Fatty liver disease now an epidemic, say experts citing gene behind rise

Hyderabad: Known as the ‘diabetes capital of the world', India might be silently brewing another epidemic: Fatty liver disease (FLD).This silent epidemic could surpass all other non-communicable diseases (NCDs) in proportion, given the estimated 30% prevalence in the general population. Experts in the field have approached the Centre, suggesting that this should be declared an epidemic.FLD has the potential to trigger other NCDs as well, bringing along cardiac, kidney and other ailments. A particular gene, PNPLA3, makes people more vulnerable to fatty liver even without alcohol consumption. It makes Indians particularly vulnerable to non-alcoholic steatohepatitis (NASH), a type of liver disease that occurs when fat builds up in the liver, causing inflammation and cell damage. This is the most severe form of non-alcoholic FLD.Dr D Nageshwar Reddy, chairman of Asian Institute of Gastroenterology Hospitals, said Indians have this special gene making them susceptible to fatty liver. "Among patients with diabetes and obesity, about 90% have fatty liver, and this means that we might be the biggest capital of fatty liver. We have recently written to the national task force on health to declare fatty liver an epidemic and work on it," he said."Today, 30% of our hospital beds are occupied by liver patients," he said and adding the primary underlying reason is found to be fatty liver disease. Dr George Chandi, former director of CMC Vellore and director of BCMC Hospital in Thiruvalla, Kerala, said: "In the hospital where I work, we get a large number of cases of otherwise healthy people who get admitted to the hospital for some ailment and are found to have completely abnormal fatty liver." In many cases, a large number of patients are unaware of how their liver is getting targeted, he said. "They think that liver disease will affect alcoholics, but we see a lot of this in non-alcoholic men, women, and even children. Since it doesn't have any symptoms, it's a huge problem," he explained.Adding how the gene PNPLA3 works, he said that the gene increases the breakdown of fats and starts killing the cells in the liver. The fat cells cut into the liver cells, leaving scar-like fibrosis. The cells get inflamed, causing NASH. "Lack of exercise and inactivity is fuelling this epidemic," he said.
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