In people with non-alcoholic fatty liver disease (NAFLD), there are fat deposits inside the liver. These deposits can inhibit the liver's ability to remove toxins from the blood. People who are obese and those with diabetes and/or high blood lipid levels (cholesterol and triglyceride) have a higher risk of NAFLD; high blood pressure also elevates risk.
When NAFLD progresses to cause cirrhosis (liver scarring) and inflammation (a disorder called non-alcoholic steatohepatitis, or NASH) and impairs liver function significantly, the patient may need a liver transplant. In fact, the number of liver transplants performed in people with NAFLD and cirrhosis has quintupled in the last decade.
NewYork-Presbyterian Hospital is a leader in the study of NAFLD and the care of patients with this disease, offering the latest therapies, comprehensive care, liver transplantation, and opportunities to participate in clinical trials. A special clinic at NewYork-Presbyterian Morgan Stanley Children's Hospital is available just for children and adolescents with fatty liver disease — the only one of its kind in the Tri-State area.
NAFLD may cause no symptoms, but a doctor may evaluate a patient's liver function if the patient is obese and has diabetes and/or high blood lipids. NASH may cause tiredness, weakness, weight loss, yellowing of the skin or eyes, persistent itching, and spiderlike blood vessels in the skin. Patients with cirrhosis may also experience fluid retention and confusion.
About 10 percent of children have NAFLD, and more than 95 percent of those patients are obese. The risk of the disease rises in overweight children who do not eat a healthy diet or have access to sports programs in safe areas, and in those who are Hispanic or Asian.
NewYork-Presbyterian doctors use imaging tests to see if there are fat deposits in the liver. The diagnosis of NAFLD and NASH are confirmed using a liver biopsy -- examination of a small amount of liver tissue obtained through a long needle inserted through the skin and into the liver. Blood tests may also be performed to look at levels of liver enzymes and other chemicals in the blood that serve as markers of liver function.
For adults with NAFLD, NewYork-Presbyterian's hepatologists (liver specialists), gastroenterologists (digestive specialists), nutrition specialists, and other members of the healthcare team recommend diet and exercise changes to achieve weight loss, which are able not only to halt progression of NAFLD, but even improve liver health. Some patients benefit from vitamin E therapy or medication.
For those with liver cirrhosis who require transplantation, NewYork-Presbyterian Hospital is one of the world's leading centers for liver transplantation, offering multidisciplinary care and achieving excellent outcomes.
The weekly Fatty Liver Disease Clinic at NewYork-Presbyterian Morgan Stanley Children’s Hospital features doctors, nurses, nutritionists, and other healthcare professionals dedicated to the care of children with fatty liver disease, offering diet and exercise guidance and other treatments in a family-friendly setting. The Clinic may be contacted by calling 212-305-NASH (6274) or e-mailing firstname.lastname@example.org.
NewYork-Presbyterian investigators are conducting clinical trials of novel therapies for NAFLD and NASH. Morgan Stanley Children's Hospital is a leading center in the NASH Clinical Research Network, and received a $1.5 million grant to study the causes, prevalence, treatment, evaluation, and progression of NASH.
Examples of current NAFLD clinical trials include:
Our doctors are also analyzing tissue from liver biopsies to identify "biomarkers" of NAFLD that may lead to the development of new diagnostic tests and eventually spare future patients from needing a biopsy to make a diagnosis.