In a second study, Klein's team found nonalcoholic fatty liver disease was related to the release of larger amounts of fatty acids into the bloodstream that were, in turn, linked to elevated triglycerides and to insulin resistance, a key precursor to type 2 diabetes.
"Multiple organ systems become resistant to insulin in these adolescent children with fatty liver disease," he says. "The liver becomes resistant to insulin and muscle tissue does, too. This tells us fat in the liver is a marker for metabolic problems throughout the entire system."
The findings indicate that children and adults with fatty liver disease should be targeted for intensive interventions, according to Klein. Those who are obese but don't have fatty liver disease still should be encouraged to lose weight, but those with evidence of fatty liver are at particularly high risk for heart disease and diabetes. They need to be treated aggressively with therapies to help them lose weight because weight loss can make a big difference.
"Fatty liver disease is completely reversible," he says. "If you lose weight, you quickly eliminate fat in your liver. As little as two days of calorie restriction can improve the situation dramatically, and as fat in the liver is reduced, insulin sensitivity and metabolic problems improve."
|Contact: Jim Dryden|
Washington University School of Medicine