A normal liver contains about 5% fat. Fatty liver refers to a condition where the amount of fat deposited in the liver exceeds 5%. Fatty liver is mostly asymptomatic, and is common in 20-30% of adults, so there are not a few cases that are neglected without proper treatment. However, a neglected fatty liver can cause various complications and symptoms, so care must be taken. We discussed the importance of fatty liver treatment and treatment methods with Seo Ji-ho, director of internal medicine (Jangsoksok Internal Medicine).
Seo Ji-ho, director of Jangsoksok Internal Medicine｜Source: Haidak
Q. What is the difference between alcoholic and non-alcoholic fatty liver?
It is classified as alcoholic and non-alcoholic according to the amount of alcohol consumed. Non-alcoholic fatty liver disease is classified as non-alcoholic fatty liver disease if you don’t drink alcohol or only drink a small amount. A small amount here is based on alcohol intake of no more than one bottle of soju per week for women and no more than two bottles of soju per week for men.
The incidence of fatty liver is increasing rapidly due to the recent increase in the population of obesity and diabetes, and it is estimated to occur in about 20-30% of adults in Korea. Non-alcoholic fatty liver disease can progress not only to simple fatty liver but also to end-stage liver diseases such as cirrhosis (cirrhosis of the liver) and hepatocellular carcinoma. In particular, as the risk of cardiovascular disease is high, active management is required.
Q. What are the methods and criteria for diagnosis?
Liver function tests and abdominal ultrasonography are often used. However, liver function tests are often normal, so an abdominal ultrasound is recommended as the primary screening test. If non-alcoholic fatty liver disease is suspected by abdominal ultrasonography, non-invasive tests such as CT, MRI, serum test, and liver fibrosis scan may be performed as additional tests. An invasive liver biopsy may also be considered in high-risk groups with advanced liver fibrosis or in cases where other liver diseases need to be excluded.
In particular, a screening test for non-alcoholic fatty liver disease is required if the liver level is persistently elevated in a health check-up. In the case of diabetes, an active check-up is recommended regardless of the liver level.
Q. Are there any symptoms of non-alcoholic fatty liver disease?
There are no specific symptoms. However, depending on the course of the disease, it can be accompanied by various symptoms. A mild fatty liver with only simple fat and no liver cell damage has no symptoms, but if liver cell damage is severe and lasts until cirrhosis (cirrhosis of the liver), severe fatigue, itching, ascites or accompanying jaundice.
The reason why the liver is often called a silent organ is because there are no abnormalities in blood tests or subjective symptoms even when cirrhosis of the liver develops to a moderate or severe degree. Therefore, if you have risk factors, it is recommended to have blood tests and abdominal ultrasound follow-up tests from time to time.
Fatty Liver｜Source: Getty Image Bank
Q. Is non-alcoholic fatty liver a disease that needs to be managed and treated?
Non-alcoholic fatty liver is associated with cirrhosis of the liver (cirrhosis) and hepatocellular carcinoma due to ongoing damage to liver cells, as well as metabolic syndrome such as obesity, diabetes, and insulin resistance, which lead to increased mortality due to cardiovascular diseases and liver-related complications. Therefore, it needs to be controlled and tracked.
The most important thing in treating fatty liver is lifestyle modification. Weight loss of 5% or more, a diet that includes a reduction in energy intake of 500 kcal or more per day, moderate intensity exercise therapy for at least 30 minutes at least 3 times per week, and alcohol restriction are required.
Reducing overall calorie intake is particularly important. A low-fat diet is important, but a low-carb diet is even more important. It is recommended to reduce the intake of carbohydrates and eat a good balance of fat and protein. It is recommended to do aerobic exercise such as walking, jogging, swimming, and cycling at a moderate intensity for 30 to 60 minutes at least twice a week for at least 6 weeks.
Q. Are there any nutritional supplements that help cure fatty liver?
To date, there are no nutritional supplements that have been proven to have therapeutic effects. Nutrients that are useful or help with metabolic syndrome associated with non-alcoholic fatty liver are recommended on the Internet, but the management of fatty liver through weight loss described above is the most effective and important.
In addition, non-alcoholic fatty liver increases the incidence and mortality of cardiovascular disease, so patients with cardiovascular risk factors require treatment for the disease. Finally, taking health juices and nutritional supplements, not prescription medications prescribed by a specialist, can cause an increase in the level of the liver or dysfunction of hepatocyte synthesis, so it is recommended that you consult your doctor before taking them.
Support = Director Seo Ji-ho (Jangsoksok Internal Medicine Specialist)
