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The amount of fatty acid in the liver depends on the balance between the processes of delivery and removal. Fatty liver develops in every individual who consumes more than 60 g/d of alcohol. Many mechanisms of ethanol-induced fatty liver have been proposed. Increased hepatic levels of glycerol 3-phosphate (3-GP) following ethanol ingestion are related to an increase in the ratio of nicotinamide adenine dinucleotide, reduced form, (NADH) to nicotinamide adenine dinucleotide (NAD) in the liver. Increasing concentration of 3-GP results in enhanced esterification of fatty acids.
An increased level of free fatty acids also has been incriminated in the pathogenesis of fatty liver. Large amounts of alcohol enhance lipolysis because of direct stimulatory effect on the adrenal and pituitary axis. In addition, chronic ingestion of ethanol inhibits oxidation of fatty acids in the liver and release of very low-density lipoprotein (VLDL) into the blood. All of these mechanisms favor steatosis. Centrilobular localization of steatosis results from decreased energy stores from relative hypoxia and a shift in lipid metabolism, along with a shift in the redox reaction caused by the preferential oxidation of alcohol in the central zone.
Recent advancement in the understanding of the pathogenesis of alcoholic steatosis has provided some novel insights, including the role of peroxisome proliferator-activated receptor alpha, which is crucial for the regulation of hepatic fatty acid metabolism. Its blockade, in animal models, along with ethanol consumption, contributes to the development of alcoholic fatty liver. In addition, induction of adiponectin, a hormone secreted by adipocytes, has been implicated in the protective action of saturated fat against the development of alcoholic fatty liver in mice.
Another recent finding is the role of early growth response-1 transcription factor (EGr-1), which is thought to be essential for ethanol-induced fatty liver injury in mice. Hepatocyte death by apoptosis occurs in the alcoholic fatty liver and has been demonstrated in rats and mice after ethanol feeding. This may be related to mitochondrial proteins that regulate apoptosis and necrosis and that are shown to be induced in mouse fatty liver models.
Frequency
United States
Approximately 15.3 million people in United States abuse or depend on alcohol. Fatty liver develops in 90-100% of patients with heavy alcohol use.
International
One observational study from northern Italy demonstrated prevalence rates of steatosis in 46.4% of heavy drinkers (>60 g/d of alcohol) and in 94.5% of obese heavy drinkers.
Mortality/Morbidity
Simple steatosis rarely is fatal. With complete abstinence, histologic changes can return to normal within 2-4 weeks.
Continued alcohol consumption may result in more advanced forms of liver disease, either alcoholic hepatitis or cirrhosis.
Recently, a study from Denmark, which used the Danish National Registry, noted an increase in mortality among patients with a hospital discharge diagnosis of alcoholic fatty liver, which remained increased after censoring patients upon a diagnosis of cirrhosis.
Race
Very little data are available on racial differences in the incidence of alcoholic fatty liver. However, overall differences in alcoholic liver disease have been noted in various studies.
One study of 42,862 US adults showed differences in drinking patterns among different races. Whites were the most likely to drink, but blacks had the highest volume of intake and frequency of heavy drinking.
Another study showed a higher rate of cirrhosis among blacks.
Sex
Women develop more severe alcoholic liver disease (ALD) more quickly and at lower doses of alcohol than men.
Increased susceptibility of females possibly is related to sex-dependent differences in the hepatic metabolism of alcohol, cytokine production, and the gastric metabolism of alcohol.
Thank you so much. You have also helped me. I don't smoke or drink excessively.
I am though overweight and am working on that. sometimes we forget to do the things
for ourselves because we are so caught up in everyone elses problems... nervous and worried,, I eat... I have lost 11 lbs. so far and need to go another 40.
did you mean hemchromatosis?
Fatty liver is just what its name suggests: the build-up of excess fat in the liver cells. It is normal for your liver to contain some fat. But if fat accounts for more than 10% of your liver’s weight, then you have fatty liver and you may develop more serious complications.
Fatty liver may cause no damage, but sometimes the excess fat leads to inflammation of the liver. This condition, called steatohepatitis, does cause liver damage. Sometimes, inflammation from a fatty liver is linked to alcohol abuse; this is known as alcoholic steatohepatitis. Otherwise the condition is called nonalcoholic steatohepatitis, or NASH.
An inflamed liver may become scarred and hardened over time. This condition, called cirrhosis, is serious and often leads to liver failure.
NASH is one of the top three leading causes of cirrhosis.
What are the symptoms of fatty liver?
A fatty liver produces no symptoms on its own, so people often learn about their fatty liver when they have medical tests for other reasons. NASH can damage your liver for years or even decades without causing any symptoms. If the disease gets worse, you may experience fatigue, weight loss, abdominal discomfort, weakness and confusion.
What causes fatty liver?
