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Genetics and Fatty Liver- Understanding Your Risk

Fatty liver disease is a prevalent medical illness characterized by the accumulation of excess fat within the hepatic organ. The majority of individuals do not exhibit any symptoms, and the condition does not result in significant complications for them. However, in certain instances, it has the potential to result in liver damage. Fortunately, it is frequently possible to mitigate or even reverse the onset of hepatic steatosis with modifications in one’s lifestyle.

What is fatty liver disease?

Fatty liver disease, also known as steatosis, is a prevalent medical illness characterized by excessive accumulation of fat within the liver. A liver in a state of good health possesses a modest quantity of adipose tissue. The accumulation of fat in the liver becomes problematic when it constitutes 5% to 10% of the organ’s total weight. The phenomenon undergoes a sequential progression consisting of three distinct stages.

  • Hepatic inflammation, characterized by the enlargement of the liver, results in tissue impairment. This particular stage is referred to as steatohepatitis.
  • The formation of scar tissue occurs in instances of liver injury. The aforementioned biological phenomenon is commonly referred to as fibrosis.
  • The replacement of healthy tissue with a substantial amount of scar tissue is observed. 

Who is susceptible to developing fatty liver disease?

The etiology of nonalcoholic fatty liver disease (NAFLD) remains uncertain. It is widely acknowledged among researchers that this phenomenon exhibits a higher prevalence among those who:

  • Have been diagnosed with type 2 diabetes and prediabetes.
  • Obesity patients
  • Middle-aged and older individuals, while youngsters can also be affected,
  • Hispanic individuals are followed by non-Hispanic whites. The prevalence of this condition is lower in individuals of African-American descent.
  • Elevated concentrations of lipids in the bloodstream, including cholesterol and triglycerides.
  • Hypertension patients
  • Administer specific pharmaceutical substances, such as corticosteroids and some anti-neoplastic agents.
  • Certain metabolic illnesses, such as metabolic syndrome, have been identified.
  • Significant and expedited reduction in body mass.
  • Certain illnesses, such as hepatitis C, have been found to be prevalent in specific populations.
  • Exposure to certain toxic substances.

Non-alcoholic fatty liver disease (NAFLD) has a global prevalence of approximately 25% among the general population. The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing in the United States, paralleling the rising rates of obesity, type 2 diabetes, and high cholesterol. Non-alcoholic fatty liver disease (NAFLD) is widely recognized as the prevailing chronic hepatic illness in the United States.

Alcoholic fatty liver disease exclusively manifests in individuals with a history of heavy alcohol consumption, particularly those who have engaged in prolonged drinking patterns. Women who consume alcohol excessively, individuals who are obese, and those with specific genetic abnormalities are at an increased risk.

Is there a genetic component to the development of fatty liver?

There exists empirical data supporting the hereditary nature of non-alcoholic fatty liver (NAFL). Individuals with a familial history of non-alcoholic fatty liver are at a heightened susceptibility to developing the illness. Nevertheless, it should be noted that the presence of these factors does not guarantee the development of non-alcoholic fatty liver.

Recent research has substantiated the presence of hereditary variants of non-alcoholic fatty liver. One potential cause could be attributed to a genetic mutation in the ABHD5 gene.

Ongoing research is being conducted to investigate the potential of genetic testing in predicting an individual’s susceptibility to non-alcoholic fatty liver disease. It is postulated by researchers that this may potentially become a viable prospect in the foreseeable future. This intervention may also contribute to the effective management of the escalating prevalence of the aforementioned ailment on a global scale.

Consensus among researchers exists about the role of genetics in the etiology of non-alcoholic fatty liver (NAFL) and its associated comorbidities.

What are the etiological factors contributing to the development of fatty liver disease?

Fatty liver disease can manifest in individuals without any underlying medical issues. However, these identified risk factors increase the probability of developing the condition.

  • Experiencing overweight or obesity.
  • Individuals who have been diagnosed with Type 2 diabetes or insulin resistance.
  • The individual exhibits metabolic syndrome, characterized by insulin resistance, elevated blood pressure, increased cholesterol levels, and elevated triglyceride levels.
  • The use of specific prescription drugs, such as amiodarone (Cordarone®), diltiazem (Cardizem®), tamoxifen (Nolvadex®), or steroids.

What are the clinical symptoms associated with fatty liver?

Individuals afflicted with fatty liver disease frequently exhibit an absence of symptoms until the ailment advances to the stage of liver cirrhosis. In the event that an individual experiences symptoms, they may manifest as follows:

  • The individual may have abdominal pain or a sensation of satiety in the upper right quadrant of the abdomen.
  • Symptoms such as nausea, diminished appetite, or unintended weight loss may be experienced.
  • The presence of a yellowish hue in the skin and the sclera of the eyes, commonly referred to as jaundice.
  • The individual presents with an enlarged abdominal region and swelling in the lower extremities, commonly referred to as edema.
  • Severe fatigue or cognitive impairment.
  • Weaknesses

What are the various types of fatty liver disease?

