Danger: fatty liver

The 20th of November is German Liver Day. The IFB informs about causes and consequences of fatty liver disease.

The motto of this year's 13th German Liver Day on November 20th is "Which value does your liver has?" In advance, the Integrated Research and Treatment Center (IFB) AdiposityDiseases explains why the liver is so important and why the biggest gland in the human body needs to be preserved by a healthy lifestyle.

We can hear our heartbeat, the chest moves when we breathe. However, we don't feel our liver. Only very few people are aware of their liver function test results or the function of the organ that has its place in the upper right abdominal area. Yet the liver plays an indispensable role in the metabolism of our body: absorbed substances either are disposed, stored, metabolized or broken down in the liver cells. Whether it's detoxication, storage of glucose and fats or synthesis of proteins and the body's cholesterol - the liver is involved.

The effects of an unhealthy lifestyle on this vitally important organ are underestimated by many since not only alcohol can harm the liver!

Already 20 to 30 percent of the population in industrialized countries suffer from a fatty liver disease that was not caused by alcohol. In fact, only 10 percent of liver diseases can be traced back to excessive alcohol consumption. 90 percent of people with excessive overweight will suffer from a fatty liver later in life. Also 30 to 50 percent of all diabetes patients and the majority of people with increased blood fat levels are seriously affected from fatty liver.
Dr. Thomas Karlas, internist at the IFB, explains that "for the development of a fatty liver that is not caused by alcohol it is most likely an unhealthy diet with an excessive consumption of carbs and fat" that is responsible. Especially obese people are affected since the fat is not only stored in the subcutaneous fat tissue but also in the abdominal area and in organs such as the liver." Anyway, not only overweight is related to the development of fatty liver. Genetic predisposition or changes in the intestinal flora can cause fatty liver disease as well. Dr. Karlas, together with PD Dr. Johannes Wiegand investigate special ultrasound procedures (elastography) that show the degree of liver damage by measuring the elasticity of the liver. By ultrasound it can be examined whether a fatty liver (steatosis), a cicatrisation of the liver (fibrosis) or even liver cirrhosis is the case. "It is alarming that in 10 to 25 percent of all cases people with a fatty liver develop liver cirrhosis that can remain undetected and asymptomatic over years," Dr. Karlas warns. In most cases increased liver function test results and inflammation parameters remain undetected until the blood is examined.

Nutritionist Dr. Tatjana Schütz knows about therapeutic possibilities concerning fatty liver. In the research area "Bariatric Surgery" she employs different "low energy" diets for adipose patients that prepare for a bariatric surgery such as stomach stapling surgery. Those patients often don't have any other possibilities left after diets and exercise programs have failed. Dr. Schütz explains how this diet works: "The linchpin is the reduction of the energy supply to 800 to 1200 kcal per day. The patients get special finished products, mostly in pulver form, which are prepared with water and contain all the necessary vitamins and minerals. Employed during two weeks before a bariatric surgery this diet reduces the liver fat levels and the liver becomes smaller." That especially thrills the surgeons who thus have more space in the abdominal area during surgery.

The non-alcoholic fatty liver disease just like a slight alcohol-induced fatty liver can be reformed by corresponding treatment and change in lifestyle. In order to prevent possible complications of the disease especially overweight patients with fatty liver disease should regularly consult a doctor.

Annekathrin Härter

Milic S, Stimac D. Nonalcoholic fatty liver disease / steatohepatitis: epidemiology, Pathogenesis, Clinical Presentation and treatment. Dig Dis 2012; 30: 158-162.

Colles SL, Dixon JB, Marks P, Strauss BJ, O’Brien PE. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr 2006; 84:304-311.

Keywords: associated diseases