NAFLD* WHAT IT IS AND WHY IT MATTERS

Non-alcoholic fatty liver disease, or NAFLD, is becoming increasingly common, estimated to affect nearly one-third of adults in Western countries like Australia. If you have type 2 diabetes, you are more likely to be affected. DL magazine dietitian and diabetes educator, Dr Kate Marsh, explains what it is, why it matters and what you can do to keep your liver healthy.

- Dr Kate Marsh

*Non-alcoholic fatty liver disease

Fatty liver - what is it?

Fatty liver is just what its name suggests – the build-up of fat in the liver cells. Excess alcohol intake is a major cause of fatty liver. However the condition is becoming increasingly common in those who don't drink to excess and is referred to as non-alcoholic fatty liver disease, or NAFLD. This type of fatty liver appears to be related to insulin resistance, the underlying problem in type 2 diabetes. Insulin resistance changes the way in which the liver, muscles and fat cells process sugar and fat. As a result, the liver cells take up more fat, in the form of triglycerides (also known as blood fats) and these fats are stored inside the liver cells, causing a fatty liver.

How do I know if I have a fatty liver?

One problem with fatty liver disease is that it doesn't usually have any symptoms in the early stages, so most people aren't aware they have it. It is usually diagnosed when blood tests show abnormal liver function tests, or on an ultrasound. The only way to get a definite diagnosis is by having a liver biopsy, but this isn't always necessary as other tests can give your doctor enough information to suggest that something needs to be done. If symptoms do occur, the most common are fatigue, abdominal pain (particularly in the upper right part of the abdomen) and an enlarged liver on examination.

The strong link between NAFLD and diabetes, overweight and metabolic syndrome has led some experts to recommend a change in name from NAFLD to metabolic dysfunction-associated fatty liver disease, or MAFLD.

Why does fatty liver matter?