“Fatty liver disease” is a constantly increasing condition: what does it depend on?

I suffer from fatty liver disease and I know that this disease is constantly increasing in the population: what could be the causes?

He answers Roberta D’Ambrosiohead of the gastroenterology and hepatology clinics, Ospedale Maggiore Policlinico, Milan (GO TO THE FORUM)

The presence of hepatic steatosis (or fatty liver disease) is a fairly common condition, now also in Italy. Its spread is linked to incorrect lifestyle and diets and is associated with some pathologies with a high prevalence in the general population, including diabetes and obesity. The condition Mafld (metabolically associated fatty liver disease) served to define, before recent changes in nomenclature, the clinical condition characterized by hepatic steatosis in the presence of diabetes, obesity or complete metabolic syndrome. A few weeks ago this term was replaced by the acronym Sld (steatotic liver disease), indicating the presence of fatty liver disease without any reference to the underlying metabolic disorder.

A growing problem

The global prevalence of SLD in the adult population is estimated at: 25-30%; in Italy this figure is between 22% and 27%. These percentages increase in persons suffering from diabetes (up to 80%) and in obese patients (up to 90%), with prevalence influenced by clinical, genetic and environmental factors, including the geographical area to which they belong. A recent study presented at Endo 2023, the annual meeting of the Endocrinology Society, reported rising global SLD rates in the twenty-year period 1988-2018. By analyzing the data of more than 32 thousand subjects who participated in the Nhanes survey (National Survey of Health and Nutrition), it was reported an increase in the Sld by 131%with prevalences of 18% in 1988 compared to 37% in 2018. During the same period it was observed an increase in the prevalence of obesity (23% vs. 40%, +74%), while data regarding diabetes were not provided.

The strategy: lose weight

The research made it possible to confirm this a higher prevalence of SLD among Hispanic subjects compared to Caucasian and African American populations. The high prevalence of SLD at the global level is explained by the distribution of the risk factors associated with it. Even in the absence of diabetes and obesity, it is favored by clinical conditions such as dyslipidemia, arterial hypertension and obesity. On the contrary, regular exercise and the Mediterranean diet are considered protective factors. Alcohol consumption is always discouraged. There are no approved pharmacological therapies for the treatment of SLD. Weight loss is the only viable strategy contributes to the reduction of body fat and also acts on inflammation and fibrosis. Pending the development of specific drugs, the control and treatment of SLD risk factors play a central role.