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Liver fat: know the causes, diagnosis and treatment of hepatic steatosis

by Guilherme Sauniti
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Hepatic steatosis, popularly known as fatty liver, is an increasingly common and worrying health condition. Characterized by the excessive accumulation of fat in liver cells, hepatic steatosis can be caused by various factors that compromise its proper functioning.

It is necessary to identify the condition early, as hepatic steatosis can progress to more severe conditions.

Therefore, it is essential to understand this complex disease and discover how it can arise. 

In addition, the precise diagnosis of hepatic steatosis, through specific tests and analysis of clinical results, makes a big difference in the appropriate and quick treatment to reverse this condition. 

Lifestyle changes, such as a balanced diet and regular physical activity, play a crucial role in the prevention and control of hepatic steatosis. 

Discover what causes hepatic steatosis, how to diagnose and treat it with this complete guide. Don’t stop reading here!

What is fatty liver or hepatic steatosis?

Fatty liver, also known as hepatic steatosis, is a condition in which there is excessive accumulation of fat in liver cells.

This accumulation occurs when the organ cannot process and metabolize fat properly. 

Hepatic steatosis can be caused by various factors, and several conditions can accentuate the deposition of fat in the liver.

Fatty liver is a silent and often asymptomatic condition, but it can lead to serious complications if not treated. 

The accumulation of this fat in the organ can cause inflammation and injuries, and can progress to more severe liver diseases, such as, for example, non-alcoholic steatohepatitis (NASH) and cirrhosis.

What are the causes of hepatic steatosis?

Some metabolic factors, diseases or habits and lifestyle can contribute to the development of hepatic steatosis. Here are some of the causes:

1- Insulin Resistance:

Insulin resistance, characterized by the inability of cells to respond adequately to the effects of insulin, is a key factor in the pathogenesis of hepatic steatosis. It is more common in overweight and obese patients as we will see below.

Insulin resistance leads to an increase in blood glucose levels, which stimulates the pancreas to produce more insulin, which leads to more difficulty in its function in the cell, generating an increase in blood glucose, thus creating a cycle.

Excess insulin promotes the synthesis of fatty acids (fat) in the liver, leading to its accumulation in the liver.

2- Overweight and Obesity:

Overweight and obesity are significant risk factors for the development of hepatic steatosis. 

Excess weight is often associated with insulin resistance, dyslipidemia and low-grade chronic inflammation, which contribute to the accumulation of fat in the liver. 

The central distribution of fat, with accumulation of fat around the waist, known as visceral obesity, is particularly related to the increased risk of hepatic steatosis.

3- Inadequate diet:

An unbalanced diet, characterized by excessive consumption of calories, saturated fats, sugars and processed foods, can play a significant role in the development of hepatic steatosis. 

The diet rich in saturated fats and refined carbohydrates contributes to insulin resistance, promoting the synthesis and accumulation of fat in the liver.

4- Sedentary lifestyle:

Sedentary lifestyle is a risk factor for the disease, as lack of physical activity can lead to a decrease in energy expenditure and an increase in fat storage in the liver. 

5- Excessive alcohol consumption:

Although non-alcoholic hepatic steatosis is the most common form of fatty liver disease, excessive alcohol consumption can also lead to fat accumulation in the liver, resulting in alcoholic hepatic steatosis. 

Alcohol can cause inflammation in the liver, interfering with the organ’s ability to metabolize fats.

6- Hypertension and Diabetes

These two diseases are very common, and affect many patients, especially obese ones. They are risk factors that greatly increase the chance of hepatic steatosis. When present, along with obesity and dyslipidemia (alteration of cholesterol levels in the blood), we have a condition called Metabolic Syndrome or Syndrome X, which increases the risks of steatosis and cardiovascular diseases such as heart attacks and strokes (cerebrovascular accidents).

How is the diagnosis of hepatic steatosis made?

Fortunately, the diagnosis of hepatic steatosis is generally simple and non-invasive. 

Doctors usually start with a complete clinical evaluation, taking into account the patient’s symptoms, medical history and risk factors. 

Then, blood laboratory tests are requested, such as liver enzyme levels, lipid profile, blood glucose and others, which can provide clues to the presence of fat in the liver.

In addition, abdominal ultrasound is one of the main tools to detect hepatic steatosis. 

This exam uses sound waves to create images of the liver, allowing doctors to identify the accumulation of fat in the organ.

Therefore, it can be said that the diagnosis of hepatic steatosis is a smart combination of clinical evaluation, laboratory tests and ultrasound, allowing doctors to identify the presence of this condition accurately and effectively to treat it as soon as possible.

What are the treatments for hepatic steatosis?

This condition can be reversible if treated properly, and there are several approaches that can help improve liver health and reverse fat accumulation. 

Some of the available treatment options include lifestyle changes.

This includes following a balanced diet, rich in fruits, vegetables, whole grains and lean proteins, while limiting the consumption of saturated fats and added sugars. 

In addition, it is recommended to practice regular physical activity, as exercise can help reduce the fat accumulated in the liver.

For individuals who are overweight or obese, weight loss is a crucial aspect of the treatment of hepatic steatosis.

The control of diseases such as diabetes, hypertension and dyslipidemia is also fundamental in the treatment of hepatic steatosis.

It is worth remembering that it is necessary to avoid alcohol consumption, as hepatic steatosis is often associated with excessive consumption of alcoholic beverages. 

In some cases, when lifestyle changes are not enough, the doctor may prescribe medications to treat hepatic steatosis, as they can help improve insulin sensitivity, reduce inflammation and fat in the liver. 

It is essential to have regular medical consultations to monitor the progression of the disease and adjust the treatment plan, if necessary. 

How to prevent hepatic steatosis?

Fortunately, there are simple and effective measures that we can adopt to prevent this condition and keep the liver healthy. 

Maintaining a balanced diet, controlling weight, adopting an active lifestyle, moderating alcohol consumption, having regular medical check-ups and avoiding self-medication are just a few important ways to prevent the disease.

With these habits, it is possible to promote a healthier life and prevent problems such as hepatic steatosis from impairing the proper functioning of the liver.

Conclusion

In summary, hepatic steatosis, or fatty liver, is a condition that results from the accumulation of fat in liver cells, caused mainly by unhealthy lifestyle habits. 

Early and accurate diagnosis is essential to start appropriate treatment, which involves lifestyle changes, such as balanced diet, exercise and various other routines.

Awareness of the risks of hepatic steatosis and the adoption of preventive measures are essential to preserve liver health and prevent more serious hepatic complications in the future. 

With appropriate actions, it is possible to control and reverse hepatic steatosis, allowing for a healthy and full life.

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Doutor em Gastroenterologia pela FM-USP.
Especialista em Cirurgia do Aparelho Digestivo (HCFMUSP), Endoscopia Digestiva (SOBED) e Gastroenterologia (FBG).
Professor do curso de Medicina da Fundação Educacional do Município de Assis - FEMA.
Médico da clínica Gastrosaúde de Marília.


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