One-third of Indians, including children, have fatty liver, says AIIMS study

A recent AIIMS study, which analysed published reports on non-alcoholic fatty liver disease in India, states that over one-third (38 per cent) of Indians have fatty liver or non-alcoholic fatty liver disease.

The phenomenon is not restricted to adults, but affects nearly 35 per cent of the children as well, says the study published in the Journal of Clinical and Experimental Hepatology in June 2022.  

"Non-alcoholic fatty liver disease (NAFLD) is often unrecognised since it does not cause symptoms in the early stage, but may progress in some patients with severe liver disease.

"The cause of 'fatty liver' or 'steatohepatitis' is the recent westernisation of our diets which involves increased intake of fast food, lack of healthy fruits and vegetables on the plate, and an unhealthy and sedentary lifestyle," Dr Anoop Saraya, head of department of gastroenterology, said.

He said the ailment is considered the "liver counterpart" of metabolic diseases such as diabetes, hypertension and heart disease. Although there is currently no approved drug treatment for fatty liver, the condition is reversible, he added.

"The only way to conquer this new epidemic is to adopt a healthy lifestyle and achieve weight loss in obese individuals through adequate diet, restrict junk and sugary food intake, and exercise regularly," Saraya noted.

Experts say alcohol intake remains a common cause of liver disease in India. Intake of alcohol can lead to "alcoholic hepatitis" and cirrhosis, which can progress to liver cancer and death.

"Alcohol accounts for most of the cases of severe liver damage which are admitted to hospitals with diagnosis such as 'acute chronic liver failure' and these have a high mortality," Dr Saraya stated.         

What makes matters worse is a high recidivism rate in the few patients who survive this disease, and the non-availability of any specific drug to treat alcoholic hepatitis. The only way to avoid this deadly disease is to avoid the alcohol intake as no alcohol is safe for the liver.

Use of common over-the-counter drugs, which are generally considered safe, may also lead to liver damage, according to experts.     

Drugs used for the treatment of tuberculosis, antibiotics, antiepileptic drugs, and chemotherapy, are also associated with liver injury, as are those taken as complementary and alternative medications (CAM).         

A study by the All India Institute of Medical Sciences (AIIMS) in New Delhi reported 67 per cent deaths among patients with anti-tuberculosis drug-related acute liver failure. Of all patients with anti-tuberculosis drug-related acute liver failure, 60 per cent were started on medicines without confirmed tuberculosis. Self-medication must be avoided, Dr Saraya asserted. 

Another AIIMS study has shown that hepatitis A and E constitute 30 per cent of cases of acute liver failure, with high mortality of over 50 per cent. This study was conducted by the Department of Gastroenterology and HNU, AIIMS, New Delhi.

"The spread of hepatitis A and E can be largely prevented by ensuring access to clean drinking water," Saraya added.