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November 19, 2003
ST. LOUIS -- Diabetes. Heart disease. High blood pressure. Sleep apnea. Osteoarthritis. And now, fatty liver disease.
The latest consequence of Americans' sedentary lifestyle, fatty liver disease - literally, the development of excessive fat deposits in the liver - is becoming increasingly common. Left untreated, it can lead to inflammation and scarring similar to that seen in alcoholics.
Dr. Brent Tetri, a hepatologist at the Liver Center at Saint Louis University School of Medicine and a leading researcher of the condition, says nonalcoholic fatty liver disease (NAFLD) is a growing problem, affecting about 20 percent of Americans.
"This is a diagnosis we weren't making very often just a few years ago. Now I see new cases every week," he said. "We don't yet know the full extent of the problem, since it is a 'silent disease' with few symptoms. A lot of people don't even know they have it until the damage is very severe.
"This is one more reason to eat less and exercise more."
While NAFLD does not cause problems for everyone who has it, about a quarter of fatty liver patients go on to develop inflammation known as nonalcoholic steatohepatitis (NASH). In a third of those patients, NASH can lead to scarring and ultimately cirrhosis-severe liver scarring-which can cause organ failure, requiring a liver transplant, or even death. Symptoms of cirrhosis include exhaustion, nausea, weakness and jaundice.
"The idea is to reverse the condition before it progresses to that point," Dr. Tetri said. "We know this is directly related to lifestyle. By increasing their activity level and eating fewer calories, patients can avoid the unpleasant symptoms."
Dr. Tetri published research in the October issue of the journal Hepatology suggesting that insulin resistance - which is linked to overweight and obesity - directly contributes to NASH. "Improving insulin sensitivity may be an important way to treat this liver disease."
He recommends those who are concerned they may have fatty liver disease to have a blood test done by their family physician. Blood tests can indicate the presence of a fatty liver, although definitive diagnosis of the disease must be done through a liver biopsy, he said.
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first M.D. degree west of the Mississippi River. Saint Louis University School of Medicine is a pioneer in geriatric medicine, organ transplantation, chronic disease prevention, cardiovascular disease, neurosciences and vaccine research, among others. The School of Medicine trains physicians and biomedical scientists, conducts medical research, and provides health services on a local, national and international level.