What is Hepatic Steatosis?

Popularly known as fatty liver, hepatic steatosis, related to alcohol consumption, consists of an accumulation of triglycerides in the liver. With proper treatment, it can be reversed.

The hepatic steatosis, popularly known as fatty liver, consists of an accumulation of triglycerides in the liver. The organ increases in size and drops of fat appear scattered throughout the liver tissue, which can be seen with the naked eye.

The condition occurs, above all, after excessive alcohol consumption; This anomaly has even been observed in 90% of individuals with chronic alcoholism. However, there is also non-alcoholic hepatic steatosis. In this case, the condition is not related to alcohol consumption and can appear in abstainers or patients without significant alcohol consumption history.

It is the most common cause of chronic liver disease in the developed world. Its incidence has been increasing due to the greater number of people with obesity and diabetes and the greater use of abdominal ultrasound in the health field in the routine study of elevated transaminases. A prevalence of around 25-30% of the population is estimated.

Currently, it is said that this liver disorder is the clinical expression of metabolic syndrome in the liver. It can also occur in children, also being related to 50% of obese children.

Except for complications, in most cases, it is a benign and reversible process that, with proper treatment, does not cause liver damage. It can present as a simple fatty deposit in the liver, but it can progress to cirrhosis and liver carcinoma in some cases. In fact, in many cases of cirrhosis of unknown cause (not alcoholism, not hepatitis B and C viruses, etc.), it is postulated as a hidden cause of these problems.

Causes and risk factors of hepatic steatosis

The main cause of fatty liver formation is the uptake of free fatty acids and their liver deposition. If this situation evolves and a hepatic inflammatory phenomenon occurs, steatohepatitis occurs, which can progress to cirrhosis if the chronic inflammation turns into fibrosis. The filter mechanism of the liver would be altered in very advanced stages.

As we have mentioned, fatty liver is frequently associated with chronic alcoholism. Still, other causes originate the disorder, as well as various risk factors that increase the chances of suffering from it, such as:

  • Diabetes mellitus: occurs in half of the patients with type II DM.
  • Obesity: 60-90% of people with significant obesity end up developing hepatic steatosis.
  • Hypertriglyceridemia
  • Metabolic syndrome and insulin resistance. The increase in free fatty acids in these situations leads to a greater accumulation of these in the viscera, mainly the liver, and at the muscular level.
  • Diverticulosis: the presence of diverticula in the intestine.
  • Family history of hepatic steatosis.
  • Hepatitis chronic C.
  • Poor nutrition: cases of steatosis have been described in patients with prolonged starvation and protein-calorie malnutrition.
  • Drugs: intravenous tetracyclines, corticosteroids, tamoxifen, methotrexate, valproic acid, etc.
  • Exposure to toxic agents: such as carbon tetrachloride (used as a coolant).
  • Sleep apnea syndrome.
  • Hypothyroidism.
  • Pregnancy: acute hepatic steatosis of pregnancy, a very rare complication whose cause is unknown.