23 January 2019
A CUHK study has found that up to 27 percent of Hong Kong adults had fatty livers. Early detection is key to taking remedial measures. Photo: HK Govt
A CUHK study has found that up to 27 percent of Hong Kong adults had fatty livers. Early detection is key to taking remedial measures. Photo: HK Govt

Early diagnosis and intervention on fatty liver

People who have hectic lifestyles, poor eating habits and don’t get sufficient rest, as is the case with many city dwellers, are vulnerable to liver-related issues. However, most victims fail to detect the problem early since there are usually no obvious signs and symptoms for hepatic diseases.

Studies conducted by the Center for Liver Health of the Chinese University of Hong Kong found that up to 27 percent of the adult population in Hong Kong suffers from fatty liver, medically known as non-alcoholic fatty liver disease (NAFLD).

The problems of the ‘three highs’ condition — high blood pressure, high blood glucose and high cholesterol — and obesity are highly linked to the incidence of fatty liver. Those who are obese or have the ‘three highs’ condition would be more than 1.5 times likely to get fatty liver than people who have normal body weight.

Everyone should have check-ups regularly to better monitor their bodily functions. With early diagnosis and follow-ups, permanent damage to the liver can be avoided as fatty liver is a reversible condition that can be resolved with improved, healthier lifestyle.

Too much fat accumulated internally would pose a threat to the human body. Not only do the fatty tissues exert pressure to the liver organ, they can also weaken the liver functions and cause inflammation that could lead to fibrosis.

If inflammation goes untreated for years, NAFLD would enter the final stage of cirrhosis, where the liver would shrink and become scarred and lumpy. Such permanent damage could lead to liver failure and liver cancer.

Obesity is the first and foremost risk factor for fatty liver. Anyone who has a BMI value over 25, or central obesity — a waist size greater than 29 inches for women or more than 33 inches in the case of men — should regularly check for any elevated liver enzymes.

If there are warning signs, patients should take ultrasound scan or non-invasive diagnostic tests for fatty liver to find out how serious is the condition, which can help them take steps to avoid further damage.

Around two years ago, a person surnamed Lam, who was aged over 50 and had a BMI of 32.8 and the ‘three highs’ condition, sought medical attention as he experienced an upset stomach. His liver function tests gave a liver enzymes reading of 97 IU/L, where normally it should be 40 IU/L or below.

As Lam had all high risk factors for fatty liver, he was advised to take a non-invasive test which gave the controlled attenuation parameter (CAP) value for steatosis as 320 dB/m, suggesting a “severe” condition, as the normal range of CAP value is 238 dB/m or below. Meanwhile, the tested value for fibrosis also reached 10.9 kPa, a moderately alarming level.

Fortunately, with medications, regularly follow-up sessions and a change in lifestyle, Lam managed to bring his condition under control. The steatosis value dropped to 269 dB/m and the value for fibrosis fell to 3.1 kPa during a consultation session early this year.

This article appeared in the Hong Kong Economic Journal on Sept 5

Translation by John Chui with additional reporting

[Chinese version 中文版]

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FHKAM (Medicine), specialising in gastroenterology & hepatology

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