A recent study on fatty liver disease has found that more than 15 million people in the US, UK, Germany and France do not know they have the most aggressive form of fatty liver disease.
It was reported that metabolic dysfunction-associated liver disease (MASLD) – the formal name for non-alcoholic fatty liver disease – occurs in people who drink no or minimal amounts of alcohol whose liver contains more than 5% fat.
The report goes on to state that, the condition, which is also associated with obesity, heart and circulatory disease, affects about two-thirds of patients with type 2 diabetes.
Across the world, about 5% of adults are said to have the most aggressive form of MASLD. Metabolic dysfunction-associated steatohepatitis (MASH) causes fibrosis (scarring and is linked to greater risk of cardiovascular disease, chronic kidney disease and liver cancer ) and can lead to cirrhosis.
What Is fatty liver disease?
Non-alcoholic fatty liver disease is the name given to a range of conditions caused by a build-up of fat in the liver. Early-stage NAFLD does not usually cause any harm, it can go on lead to serious liver damage, including cirrhosis, if it gets worse.
According to the NHS: “having high levels of fat in your liver is also associated with an increased risk of serious health problems, such as diabetes, high blood pressure and kidney disease”.
NAFLD also increases your chance of developing heart problems, If you already have diabetes.
It is possible to stop NAFLD getting worse and reduce the amount of fat in your liver, if the problem is detected and managed at an early stage.
People unaware they have fatty liver disease
Most worryingly of all is the fact that the vast majority of people who have the condition do not know they have it. The report highlights that an international group of researchers examined prevalence and diagnosis of aggressive fatty liver disease in the US, UK, Germany and France.
The researchers found that just under 3% of people in the UK, France and Germany, and 4% of those in the US have MASH, but diagnosis rates were below 18%. That means about 20 million people in the US, UK, Germany and France are living with MASH but only 2.5 million people have a diagnosis, leaving more than three-quarters – about 16.7 million people – unaware they have the condition.
The report, by The Lancet Regional Health Journal, is calling for a doubling in diagnosis rates from 2022 levels. Non-invasive methods such as blood tests, ultrasound and MRI scans can be used to diagnose MASH, as well as the traditional diagnosis through biopsy. Consequently, it is said that the researchers have concluded that everyone with type 2 diabetes; obesity combined with one or more other risk factors; and those with persistently high liver enzymes should be screened for MASH.
Dr Jeffrey Lazarus
The lead author of the paper is Dr Jeffrey Lazarus, who is a professor of global health in New York and Barcelona. Was reported as saying, in The Guardian: “Undiagnosed MASH costs economies billions of pounds in lost productivity and poor health. Unless diagnosis rates are doubled, alongside similar increases in treatment and care, direct health costs alone are predicted to triple over the next 20 years.”
In response to the findings, Emmanouil Tsochatzis, a professor of hepatology at University College London and a consultant hepatologist at the Royal Free hospital, commented: “More than 15 million people across the US and Europe have the deadliest form of fatty liver disease – and don’t know it. Without faster diagnosis and access to treatment, the human and economic toll will skyrocket.”
What to do if you have non-alcoholic fatty liver disease
According to the NHS there are a number of things you can do if you have non-alcoholic fatty liver disease:
Adopting a healthy lifestyle is the main way of managing NAFLD.
For example, it can help to:
- Lose weight – you should aim for a BMI of 18.5 to 24.9 (use the BMI calculator to work out your BMI); losing more than 10% of your weight can remove some fat from the liver and improve NASH if you have it
- Eat a healthy diet – try to have a balanced diet high in fruits, vegetables, protein and carbohydrates, but low in fat, sugar and salt; eating smaller portions of food can help.
- Have water instead of sweet drinks
- Exercise regularly – aim to do at least 150 minutes of moderate-intensity activity, such as walking or cycling, a week; all types of exercise can help improve NAFLD, even if you do not lose weight
- Stop smoking – if you smoke, stopping can help reduce your risk of problems such as heart attacks and strokes
- NAFLD is not caused by alcohol, but drinking may make it worse. It’s therefore advisable to cut down or stop drinking alcohol.
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