“Treatment is essential even if there are no symptoms”…How to treat and manage fatty liver [황수경의 건강칼럼]

Fatty liver, more than 30% increase in new patients in 4 years
Be careful if you have metabolic syndrome such as diabetes or obesity.
Director Jeon Baek-kyu “If you have been diagnosed with fatty liver, you should treat it instead of neglecting it”

[내레이션 : 황수경 아나운서]

Fatty liver is a representative liver disease. It has a high prevalence rate, with 20-30% of adults in Korea suffering from it. There are probably quite a few people who have been found to have a ‘fatty liver’ as a result of a health check.

The number of patients who visited the hospital in the last 2021 years has increased by over 30% compared to 2017 with 430,000 people. The problem is that the risk of this disease is underestimated. This is because there are no specific symptoms, and it is not difficult to see cases around me complaining that ‘I also have fatty liver’. Fatty liver can progress through hepatitis to cirrhosis and further to hepatocellular carcinoma. It is a disease that must be detected and treated early because in some cases it can go directly to liver cancer without going through cirrhosis.

In fact, the liver itself is not completely lean. A normal liver contains less than 5% fat. The name that has accumulated more than this is ‘fatty liver’. To be precise, the triglycerides we ingest accumulate in the liver cells. It is caused by excessive accumulation of fat from food, etc., and the body cannot process it smoothly.

Fatty liver is closely related not only to the liver but also to metabolic syndrome such as obesity or diabetes. In fact, 91% of obese patients and 69% of type 2 diabetic patients have fatty liver. It has been reported that the number of fatty liver increases if there is insulin resistance even in normal weight.

Ultrasound is a well-known method for examining fatty liver. It has the advantage that the process is easy and there are not many side effects. However, the accuracy of the test may be reduced in mild fatty liver with less than 30% liver fat. In the case of CT scans, while the diagnostic accuracy is high in cases of moderate or severe fatty liver, there may be a problem with radiation exposure. Although MRI is considered the most accurate examination method for measuring the amount of fat in the liver, it is not mainly used for the treatment of fatty liver due to its high cost.

Considering the advantages and disadvantages of these three tests, the best method of diagnosing fatty liver is an ultrasound examination in a primary medical institution.

How does fatty liver treatment proceed? There are two types of drugs under clinical study: anti-steatohepatitis and anti-fibrotic drugs that target the liver, and drugs associated with metabolic syndrome that reduce the amount of fat in the liver or improve resistance insulin. This also means that there are no drugs that can be used in primary care settings yet.
This is also the reason why you should focus not only on treatment in hospital, but also on managing everyday life. Fatty liver can occur on its own, but most of them are related to being overweight or obese, so the focus should be on weight control. You need to reduce your total energy intake while controlling your carbohydrate and fat intake. Also, to improve insulin resistance and prevent metabolic syndrome such as hyperlipidemia, I hope you will continue to do aerobic exercise and strength training.

Column = Haidaq Counseling Doctor Jeon Baek-gyu (internal medicine specialist at Seoul Asan Internal Medicine)