Obesity is accompanied by several co-morbidities due to accumulation of excess fatty tissue. This fat can even form a layer/coating on the liver impairing its functioning and gradually causing destruction of cells often termed as fatty liver of the non-alcoholic fatty liver disease (NAFLD). In India, 9-32% of the general population is known to have fatty liver with incidence being higher in those who are obese or suffering from diabetes. Although fatty liver disease is known to occur in middle age and old age , with the increasing obesity prevalence at young age, abnormal liver enzymes may be seen much earlier.
Functions of the Liver
Liver has been credited as the only organ in the body with the power to regenerate. But, considering the immensely vital role it plays makes it essential to protect its cells and maintain normal function. Some of the most important functions of liver are as follows:
- Production of bile, which helps carry away waste and break down fats in the small intestine during digestion
- Production of certain proteins for blood plasma
- Production of cholesterol and special proteins to help carry fats through the body
- Store and release glucose as needed
- Processing of hemoglobin for use of its iron content (the liver stores iron)
- Conversion of harmful ammonia to urea (urea is one of the end products of protein metabolism that is excreted in the urine)
- Clearing the blood of drugs and other harmful substances
- Regulating blood clotting
- Resisting infections by producing immune factors and removing bacteria from the bloodstream
- Clearance of bilirubin (if there is a buildup of bilirubin, the skin and eyes turn yellow)
Liver enzymes- what is abnormal?
ALT (Alanine Transaminases) OR SGPT (Serum Glutamate Pyruvate Trasaminase)
SGPT enzymes is found in liver cells and an elevated level is a definite indicator of acute liver disease such as an infection. Even before jaundice appears, the SGPT levels increase and will return back to normal only after complete healing has occurred. Very high levels indicate viral hepatitis or drug induced hepatitis, or other conditions leading to damage/death of liver cells. Other causes for increased SGPT may include alcoholism, liver damage, kidney infection, chemical pollutants or myocardial infarction.
An abnormal SGPT tells us that there is a damage but does not specify the extent of damage and its actual cause. Further investigations such as biopsy and scan will reveal that information.
Normal Adult Range: 0 – 48 U/L
AST (Aspartate transaminase) or SGOT (Serum glutamate Oxaloacetate Transaminase)
SGOT is more concentrated in the cardiac /heart muscles and hence indicates recent heart attack due to poor blood supply to heart muscles also termed as myocardial infarction . It is also elevated during acute liver disease. very high elevations (more than 20 times normal) may indicate acute viral hepatitis, severe skeletal muscle trauma, extensive surgery, drug- induced hepatic injury, and severe liver congestion.SGOT
Normal Adult Range: 0 – 42 U/L
SGPT is a better indicator of liver damage while SGOT can signal cardiac tissue damage. However, either of the two may be elevated in both the conditions.
In more recent studies, Non alcoholic fatty liver disease has shown to be associated with high blood pressure . Individuals with high abdominal fat (waist circumference) were also found to be at greater risk of fatty liver disease. A normal HDL or good cholesterol level can protect an individual from this disease.
The impact of increased fatty tissues are far beyond imagination. Liver has to shoulder the enormous responsibilities of protecting body against toxins and building immunity and cannot take the added burden of excess fat. So increase your physical activity in order to dislocate that fat sitting at your waistline before it is too late.
Dr Pooja Chhawcharia is the Senior Nutritionist at eKincare with over 7 years of experience in Nutrition education, diet counseling and research. She is a Registered Dietician with the Indian Dietetic Association and Certified Diabetes Educator recognized by the International Diabetes federation . She is also interested in ancillary sciences such as Yoga and Naturopathy.