The liver is the heaviest organ in the body. Among other functions, it is responsible for converting sugar into fat, storing nutrients such as vitamin B12, filtering toxic substances out of the blood and converting them into compounds that can be eliminated from the body. Fatty liver is the excessive deposit of fat inside the liver which generates swelling and liver dysfunction.
There are four types of fatty liver: non-alcoholic, alcoholic, non-alcoholic steatohepatitis and cirrhosis.
The non-alcoholic fatty liver is basically formed when there is a constant excess of triglycerides, which are those fats that are formed in diets with high carbohydrate content. This is the type of fatty liver that may be of most interest to the cardiology setting.
Why can the liver become fatty?
The most frequent cause of fatty liver is excessive alcohol consumption, as alcohol causes a lot of triglycerides, a form of fat storage, to be produced. Another cause is the excess of carbohydrates in our modern diet which is full of toxic substances (dyes, preservatives, etc).
And finally, we have liver metabolism problems whose detoxification system consists of two phases. When phase I is faster than phase II, there are toxic substances that remain half-detoxified and the liver also ends up covering them with fat, which is the best way for the body to keep toxins out of the circulation.
What is the relationship between fatty liver and the heart?
Both fatty liver and cardiovascular disease are the final stages of what is known as Metabolic Syndrome. Through multiple pathophysiological mechanisms, fatty liver is closely related to cardiovascular disease.
These mechanisms are: systemic inflammation, insulin and leptin resistance, endothelial dysfunction, oxidative stress and alterations in fat metabolism. Patients with nonalcoholic fatty liver disease are known to develop arteriosclerosis, heart disease and arrhythmias more frequently.
What is the role of the cardiologist in treating fatty liver disease?
The first thing should always be to go deeply into the eating style, giving the pertinent recommendations.
It is important that we learn concepts such as Paleo Diet, Ketogenic Diet and Intermittent Fasting that, despite not being concepts that we learned during the specialty, are showing a good way back to regain the ability to feed ourselves with physiological sense instead of eating processed junk food full of toxins.
From orthomolecular medicine we know the nutritional requirements necessary for the two phases of detoxification to be done properly. From natural therapies we know the effects attributed for centuries to Silymarin (a plant also known as Milk Thistle) and from mycotherapy the benefits of mushrooms such as Reishi.
These changes will result in the prognostic benefit of the patient, since we will interrupt the process of generation of cardiovascular disease and we will make primary and secondary prevention when appropriate.