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Wednesday, Aug 21, 2019

The telltale liver

The state of your liver is an early indication of any future risk of heart disease and diabetes.

health-and-fitness Updated: Dec 18, 2011 01:31 IST
Sanchita Sharma
Sanchita Sharma
Hindustan Times

Bootleg liquor laced with highly toxic methanol killed 167 people and sickened dozens in West Bengal this week. Methanol — usually used as fuel, solvent or antifreeze — is a cheap substitute for ethanol in alcohol that can destroy the liver and kill in doses as small as 30 ml, though a fatal dose is typically 50-100 ml.

Hooch apart, the liver can be damaged from a clutch of toxins — medicines, alcohol, fatty food, aerosol insecticides, among others — that are as deadly in staggered overdoses as in a single, massive overdose. Even overdosing on the ubiquitous paracetamol over time can kill, as confirmed by the death of a young mother in the UK this week. The woman, 20, died of irreversible liver damage caused by taking a few extra paracetamol tablets to cope with pain after a minor surgery.

“People think an extra two won’t harm but taking that extra one or two over a period of time can damage your liver over time,” says Dr Shiv K. Sarin, director, Institute of Liver and Biliary Sciences (ILBS), Vasant Kunj.

Beside Toxins, the liver can be damaged by clutch of infections and too much fat, sugar and alcohol in the diet (see box). “Most people neglect liver health even though it has a direct impact on all metabolic diseases, such as diabetes and heart disease. For example, all heart diseases all over the world are caused by liver disease,” says Dr Shiv K. Sarin, director, Institute of Liver and Biliary Sciences (ILBS).

The reason for this, explains Sarin, is that the liver processes all the fat you eat. “Inefficient handing of fat in the liver leads to the build-up of fat not only in the liver (non-alcoholic fatty liver), but also the arteries,” says Dr Sarin.

People with a fatty liver disease have higher cholesterol and are more likely to die of heart disease than liver disease, reported The New England Journal of Medicine in 2010. In March this year, the Journal of Clinical Endocrinology & Metabolism reported that people with fatty liver were five times more likely to develop Type 2 diabetes than healthy people, confirming that fatty liver had an independent role in triggering type-2 diabetes. In January 2011, a UK study — from St.

Michael’s Hospital and the London Health Sciences Centre — found people with fatty liver disease were three times more likely to suffer a stroke than people with a healthy liver.

In the past, the Framingham Heart Study — the world’s longest ongoing heart study that began in 1948 — also linked nonalcoholic fatty liver disease with the metabolic syndrome, a constellation of heart disease risk factors such as raised triglycerides, blood pressure, bad cholesterol, visceral fat (fat around the organs) and insulin-resistance, a precursor to diabetes.

Experts recommend a simple blood test called alanine transaminase (ALT), also called Serum Glutamic Pyruvate Transaminase (SGPT), to test an enzyme present in the liver cells that leaks into the blood when the cells are damaged. "ALT rises when the liver is damaged, rising dramatically in acute liver damage such as caused by viral hepatitis (jaundice) or paracetamol overdose. It should ideally be below 23 in women and 19 in men," says Dr Sarin. "Just knowing your ALT — the test costs between Rs 50 and Rs 100 — can tell you whether you have or are at risk of liver or heart disease,"says Dr Sarin.

First Published: Dec 17, 2011 22:01 IST

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