Fatty Liver Disease (Metabolic Dysfunction-Associated Steatotic Liver Disease)

Fatty liver disease is the presence of too much fat in the cells of the liver. It is one of several health conditions associated with obesity, high cholesterol, high blood pressure and type 2 diabetes. 

Some fat in the liver is normal. But when too much is present, the liver can swell and become inflamed. Over time, scar tissue can form in the liver, which is called cirrhosis. Cirrhosis can cause the liver to stop working properly. When that happens, a liver transplant may be needed to save the person’s life. Cirrhosis can also turn into liver cancer.

Fatty liver disease is also known as hepatic steatosis. It used to be called nonalcoholic fatty liver disease, or NAFLD.

Fatty liver disease can develop in children who have obesity (excess body weight). It is also linked to a condition called metabolic syndrome. Metabolic syndrome is a combination of high cholesterol and triglycerides (a type of fat in the bloodstream), high blood pressure and type 2 diabetes.

If your child has fatty liver disease, you may not know it, as there may not be symptoms in early stages. But if your doctor has diagnosed your child with excess body weight, you may want to ask for further testing to determine if your child has fatty liver disease. 

A simple blood test can determine if there are signs of liver inflammation. Your child’s healthcare provider may also use the following tests to help make a diagnosis: 

• Imaging tests: Ultrasound, CT scan or MRI may show fat deposits in your child’s liver.
• Blood tests: Additional blood tests may be used to check how well the liver is working. They can also check for other causes of liver disease.
• Liver biopsy: The provider puts a long needle through your child’s skin into your liver. The needle removes a small piece of liver tissue. The tissue can be looked at under a microscope.

Based on the test results, your child’s health care provider may make the following diagnosis:

• Your child has MASLD (fatty liver disease) if they have fat in the liver but very little or no inflammation or tissue damage.
• Your child has a related condition (metabolic dysfunction-associated steatohepatitis, or MASH) if they have fat, inflammation and liver damage.
• Cirrhosis may be developing if tests show significant scar tissue in their liver called fibrosis.

There is not yet a medicine or procedure that brings fatty liver disease under control. Weight loss is the main treatment. The best approach is multidisciplinary — teamwork between doctors and healthcare providers from different specialties. It can be tough for children to lose weight, but with a strong commitment from the child and the family and expert support from the medical team, recovery is possible.

If your family doctor or pediatrician has diagnosed fatty liver disease, it is important to get help for your child. A compassionate and skilled liver disease team can put your mind at ease and get your child on the path to better health and lower risk.

It can be. If the liver has not yet developed significant scarring, lifestyle changes such as weight loss and exercise can halt progression, reverse the damage and lower your child’s risk of cirrhosis or liver cancer.

You should contact your child’s doctor or a specialist if your child experiences any symptoms that may mean fatty liver disease is getting worse, such as: 

• Severe tiredness (fatigue)
• Loss of appetite
• Weight loss
• Weakness
• Extra fluid buildup (fluid retention)
• Signs of bleeding, such as frequent nosebleeds, heavy periods or unusual bruising