Fatty Liver Disease

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UT Southwestern Medical Center offers the most advanced diagnostic and treatment options for fatty liver disease, which is one of the most common liver diseases in the United States. Our team is at the forefront of clinical research on liver conditions, with a long history of advancements in the field.

Treating Both Alcoholic and Nonalcoholic Fatty Liver Disease

In fatty liver disease, there is too much fat in the liver. There are two main types of the disease. The first is alcoholic fatty liver disease, which is caused by drinking too much alcohol, even for a short period of time.

The second is nonalcoholic fatty liver disease, a condition not caused by alcohol consumption. This is the most common type of chronic liver disease in the U.S., affecting an estimated 30% to 40% of the adult population. Nonalcoholic fatty liver disease frequently occurs in people who have some of the most common health conditions, such as being overweight, having type 2 diabetes, or having high cholesterol – which helps account for why so many people have it.

In both types of the disease, too much fat stored in liver cells causes liver inflammation, which leads to scarring, or cirrhosis. Cirrhosis can lead to loss of liver function, or it can cause primary liver cancer to develop.

UT Southwestern is leading the way in research on fatty liver conditions. Our Center for Human Nutrition is one of the world’s largest and most recognized centers for lipid and fatty liver research. Our liver disease specialists can improve patients’ health and quality of life by preventing or delaying additional liver damage and related complications through innovative therapies.

Symptoms of Fatty Liver Disease

Most people with fatty liver disease don’t show any symptoms. We often see patients who have been referred by their primary care doctors after a routine physical exam has shown elevated liver enzyme levels. Many of these patients already have diabetes.

When there are noticeable symptoms, they can include fatigue and discomfort in the upper abdomen.

Over time, as the liver loses function, more noticeable complications can occur, such as:

  • Swelling
  • Jaundice
  • Confusion
  • Kidney damage
  • Low oxygen levels in the blood
  • Bleeding from varicose veins
  • Elevated pressure in the heart
  • Liver cancer

Risk Factors of Fatty Liver Disease

The major cause of alcoholic fatty liver disease is drinking too much alcohol. For both types of fatty liver disease, obesity is a leading risk factor.

Our research has also shown that genetic factors such as ethnicity can also play a role in who’s at risk for fatty liver disease. For example, we found in the Dallas Heart Study that Hispanic people are at a higher risk for fatty liver disease, regardless of their weight. Caucasian people have a lower overall risk than Hispanic people, and African-American people are somewhat protected from having as much fat in the liver.

Diagnosing Fatty Liver Disease

If our team suspects fatty liver disease, we first conduct a thorough physical examination. We then talk with patients about their medical and family history, including alcohol use and any medications being taken.

Generally, we will order blood tests to check for high levels of liver enzymes. Depending on these results, we might also order imaging tests, including an abdominal ultrasound, computed tomography scan (CT), or magnetic resonance imaging (MRI) to check for fat in the liver. The most accurate way to diagnose fat in the liver is through a liver biopsy, in which we obtain a small sample of liver.

It’s then necessary to determine whether there is a significant amount of scarring (fibrosis) in the liver and whether it’s getting worse. A liver biopsy alone isn’t able to accurately provide this information.

We measure the level of scarring throughout treatment. UT Southwestern was one of the first centers in the country to use a FibroScan machine, a specialized ultrasound that measures the amount of scarring on the liver. We can perform this ultrasound in our clinic.

We also collaborate with UT Southwestern’s radiology experts on magnetic resonance elastography (MRE), which combines MRI with sound waves, to assess the level of scarring.

Treating Fatty Liver Disease

UT Southwestern’s team of liver specialists has a long history of advancements in the field, translating groundbreaking scientific insights into superior patient care.

There is currently no medication to treat fatty liver disease, but our physicians are working to develop new medications such as PCSK9 inhibitors based on the discoveries by UT Southwestern’s Jay Horton, M.D., and Helen Hobbs, M.D.

Until better treatments are available, the best approach to combat fatty liver disease is to prevent further scar formation and future complications. Diet, lowering carbohydrates, and exercise have been shown to be effective at treating fatty liver and preventing its progression. Our dedicated team works with a dietitian and each patient to develop an individualized nutrition and exercise plan.

For patients with alcoholic fatty liver disease, the best strategy is to abstain from drinking alcohol. UT Southwestern’s world-renowned Addiction Psychiatry team offers a unique way to treat alcohol abuse disorder that can improve long-term outcomes. It is one of the few programs in the U.S. that works alongside liver specialists.

If a patient does have complications, we can facilitate liver transplantation. Our highly trained specialists use the most advanced surgical techniques and technologies, and our program has a three-year patient survival rate that surpasses the national average.

Clinical Research

UT Southwestern has been part of more than 40 clinical trials on liver diseases in the past 20 years.

  • Helen Hobbs, M.D., and Jay Horton, M.D., are pioneers in fatty liver disease research and have uncovered genetic risk factors and novel potential treatment targets.
  • Mack Mitchell, M.D., is at the forefront of research aimed at understanding and managing alcoholic fatty liver disease.
  • For patients with more severe alcoholic liver disease – specifically alcoholic hepatitis – UT Southwestern is part of a select group of centers in the U.S. involved in clinical trials for treatment.

Learn more about current studies at UT Southwestern.

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Transplant Intake Coordinator: Helen Bankston, RN, B.S.N.