Fatty Liver Disease

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Fatty Liver Disease

Context:

13th June is celebrated as Global Fatty Liver Day. A day to raise awareness of fatty liver disease which affects more than 115 million people around the world. This is expected to increase to 357 million by 2030.

 

More in news:

  • The theme for this year is ‘Act Now, Screen Today’.
  • Historically, liver diseases were primarily associated with excessive alcohol consumption.
  • Non-alcoholic fatty liver disease (NAFLD) is now recognized as a significant health threat.
    • It has been reclassified as ‘Metabolic dysfunction-associated steatotic liver disease’ (MASLD).
  • MASH (Metabolic dysfunction-associated steatohepatitis) is expected to be the leading cause of chronic liver disease and liver transplantation.
    • Global MASLD prevalence is estimated at 25-30%.
    • In India, prevalence among adults: 38.6%; among obese children: 36%.
  • The approach to liver health has shifted to emphasise screening, testing, and treatment.

What are MASLD and MASH?

  • MASLD: Metabolic dysfunction-associated steatotic liver disease, formerly known as non-alcohol related fatty liver disease (NAFLD).
  • MASH: Metabolic dysfunction-associated steatohepatitis, formerly known as non-alcoholic steatohepatitis (NASH).
    • MASH is the advanced stage of MASLD. It means that your condition is causing inflammation and damaging your liver again, despite low or no alcohol use.
  • Causes and Progression: Both MASLD and MASH are caused by fat accumulation in the liver, leading to irritation and damage, which can result in scarring.

 

Fatty Liver Disease

Link Between Fatty Liver Disease and Metabolic Syndrome:

  • Close association with metabolic syndrome, including obesity, diabetes, high blood pressure, and abnormal cholesterol levels.
  • Excessive consumption of carbohydrates, especially refined carbs and sugars, exacerbates metabolic issues.
    • Elevated glucose levels lead to increased insulin production to manage glucose absorption.
    • Persistent high insulin levels result in insulin resistance.
    • It disrupts normal metabolism, promoting conversion of excess glucose into fatty acids.
  • Fatty acids accumulate in liver cells, leading to fatty liver disease.
  • Progressive damage can impair liver function, advancing from simple fatty liver to steatohepatitis and cirrhosis.
    • These severe conditions may necessitate liver transplantation.

The National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) provides wider coverage. 

  • Providing services for Chronic Obstructive Pulmonary Disease (COPD) and Asthma, Chronic Kidney Disease (CKD) and Non-Alcoholic Fatty Liver Diseases NAFLD), ST Elevation of Myocardial Infarction (STEMI) apart from Hypertension, Diabetes and three common Cancers including Oral, Breast and Cervical. 

Importance of Early Detection and Comprehensive Screening:

  • Disease often goes undetected due to the lack of early symptoms, leading to diagnosis at advanced stages with significant liver damage.
  • Early diagnosis requires comprehensive health screening,
    •  including history, physical examination (height, weight, BMI, abdominal girth, waist-to-hip ratio), blood tests (cardio-metabolic risk factors, liver and kidney tests), and abdominal ultrasound.
  • An integrated approach using ultrasound, comprehensive metabolic screening, and Liver fibrosis assessment via transient elastography effectively detects and manages liver diseases early.

 

Personalized Approach to Disease Screening and Management:

  • Not to rely solely on age or physical markers, as non-communicable diseases affecting children.
  • Silent Organ: The liver often shows no signs of damage until advanced stages.
  • Lifestyle Impact: Active health management, mindful consumption, and regular screenings are vital for maintaining good health and preventing liver disease.

Tips for Maintaining Liver Health:

  • Regular Exercise Routine,Limiting Alcohol Intake, Maintaining a Healthy Weight, Avoiding Exposure to Toxins.
  • FSSAI is transforming India’s food system to ensure safe, healthy, and sustainable food for all through the ‘Eat Right India’ movement, with the tagline ‘Sahi Bhojan,Behtar Jeevan’

Liver and its Functions:

  • The liver is the largest gland and most intricate internal organ, situated in the upper right quadrant of the abdomen.
  • The functional unit of the liver is the lobule.
  • Primary Functions:
    • Metabolic Centre: central to various metabolic processes, including the conversion of nutrients from food into essential blood components, storage of vitamins and minerals, and regulation of blood sugar levels.
      • Production of bile, which helps carry away waste and break down fats in the small intestine during digestion.
    • Detoxification: It detoxifies harmful substances from the blood, breaking down and eliminating toxins, drugs, and metabolic waste.


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