Harvard Heart Letter

Fatty liver disease and your heart

About one in three adults has nonalcoholic fatty liver disease, an often-silent condition closely linked to heart disease.

fatty liver disease and your heart
Image: decade3d/ iStock

The largest organ inside your body, your liver performs hundreds of vital functions. It converts food into fuel, processes cholesterol, clears harmful toxins from the blood, and makes proteins that help your blood clot, to name a few. But an alarming number of Americans have a potentially dangerous accumulation of fat inside their livers. Known as nonalcoholic fatty liver disease (NAFLD), this condition is a leading cause of chronic liver disease in the United States—and an increasingly recognized contributor to heart disease.

"NAFLD increases the risk of heart disease independent of other traditional risk factors such as high blood pressure and cholesterol," says Dr. Kathleen Corey, director of the Fatty Liver Disease Clinic at Massachusetts General Hospital. Among people with NAFLD, heart disease is the top killer, accounting for more than 25% of deaths.

The obesity connection

Prior to 1980, fatty liver disease was rarely diagnosed except in people who drank large amounts of alcohol. However, scientists discovered that excess body fat and diabetes can also cause fatty liver disease, even in people who drink very little. As Americans have gotten fatter, so have their livers. Up to one-third of American adults have NAFLD, and nearly all (90%) people with severe obesity who are candidates for weight-loss surgery have the disease. Half of people with diabetes have NAFLD.

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