A study conducted at Linköping University (LiU) indicates that the presence of non-alcoholic fatty liver disease (NAFLD) is more serious than previously thought. Affected individuals have a significant risk of developing end-stage liver disease, and the majority may acquire type 2 diabetes which, in turn, can lead to cardiovascular complications.
Details of the study are published in the October 2006 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Over a mean period of fourteen years, the LiU research team followed 129 patients who had elevated liver enzymes because of NAFLD. Only 11 subjects (8 %) had been diagnosed with diabetes before entering the study, but when the study population many years later returned for follow-up, 78 percent were found to have the disease or its preliminary stage.
Public health officials will be concerned to learn that the LiU study indicates an increased morbidity among NAFLD patients. “Indeed, these patients run a twofold risk of dying from cardiovascular disease,” says Dr. Stergios Kechagias, chief physician at the Division of Internal Medicine at University Hospital in Linköping, who led the study.
The LiU study also shows that fat in the liver may cause serious liver damage. Microscopic examination of liver tissue samples revealed that 41 percent of the patients had an increasing build-up of scar tissue in the liver. Most at risk were those whose weight gain during the study period exceeded 5 kilo, and those who exhibited the most pronounced accumulation of fat in the liver.
Approximately five percent of the participants developed scar tissue so pronounced that they required hospitalization for cirrhosis-related complications. Half of these patients later developed cancer of the liver.
“Physicians and patients ought to pay more attention to NAFLD, a medical condition that may lead to serious complications. All patients with NAFLD should modify their life-style, starting with exercise and dietary change,” conclude the authors of the Hepatology article: Mattias Ekstedt, Lennart E. Franzén, Ulrik L. Mathiesen, Lars Thorelius, Marika Holmqvist, Göran Bodemar and Stergios Kechagias.
Åke Hjelm | alfa
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