Historically fatty liver was viewed as being mostly benign. The theory was that while liver fat might make the organ vulnerable to other problems it was, after all just normal fat. This view naturally led to medicine focusing on other problems where symptoms existed. I thought that view made little sense if only because fat people died younger but the science wasn't there so that remained the story.
Research is now coming out which shows that a fatty liver is an active cause of disease in other organs. Did you ever wonder why people frequently get fat then get type 2 diabetes? Consider all the effort devoted to diabetes in the management of the symptoms and the long term medical needs. German research has now shown that a fatty liver begins to produce different secretions, such as one called fetuin-A, into the blood stream. Those substances enter other organs and trigger reactions there.
This image from IDM shows pancreatic islet cells surrounded by fat cells. The study was reported in Science Daily at this link but I'll summarize it below.
When the fatty liver begins to produce altered secretions, one of them is fetulin-A. Excess fetulin-A finds its way to the pancreas where it stimulates the fat cells which surround the critical insulin producing islet cells of the pancreas. Those fat cells begin to produce inflammatory markers which cause the defensive cells of the immune system to notice. As the inflammatory process increases the immune system mobilizes to clean up the mess which harms the islet cells who are really just innocent bystanders. The insulin management system that is the primary job of the pancreas becomes more difficult as damage accumulates because of degenerative fat cells.
There are a variety of ways that pancreatic function may be compromised and this study doesn't suggest that this is the only cause of type 2 diabetes, but clearly if your fatty liver is indirectly killing crucial cells of your pancreas might that just lead you down the path to disease?
Diabetes is becoming epidemic in our society and mirrors the fattening of society over the last 40 years. Many questions are yet to be answered but the implications of this are clear if you care to take heed. Liver fat is not really benign and it is something that you can control. If you are told that you are pre-diabetic or have fatty liver consider real lifestyle changes as there is nothing good waiting for you down that path. If you are overweight think seriously about the possibility that it may be more than a cosmetic issue and become pro-active before some doctor has to give you disquieting news.
If you would like to learn more about fatty liver disease and the more advanced problems consider spending some time on our disease page.