JULY , 2018 | The HEALTH issue : hepatitis 13
JULY , 2018 | The HEALTH issue : hepatitis 13
CREDIT : OUR PLACE IN THE WORLD
( From left to right ) An illustration of a healthy liver , non-alcoholic fatty liver disease , non-alcoholic steatohepatitis and cirrhotic liver .
Fatty liver disease
FATTY liver disease is characterised by access fat in the liver . It can be divided into alcoholic and non-alcoholic .
University of Malaya Faculty of Medicine , Department of Medicine Associate Professor Dr Chan Wah Kheong explained that alcoholic fatty liver disease is caused by significant amount of alcohol consumption .
“ We take that as more than 21 units per week for men and more than 14 units per week for women . One unit of alcohol is ; for example – half a pint of beer , one glass of wine and one shot of spirit .”
Anyone who has a history of consuming a significant amount of alcohol and has a fatty liver , alcohol could be the cause .
On the other hand , there is nonalcoholic fatty liver disease ( NAFLD ) which occurs in a person that doesn ’ t consume significant amounts of alcohol .
METABOLIC syndrome has five components ; central obesity , high blood pressure , high triglycerides level , low HDL level and impaired fasting glucose , or frank diabetes .
University of Malaya Faculty of Medicine , Department of Medicine Associate Professor Dr Chan Wah Kheong explained that if the person , has any three of the five components , that person is considered to have metabolic syndrome . All these are risk factors for cardiovascular disease .
“ So , non-alcoholic fatty liver disease ( NAFLD ) is actually the liver manifestation of the metabolic syndrome . When somebody has some of these components , they are at a higher risk of having NAFLD . When a person has all five components , they are at 80 per cent risk of having NAFLD .”
In general , NAFLD is really the bigger problem because obesity is so common now and Malaysia is the most common obese country in South East Asia .
He explained that NAFLD patients are at an increased risk of having cardiovascular disease because it ’ s closely associated with metabolic syndrome . But on top of that , some of the patients are at risk of liver related
Dr Chan Wah Kheong examining the editor for non-alcoholic fatty liver disease .
“ But as you see , obviously there are two causes due to the amount of alcoholic intake which overlaps .”
“ By street definition of NAFLD , there shouldn ’ t be a significant amount of alcohol intake . If the person doesn ’ t consume alcohol , the main cause for the fatty liver is over nutrition which is closely associated with obesity .”
“ Obesity has been on the rise , and along with it , obesity related diseases ,
complications .
“ They are at risk of developing cirrhosis – if the liver is so damaged that there is scaring that the liver becomes modular .”
Complications associated with liver cirrhosis can lead to cancer . So these patients who has more severe liver disease , will have a higher risk of getting liver related complications which will lead to death .
“ NAFLD patients who are at a higher risk of this complications are those who have Non-alcoholic steatohepatitis ( NASH ).
“ The difference between NAFLD – those who have a steatohepatitis is fat in the liver compared to NASH where there is inflammation , swelling of liver cells ( ballooning ).
Patients with NASH are at a higher risk of getting scaring in the liver or fibrosis which eventually would lead to cirrhosis as well as liver cancer .
Think before you toast .
Practical tips to care for your liver
• CONSUMING to much of alcohol can damage liver cells and lead to cirrhosis , which is deadly .
• Eat a healthy diet and exercise regularly . Keeping your weight under control helps prevent non-alcoholic fatty liver disease away .
• Be careful when consuming certain medications . Some drugs , when taken for a long period of time can cause liver problems .
• Do not take medicines and consume alcohol at the same time .
• Learn how to prevent viral hepatitis . Abstain from eating or drinking water that is contaminated .
• Don ’ t share items like toothbrushes , razors or needles .
• Limit the number of sex partners and always use protection .
• Don ’ t breathe in toxins such as products containing insecticides and aerosol products .
• Don ’ t smoke as additives in cigarettes can damage your liver .
• Exercise precaution when consuming dietary supplements such as cascara , chaparral , comfrey , kava , and ephedra , milk thistle seed , borotutu bark and chanca piedra .
• Research shows that coffee can lower your risk of getting liver disease .
Five components of a
Statistics metabolic syndrome
RAIHAN R , Mohamed R , Hasan MRA , Rosaida MS . Chronic Viral Hepatitis in Malaysia : “ Where are we now ?”
The various components of a metabolic syndrome .
including non-alcoholic fatty liver disease , which is considered as the liver ’ s manifestation of the metabolic syndrome .”
Metabolic syndrome is basically a constellation of risk factors for cardiovascular disease which include central obesity . In Asians , it is defined as a waist circumference of 90cm in men and more than 80cm in women .
“ Other components of the metabolic syndrome will be hypertension , high blood pressure , high triglycerides level in the blood , high density lipoprotein cholesterol level , impaired fasting sugar – impaired glucose tolerance of frank diabetes ( where a person is frankly diabetic ).”
“ When a person takes a fasting sugar , normally , it is less than 5.5 . If it ’ s more than seven , the person would be expected to have diabetes . But there ’ s a range in between that which is called impaired fasting glucose . So , it ’ s not normal but it ’ s not diabetes range yet ,” he said .
Euroasian J Hepato-Gastroenterol 2017 ; 7 ( 1 ): 65-67
Globally
400 million people live with hepatitis B virus ( HBV ) or hepatitis C virus ( HCV ) infection
1.4 million people die every year from complications of viral hepatitis
Malaysia
1 million people are chronically infected with hepatitis B virus ( HBV )
2.5 % of the adult population are positive for antibody to hepatitis C virus ( HCV )
World Health Organisation 2017 “ Liver Disease Deaths in Malaysia ”
Liver disease deaths were 2,286 or
1.65 % of total deaths .
The age adjusted death rate is 9.18 per
100,000 of population
AsiaOne . com “ The facts about fatty liver ”
17 per cent of the population is believed to be afflicted with fatty liver disease .