Fatty Liver and NASH in Women

What is Nonalcoholic fatty liver disease (or NAFLD)?

Nonalcoholic fatty liver disease is a build up of extra fat in the liver not caused by alcohol. The liver normally has some fat; however, if more than 5-10% of the liver's weight is fat then it is described as fatty liver (or steatosis).


How common is NAFLD?

NAFLD is a growing global health problem, affecting roughly anywhere from ¼ or 1/3 of individuals in the U.S. A woman’s risk for fatty liver increases after menopause.


What causes NAFLD?


What are the risk factors for NAFLD?

Risk factors for NAFLD include obesity, diabetes, insulin resistance, hypertension, high cholesterol, high triglycerides, and being overweight. NAFLD is strongly associated with obesity.

Fatty liver is associated with an increased risk of cardiovascular disease, whether or not you have other risk factors for cardiovascular disease like obesity and diabetes.


How is NAFLD diagnosed?

Nonalcoholic fatty liver disease is generally diagnosed because of persistently elevated liver function tests. If your primary care provider notices persistently elevated liver function tests they may refer you to our office for further workup of elevated liver function tests. Fatty liver may be diagnosed based on ultrasound findings. 


What is the treatment for NAFLD? Can I get rid of the fat in my liver?

Gradual weight loss and good control of blood glucose levels are generally recommended for patients with basic fatty liver. Weight loss seems to be the best treatment so far. Weight loss should be gradual as rapid weight loss may actually worsen the disease. Studies show that losing even a small amount of weight can improve liver enzyme function, and reduce liver inflammation caused by the extra fat. NASH requires more aggressive treatment.


What is Nonalcoholic Steatohepatitis (or NASH)?

In some cases, nonalcoholic fatty liver disease may progress on to another more serious condition known as Nonalcoholic Steatohepatitis (or NASH). NASH is an aggressive form of fatty liver disease marked by liver inflammation and damage that can progress to advanced scarring (or cirrhosis of the liver), liver failure, liver cancer (also known as hepatocellular carcinoma), and death.

Patients with NASH should NOT consume any alcohol. Alcohol in patients with NASH is detrimental and has been shown to lead to liver cancer when consumed at ANY quantity.

Avoiding alcohol is especially crucial in women diagnosed with NASH.


Are women more susceptible to the damaging effects of alcohol?

  • Women ARE more susceptible to the damaging effects of alcohol compared with men because they are generally smaller in stature, and proportionately have more fat and less body water than men. Water dilutes alcohol, and fat retains alcohol. Women also have less alcohol dehydrogenase, an enzyme released in the liver that breaks down alcohol before it reaches the bloodstream.
    • Due to these differences, women tend to experience a more dramatic physiological response to alcohol compared with men.
    • As we age, our bodies contain even less water and more fat. We also metabolize alcohol less effectively, so blood alcohol levels rise FASTER, QUICKER than when we were younger.
  • Compared with men, women develop alcohol-induced liver disease over a shorter period of time and after consuming less alcohol. Women are more likely than men to develop alcoholic hepatitis and to die from cirrhosis.

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