Liver Fats Domino Effect

Dr. Michael Koren joins Kevin Geddings to discuss the Fatty's Liver's Domino Effect; the concept that a fatty liver can cascade into serious liver problems, including a need for a liver transplant. The duo also discusses the FibroScan, a non-invasive test to assess the level of fatty liver for at-risk individuals. They finish by talking about the importance of early diagnosis to stop the domino effect before it gets out of control.

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Transcript

Welcome And Today’s Focus: Fatty Liver

Announcer 0:00

Welcome to the MedEvidence Monday Minute Radio Show, hosted by Kevin Geddings of WSOS St. Augustine Radio and powered by ENCORE Research Group. Each Monday morning, Dr. Michael Koren calls in to bring you the latest medical updates and insightful discussions. MedEvidence is where we help you navigate the real truth behind medical research, both a clinical and research perspective. So sit back, relax, and get ready to learn about the truth behind the data in medicine and healthcare. This is MedEvidence!

Kevin Geddings 0:31

Dr. Michael Koren joining me live on the studio line. This morning, as he does on Mondays, we appreciate him very much. Medical doctor, cardiologist, and research scientist. But this morning, you know, we wanted to talk about, you know, fatty liver, right?

Dr. Michael Koren 0:45

Absolutely. Good morning, Kevin. How are you?

Kevin Geddings 0:47

Well, I'm doing well. Doing well. Are you ready for the big golf tournament up in Ponte Vedra?

Dr. Michael Koren 0:52

I am.

Kevin Geddings 0:53

And the associated traffic.

Dr. Michael Koren 0:54

It's always a fun event.

Kevin Geddings 0:55

Yeah, it should be good.

Dr. Michael Koren 0:56

It's always a fun event. Yeah. Should be. Hopefully the weather will cooperate and we'll have a a great, exciting tournament.

The Domino Effect: Fat To Cirrhosis

Kevin Geddings 1:03

Yeah. Yeah. So talk to us a little bit about our liver. We hear of liver disease, but most of us that are laymen just know that it's not a good thing, but we don't really know much about it, right?

Dr. Michael Koren 1:13

Yeah. Well, we coined the term the Liver Fats Domino Effect last week with the team. And the reason we did that, obviously it's a little bit of a play on words, but what it really is describing is how one thing leads to another. So, Kevin, if um you have a typical American diet and maybe you're genetically not ready to process all this fat, what happens is that the fat accumulates in your liver. And then one domino falls and then you develop inflammation. Then another domino falls and you develop fibrosis, which turns into irreversible scarring. And then another domino falls, and then that scarring turns in cirrhosis. And when your liver develops cirrhosis, it no longer functions appropriately. And then what can happen to some people, not everybody of course, but some people then get cirrhosis that leads to the need for a liver transplant. And uh you probably don't know this, but nowadays the number one reason people get liver transplants is because of fatty liver disease. And twenty years ago that was very different. Most people developed uh cirrhosis or problems related to hepatitis that led to a liver transplant. But that's completely changed because through research we found great ways to treat hepatitis, and now fatty liver disease is the most common reason that people end up needing a liver transplant.

Kevin Geddings 2:37

And what typically brings that about in people?

Dr. Michael Koren 2:40

Well, again, it's this cascade, this domino effect, this liver fats domino effect. And it's a little bit unpredictable who has the genetic predisposition for this. But again, it starts with fatty depositions in the liver and progresses. Not everybody, but in many, many people. But here's the interesting part, uh Kevin, it's actually pretty easy to see if you're at risk for this problem. And that's using a technique called a FibroScan, which is a type of what we call elastography or a way of looking at how stiff your liver is. And based on this machine and this technology that allows us to study the stiffness of the liver, we can determine if you have fatty liver disease and whether or not you're prone to fibrosis, scarring, and cirrhosis.

FibroScan: Fast Risk Assessment

Kevin Geddings 3:27

And is this a disease condition that can be reversed, or is it our best hope is to just halt any further deterioration?

Dr. Michael Koren 3:35

Well, in the early stages, it's absolutely reversible. And then in the middle stages, it may be reversible. And that's some of the research that we're doing, is to see if we can reverse it in the middle stages. And then at end stage, unfortunately, there's not that much you can do about it. So again, the goal is to intervene before you get to the end stage.

Kevin Geddings 3:54

So what indication would you know would there be that somebody would need to or should get this test for it? It would be some indication in their blood work, or what what would be uh, you know, they're driving around right now, who would be the best people to do this?

Can Damage Be Reversed

Who Should Get Tested

Dr. Michael Koren 4:06

Yeah, great question. It could be because you had a you had some lab tests uh drawn by your primary physician or by somebody else, and then you had an elevation in your liver function test, that could be one reason. It could be that you have borderline diabetes and you're overweight and you're concerned about it. It could be it could be that you had a CAT scan for some other reason, and that and people who interpreted the CAT scan felt that there may have been some fatty liver disease. All these things are reasons for doing it. But typically the type of patients that have these problems are more likely to be overweight, more likely to be diabetic, and often have high blood pressure. This is a combination of symptoms and signs that we call metabolic syndrome.

Kevin Geddings 4:49

Well, once again, if uh those different attributes may apply to you, we would encourage you to reach out and learn more. The testing doesn't cost you anything. If you ultimately participate in a clinical trial, not only will you be compensated for your time and expenses, but you're obviously participating in leading edge medical research that could directly benefit you. Dr. Michael Koren, we appreciate your time on this Monday morning. We'll talk soon, okay?

Trials, Costs, And Next Steps

Dr. Michael Koren 5:11

Sounds good. And again, get a fiber scan, and maybe they'll find their freedom, Kevin.

Announcer 5:16

Absolutely. Thanks for joining the MedEvidence Podcast. To learn more, head over to MedEvidence.com or subscribe to our podcast on your favorite podcast platform.