography, measures the liver’s stiffness. Greater stiffness suggests greater scarring.

If these tests are inconclusive, your doctor may recommend a liver biopsy. In this test, the doctor removes a small sample of liver tissue with a needle inserted through the abdomen. The sample is studied in a lab for signs of inflammation and scarring.

Blood Tests

  • Complete blood count
  • Celiac Disease screening test
  • Fasting blood sugar
  • Hemoglobin A1C, which shows blood sugar stability
  • Liver enzyme and liver function tests
  • Tests for chronic viral hepatitis (hepatitis A, hepatitis C and others)
  • Lipid profile, which measures blood fats, such as cholesterol and triglycerides

Imaging Procedures

Imaging procedures used to diagnose NAFLD include the following:

  • Abdominal ultrasound, which is often the initial test when liver disease is suspected.
  • Computerized tomography (CT) scanning or magnetic resonance imaging (MRI) of the abdomen. These techniques lack the ability to distinguish NASH from NAFLD, but still may be used.
  • Transient elastography, an enhanced form of ultrasound that measures the stiffness of your liver. Liver stiffness indicates fibrosis or scarring.
  • Magnetic resonance elastography, works by combining MRI imaging with sound waves to create a visual map (elastogram) showing the stiffness of body tissues.

Liver Biopsy

If other tests are inconclusive, your healthcare provider may recommend a procedure to remove a sample of tissue from your liver which is also known as liver biopsy. The tissue sample is examined in a laboratory to look for signs of inflammation and scarring.

A liver biopsy procedure can be uncomfortable, and it does have small risks that your healthcare provider will discuss with you in detail. This procedure is performed by a needle insertion through the abdominal wall and into the liver to obtain the liver tissue.


Treatment of Nonalcoholic Fatty Liver Disease

There is no medical treatment for a fatty liver, but various strategies can reduce the risk of liver problems and may reverse some damage that already exists.

The American Liver Foundation recommends:

  • Avoiding alcohol
  • Cooking with healthy oils, such as olive, soybean, safflower, or other vegetable oils
  • Eating plenty of whole grains and fresh fruits and vegetables
  • Exercising for at least 30 minutes a day
  • Limiting the intake of sugar, including sodas and sweetened juices
  • Restricting the intake of red meat and saturated fats
  • Avoiding foods containing added salt
  • Weight loss

The first line of treatment is usually weight loss through a combination of a healthy diet and exercise. Losing weight addresses the conditions that contribute to NAFLD.

Ideally, a loss of 10% of body weight is desirable, but improvement in risk factors can become apparent if you lose even 3% to 5% of your starting weight.

Weight-loss surgery is also an option for those who need to lose a great deal of weight. For those patients who have cirrhosis due to NASH, liver transplantation may be an option.

Diet

Researchers in a 2019 study investigating whether dietary changes can benefit people with NAFLD suggest consuming prebiotic fiber, found in leeks, asparagus, and other plant foods, and probiotic-enriched yogurt to help manage the intake of calories and boost the health of the gut microbiota.

Scientist also recommend opting for plant-based protein rather than animal-based protein.

Researchers are investigating whether vitamin E may help, but more research is required.

A tailored diet and exercise plan may also reduce the risk of various conditions, including obesity, diabetes, and cardiovascular disease, that often occur alongside NAFLD.

Alternative Medicine

No alternative medicine treatments are proved to cure nonalcoholic fatty liver disease. But researchers are studying whether some natural compounds could be helpful, such as:

  • Vitamin E: In theory, vitamin E and other vitamins called antioxidants could help protect the liver by reducing or neutralizing the damage caused by inflammation.Some evidence suggests vitamin E supplements may be helpful for people with liver damage caused by nonalcoholic fatty liver disease.
  • Coffee: In studies of patients with nonalcoholic fatty liver disease, those who reported drinking two or more cups of coffee a day had less liver damage than those who drank little or no coffee. It’s not yet clear how coffee may influence liver damage, but findings suggest it may contain certain compounds that may play a role in fighting inflammation.


Complications of Nonalcoholic Fatty Liver Disease

The main complication of NAFLD and NASH is cirrhosis, which is late-stage scarring in the liver. Cirrhosis occurs in response to liver injury, such as the inflammation in NASH. As the liver tries to halt inflammation, it produces areas of scarring (fibrosis). With continued inflammation, fibrosis spreads to take up more and more liver tissue.

Between 5% and 12% of patients with NASH will progress to cirrhosis.

If the process of fibrosis is not interrupted, cirrhosis can lead to:

  • Liver cancer
  • Confusion, drowsiness and slurred speech (hepatic encephalopathy)
  • Fluid build-up in the abdomen (ascites)
  • End stage liver failure
  • Hepatic encephalopathy
  • Swelling of veins in your esophagus (esophageal varices), which can rupture and bleed


Prevention of Nonalcoholic Fatty Liver Disease

To reduce the risk of nonalcoholic fatty liver disease (NAFLD). Th patient must choose the following:

  • Eat a healthy diet
  • Maintain a healthy weight
  • Exercise regulary

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