Fatty Liver And The Impact On Elevated Transaminase Levels

Fatty liver disease encompasses a range of conditions, starting from simple fatty liver and progressing to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and in severe cases, even hepatocellular carcinoma. During the early stage of simple fatty liver, the condition is often detected during routine physical exams, where fat accumulation in the liver may be identified through imaging or blood tests. At this point, patients might have mild or moderate fatty liver without any noticeable symptoms or elevated liver enzymes.

However, if the condition is left unmanaged, it can progress to more severe forms such as fatty liver inflammation or steatohepatitis. Once the disease reaches the stage of fatty liver inflammation, elevated transaminase levels — particularly ALT and AST — become more common. These enzymes are typically indicators of liver damage or stress. The normal range for transaminases is generally below 40 U/L, but in cases of fatty liver disease with inflammation, levels can rise to two or even ten times above the normal range.

It's important to note that while fatty liver can cause elevated transaminase levels, significantly high enzyme levels may also suggest the presence of other underlying liver-damaging conditions. Therefore, when elevated liver enzymes are detected during a routine check-up or medical evaluation, especially in individuals with fatty liver, it is crucial to determine whether the elevation is solely due to fatty liver or if other contributing factors such as viral hepatitis, autoimmune diseases, or medication-induced liver injury are involved.

Proper diagnosis and evaluation are essential to understand the extent of liver damage and to rule out other potential causes of liver dysfunction. This ensures that appropriate lifestyle changes, medical interventions, or monitoring can be implemented to prevent further progression of liver disease.