Nonalcoholic Fatty Liver Disease: Overview and Risk Factors

Nonalcoholic fatty liver disease is the most common form of liver disease in the United States. As its name suggests, it is associated with abnormal fat accumulation in the liver.

Put simply, fatty liver develops from eating too much. When the amount of nutrients (particularly fat) entering the liver exceeds our ability to use it up, fat accumulates in the liver. A related cause is insulin resistance–the decreased ability of this hormone to clear nutrients from the bloodstream. Insulin increases the storage of fat in the liver.

Most patients do not have visible symptoms, although they may suffer from fatigue, malaise, and right–upper–abdominal discomfort. In more serious cases, the disease may result in hepatitis, liver failure, and/or cirrhosis.

Risk Factors

• Obesity and related metabolic states
  
• Elevated cholesterol, especially elevated triglycerides (the chemical form of fat in the body)
  
• Total parenteral nutrition (intravenous feeding, as occurs in some hospitalized patients)
  
• Drugs (e.g., amiodarone, tetracycline, glucocorticoids, synthetic estrogens, and certain pesticides)
  
• Pregnancy: Rarely, fatty liver can occur during pregnancy.