by Natalie Homan from In The Cloud Copy
A review article published in Endocrinology in August of this year highlights the fact that a female’s risk of developing nonalcoholic fatty liver disease (NAFLD) increases after she experiences menopause. Furthermore, not only does the risk of developing NAFLD increase as females age, but they are also more likely to die due to complications of the disease than males are. While the exact reasons for this aren’t yet completely understood, Dr. Johanna DiStefano, the senior author of the study, hopes that more research will be performed to help at-risk females treat the disease and lower their chance of developing it to begin with.
Nonalcoholic Fatty Liver Disease
NAFLD is a condition in which the liver contains excess fat due to causes other than alcohol consumption (which is the leading worldwide cause of liver disease). The majority of people with NAFLD have simple fatty liver, which usually has few complications and causes little damage to the liver. However, with simple fatty liver there is still cause for concern, because the condition can develop into nonalcoholic steatohepatitis (NASH).
NASH is a much more dangerous condition, marked by inflammation and damage to liver cells. This damage can lead to scarring as the liver repairs itself, and the scarring hardens and can eventually cause cirrhosis or liver cancer. Experts aren’t sure why some cases of NAFLD progress to NASH and others don’t.
NAFLD is a common and very costly disease; according to the review, nearly one quarter of the global population is affected. The total economic burden in the United States is estimated at $292 billion per year. Cases of both NAFLD and the more severe NASH are climbing and are expected to continue in their upward trajectory, making this a very important disease to develop treatments for.
How is NAFLD Treated?
There is currently no treatment for NAFLD. When it progresses to NASH and cirrhosis or liver failure occurs, a transplant is the only solution. This is obviously very invasive and costly, and it isn’t always an option. Furthermore, NAFLD often returns even when a patient has received a liver transplant.
Who Is at Risk for NAFLD?
According to the Endocrinology review, males have overall higher rates of NAFLD, and premenopausal females have lower rates than postmenopausal females. Obesity and diabetes are leading causes of NAFLD, and so preventative lifestyle changes like losing weight and improving diet are key to helping patients who are at risk.
The review published in Endocrinology found that estrogen, an important hormone involved in the female menstrual cycle, likely provides some level of protection against NAFLD. When a female goes through menopause, her production of estrogen slows down significantly, and she loses much of that protection.
Future Research Possibilities
Exactly how estrogen protects against NAFLD is not entirely understood. However, the relationship between this hormone and the disease suggest that hormone replacement therapy might be a successful treatment option. Little has been done to study this so far, but further research on sex-specific strategies to prevent and treat NAFLD would greatly benefit millions of females who are at risk of developing it.
Find the original study abstract here.
Read more on this subject here.