Can Fatty Liver Disease Put Your Heart At Risk?

Fatty liver disease, once called nonalcoholic fatty liver disease (NAFLD), is becoming more common. The National Institute of Diabetes and Digestive and Kidney Diseases estimates that up to 40 percent of U.S. adults may have some form of liver disease. Many people don’t realize they have it. But fatty liver disease can lead to serious health problems, including a higher risk of heart disease.

Robert Vincent, MD, an Indianapolis gastroenterologist who chooses to practice at Franciscan Health, explains what you need to know about fatty liver disease.

What Is Fatty Liver Disease?

Your liver does a little bit of everything and has many important jobs. It filters toxins, processes nutrients from food and produces proteins that your body needs.

“It makes your blood clot, stores vitamins, provides backup energy and helps you digest fats,” Dr. Vincent said.

The condition has been renamed metabolic-associated steatotic liver disease (MASLD) and, in more severe cases, metabolic-associated steatohepatitis (MASH).

“It happens when excess fat, mainly triglycerides, builds up in the liver,” Dr. Vincent explained. That extra fat, called steatosis, can lead to inflammation and scarring.”

While 40 to 50 percent of Americans develop this condition, not everyone will have serious liver damage.

“The real concern is for those who develop significant inflammation and scarring, which can lead to long-term health issues.”

How Is Fatty Liver Disease Staged?

Doctors stage liver disease based on how much scarring (fibrosis) is present. They usually assess the stage through a FibroScan, a specialized test that checks liver stiffness. You may also need a liver biopsy to rule out other conditions. The staging system includes:

• F0: No fibrosis (healthy liver)
• F1-F3: Mild to moderate scarring
• F4: Cirrhosis (severe scarring that can cause complications)

“The goal of treatment is to prevent the disease from reaching F4, where we start to see major complications,” Dr. Vincent said.

Patients with advanced fibrosis or cirrhosis require ongoing monitoring, imaging and sometimes endoscopy to detect problems early.

“While researchers are exploring ways to reverse fibrosis, current treatments focus on slowing or stopping its progression,” Dr. Vincent said.

Who Is At Risk For MASLD?

Individuals with certain health conditions face an increased risk of developing the disease:

• Diabetes
• Genetics
• High cholesterol
• Hypertension (high blood pressure)
• Obesity

Some people may have these risk factors and never develop severe liver damage. Others may face serious complications.

Can You Have Fatty Liver Disease Without Knowing It? 

Yes. We call fatty liver disease a silent disease because most people don’t have symptoms.

“It can go under the radar for years,” Dr. Vincent said. “Even routine blood tests from your primary care doctor may not detect it.”

We discover many cases by accident through CT scans or ultrasounds, which we do for other reasons.

Can You Prevent MASLD?

Yes. The good news is you can often manage or even reverse it with lifestyle changes. If caught early, there are efforts that can help reduce it. Dr. Vincent recommended:

• Keep a healthy weight
• Eat a heart-healthy diet
• Manage conditions like diabetes and high cholesterol
• Avoid alcohol

Treatment depends on the severity of the disease.

“If we find early-stage liver disease, we focus on lifestyle changes first,” Dr. Vincent said. “We also track progress with the scan and liver enzyme tests to see if inflammation improves.”

For those with advanced fibrosis, ongoing monitoring is necessary. In rare cases where cirrhosis leads to liver failure, we may need to make a transplant referral.

Does Fatty Liver Disease Affect Your Heart?

Yes. The disease doesn’t just affect the liver — it raises the risk of heart failure. One study found that adults with fatty liver disease were 3.5 times more likely to develop heart failure than those without it.

“If you take care of your heart, it’s healthy for your liver,” Dr. Vincent said.

That’s why managing cholesterol, blood sugar and overall heart health is vital.

Why Is Early Detection Important?

While you can’t reverse scarring from advanced liver disease, you can catch the disease early and keep it from getting worse.

“Fatty liver disease is more than just a liver issue. It’s a major risk factor for heart disease,” Dr. Vincent said.

Know your risk, get screened and make lifestyle changes to help protect both your liver and heart. If you’re concerned about fatty liver disease, talk to your doctor about your risk factors. Our providers offer comprehensive treatment options. We make it easy to find exceptional providers and get world-class care, right where you live and work.