Reviewed By: Pramod Kerkar, MD, FFARCSI

Non-alcoholic liver disease (NAFLD) describes the liver abnormalities, which are ranging from simple steatosis to nonalcoholic steatohepatitis with or without cirrhosis development. It commonly occurs in the significant absence of alcohol consumption. It occurs in all the age and races and is recognized to occur in 14%–30% of the general population. Obesity, type 2 diabetes mellitus, and dyslipidemia (abnormal cholesterol level) are the most common metabolic risk factors associated with NAFLD. The effective prevention and treatment of NAFLD are expected to reduce the burden of liver disease and cardiovascular disease.

Can Fatty Liver Disease go Away?

Can Fatty Liver Disease Go Away?

The condition is “reversible” if appropriate treatment strategies are followed. It includes identification and treatment of associated metabolic conditions such as diabetes, obesity, and dyslipidemia. Hepato-protective agents such as antioxidants drugs help to protect the liver from secondary insults. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and other markers of liver injury may be useful in the diagnosis of NAFLD. One can make it “reversible” by improving insulin resistance by weight loss, food control, and physical exercise. Weight reduction may be achieved by caloric restriction from dieting and physical exercise. Patients who are morbid obesity, bariatric surgery may be helpful. It is achieved by reducing the size of the stomach with a gastric band or through the removal of a portion.

Diet, Weight Loss, and Exercise Can Get Rid Of The Fatty Liver Disease

Most of the triggering factors associated with NAFLD are overweight and obese. 10% of weight reduction and regular exercise are associated with improvement in insulin sensitivity. Rapid weight loss induced by very low energy diet (388 kcal/day) is associated with increased portal inflammation and serum bilirubin levels and thus should be avoided. Energy restriction of about 25–30 kcal/kg/day seems reasonable with a target weight loss of about 10% of body weight over six months. Physical exercise is a proven therapeutic strategy to improve fatty liver disease. Physical exercise increases fatty acid oxidation, decreases fatty acid synthesis, and prevents mitochondrial and hepatocellular damage through a reduction of the release of damage-associated molecular patterns.

Patients with NAFLD seem more likely to have a diet high in saturated fats and cholesterol and low in fiber and antioxidants. This kind of diet is the main triggering factor NALFD. Mono and poly-unsaturated fats may potentially improve insulin resistance and may be beneficial in improving hepatic steatosis.

Pharmacotherapy for NALFD

Understanding of the pathogenesis of NAFLD and appropriate drug treatment to manage the metabolic disorder can help to get rid of liver disease easily. Insulin-sensitizing drugs, anti-oxidants drugs, and lipid-lowering drugs are potential candidates for the treatment of NAFLD. Metformin is a biguanide antihyperglycaemic agent have shown much improvement for hepatic steatosis. Probucol is a lipid-lowering potent antioxidant and has effect in patients with NAFLD. Vitamin treatment significantly improved hepatic inflammation and fibrosis compared with baseline. However, recent evidence has also suggested that vitamin E supplementation may be associated with an increased risk of death and heart failure. Angiotensin II promotes insulin resistance and hepatic fibrosis and Ursodeoxycholic acid (UDCA) has anti-inflammatory, immune modulating, and antiapoptotic properties and is widely used in chronic cholestatic liver diseases. Statins are the well-known candidate, which reduces the level of low-density lipoprotein or “bad cholesterol” in the body.

Conclusion

Various regimens of aerobic and resistance training have been shown to reduce hepatic fat content through improvements in insulin resistance, liver fatty acid metabolism, liver mitochondrial function, and activation of inflammatory cascades. Moreover, appropriate drugs are effective in treating the elevations of liver enzymes, type 2 diabetes, obesity, and dyslipidemia. Early detection of NAFLD can reduce the risk of cirrhosis, hepatocellular carcinoma and cardiovascular disease in diabetes patients. The condition is “reversible” if appropriate treatment strategies are followed.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: November 14, 2018

This article does not provide medical advice. See disclaimer

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