Managing and treating fatty liver: The importance of proactive care even in the absence of symptoms [Health Column by Hwang Soo-kyung]

｜ Fatty liver, more than 30% increase in new patients in 4 years
｜ If you have metabolic syndrome, such as diabetes or obesity, be careful.
｜ Director Jeon Baek-gyu “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 ‘fatty liver’ as a result of a health checkup.

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. It’s because I don’t have any specific symptoms, and it’s 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 fat-free. A normal liver contains less than 5% fat. Accumulated more than this is called ‘fatty liver’. To be precise, the triglycerides we ingest accumulate in the liver cells. It is caused by excessive accumulation of fat by 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 incidence 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 few side effects. However, the accuracy of the test may be reduced in mild fatty liver with less than 30% fat in the liver. 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 primarily used for treatment of fatty liver due to its high cost.

Considering the pros and cons of these three tests, it can be seen that the best method for diagnosing fatty liver is to perform an ultrasound scan at a primary medical institution.

How does fatty liver treatment proceed? Two types of drugs are under clinical study: anti-steatohepatitis and anti-fibrotic drugs targeting the liver, and metabolic syndrome-related drugs that reduce the amount of fat in the liver or improve insulin resistance. This also means that there are no drugs that can be used in primary care institutions yet.
It is also the reason why you should focus not only on treatment at the hospital, but also on daily life management. Fatty liver may occur alone, but most of them are related to overweight or obesity, so weight management should be focused. 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 continue to do aerobic and strength training.

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

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