July 4, 2015
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Fatty Liver (cont.)

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What is the relationship between nonalcoholic fatty liver disease and the metabolic syndrome?

The metabolic syndrome is a syndrome defined by the association of several metabolic abnormalities that are believed to have a common cause. These metabolic abnormalities result in obesity, elevated blood triglycerides, low high density lipoprotein (HDL) cholesterol, high blood pressure, and elevated blood sugar (diabetes). NAFLD is considered a manifestation of the metabolic syndrome and thus occurs frequently with the other manifestations of the syndrome. Occasionally it may occur without the other abnormalities of the syndrome.

What are the symptoms of fatty liver?

Fatty liver disease rarely causes symptoms until the liver disease is far advanced. At most, there is enlargement of the liver which may give rise to mild right, upper abdominal discomfort.

Patients with advanced fatty liver disease - which means that the liver has developed large amounts of scar tissue or cirrhosis - have all of the well-known complications of advanced liver disease of any cause. The complications result from 1) loss of liver cells and their ability to perform their normal functions, and 2) blockage of the flow of blood from the intestines through the scarred liver.

Specifically, liver cells produce critical proteins, for example, proteins necessary for blood to clot, and advanced liver disease can result in excessive bleeding. The liver also removes waste products from the blood, for example, bilirubin and advanced liver disease can result in retention of bilirubin and jaundice (yellow skin due to the accumulation of bilirubin in tissues).

The blockage of the flow of blood through the liver causes the blood to go around (bypass) the liver. The pressure within the bypassing blood vessels increases and the vessels enlarge, particularly in the esophagus, and these vessels can rupture and bleed profusely. The flow of blood from the intestine that bypasses the liver prevents the liver from removing toxic chemicals produced in the intestine. These toxins are shunted to the brain where they interfere with all of the brain's functions, ultimately leading to coma.

In addition, because of the increase in pressure within blood vessels, fluid leaks from the vessels. It may leak into the abdomen (ascites) or into the tissues, particularly of the legs (edema).

Medically Reviewed by a Doctor on 7/9/2014

Source: MedicineNet.com

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