The elevation of liver enzymes like AST,ALT, ALP and GGT are often the first things that might alert a healthcare provider to the possible presence of a fatty liver when looking at blood work alone.

While these liver enzymes may be elevated for other reasons, the most likely explanation for them being out of range is the presence of excess liver fat.

Why?

Well, liver enzymes generally tend to go up in response to liver inflammation and liver inflammation increases as a chain of reactions that occur as a result of excess fat being stored in the liver – where it should not be.

Of the four primary liver enzymes, GGT is considered the most relevant and forms part of a predictive equation called the Fatty Liver Index.

Another big aspect of the Fatty Liver Index is triglyceride levels, which leads us to the goal of today’s post.

Fatty Liver Bloodwork

In 2023, The Journal Of Lipid Research published a fascinating study exploring the relevance of triglycerides, HDL cholesterol and Apolipoprotein B in fatty liver disease.

Let’s explore what they did, and more importantly, what they found.

Sample Size & Duration

9,000 people aged 40+ followed for a 4+ year period divided into two groups – those with a fatty liver and those without.

What They Looked At

The extent to which specific bloodwork (triglycerides, apoB and HDL) predicted whether or not someone without a fatty liver ended up with one AND whether or not someone with a fatty liver was able to reverse it during this time period.

What They Found

Having low HDL and high apoB & triglycerides was considered to be a very problematic bloodwork profile for people with a fatty liver.

Over half the people with this bloodwork profile at the start had a fatty liver.

People with this bloodwork profile without a fatty liver had 1.75x the risk of ending up with a fatty liver over a 4+ year period.

People with this bloodwork profile with a fatty liver had a 43% lower chance of reversing the condition over a 4+ year period.

Take Home Message

Whether you have a fatty liver at this moment or not, if your bloodwork indicates a combination of low HDL, high triglycerides and high apoB – the time to act is now.

The good news?

I can help.

Whether by working with me in private consultation or via my Online Course & Community (a more economical option, details below) – I can provide you the guidance and support you need to improve your metabolic health with the goal of reversing fatty liver disease or making sure you never deal with it in the first place.

Andy De Santis RD MPH