By A.J. Hostetler

To boost awareness about the importance of screening for fatty liver disease, one of the world’s biggest liver patient advocacy groups is teaming up with the director of Virginia Commonwealth University’s liver institute.

The Global Liver Institute, based in Washington, D.C., collaborates with over 220 organizations from more than 75 countries to recognize June 13 as Global Fatty Liver Day. Since 2018, this special day has raised awareness and educated people about a disease that affects roughly 1 in 4 people worldwide. This year’s theme, “Act Now, Screen Today,” underscores the importance of early detection and intervention.

Fatty liver disease, now formally called steatotic liver disease, occurs when excessive fat accumulates in liver cells. A healthy liver contains a small amount of fat, but when it reaches over 5% of a liver's weight, it can lead to serious health issues like cirrhosis, liver cancer, or even the need for a liver transplant.

The advocacy group’s vice president of liver health programs visited VCU to speak with Arun Sanyal, M.D., director of the Stravitz-Sanyal Institute for Liver Disease and Metabolic Health and a professor of medicine at the VCU School of Medicine. They discussed the importance of screening and how health care systems and medical institutions can help develop better treatments for patients. Their conversation was recorded to spread the word.

“The Global Liver Institute is proud to partner with the VCU Stravitz-Sanyal Institute for Liver Disease and Metabolic Health for Global Fatty Liver Day 2024 and in supporting liver patients worldwide for better prevention, diagnosis, and treatment,” said Jeff McIntyre of the Global Liver Institute. “Dr. Sanyal and the institute are leaders in the field of liver health and we value their participation in Global Fatty Liver Day to build awareness and education about this chronic, progressive condition.”

Although fatty liver disease is common, many people don’t know they have it because there are often no symptoms that fat is accumulating in their livers, causing scarring and inflammation. As a result, 20-30% of those affected may develop cirrhosis, a severe form of liver disease, before they even get diagnosed.

“The majority of people who visit a physician for the first time regarding their liver, that is also the first day that their liver disease is diagnosed,” Sanyal said. “Cirrhosis doesn’t happen overnight, so that means this condition has gone undetected for decades likely before it got to this point. We need to find people early in the disease, before it has done serious damage to the liver, so we can stop the ship and turn it around before it’s too late.”

That’s why screening is so crucial, Sanyal says. He advises people who are overweight, have type 2 diabetes, or high blood pressure to talk to their doctor about their liver disease risk and how to lower it through weight loss and other healthy lifestyle changes.

Screening can start with a simple blood test whose results help calculate a patient’s risk using the FIB-4 index, was developed by the VCU liver institute’s chief clinical officer and professor of medicine, Richard K. Sterling, M.D. Other non-invasive tests that help evaluate a patient’s risk include another blood-based test called ELF or imaging scans using Fibroscan or an MRI.

But for diagnosis, however, fatty liver disease requires a liver biopsy, which can be painful and costly.

Typically, treatment has focused on weight loss and lifestyle changes, but in March, the U.S. Food and Drug Administration approve the first medication to treat fatty liver disease, Rezdiffra.