Fatty liver disease manifests in two primary forms:

Alcoholic fatty liver disease

Regular alcohol use is the primary cause of alcohol-induced fatty liver disease. Approximately 5% of individuals residing in the United States are affected by this particular variant of hepatic disorder.

Non-alcoholic fatty liver disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is not associated with the usage of alcohol. The prevalence of this illness is observed in approximately 33% of adults and 10% of children residing in the United States. The precise etiology of non-alcoholic fatty liver disease has yet to be determined by researchers. There are other conditions, such as obesity and diabetes, that can elevate one’s susceptibility.

What are the therapeutic interventions available for patients diagnosed with non-alcoholic fatty liver disease (NAFLD)?

Medical professionals advise individuals with nonalcoholic fatty liver to pursue weight loss as a recommended course of action. The process of weight loss has been seen to have the potential to mitigate the accumulation of adipose tissue in the liver, alleviate inflammatory responses, and attenuate the development of fibrotic conditions. 

If a medical professional determines that a specific medication is the etiological factor behind an individual’s non-alcoholic fatty liver disease (NAFLD), it is advisable for the patient to discontinue the usage of this medication. However, it is advisable to consult with a healthcare professional prior to discontinuing the medication. It may be necessary to progressively discontinue the use of medication and maybe transition to an alternative pharmaceutical intervention.

  • Currently, there is a lack of approved pharmaceutical interventions for the treatment of non-alcoholic fatty liver disease (NAFLD). Ongoing research endeavors are currently examining the potential efficacy of a specific pharmaceutical intervention for diabetes as well as the potential benefits of Vitamin E. However, it is imperative to underscore the necessity for further investigations in order to establish conclusive evidence.
  • The cessation of alcohol consumption is paramount in the management of alcohol-related fatty liver disease. If assistance is required in accomplishing that task, it may be advisable to seek the guidance of a therapist or engage in an alcohol recovery program. Additionally, pharmaceutical interventions exist that can aid individuals in managing their alcohol consumption. These medications function by either diminishing appetites for alcohol or inducing unpleasant physical reactions upon alcohol ingestion.
  • Both alcoholic fatty liver disease (AFLD) and nonalcoholic steatohepatitis (NASH), a subtype of nonalcoholic fatty liver disease, have the potential to progress to cirrhosis. Healthcare professionals have the ability to address the health complications arising from cirrhosis through the administration of medications, surgical interventions, and several other medical procedures. In the event that cirrhosis progresses to liver failure, the potential necessity of a liver transplant may arise.

What are many lifestyle modifications that can contribute to the management of fatty liver disease?

For those diagnosed with any form of fatty liver disease, implementing certain lifestyle modifications can be beneficial.

  • Adopting a nutritious dietary pattern that includes the consumption of ample amounts of fruits, vegetables, and whole grains, while simultaneously restricting the intake of salt and sugar, is recommended for maintaining optimal health.
  • It is recommended to have immunizations for hepatitis A and B, influenza, and pneumococcal illness. The co-occurrence of hepatitis A or B in conjunction with fatty liver has an increased propensity to culminate in liver failure. Individuals diagnosed with chronic liver disease exhibit an increased susceptibility to infections, hence emphasizing the significance of administering the remaining two immunizations.
  • Engaging in regular physical activity has been shown to contribute to weight loss and the reduction of hepatic adiposity.
  • It is advisable to consult with a healthcare professional prior to incorporating dietary supplements, such as vitamins, or engaging in other complementary or alternative medical interventions or practices. Certain herbal medicines have the potential to cause liver damage.

There exists certain data suggesting a potential genetic component in the development of non-alcoholic fatty liver (NAFL). There exists a possibility that specific genes may contribute to an individual’s susceptibility to the aforementioned illness.

Non-alcoholic fatty liver (NAFL) is generally asymptomatic during its initial phases. In the event that an individual encounters symptoms, they may encompass feelings of exhaustion and sensations of discomfort localized in the upper right quadrant of the abdomen.

The standard approach to managing non-alcoholic fatty liver (NAFL) often entails implementing strategies to achieve progressive weight loss and engaging in consistent physical exercise.

Takeaway

Fatty liver disease is a prevalent medical illness characterized by the accumulation of excess fat within the hepatic organ. The majority of individuals do not exhibit any symptoms, and the condition does not result in significant complications for them. However, in certain instances, it has the potential to result in hepatic impairment. Fortunately, it is frequently possible to mitigate or even reverse the onset of hepatic steatosis with modifications in one’s lifestyle.

References:

  1. https://www.medicalnewstoday.com/articles/is-fatty-liver-hereditary
  2. https://my.clevelandclinic.org/health/diseases/15831-fatty-liver-disease
  3. https://medlineplus.gov/fattyliverdisease.html 
  4. https://www.nhs.uk/conditions/non-alcoholic-fatty-liver-disease/ 

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