Fatty liver disease is closely linked to the development of metabolic abnormalities such as insulin resistance, dyslipidemia, obesity and hypertension. In the new clinical guidelines on fatty liver, recently published in Hepatology, these abnormalities associated with the accumulation of fat in the liver are discussed.
Obesity
Obesity is associated to the development of fatty liver and the progression of the disease. The distribution of body fat is known to be an important factor in the development of fatty liver. Thus, the distribution of android fat (fat accumulation at the abdominal level) implies a higher risk of insulin resistance, cardiovascular disease and liver fibrosis, regardless of body mass index. On the contrary, the gynoid fat distribution (increased fat in the hips and buttocks, which is very frequent in women) could be favorable to avoid or reduce the risk of developing fatty liver. The risk of an aggressive progression of fatty liver disease depends on the fat deposited in the viscera (visceral fat). In our Foundation, Dr. Carreño and the team of hepatologists take into account the distribution of body fat as a prognostic factor in the progression of fatty liver disease.
Type 2 diabetes
Type 2 (adult-onset) diabetes carries a risk of developing fatty liver, progression of liver fibrosis and hepatocarcinoma. The prevalence of fatty liver in patients with type 2 diabetes ranges from 30-75%.
Arterial hypertension
Similarly, arterial hypertension is also frequently associated with fatty liver. In the initial stages of fatty liver disease, 6.5% of patients present arterial hypertension, rising to 14.5% in those with liver cirrhosis. Also patients with fatty liver present twice the risk to have elevated cholesterol and triglyceride levels than people without this disease. In addition, fatty liver is associated with the possibility of suffering from kidney disease.
Cardiovascular diseases
On the other hand, cardiovascular diseases constitute an important cause of death in patients with fatty liver. There is a strong association between fatty liver and sclerotic heart disease, heart failure, and arrhythmias, especially with atrial fibrillation.
Finally, compared to the general population, the presence of fatty liver is associated with a higher frequency of development of digestive cancer (colon, stomach cancer, etc.).
In summary, fatty liver does not affect a single organ but is a disease that can be considered multi-organ, as Dr. Carreño explains to patients.
