The liver plays a central role in the metabolism of our body and it is important that it is healthy. Professor Massimo Colombo, Director of the Translational Research Centre in Hepatology at Humanitas, guest in the studio at Tutta Salute on Rai3, spoke about the health of the liver and the importance of treating steatosis or fatty liver by intervening in lifestyle.

“The liver plays a fundamental role in body metabolism, producing the elements that keep us alive, such as proteins, sugars and fats. It also produces and inactivates hormones and produces bile, which is essential for the digestion of foods; some foods would not be attacked by digestive enzymes if they were not pre-processed by bile,” explains Prof. Colombo.


What is a fatty liver?

“When the liver accumulates fat inside the cells (and these are usually neutral triglycerides) the liver cells expand in volume and consequently the liver may become larger. Due to this enlargement, some patients may also experience symptoms of clutter, discomfort or pain.


How is it diagnosed?

“To experience physical or clinical signs, however, it is necessary that the major part of the liver is engaged by steatosis. Therefore, for the diagnosis, the collection of the patient’s medical history (lifestyle, weight, particular diseases) and the specialist examination are of great importance”.

The patient will be subjected to blood tests and abdominal ultrasound. “This test, which is carried out on an empty stomach, is able to detect and quantify steatosis. If there is a clinical interest in understanding the presence of steatosis below the limit of 30% of liver cells involved (and therefore not seen by ultrasound), magnetic resonance imaging can be used, which goes down to diagnose steatosis up to the limit of 5%. However, this examination is only carried out in selected cases.


What should be done in case of fatty liver?

“Risk factors for fatty liver are excess weight, diabetes, high cholesterol and triglycerides, alcohol abuse and certain medications. In 1-2% of cases the fatty liver may evolve into structural damage of the liver. It is therefore good to follow a correct diet and exercise to normalize weight and cholesterol, with a benefit on cardiovascular and cerebral risks: in 98% of cases this protects the liver from the evolution towards fibrosis.

In the case of fatty liver, it is advisable to investigate the causes of steatosis, treat the disease components that determine it, avoid excess weight by following a healthy diet that takes into account an adequate calorie balance in relation to physical activity, limit the consumption of alcohol and do not smoke,” concludes Prof. Colombo.


Watch the full interview with Professor Colombo: