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Fatty Liver More Risky than Apple Shape

By Daniel H. Rasolt

Posted: Friday, December 05, 2008

(Defeat Diabetes® News) -- It's long been accepted that overweight individuals with higher proportions of fat in the gut, as apposed to the lower body, are more at risk for conditions such as heart disease and diabetes. A new study has found, however, that excess liver fat is the most indicative of future health risks, with outer fat proportions taking a back-seat in riskiness.

Past research popularized the variance of fat distributions in overweight individuals by calling them apple (fat in the abdomen, or round) shaped and pear (larger fat distribution in the thighs and buttocks) shaped. It's been accepted for several years, that being apple-shaped poses a higher risk for the contraction of numerous health conditions, such as heart disease, high blood pressure and diabetes.

Two Washington University of St. Louis studies found that "non-alcoholic fatty liver disease," which is the term given to excess fat buildup on the liver, is ultimately the most responsible for developing heart disease and diabetes. According to the research teams news release, "excess liver fat appears to be the real key to insulin resistance, cholesterol abnormalities and other problems that contribute to diabetes and cardiovascular disease."

Fatty liver disease is a common occurrence in many obese individuals, both pear and apple shaped. According to Dr. Samuel Klein, senior investigator for the studies, "since obesity is so much more common now, both in adults and in children, we are seeing a corresponding increase in the incidence of nonalcoholic fatty liver disease."

The first study focused on obese adolescents, a group that has seen tremendous growth (in numbers) over the past decade. By testing, and then separating based on presence of excess liver fat, it was found that those with fatty livers were more likely to have "abnormalities in glucose and fat metabolism, including lower levels of HDL cholesterol [good cholesterol]."

In a second study, again focusing on overweight youth, fatty liver disease was linked to insulin resistance, which can often be followed by type 2 diabetes. "Multiple organ systems become resistant to insulin in these adolescent children with fatty liver disease. The liver becomes resistant to insulin and muscle tissue does, too. This tells us fat in the liver is a marker for metabolic problems throughout the entire system," states Dr. Klein.

It's believed by the researchers that the findings extend to all ages and races, though the studies focused on young individuals. If this is true, the researchers will have succeeded in challenging a very popularly held belief. Dr. Klein concludes that "abdominal fat is not the best marker for risk. It appears liver fat is the real marker. Abdominal fat probably has been cited in the past because it tends to track so closely with liver fat. But if you look at people where the two don't correspond — with excess fat in the liver but not in the abdomen and vice versa — the only thing that consistently predicts metabolic derangements is fat in the liver."

So what is the solution? It's quite simple. All obese individuals should lose weight, but for those with fatty liver disease (which should be tested for more often, suggest the researchers), it is imperative, but very constructive. Dr. Klein stresses that "ff you lose weight, you quickly eliminate fat in your liver. As little as two days of calorie restriction can improve the situation dramatically, and as fat in the liver is reduced, insulin sensitivity and metabolic problems improve."

Source: Defeat Diabetes Foundation: Klein, Samuel. Dryden, Jim. University of Washington St. Louis news release. December 2008.

Daniel H. Rasolt writes for Defeat Diabetes® News. Read more of his original content articles.

Copyright © 2008 Defeat Diabetes Foundation, Inc. All rights reserved.

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