MCB181R
Vince Guerriero
Fatty Liver Fatty liver is the condition when there is excessively extra amount of fat in liver, over five percent of liver weigh. Fatty liver has become a new issue, as up to twenty percent of Americans have the condition (“When the Liver Gets Fatty”), and it is one of the most common factor for the development of liver dysfunctional diseases. Long term fatty liver can process into liver fibrosis and cirrhosis. Fatty liver is also found to correlate to insulin resistance (Kimura et la.), metabolic diseases like types II diabetes (Kimura et la.), and hypertension (Sung, Ryan, and Wilson). There are two type of fatty liver, alcoholic fatty liver and non-alcohol fatty liver. Alcoholic fatty liver, like the name is caused by the alcohol consumption, while non-alcohol fatty liver can be caused by obesity, and fructose consumption. Alcoholism accounts for 2.5 million deaths annually worldwide. It is ranked as the leading risk factor for mortality for ages 15-59 in males, and the eighth leading risk factor for mortality for all ages in both sexes (Jaurigue and Cappell). Alcohol is also known for being the most common cause of liver diseases. About ninety percent of alcoholics will develop fatty liver (Jaurigue and Cappell). The reason behind it is the metabolic process of ethanol in alcohol. Body metabolizes ethanol in liver. Ethanol (CH3CH2OH), with the help of Alcohol Dehydrogenase (ADH) enzyme, will be turn into Acetaldehyde (CH3CHO), then the Acetadehyde will be broken down into Acetate (CH3COO-), with the assistance of Aldehyde Dehydrogenase (ALDH) enzyme. Liver mitochondria than can convert acetate into acetyl CoA, an enzyme that activates activates short-chain fatty acids synthesis. Also, the action of ADH followed by ALDH results in the production of reduced NAD (Nicotinamide Adenine Dinucleotide). The high NADH/NAD+ concentration favours fatty acid synthesis and the formation of triglycerides in the liver. Fatty liver can be reversible by reduce the alcohol consumption. The amount of alcohol intake recommended by Department of Health for man is 3-4 units of alcohol per day, and for women is 2-3 units per day (a unit is equal to 10ml of pure alcohol). The Royal College of Physicians also suggests to have 2-3 days of alcohol –free days, every week, to allow the liver to recover. Obesity is defined in term of Body Mass Index (BMI), which is calculated by weight in kilogram over height in meters. A BMI of over 30 is considered as obese. Obesity is one of the biggest health issues today. 1.1 billion adults and ten percent of children are now classified as obese worldwide (Haslam and James). It is related to many other health problems like diabetes, heart diseases, strokes, and even fatty liver. NHANES (National Health and Nutrition Examination Survey) III research indicates thirty percent of obese men and forty percent of obese women have Non-Alcoholic Fatty Liver Disease (NAFLD) (Clack, Frederick, and Anna). Obesity can lead to fatty liver condition, as obese people have an excessive amount of extra fat, more than thirty percent of body mass in women, and more than twenty five percent in men. This extra fat can then build up around the internal the organs like liver. In addition, obesity is related to insulin resistance, which can lead circulating levels of free fatty acids to raise. This then will result in increasing fat synthesis in liver. Other factor is obese people also tend to consume more sugar, or more specific, fructose, which is a type of carbon hydrate. Fructose can be found naturally in fruit and vegetables. However, it is mostly consummed through processed products, sugar, high fructose corn syrup, and especially soft drinks. In fact, fructose represents up to 10 percent of the total energy intake in US and many European countries (Tappy, and Le), as it is used in most of processed products nowadays. Fructose can be metabolized by liver only, which also results in