Impacto de la Enfermedad Hepática Grasa No Alcohólica (EHGNA) en Adultos Mayores de 50 años

The Impact of Non-alcoholic Fatty Liver Disease (NAFLD) in Adults over 50

Non-alcoholic fatty liver disease (NAFLD) has become a significant health concern, particularly among adults aged 50 to 70. This condition, characterized by an accumulation of fat in the liver, has the potential to develop into more severe forms — such as non-alcoholic steatohepatitis (NASH) — which can lead to liver damage, fibrosis, and even cirrhosis.

Prevalence and Risk Factors

NAFLD has emerged as the most common liver disorder in Western countries, affecting approximately 20-30% of adults, with this percentage rising to 40-50% in patients with specific risk factors. Major risk factors include:

• Obesity
• Insulin resistance
• Type 2 diabetes
• High blood pressure
• High cholesterol levels
• Sedentary lifestyle
• Cardiovascular disease
• Metabolic syndrome

Complications

NAFLD and its more severe forms can lead to a range of complications, including:

1. Non-alcoholic steatohepatitis (NASH): A progressive form of NAFLD characterized by liver inflammation, which increases the risk of liver cirrhosis.
2. Liver fibrosis: The excessive buildup of scar tissue in the liver, which can lead to cirrhosis if not addressed.
3. Cirrhosis: A chronic liver disease characterized by liver scarring, which can cause liver failure and increase the risk of liver cancer (hepatocellular carcinoma).
4. Cardiovascular disease: NAFLD has been associated with an increased risk of cardiovascular disease, including heart attack, stroke, and heart failure.
5. Insulin resistance: NAFLD can contribute to the development of insulin resistance and type 2 diabetes.

Diagnosis and Screening

Early diagnosis of NAFLD is essential for preventing its progression and minimizing complications. Diagnostic criteria typically include:

1. Alcohol consumption of less than 14 units per week (approximately 7 drinks) in men and less than 7 units per week (approximately 4 drinks) in women.
2. The presence of one or more of the following:
   • Increased liver size (hepatomegaly)
   • Elevated liver enzymes (ALT, AST)
   • Abnormal liver ultrasound findings (fatty liver)

Treatment and Management

Treatment for NAFLD primarily focuses on lifestyle modifications, including:

1. Weight loss: Achieving and maintaining a healthy weight through dietary changes and regular exercise.
2. Nutrition: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins, while limiting added sugars, processed foods, and unhealthy fats.
3. Exercise: Engaging in regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week.
4. Monitoring blood pressure, cholesterol levels, and blood sugar levels.

Some patients may require additional measures to manage NAFLD, such as medication for insulin resistance or diabetes, or surgery (bariatric procedures) in cases of severe obesity.

In conclusion, NAFLD is a significant health concern for adults over 50, with potential complications that include liver cirrhosis, liver cancer, and cardiovascular disease. Early diagnosis and proactive management of risk factors are essential for preventing disease progression and minimizing the risk of complications. Lifestyle modifications are the primary treatment for NAFLD and should be adopted as a first-line approach by individuals at risk.