Experts are warning high levels of fatty liver disease among young people could signal a public health crisis.
Fatty liver disease is normally associated with people in their 50’s and 60’s and is linked to excess weight or alcohol use.
However a major new study reveals one in five young adults has evidence of fatty liver disease.
The surprising findings come from scans of more than 4,000 24 year-olds in one of the largest pieces of research into liver disease in the young.
Experts say the findings are an early indicator of an explosion of health problems to come including deadly liver disease, cancer, heart disease and diabetes – which are also linked to excess weight or alcohol consumption.
Dr Kushala Abeysekera, from the University of Bristol who led the study said: “Fatty liver disease is a ‘silent’ illness that can go decades without a patient feeling unwell.”
Professor Sir Ian Gilmore, a leading expert in liver disease and past president of the Royal College of Physicians said: “This is a silent epidemic. While we have seen a drop in the number of young people drinking alcohol, the curve of the weight distribution has risen progressively over the past decades, so we are seeing more people with obesity than ever before. This means that non- alcohol related fatty liver disease is the new danger, and we expect to see its incidence rise as a result. Some of these cases will ultimately lead to liver damage and we will likely see a surge in cirrhosis in the next three to four decades.”
He added: “Another consequence of the obesity problem will be a rise in other health problems including increasing cases of various cancers and heart problems. Unless action is taken now we can anticipate a public health crisis in years to come.”
Fatty liver is caused by the build up of fat cells damaging the liver. It can lead to liver fibrosis, scarring as well as potentially deadly and irreversible liver cirrhosis in severe cases.
Almost 70 percent of people with liver disease are diagnosed when they first come to hospital with late-stage complications which can include jaundice, fluid retention and internal bleeding.
Alcohol and diet related harm to the liver currently costs the NHS £3.5bn a year with mortality rates up more than 400 percent in the last 50 years.
The study of the 24 year-olds is part of a research project that has followed the health of thousands of Bristol children since the early 1990’s.
While one in five young people had early liver changes caused by fatty liver, one in forty had more advanced disease where the liver becomes scarred.
Published in The Lancet Gastroenterology & Hepatology, it is the first attempt to discover fatty liver disease and fibrosis in young healthy adults in the UK.
Fatty liver is reversible if people eat a good diet, get back to a normal weight, exercise and drink only in moderation.
Dr Abeysekera is calling for early scanning programmes to allow doctors to intervene before damage is done.
He said: “There is a long phase where people have no symptoms, which provides a window to intervene and reverse liver damage.
“When people develop disease it’s usually after years of silent disease, as the liver becomes more and more scarred.
“If we can intervene while symptoms are silent we can reverse any damage that has started.”
Dr Abeysekera, who works at Bristol Medical School, said: “The children of the 90’s data has highlighted the potential importance of liver health amongst young adults. This remains a blind spot for clinicians, as they are typically considered a “healthy” age group that are rarely studied. If the obesity epidemic and culture of alcohol abuse aren’t tackled nationally, we may see increasing numbers of patients presenting with end-stage liver disease, and at earlier ages.”
The researchers are planning to follow the 24 year olds, scanning them at 32 to see how their livers are doing compared to eight years earlier.
Dr Abeysekra said: “Alcohol and obesity cause worse liver damage when combined, which accounts for the rapid rise in liver-related deaths seen in the UK.”
Freddie Draper, one of thousands who enlisted in the Bristol Children of the 90s study, had an ultrasound to check out the condition of his liver.
He said: “I just assumed this affected older, unhealthy people. What I found most surprising was that the percentage of people in my age bracket suffering from the disease was so high.
“Any disease with no symptoms is pretty scary to be honest. Knowing how common it is becoming definitely makes me want to look after myself more and spread the word.