NAFLD, a Non-alcoholic fatty liver disease, is a liver condition that progresses with time. It involves excessive accumulation of fats in the liver. It is a major cause of end-stage liver diseases in the world. Currently, NAFLD is 25.24% globally prevalent, with South America and the Middle East having the highest percentage and Africa the lowest. It is termed non-alcoholic because it occurs in people with low intake of alcohol.

NAFLD involves a repertoire of liver problems that range from Non-alcoholic Steatohepatitis, Commonly called NASH, to Fibrosis and, eventually, cirrhosis. Although NAFLD has no specific cause, some situational factors have been established. Obesity, diabetes, or insulin resistance are risk factors attached to the development of NASH in the liver.

The well-known primary causes of NAFLD are obesity, type II diabetes, dyslipidemia, and insulin resistance. However, other less common conditions can cause a similar clinical and histologic picture and should be considered in patients who present with NAFLD but do not have traditional risk factors. This article explores NAFLD, its types, progression, and possible causes.

What is NAFLD?

Nonalcoholic Fatty Liver Disease (NAFLD) has two variants known as Simple Fatty Liver( also called NAFL) and Non-alcoholic Steatohepatitis (NASH). NAFL is considered a safe variant of NAFLD, while NASH is the uncommon and clinically dangerous type of NAFLD.

Copyright: Unsplash I License: CC0 Public Domain

NASH is a severe liver inflammation caused by excessive fat in the liver. Although this cause is not clinically proven, it has significant risk factors. It can quickly progress into dire conditions like Fibrosis, hepatocellular carcinoma, and cirrhosis. Hence, it is better to check for the signs of NASH for early detection.

Who Can Have NASH/NAFLD?

NAFLD can affect anyone, irrespective of gender, race, or financial status. However, some people have a higher rate of liver condition. People with a family health history of liver-related disease stand a high chance of developing NAFLD. Also, it has been associated with high blood lipid levels, overweight people, older people, and people with fat accumulation in the abdomen.

Also, since NAFLD is a condition related to too much fat storage leading to liver inflammation, people with a high level of fats in their blood tend to develop NAFLD. You should visit the hospital regularly for a checkup if you are obese. A liver test will check for liver inflammation, gallstones in the liver, or probable liver infection.

Prevalence of NAFLD

Non-alcoholic fatty liver disease is currently responsible for most end-stage liver problems. The rate at which people develop NAFLD is on the rise globally. The global record of NAFLD was 391.2 million in 1990. However, as of 2017, it has risen sporadically to 882.1 million globally, increasing from 8.2% to 10.9%. As of 2022, the prevalence of NAFLD worldwide is 25.2%. The growth rate of NAFLD prevalence is alarming, and individuals must take preventive measures.

Causes of NAFLD

Medical experts have tried researching the leading cause of fat accumulation in the liver but could not come up with a specific cause. Also, studies have focused on the reason behind the inflammation of fatty livers and its progression into liver scarring (cirrhosis). Below are the possible causes of NAFLD based on medical observations:

• Obesity: Excessive body fat storage
• High blood sugar: Prediabetes or type 2 diabetes
• Insulin resistance: The inability of your cells to process sugar in response to the insulin hormone
• High levels of Triglycerides and other types of fats in the blood
• Sleep Apnea
• Underactive pituitary gland 
• High levels of fats, especially triglycerides, in the blood
• Sleep Apnea
• Long-term inactivity
• Metabolic syndrome
• High blood sugar (hyperglycemia)
• Underactive thyroid.

Note that while the above health problems are not the direct cause of NAFLD, they tend to promote fat accumulation in the liver. When these fats are stored in the liver for a while, they become toxic to some people’s liver cells, leading to liver inflammation. Over time, the swelling of the liver can build up scar tissues, which will affect the functionality of the liver.

Stages of NAFLD

Copyright: Pixabay I License: CC0 Public Domain

NAFLD involves different phases of progression. It moves from simple steatosis to Steatohepatitis, which later evolves into Fibrosis and then cirrhosis. If not properly treated on time, it can lead to hepatocellular carcinoma.

Prevention is easier than the curing

Living a healthy life can reduce the risk of developing NAFLD. There are different NAFLD preventive measures that you can observe for healthy living. Ensure to consume wholesome meals and constantly watch your weight. Also, reducing sugar and cholesterol intake is another good step to take. Lastly, increase your activity level, especially if you’re overweight. A constant medical checkup can detect NAFLD to stop its progression.