How can obesity cause NAFLD? Can an untreated NAFLD lead to Liver cancer?
We spoke to Dr. Sujoy Maitra, Consultant Gastroenterologist, Manipal Hospitals, Kolkata, who told us about systemic disease called “Metabolic syndrome “.
FollowNAFLD (Non-alcoholic fatty liver disease) has emerged as the major cause of chronic liver disease and liver cancer in the last few decades owing to bad eating habits and sedentary lifestyles in developed and developing countries.
NAFLD is distinct from other liver diseases as it essentially represents the liver manifestation of a systemic disease called “Metabolic syndrome “. The central factor of this problem is obesity, leading to insulin resistance and hyperinsulinemia. This means the hormone insulin cannot work properly in the presence of obesity and therefore body produces more insulin.
This excess insulin leads to the manufacturing of more fat ( triglyceride) in the liver and fat cells, thereby precipitating a vicious cycle. No wonder the increase in the risk of developing NAFLD runs parallel to the prevalence of obesity.
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Nevertheless, apart from obesity, there are genetic factors too responsible for the ethnical variation of the disease and its progression to more severe forms like NASH, Fibrosis/ cirrhosis and HCC. Hence there is almost a 8% prevalence of NAFLD in lean individuals in South Asian countries.
METABOLIC SYNDROME
The progression of NAFLD to its more severe variants is complex and not clearly understood yet. It may sound reassuring that only a third of NAFLD progresses to NASH and even less to cirrhosis or HCC. But the scary aspect is the whole process happens silently and unpredictably. So patients present with HCC at a late stage where liver transplantation remains the only treatment option. Consequently, NASH-related HCC has emerged as the second most common indication for HCC-related liver transplant.
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Till date there is no “magic” drug for NAFLD. Therefore the key message on the eve of “World Liver day” is everyone should be on their guard and try to lose extra flab by a strict diet and exercise regime and must consult a liver doctor for proper guidance.