Eating excess calories causes fat to build up in the liver. When the liver does not process and break down fats as it normally should, too much fat will accumulate. People tend to develop fatty liver if they have certain other conditions, such as obesity, diabetes, or high triglycerides. Alcohol abuse, rapid weight loss and malnutrition may also lead to fatty liver. However, some people develop fatty liver even if they have none of these conditions – so everyone should know about it.
How is fatty liver diagnosed?
Your doctor may see something unusual in your blood test or notice that your liver is slightly enlarged during a routine checkup. These could be signs of a fatty liver. To make sure you don’t have another liver disease, your doctor may ask for more blood tests, an ultrasound, a CT scan or an MRI. If other diseases are ruled out, you may be diagnosed with NASH. The only way to know for sure is to get a liver biopsy. Your doctor will remove a sample of liver tissue with a needle and check it under a microscope.
What new treatments for fatty liver are being studied?
Fatty liver is currently the focus of intense research to provide us with better tools for treatment in the future. Scientists are studying whether various medications can help reduce the inflammation on your liver, including new diabetes medications that may help you even if you don’t have diabetes.
How is fatty liver treated?
There are no medical or surgical treatments for fatty liver, but there are some steps you can take that may help prevent or reverse some of the damage. In general, if you have fatty liver, and in particular if you have NASH, you should:
Lose weight – safely! That usually means losing no more than one or two pounds a week.
Lower your triglycerides through diet, medication or both
Avoid alcohol
Control your diabetes, if you have it
Eat a balanced, healthy diet
Increase your physical activity
Get regular checkups from a doctor who specializes in liver care
If I’ve been diagnosed with fatty liver, what questions should I ask my doctor?
“What is the likely cause of my fatty liver?”
“Do I have NASH? If not, how likely am I to develop NASH?”
“Do I have cirrhosis? If not, how likely am I to develop cirrhosis?”
“Do I need to lose weight? How can I do so safely?”
“Should I be taking any medication to control my triglyceride levels?”
“What medications or other substances should I avoid to protect my liver?”
Who is at risk for fatty liver?
Most (but not all) fatty liver patients are middle-aged and overweight. The risk factors most commonly linked to fatty liver disease are:
Overweight (body mass index of 25-30)
Obesity (body mass index above 30)
Diabetes
Elevated triglyceride levels
What is the best way to prevent fatty liver?
The best way to reduce your risk of developing fatty liver is to maintain a healthy weight and normal triglyceride levels. You should also avoid excess alcohol and other substances that could harm your liver.
unfortunately my husbands sister is also an alcoholic, she has flipped the medical journal on its binders. I have seen her in a coma, next morning checking herself out of the emergency room go home and in 2 days do it all over again... she has been drinking since her teens and she is now 60 years old!! If my husband and his siblings didn't drink
I swear they would reach 120 years old!! Her doctors told me 20 yrs ago that she wouldn't last 5 years.... but now I see her stomach getting big. Her husband and sons have also been through alot. Anyway to get back, My husband has the shakes through out the morning and afternoon. he doesn't get the hallucinations because he doesn't give his body a chance to detox. He keeps himself supplied. His sister has had hallucinations , they are not pretty.
I think I just posted on the wrong spot so you all bear with me.... thank you for the responses. He has gotten the blood pressure down , I think, He was letting me take
his B/P for a while but the doctor thing has wore off. I just posted to usarmymedic and
told him that my husband had just woken up and asked for stomach meds for gas. He is
bloated, I guess. As far as his coloring, I think it might have something to do with his 2-3 pack a day smoking habit. I am going to try again to get him to see a doctor but I really think he has to get really sick and scared before he stops. Thank you again to all
of you for the feedback. jenny
I would be WORRIED about the BP...190/114????
That and the Tylenol 4's(have acetaminophen) w/ drinking....
He NEEDS to go back to the Dr....
If the BP doesn't kill him...the ty 4's and the alcohol will...I wouldn' tmess around,..it sounds like he has alot of different serious things going on...
Keep posting..we'rre here for you!!!
agree with army...yelowish tint to the skin is usually liver induced...the stomach being swollen is very common with liver problems...and again....drinking can cause GI bleeding in a heartbeat that can be a medical emergeny and would also cause abdominal bloating...get it checked out
alcohol W/D is a medical emergancy A person in alcohol W/D may experience frighting Hallucinations and DT (delirium Tremens) a syndrome characterized by restlessness, fever, sweating, disorientation, agitation, convulsions, and death, seizures. severe acute alcohol ingustion can cause Hypoglycemia (low blood suger).
sorry you are going through all this be strong..
Chris
it could be his liver but normally turns a person yellow look at his eyes or the junctivie ( the place inside under the lower lid) this will be the first clue and if he is changing colors and it is his liver it has stopped working right for a good amount of time. the liver is an amazing organ but once you kill it you are screwed that it also could be his B/P or somthing else call hempaticlymphadosis ( fatty liver ) bloking the route to and from his liver. the tyl does not help any either. He needs to go to a doctor not somtime but soon real soon he needs to stop drinking but that needs to be in a controled enviroment also since alcohol W/D or DT's are a medical emergency
take care
chris