Fatty Liver disease – its causes and effects

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Long version for Bittertruth for release on 16^th May 2025

Health chat with Dr Anthony Leeds Series 5 part 2 episode 2

Title: Fatty Liver disease – its causes and effects

Interview with Professor Shahrad Taheri, University of Leicester, United Kingdom

In this interview Professor Taheri describes the causes and consequences of fatty liver disease. In this condition abnormal amounts of fat build up in the liver with consequences for the body’s metabolism (such as diabetes) but also direct risks to the liver of progression to later stages of the condition:

Fatty liver (without inflammation) – was once thought harmless but is associated with increased risk of heart disease in those with diabetes;
Fatty liver with inflammation (steatohepatitis) – inflammation can lead to fibrosis, so is best checked before it gets to this stage;
Fibrosis – scar tissue forms and distorts the structure of the liver, though overall a lot of liver function is maintained;
Cirrhosis – after years of inflammation, fibrosis and scarring the liver becomes lumpy and nodular and the amount of functioning liver tissues is reduced eventually leading to liver failure.
In the very late stages liver cancer can develop.

Liver disease, which can also be due to excessive alcohol intake, is difficult to detect without doing blood tests and liver scans.

People are at risk of non-alcoholic fatty liver if they have:

Obesity or are overweight especially with a high waist circumference;
type 2 diabetes;
age over 50 years;
metabolic syndrome or some of its components such as insulin resistance;
high blood pressure, high cholesterol, or an underactive thyroid.

Prevalence of fatty liver disease across the globe is high with estimates of around 30% but some Asian populations have estimated rates of 40%. In Pakistan the overall prevalence has been estimated at 30% but higher in groups of people with medical conditions (e.g. nearly 60% in people with diabetes and 75% in those with high blood pressure).

Prof Taheri then discussed the evidence from clinical trials that showed that sufficient weight loss in the early stage of fatty liver can greatly reduce the amount of fat in the liver thereby reducing the risk of progression of liver disease and better outcomes from other obesity related problems such as diabetes and high blood pressure.

In another recent study by Prof Taheri with colleagues including Professors Lean and Taylor (see below) in which thousands of protein markers in tiny blood samples from the participants of the DiRECT and DIADEM-1 study were measured by a novel technique to observe effects of weight loss. Proteins linked to cardiovascular function and separate markers of liver function and fatty liver changed in response to weight loss, more so after weight losses greater than 10kg in samples taken up to one year from starting the diet. The greater benefits shown by protein markers after greater weight losses showed the importance of maintaining the greater dietary energy restriction after the initial weight loss to achieve maintained reduced fat in the liver. The value of maintained weight losses in excess of 10kg was thus shown and this augers well for the use of total diet replacement (800kcal/d) diets in the management of non alcoholic fatty liver disease.

Web-links to useful sources of information are given below. Those concerned about their risk of developing diabetes can use the on-line risk calculators given in the notes under the diabetes remission update at: Update on Diabetes remission and if appropriate should consult a doctor or health care professional where possible.

Anthony R Leeds

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About Diabetes:

Series 4 Episode 2: June 14^th 2024 Update on Diabetes remission – Prof Mike Lean, University of Glasgow

Studies of multiple protein markers (proteomics) in the DiRECT and DIADEM studies:

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Fatty liver disease

UK – Non Alcoholic Fatty Liver disease

USA – Fatty Liver disease

Canada – Fatty Liver disease

Malaysia – Fatty Liver

Singapore – Fatty Liver