In this video we will talk about an increasingly common health problem, even among children. I'm talking about fatty liver disease, known to most as fatty liver and common especially among alcoholics and heavily overweight people.
Fatty liver disease is a disease characterized by an excessive accumulation of fat inside the liver. In particular, we speak of fatty liver disease when the lipid content of the liver exceeds 5% of the weight of the organ. Usually, the fatty liver is due to a functional overload of the liver cells, which are called hepatocytes. When these cells are struggling with a greater amount of fat than they can process, they go into crisis and begin to accumulate triglycerides inside them. , therefore, as fatty liver is common especially among overweight and obese subjects. Furthermore, it is often associated with diabetes or high levels of triglycerides and cholesterol in the blood. Fatty liver usually has a benign but long-lasting course going can get complicated, especially if some predisposing factors persist; among these, the excessive consumption of alcoholic beverages plays a leading role. appropriate treatment, it may happen that the accumulation of fat leads to chronic inflammation of the liver, called steatohepatitis. This, in turn, over the years, can degenerate into cirrhosis, severely damaging the liver. Fatty liver disease does not involve specific symptoms, so its discovery is often a chance event; the suspicion of fattening of the liver arises, in particular, in the face of an increase in transaminases or in the volume of the organ on palpation. Then, for a certain diagnosis, further tests are necessary, such as liver ultrasound or a biopsy. The treatment of steatosis consists, as appropriate, in limiting alcohol, controlling weight and reducing the consumption of sugars and fats, respecting a balanced diet and practicing regular physical activity.
When talking about the causes of steatosis, first of all, a distinction must be made. In fact, two main forms of fatty liver can be observed: alcoholic steatosis and non-alcoholic steatosis. In the first case, the excess fat in the liver is obviously related to alcohol abuse, while non-alcoholic steatosis is mainly due to a poor diet, rich in fats and sugars, or even to type II diabetes. As anticipated, the excessive accumulation of fat inside the liver cells occurs when the quantities of fat in the blood exceed the disposal capacity of the liver. This excess can derive not only from dietary abuse, but also from alterations in the metabolism of fat, as occurs in the case of some genetic dyslipidemias characterized by high levels of triglycerides and cholesterol in the blood. Even too rapid weight loss for extreme diets and malnutrition can paradoxically lead to fatty liver disease. In addition, fatty liver can be found in the course of liver diseases of viral origin, such as chronic hepatitis from virus C. Among the most common risk factors, there are however those that characterize the so-called metabolic syndrome, or obesity, especially in the abdominal area, hypertension arterial blood pressure, increased blood fat, increased blood sugar and insulin resistance.Even the intense and prolonged use of some drugs, such as corticosteroids or some antiarrhythmics, can predispose to the onset of steatosis. Fatty liver can occur at all ages, but is mostly observed between the ages of 40 and 60. introductory part, fatty liver is not so rare in children; as in adults, even in pediatric age steatosis is related to the spread of childhood obesity and sedentary lifestyle.
Most patients with fatty liver do not have any particular symptoms or complaints. For this reason, fatty liver disease is often diagnosed following medical tests carried out for other reasons. Other patients suffering from fatty liver disease report, however, feelings of general malaise and fatigue, while at other times there may be mild discomfort or pain in the upper right part of the abdomen. However, the symptomatic picture becomes complicated in cases where steatosis evolves into fibrosis and cirrhosis; in these circumstances, loss of appetite and weight, loss of muscle mass, enlargement of the spleen and swelling of the lower limbs may occur.
Precisely with regard to the possible complications, even if it usually has a benign course, in 10-15% of cases non-alcoholic fatty liver disease can become complicated in steatohepatitis; in practice, in addition to the accumulation of fat, there is also a chronic inflammation of the liver. Unlike uncomplicated fatty liver disease, steatohepatitis is therefore characterized by the presence of an inflammatory reaction, which can also be associated with the death of liver cells . If steatohepatitis persists, attempts to repair this cellular damage can progressively lead to liver fibrosis, ie the replacement of liver cells with scarring connective tissue. This phenomenon causes hardening and scarring that permanently alter the function of the liver. inflammation can thus evolve, over time, towards liver cirrhosis and liver failure.
Fatty liver disease can be suspected in the presence of a liver which, on palpation, is increased in volume or in the face of altered levels of liver enzymes in the blood. The main alteration that can emerge from blood tests is the increase in transaminases and other liver enzymes, such as gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP). In addition to these indicators of liver damage, it is also possible to find an increase in parameters related to the metabolism of fats and sugars. An increase in blood triglycerides and cholesterol, blood sugar and basal insulin levels can therefore be detected. The diagnosis of fatty liver can be confirmed through imaging methods, such as liver ultrasound, CT scan or magnetic resonance imaging (MRI). For example, on ultrasound the liver appears larger and "brighter" than normal, a typical sign of steatosis due to excess fat mass. To confirm the diagnosis of steatohepatitis, however, it is necessary to collect a small sample of the liver by biopsy; The microscope analysis of the sample thus taken allows to estimate the possible presence of fibrosis and the degree of hepatic inflammation.
Regarding therapy, there are no specific pharmacological or surgical treatments for fatty liver. Fortunately, however, uncomplicated fatty liver disease tends to regress spontaneously with the decrease in body weight and the correction of eating habits. For this reason, it is usually sufficient to act on the triggering causes and carefully monitor steatosis through regular medical checks. To slowly regress steatosis it is therefore very important to follow a healthy and balanced diet, which helps to keep weight under control and reduce blood triglyceride levels. In summary, preference should be given to whole grains, lean protein sources, fish, fruit, legumes and vegetables. To be limited, however, are sweets and simple sugars and sugary drinks, in addition to saturated fats, preferring olive oil as a condiment. I remind you in this regard that saturated fats are present above all in red meats, cheeses and fatty meats and in condiments of animal origin. Equally useful and important is the practice of moderate and regular physical activity, while on the food front it is also necessary to avoid the consumption of alcohol, an important precaution to avoid triggering or worsening the inflammatory reaction.
