Fatty Liver Disease: A Silent Pandemic and the liver function blood tests
Foie gras is a delicacy most closely associated with France. It is produced by force feeding geese or ducks by pushing a pipe down their throats each day and pumping them full of feed. This causes the birds to fatten and, in particular, the liver becomes very fatty and can enlarge up to ten times its normal size (foie gras translates as ‘fat liver’). The result is a liver with a rich, buttery taste. To many modern eyes, the process of producing foie gras is very cruel, and yet many of us are actually doing the very same thing to ourselves.
Excess fat and the liver function
Fatty Liver Disease simply refers to the presence of excess fat in the liver which can be caused by various medications, some illnesses, and by excess alcohol, but the most common cause of all is an unhealthy lifestyle with a poor diet and little exercise. When the problem is caused by lifestyle, rather than alcohol, it is known as ‘Non-Alcoholic Fatty Liver Disease’ (NAFLD).
NAFLD is extremely common, affecting between 20-30% of the adult European population, and over 90% of obese adults. Some studies even estimate that up to 10% of European children are affected. Your risk of developing NAFLD is even higher if you also drink alcohol, have polycystic ovary syndrome or if you suffer with other features of the metabolic syndrome (such as Type 2 Diabetes, obesity, high cholesterol, or high blood pressure).
How you can test your liver function
Non-alcoholic fatty liver disease (NAFLD)
Essentially, in NAFLD, fat builds up in the liver in the same way as fat builds up elsewhere in the body. This can affect liver function and NAFLD is the most common cause of abnormal liver function tests. For many people the condition may remain stable and may cause no symptoms but, in a minority of people, inflammation of the liver develops, and this can progress to cirrhosis (permanent scarring of the liver), liver failure, liver cancer, and eventually death.
Because the liver is a remarkably resilient organ, the liver function will keep doing its job even when quite severely damaged. To some extent, this is a good thing, but it does mean that liver disease is often masked, causing no symptoms until quite a late stage. Many people therefore have no idea that there is a problem until significant and permanent damage has been done.
The powers of recovery
However, there is good news. Just as the liver is resilient in the face of harm, it also has tremendous powers of recovery. Fatty liver is frequently reversible, and the discovery of abnormal liver test should not necessarily be seen as an entirely bad thing for the liver function, rather as a prompt to make positive lifestyle changes that will not only improve the health of your liver, but lower your weight, reduce your cardiovascular risk, reduce your risk of diabetes and, ultimately, lead you to living a longer and healthier life.
Just as with fat anywhere else in the body, the key to ridding your liver of fat is a healthy diet and increased exercise, usually aiming to lose 1-2lbs per week. If you drink too much alcohol, you should also reduce or stop as alcohol can rapidly accelerate the process of harm.
Checking your liver function, and taking action to address any abnormal results, can be the difference between living a long and healthy life, or possibly dying early, albeit with a rich and buttery tasting liver.
Blood tests for the liver function monitoring
What we measure in the liver function
Our liver function blood tests typically measure a range of different biomarkers that reflect the health and function of the liver. While all of these biomarkers are important and can provide valuable information about liver health, one of the most important biomarkers is the liver enzyme alanine aminotransferase (ALT).
ALT is primarily found in liver cells and is released into the bloodstream when liver cells are damaged or destroyed. Elevated levels of ALT in the blood can indicate liver injury or disease, including viral hepatitis, alcohol-related liver disease, non-alcoholic fatty liver disease, and drug-induced liver injury.
ALT is considered a more specific biomarker for liver damage than other liver enzymes, such as aspartate aminotransferase (AST), which is also found in other organs such as the heart and muscles.
In addition to ALT we measure alkaline phosphatase (ALP), bilirubin, and albumin which are incredibly important in assessing liver health and diagnosing liver conditions.
The interpretation of liver function blood tests should always be done in the context of all of the biomarkers, as well as person's overall health and medical history, and in conjunction with other diagnostic tests as necessary.