Fatty liver disease, a growing concern

Non-alcoholic fatty liver disease (NAFLD) has emerged as a key public health threat in India. According to surgical and gastroenterology professor and HOD at a Patna hospital Dr Manish Mandal, “India has over 40 million hepatitis B patients and nearly 12 million chronically infected with hepatitis C. The prevalence of non-alcoholic fatty liver disease among adults is approximately 38.6 per cent. According to WHO data published in 2020, liver disease was responsible for 2,68,580 deaths in India, accounting for 3.17 per cent of all deaths.

Dr Mandal notes that liver diseases in India are on the rise, with NAFLD  becoming a major concern due to increasing obesity and diabetes. Hepatitis B and C remain significant public health issues, with high rates of chronic infections.

Liver cancer is also growing, largely linked to chronic hepatitis B and C infections, he adds. 

Metabolic disorders

Dr Shiv K Sarin, gastroenterology and hepatology expert, who is also a chancellor at Delhi’s liver and biliary sciences institute, points out that while NAFLD is strongly associated with metabolic disorders such as obesity and diabetes, Indians, even those with normal body mass index (BMI), often have higher levels of visceral fat compared to Europeans or Americans.

On the ongoing research in India pertaining to treatment of NAFLD, which is now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD) he said, “It is increasingly focusing on lifestyle changes, early diagnosis, and the management of related metabolic conditions.”

The expert sounds a note of caution when he says that while there is no doubt about the availability and efficacy of medications based on active ingredients like semaglutide and tirzepatide in India, these  should be used in only specific group of patients, and are expensive. 

Focusing on the potential role of therapies and treatment, Dr Sarin says, “Stem cell therapy is becoming an important option for treating liver diseases, especially alcoholic liver disease. In India it is gaining attention as a promising way to improve recovery and reduce the need for liver transplants. Stem cells can stimulate other liver cells to repair damaged tissue and even support liver regeneration.”

The most common stem cell therapy uses mesenchymal stem cells (MSCs). These can be obtained from the bone marrow or the umbilical cord. These cells can be given through peripheral vein or directly to the liver. 

Dr Sarin explains that early detection and raising awareness are key to effective management of liver disease.

In the absence of timely intervention, these silent conditions can progress and cause serious liver damage.

An early diagnosis enables prompt treatment, which can slow or even stop disease progression, reducing the risk of advanced complications such as the need for liver transplantation, he adds.

The liver plays a significant role in digestion, metabolism, and detoxification.

It is responsible for critical functions like filtering of toxins from the blood, regulating the blood sugar in the body, and producing bile, among others. 

Diseases related to the liver may be attributed to infections, autoimmune diseases, and also genetic factors. 

Visceral fat is the fat that envelopes abdominal organs and the heart. Excessive visceral fat is one of the causes of non alcoholic fatty liver disease. A combination of diet, exercise, quality sleep and stress management helps lower visceral fat. 

Fatty liver complications

NAFLD, especially in its more advanced form (nonalcoholic steatohepatitis or NASH), leads to several serious health conditions including both liver-related and non-liver-related diseases such as 

Liver fibrosis: scarring of the liver tissue

Cirrhosis: advanced liver scarring that can impair liver function

Liver cancer (hepatocellular carcinoma): increased risk, especially in those with cirrhosis and liver failure

End-stage liver disease: the liver no longer functions properly and can lead to mortality