Illustration depicting the hidden risk of fatty liver disease in individuals with metabolic risk factors.

Is Your Liver at Risk? The Hidden Danger of Fatty Liver Disease in Plain Sight

"New research reveals a surprisingly high prevalence of hepatic steatosis (fatty liver) in people with common metabolic risk factors – and how it's easily missed."


Non-alcoholic fatty liver disease (NAFLD) has emerged as a significant health concern worldwide, affecting approximately 25% of the global population. Fuelled by the rising rates of obesity, type 2 diabetes, and metabolic syndrome, NAFLD often progresses silently, increasing the risk of cirrhosis, liver cancer, and cardiovascular complications.

Primary care physicians are at the frontline of identifying individuals at risk. However, diagnosis often relies on methods like ultrasound, which can be limited in sensitivity and accuracy, especially in individuals who are overweight. This makes early detection and intervention challenging, potentially leading to underestimation of the true burden of the disease.

Now, a new population-based study published in PLOS One sheds light on the prevalence of hepatic steatosis (fatty liver) in individuals with metabolic risk factors within the primary care setting. Using Controlled Attenuation Parameter (CAP), a non-invasive method for measuring liver fat, researchers uncovered alarming rates of previously undiagnosed liver disease. This article will explore the key findings of this study, highlighting the importance of proactive liver health monitoring and early intervention.

The Silent Epidemic: Fatty Liver Prevalence Revealed

Illustration depicting the hidden risk of fatty liver disease in individuals with metabolic risk factors.

The study, conducted in a primary care center, involved 215 participants with metabolic risk factors (obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome) and a control group of 80 individuals without these risk factors. All participants underwent CAP and liver stiffness (LS) measurements using FibroScan.

The results revealed a stark contrast between the two groups:

  • Subjects with metabolic risk factors had significantly higher CAP values compared to the control group (268±64 dB/m vs 243±49 dB/m, p<0.001), indicating a higher degree of liver fat.
  • A staggering 43% of subjects with risk factors had severe steatosis (CAP > 280 dB/m).
  • Increased liver stiffness, suggestive of liver fibrosis, was found in 12.6% of the risk group, while none of the control group exhibited increased stiffness (p<0.001).
  • Fatty Liver Index (FLI) and HOMA (Homeostatic Model Assessment for Insulin Resistance) were identified as independent predictive factors of severe steatosis.
These findings underscore the high prevalence of hepatic steatosis in individuals with metabolic risk factors. The fact that a significant proportion of these individuals had severe steatosis and increased liver stiffness highlights the urgent need for improved screening and early intervention strategies in primary care.

Take Control of Your Liver Health: What You Need to Know

The study emphasizes the importance of proactive liver health monitoring, especially for individuals with metabolic risk factors. While CAP is a valuable tool, it may not be readily available in all primary care settings. The Fatty Liver Index (FLI), a simple calculation based on readily available clinical data, could serve as a surrogate marker for identifying individuals at high risk of steatosis.

Individuals concerned about their liver health should:

<ul> <li>Consult their primary care physician to discuss their risk factors and potential screening options.</li> <li>Consider lifestyle modifications, such as weight loss, a healthy diet, and regular exercise, to reduce their risk of NAFLD and improve their overall metabolic health.</li> <li>Be aware that normal transaminase levels (liver enzymes) do not always indicate the absence of liver disease. In this study, a significant proportion of individuals with moderate to severe steatosis had normal liver enzyme levels.</li> </ul>

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1371/journal.pone.0200656, Alternate LINK

Title: Prevalence Of Hepatic Steatosis As Assessed By Controlled Attenuation Parameter (Cap) In Subjects With Metabolic Risk Factors In Primary Care. A Population-Based Study

Subject: Multidisciplinary

Journal: PLOS ONE

Publisher: Public Library of Science (PLoS)

Authors: Núria Fabrellas, Rosario Hernández, Isabel Graupera, Elsa Solà, Pilar Ramos, Natividad Martín, Gemma Sáez, Consuelo Simón, Almudena Pérez, Teresa Graell, Andrea Larrañaga, Manel Garcia, Ana De La Arada, Adrià Juanola, Alicia Coiduras, Isabel Duaso, Angel Casado, Julian Martin, Marta Ginès, Nuria Moreno, Ana Gema Perez, Laia Marti, Mireia Bernat, Montse Sola, Carmina Olivé, Cristina Solé, Pere Ginès

Published: 2018-09-18

Everything You Need To Know

1

What is non-alcoholic fatty liver disease (NAFLD), and why is it a concern?

Non-alcoholic fatty liver disease (NAFLD) is a condition where there is excessive fat accumulation in the liver, affecting approximately 25% of the global population. It is closely linked to obesity, type 2 diabetes, and metabolic syndrome. NAFLD is a silent disease that progresses slowly, potentially leading to serious complications like cirrhosis, liver cancer, and cardiovascular issues. Early detection and lifestyle modifications are key to managing and preventing the progression of NAFLD.

2

How does the Controlled Attenuation Parameter (CAP) help in detecting fatty liver, and what do the CAP values indicate?

The Controlled Attenuation Parameter (CAP) is a non-invasive method used to measure the amount of fat in the liver. A high CAP value suggests a higher degree of hepatic steatosis. In a study, individuals with metabolic risk factors showed significantly higher CAP values (268±64 dB/m) compared to those without (243±49 dB/m). A CAP value greater than 280 dB/m indicates severe steatosis.

3

What is the Fatty Liver Index (FLI), and how can it be used in primary care settings?

The Fatty Liver Index (FLI) is a calculated score based on readily available clinical data which can be used to identify individuals at high risk of hepatic steatosis. It serves as a surrogate marker for identifying individuals at high risk of steatosis. It helps primary care physicians to proactively monitor liver health and make informed decisions about further testing or intervention. In addition to FLI, HOMA (Homeostatic Model Assessment for Insulin Resistance) was identified as an independent predictive factor of severe steatosis.

4

What does liver stiffness measurement tell us about liver health, and how is it related to hepatic steatosis?

Liver stiffness measurement, often done alongside CAP using FibroScan, helps assess the degree of fibrosis (scarring) in the liver. Increased liver stiffness suggests more advanced liver disease and a higher risk of complications. In a study, 12.6% of individuals with metabolic risk factors showed increased liver stiffness, while none of the control group exhibited increased stiffness.

5

What are the main metabolic risk factors associated with hepatic steatosis, and what is the impact of having these risks?

Metabolic risk factors such as obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome significantly increase the risk of hepatic steatosis. A study showed that 43% of individuals with these risk factors had severe hepatic steatosis. Managing these metabolic risk factors through lifestyle changes like diet and exercise, and potentially with medication, is crucial for preventing and managing non-alcoholic fatty liver disease (NAFLD).

Newsletter Subscribe

Subscribe to get the latest articles and insights directly in your inbox.