Did you know that nonalcoholic fatty liver disease is the most common cause of elevated liver enzymes?

Did you know that this disease can range from simple fatty infiltration of the liver to full blown cirrhosis (permanently destroyed liver tissue)?  Cirrhosis can lead to the need for a liver transplant!

Did you know that obesity, diabetes, and high triglycerides are all closely linked to this condition?  And   most often, people are not even aware they have it!

Two thirds of patients with a BMI of 30 (obese) or greater have fatty liver disease.  More than 90% of patients with a BMI greater than 39 have this condition.

The diagnosis of nonalcoholic fatty liver disease requires that the daily alcohol intake be less than 20 grams (1.5 standard drinks) for women and less than 30 grams (2.0 standard drinks) for men.  Other causes of elevated liver enzymes (e.g. viral hepatitis, hemochromatosis, autoimmune, drug-related) must be ruled out.  Ultrasound provides a useful diagnostic tool, but ultimately if abnormalities persist, liver biopsy may be necessary.

Treating high triglycerides and insulin resistance (see previous newsletter article) with medication (statin drugs and metformin respectively) can be useful.

But weight loss and exercise are critical components to any successful treatment program for nonalcoholic fatty liver disease and often curative by themselves!

Samuel D. Blackwell, MD