Nonalcoholic Fatty Liver Disease

What Is Nonalcoholic Fatty Liver Disease?

There is growing evidence that fatty liver disease, previously believed to be a harmless condition, may seriously damage the liver. A recent study conducted at the Johns-Hopkins University School of Medicine using data from the Third National Health and Nutrition Examination Survey (NHANES-III) indicates that nonalcoholic fatty liver disease (NAFLD) might be very common in the United States. NAFLD is now being recognized as a spectrum of liver disorders from sample fatty infiltration (steatosis) to inflammation necrosis (steatohepatitis), to fibrosis and cirrhosis that is virtually indistinguishable from acute alcoholic liver disease.


Fat may accumulate in the liver with extreme weight gain or diabetes mellitus. Fatty liver can also occur with poor diet and certain illnesses, such as tuberculosis, intestinal bypass surgery for obesity, and certain drugs such as corticosteroids. A patient has fatty liver when the fat makes up at least ten percent (10%) of the liver. It is usually diagnosed when one of the above conditions is being investigated. A liver biopsy is performed to confirm the condition. Because NAFLD has not been considered a harmful condition, it has not been thought to be necessary to treat. If the condition was brought on by obesity, weight loss is suggested; if by diabetes, diet and insulin treatment is recommended. The benefits of these treatments, however, have not yet been proven.


In light of recent evidence, the medical community will have to rethink how it diagnoses, treats, and prevents NAFLD. Now in America the common cause of abnormal liver enzymes is nonalcoholic fatty liver disease. The 1988 - 1994 NHANES-III data, indicate that as many as 29 percent of adults in the United States have abnormal liver enzymes. The report shows that for a majority of these abnormal tests (84 percent) an identifiable cause can not be found (such as hepatitis-B or -C). NAFLD is surmised to be the cause for the unidentifiable cases. It is now presumed that 24 percent of the population has NAFLD.


The disease is associated with age and obesity. It is most common in men, post-menopausal women, and people of African and Hispanic ancestry. In 1997, chronic liver disease, cirrhosis, was the tenth leading cause of death in the United States. Approximately ten percent of cirrhosis-related deaths are attributed to cirrhosis of unknown underlying cause. Although further research is needed, recent evidence suggests that some of these causes may stem from NAFLD.


Further studies are needed to examine these disturbing discoveries and to investigate causes, high risk groups, consequences, and cures. Until now, we have stated that one-in-ten Americans is affected by hepatitis and other liver and gallbladder diseases. The Johns-Hopkins data if verified, means that the number of Americans affected by liver disease would triple to three-in-ten. The magnitude of more than 75 million Americans with liver disease will provide a powerful platform for the American Liver Foundation to educate the public and health professionals as well as for advocacy for liver disease research.


For more information:

The American Liver Foundation (ALF)
75 Maiden Lane
Suite 603
New York, NY 10038
800.GO.Liver (465-4837) toll-free
888.4HEP.USA (443-7872) toll-free