5 surprising things to know about fatty liver disease

1. YOU CAN BE A TEETOTALER AND HAVE NAFLD There are two types of liver disease that are caused by an abnormal buildup of fat in the liver. NAFLD is the one not caused directly by alcohol

consumption, even though alcohol use can aggravate it. And while it’s true that you can live with a fatty liver, it’s also true that doing so raises your risk for type 2 diabetes and

cardiovascular disease, both of which are linked to an increased risk for liver disease, Abdelmalek says. “Simple fatty liver does not disturb liver function; however, progressive liver

injury and advanced [liver scarring] can impact liver function.” 2. MOST PEOPLE WITH NAFLD DON’T HAVE SIGNIFICANT LIVER DAMAGE In about 15 to 20 percent of cases, however, the excess fat in

the liver is accompanied by inflammation and damage to the liver’s cells, leading to an aggressive form of the disease called nonalcoholic steatohepatitis (NASH, for short). With NASH, the

liver damage is similar to the kind that’s caused by heavy alcohol use. There’s scarring of the liver (cirrhosis), liver cancer or liver failure. Not surprisingly, people with NASH are five

times more likely to die of liver disease than those with NAFLD that hasn’t progressed, according to research published in _Clinical Liver Disease_. Among people with NAFLD that hasn’t

progressed to the far more serious NASH, cardiovascular disease is the leading cause of death “due to the many shared metabolic risk factors,” Chen says. “Liver disease is the second leading

cause of death.” 3. YOU CAN HAVE NAFLD WITHOUT KNOWING IT People in the early stages of NAFLD usually have no symptoms, and routine blood tests may not show anything amiss with the liver,

Abdelmalek says. Complicating matters, elevated liver enzymes in the blood, a possible sign of NAFLD, are often dismissed as a side effect of other medications or the result of recent

alcohol consumption. “The disease has no specific symptoms until the very late stages, which occur after decades, so the disease is often undetected unless the patient has abnormal liver

tests or an abdominal ultrasound that demonstrates fat,” says Scott Friedman, M.D., chief of liver diseases and dean for therapeutic discovery at the Icahn School of Medicine at Mount Sinai

in New York City. “Physicians caring for patients with type 2 diabetes, hypertension or high blood lipids — especially if these patients are obese — should consider the possibility of

underlying NAFLD. Patients should also encourage their physicians to screen for this condition under these circumstances,” he adds. NAFLD can be diagnosed through standard blood tests for

the liver, “combined with imaging that includes either ultrasound or a bedside test that can measure liver stiffness,” Friedman says. This test, known as Fibroscan or transient elastography,

is now widely available in most liver specialists’ offices. 4. WOMEN ARE AT GREATER RISK OF NAFLD AS THEY AGE