Fatty Liver

Fatty liver disease refers to the abnormal accumulation of triglycerides in liver cells (hepatocytes). It progresses through a spectrum of liver conditions, from simple steatosis (fat accumulation) to more severe stages like non-alcoholic steatohepatitis (NASH), liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC).

Stages of Liver Disease

Normal Liver

Fatty liver

Liver Fibrosis

Cirrhosis

Symptoms of Fatty Liver Disease

Fatigue and unexplained weakness
Abdominal discomfort (especially in the upper right quadrant)
Jaundice (yellowing of skin and eyes)
Dark patches on skin (Acanthosis Nigricans)
Redness of palms (Palmar Erythema)
Hair thinning or hair loss

Causes of Fatty Liver Disease

Obesity and Metabolic Syndrome
Type 2 Diabetes and Insulin Resistance
Excessive Alcohol Consumption
High Cholesterol and Triglycerides
Poor Diet (high in processed foods and sugars)
Sedentary Lifestyle
Chronic Viral Hepatitis (e.g., Hepatitis C)

Limitations of Medication Therapy

Pharmacological Interventions
Approach: Drugs like Pioglitazone (for insulin resistance), Vitamin E (for NASH in non-diabetics), and emerging options like GLP-1 receptor agonists (e.g., Semaglutide).
Limitations: No FDA-approved drug specifically for NAFLD/NASH; side effects include weight gain (Pioglitazone) and bleeding risk (Vitamin E).
Lipid-Lowering Medications (Statins & Fibrates)
Approach: Used to manage high cholesterol and triglycerides, which contribute to NAFLD progression.
Limitations: Does not directly reverse fatty liver; requires long-term use and may elevate liver enzymes in rare cases.
Bariatric Surgery
Approach: Weight-loss surgeries (e.g., gastric bypass or sleeve gastrectomy) in severe cases with obesity (BMI >35).
Limitations: Invasive procedure with surgical risks; requires lifelong dietary adjustments; not suitable for all patients.