Fatty liver disease is the most common liver disease in Finland

Fatty liver disease is the most common liver disease in Finland and occurs in more than a third of the adult population. Fatty liver disease is most common in older overweigh people, but it is diagnosed even in children under school age. Obesity, especially abdominal obesity, is a significant cause of fatty liver disease, but the disease can also occur in people of normal weight.

What is fatty liver disease? 

When more than five percent of the liver cells contain large droplets of fat, the condition is called fatty liver disease. The accumulation of fat causes the liver to swell. As a result of this swelling, the wight of the liver can increase by many kilograms. 

Fatty liver is strongly associated with metabolic disorders such as type 2 diabetes, fat metabolism disorders and high blood pressure. People with diabetes and metabolic syndrome have an increased risk of developing fatty liver disease. Fatty liver can also be caused by pregnancy, excessive consumption of fructose, some medications, and alcohol consumption, for example.

Fatty liver can become cirrhosis

If left untreated, fat accumulation can damage the liver, as the disease can precede liver inflammation and cause scarring, fibrosis, which means the formation of connective tissue, and even liver cirrhosis. Fatty liver also increases the risk of cardiovascular disease. 

Diagnosing fatty liver

Fatty liver cannot be diagnosed without examinations, but it should always be suspected if a person is clearly overweight or has metabolic risk factors. Fatty liver is often diagnosed when looking for a reason for elevated liver values detected during a health check. A fatty liver can result in elevated values in blood tests that provide information about the state of the liver. If elevated values are found in a person with abdominal obesity and no other reason is detected, fatty liver is evident. However, normal liver values do not exclude the existence of fatty liver disease. 

Fatty liver and alcohol 

Fatty liver is the most common cause of chronic liver disease worldwide. In connection with fatty liver, the general terms of metabolic fatty liver disease and alcoholic liver disease are used. In the case of more than 25% of people with fatty liver disease, the condition is directly related to alcohol consumption  This means the daily consumption of more than three alcoholic drinks for men and more than two alcoholic drinks for women

Studies have found that the effect of binge drinking is the most harmful on the body. Alcohol use cannot always be considered in isolation from other health-related risk factors, and alcohol-related harm is not limited to a small minority of people who are addicted to alcohol. However, safe levels of alcohol consumption are difficult to determine because the risk of severe liver disease is also affected by other factors, such as gender, genome and metabolic risk factors. There is currently no safe alcohol consumption limit.

The link between fatty liver disease and alcohol use and metabolic syndrome has been extensively studied recently. The official risk limit values are the following:

• Waist circumference in excess of 100 cm for men and 90 cm for women

• A blood lipid value, or triglyceride, of more than 1.7 mmol/l

• Good blood cholesterol, or HDL cholesterol, of less than 1.0 mmol/l in men and less than 1.3 mmol/l in women.

• Blood pressure of 130/85 mmHg or higher.

• Fasting blood sugar of 5.6 mmol/l or higher.

The development of metabolic syndrome is largely due to excessive calorie intake and physical inactivity. In addition, metabolic syndrome often occurs in people with metabolic fatty liver disease. 

For a person with fatty liver disease, alcohol is more harmful than usual, and safe risk limits cannot be determined. Even small doses of alcohol can lead to an inflammatory reaction of liver cells over time and increase the risk of cirrhosis.

Based on a Finnish study, it has been concluded that one pint of beer is as harmful to the liver of a person with belly fat as four pints for a person of normal weight.

The prognosis for fatty liver treatment is good

The primary goal of fatty liver treatment is moderate weight loss. A 10% weight loss reduces the size of the liver, and the amount of fat in the liver decreases proportionally more than in other parts of the body. In addition, inflammatory changes and mild fibrosis changes also begin to repair themselves.

In addition to lifestyle changes, good treatment of any other diseases, such as diabetes and fat metabolism disorders, is important. In the case of alcohol-induced fatty liver disease, the use of alcohol must be stopped. Alcohol is always a burden on the liver, which is why its consumption should be kept moderate in any case.

A fatty liver alone has a good prognosis. If there is fatty liver inflammation in addition to fat in the liver, the situation is more serious. In this case, connective tissue, or fibrosis, can form in the liver as a result of inflammation, which can develop into liver cirrhosis in some people. Liver cirrhosis is always associated with a risk of liver cancer. Severe fatty liver disease increases the risk of inflammation, but genetic predisposition also has an effect. 

Sources:

www.muma.fi 

www.terveyskylä.fi 

www.hus.fi 

Alcohol consumption and metabolic syndrome: Clinical and epidemiological impact on liver disease, Fredrik Åberg1, Christopher D. Byrne Carlos J. Pirola, Ville Männistö, Silvia Sookoian, Journal of Hepatology, January 2023. vol. 78 j 191–206. 

Interaction Between Alcohol Use and Metabolic Risk Factors for Liver Disease: A Critical Review of Epidemiological Studies, Fredrik Åberg, Martti Färkkilä, and Ville Männistö, Alcohol Clin Exp Res, Vol **, No *, 2019: pp 1–20. 

Maksakirroosi – tunnista yleistyvä kansatautimme varhain, Fredrik Åberg & Perttu Arkkila. Lääkärilehti 37/2017 VKS72. 

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