Fatty Liver - Causes

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What causes nonalcoholic fatty liver disease?

The cause of NAFLD is complex and not completely understood. The most important factors appear to be the presence of obesity and diabetes. It used to be thought that obesity was nothing more than the simple accumulation of fat in the body. Fat tissues were thought to be inert, that is, they served as simply storage sites for fat and had little activity or interactions with other tissues. We now know that fat tissue is very active metabolically and has interactions and effects on tissues throughout the body.

When large amounts of fat are present as they are in obesity, the fat becomes metabolically active (actually inflamed) and gives rise to the production of many hormones and proteins that are released into the blood and have effects on cells throughout the body. One of the many effects of these hormones and proteins is to promote insulin resistance in cells.

Insulin resistance is a state in which the cells of the body do not respond adequately to insulin, a hormone produced by the pancreas. Insulin is important because it is a major promoter of glucose (sugar) uptake from the blood by cells. At first, the pancreas compensates for the insensitivity to insulin by making and releasing more insulin, but eventually it can no longer produce sufficient quantities of insulin and, in fact, may begin to produce decreasing amounts. At this point, not enough sugar enters cells, and it begins to accumulate in the blood, a state known as diabetes. Although sugar in the blood is present in large amounts, the insensitivity to insulin prevents the cells from receiving enough sugar. Since sugar is an important source of energy for cells and allows them to carry out their specialized functions, the lack of sugar begins to alter the way in which the cells function.

In addition to releasing hormones and proteins, the fat cells also begin to release some of the fat that is being stored in them in the form of fatty acids. As a result, there is an increase in the blood levels of fatty acids. This is important because large amounts of certain types of fatty acids are toxic to cells.

The release of hormones, proteins, and fatty acids from fat cells affects cells throughout the body in different ways. Liver cells, like many other cells in the body, become insulin resistant, and their metabolic processes, including their handling of fat, become altered. The liver cells increase their uptake of fatty acids from the blood where fatty acids are in abundance. Within the liver cells, the fatty acids are changed into storage fat, and the fat accumulates. At the same time, the ability of the liver to dispose of or export the accumulated fat is reduced. In addition, the liver itself continues to produce fat and to receive fat from the diet. The result is that fat accumulates to an even greater extent.

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See what others are saying

Comment from: 35-44 Male (Patient) Published: May 01

I was diagnosed with nonalcoholic fatty liver disease (NAFLD) finally about 18 months ago. I have had high ALT for at least ten years but only went to a doctor rarely. ALT is in the 180 to 100 range. I'm a farmer who is fit and strong, not overweight, and mostly well with most of the symptoms described. I may have had ten drinks per annum, no drug use legal or illegal, and healthy balanced diet, excellent cholesterol and just occasional high blood pressure. I drive heavy machinery daily so no booze. I had a bad marriage and divorced the wife; and lowered the ALT with low protein diet and vegetarian, which now works well. I have 1 gram of protein per day per kg of live weight; animal protein is hard on the liver, vegetarian diet feel heaps better. It's a lot a harder to be vegetarian than divorced.

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Comment from: gardo5, 55-64 Male (Patient) Published: March 07

I believe my fatty liver was caused because I drank alcohol when I had glandular fever. I had glandular fever when I was 21, it took doctors 6 weeks to diagnose whilst it was my 21st birthday and Christmas, I drank too much. I was told I was lucky, if the germ migrated 3 or 4 more inches I would have died. Since then I suffer same ailments, I had 6 biopsies, all say fatty liver or NASH (nonalcoholic steatohepatitis) but not yet cirrhosis. For 30 years I am one short step to cirrhosis and shortening of life. Yes, I've also been tested for iron overload and copper overload.

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