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Fatty liver, or hepatic steatosis, is a condition characterized by excessive fat accumulation in the liver. This seemingly simple imbalance can escalate into serious health complications, including liver inflammation, scarring, and even liver failure. Understanding fatty liver involves exploring its causes, types, symptoms, diagnosis, treatment, and prevention. The liver is one of the body’s most vital organs, performing crucial functions such as detoxification, protein synthesis, and bile production. It metabolizes nutrients, stores vitamins, and regulates blood sugar levels. However, excessive fat deposits in the liver can disrupt these functions, leading to significant health issues. NAFLD occurs in individuals who consume little to no alcohol. It is often linked to metabolic conditions such as obesity, type 2 diabetes, and dyslipidaemia. NAFLD can progress to Non Alcoholic Steatohepatitis (NASH), characterized by liver inflammation and potential scarring. AFLD results from excessive alcohol consumption. Alcohol metabolism generates toxic by-products that can damage liver cells, leading to fat accumulation. Continued alcohol abuse may progress to alcoholic hepatitis or cirrhosis. Excess body weight is a significant contributor to fat accumulation in the liver. These conditions impair fat metabolism, promoting hepatic fat storage. Chronic alcohol use disrupts lipid metabolism in the liver. Elevated blood lipids increase the risk of fat build up in liver cells.

These can disrupt fat metabolism, paradoxically leading to fat accumulation. Some drugs, such as corticosteroids and tamoxifen, are associated with fatty liver. Fatty liver often remains asymptomatic in its early stages, making it challenging to diagnose. Diagnosis involves a combination of medical history, physical examinations, and diagnostic tests. Understanding alcohol consumption, dietary habits, and underlying health conditions. Elevated liver enzymes (ALT and AST) may indicate liver damage. Ultrasound, CT scans, or MRI can reveal fat deposits in the liver. A definitive diagnosis may require a biopsy to assess the extent of fat accumulation and inflammation. While fatty liver is often benign in its early stages, untreated cases can lead to severe complications. Chronic inflammation can cause scarring (fibrosis), impairing liver function. Extensive scarring leads to cirrhosis, a life-threatening condition marked by liver failure and increased risk of liver cancer. Fatty liver is associated with a heightened risk of heart disease. Advanced cases can progress to liver cancer. Treatment focuses on addressing underlying causes and preventing disease progression. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Limiting saturated fats, refined sugars, and alcohol is crucial. Regular physical activity helps reduce liver fat and improve overall health.

Gradual weight loss (5%-10% of body weight) can significantly reduce liver fat. Drugs like metformin may help in cases associated with insulin resistance. Statins can address high cholesterol levels. Vitamin E and other antioxidants may reduce liver inflammation. Managing diabetes, hypertension, and dyslipidaemia is essential for controlling fatty liver. For AFLD, avoiding alcohol entirely is critical to prevent disease progression. Medications aimed at reducing liver fibrosis. Probiotics and dietary interventions to improve gut-liver axis health. Experimental approaches targeting genes involved in lipid metabolism. Regular exercise and a nutritious diet are key. Moderate alcohol consumption or complete abstinence for those at risk. Regular check-ups to manage diabetes, cholesterol, and hypertension. Use drugs with caution and under medical supervision.

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The authors declare that they have no competing interests.