Difference Between Alcoholic and Non-alcoholic Fatty Liver

The key difference between alcoholic and non-alcoholic fatty liver is that alcoholic fatty liver is caused due to alcohol consumption while non-alcoholic fatty liver is not caused due to alcohol consumption.

A healthy liver contains some fat, but it is not good to accumulate extra fat in our liver. Fatty liver disease or hepatic steatosis is a disease caused due to the accumulation of extra fat in the liver. Alcohol consumption leads to a build-up of fat in your liver. The fatty liver disease caused due to alcohol is known as alcoholic fatty liver. However, you can get fatty liver disease even if you don’t consume alcohol. We call this non-alcoholic fatty liver. Diabetes, or pre-diabetes, being overweight or obese, elevated blood lipids such as cholesterol and triglycerides, as well as high blood pressure are the major reasons for non-alcoholic fatty liver. Both alcoholic and non-alcoholic fatty liver are usually silent diseases with few or no symptoms.

CONTENTS

1. Overview and Key Difference
2. What is Alcoholic Fatty Liver
3. What is Non-alcoholic Fatty Liver
4. Similarities Between Alcoholic and Non-alcoholic Fatty Liver
5. Side by Side Comparison – Alcoholic vs Non-alcoholic Fatty Liver in Tabular Form
6. Summary

What is Alcoholic Fatty Liver?

Alcoholic fatty liver or alcoholic steatohepatitis is a type of fatty liver disease caused due to excessive alcohol use. Alcohol break down occurs in the liver. Alcohols produce toxic metabolites such as aldehydes during metabolism. These metabolites are harmful to the liver. They damage liver cells, promote inflammation, and weaken the body’s natural defences. The more alcohol a person consumes, the more damage to liver cells take place.

Figure 01: Alcoholic Fatty Liver

There are several stages of alcoholic fatty liver as alcohol-related liver disease, alcoholic hepatitis and cirrhosis. Alcoholic fatty liver only happens in people who are addicted to heavy use of alcohols. When they consume alcohol for a longer time, the risk of getting alcoholic fatty liver is high. If the heavy drinkers are overweight or have diabetes, the disease occurrence is significantly high.

What is Non-alcoholic Fatty Liver?

Non-alcoholic fatty liver is a type of fatty liver disease caused due to diabetes, or pre-diabetes, being overweight or obese, elevated blood lipids such as cholesterol and triglycerides and high blood pressure. It is not caused due to alcohol. People who drink little alcohol or no alcohol get non-alcoholic fatty liver.

Figure 02: Non-alcoholic Fatty Liver

Non-alcoholic fatty liver disease develops via four stages. They are simple fatty liver (steatosis), non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis. Cirrhosis is the severe stage in which the liver gets damaged permanently, and it can lead to liver failure or liver cancer.

What are the Similarities Between Alcoholic and Non-alcoholic Fatty Liver?

• Alcoholic and non-alcoholic fatty liver are two types of fatty liver disease caused due to the accumulation of extra fat in the liver.
• These types are serious health problems worldwide.
• Both diseases have similar pathological spectra, ranging from simple hepatic steatosis to steatohepatitis, liver cirrhosis, and hepatocellular carcinoma.
• Hence, the differentiation of the two diseases is difficult.
• Both diseases are frequently accompanied by extrahepatic complications

What is the Difference Between Alcoholic and Non-alcoholic Fatty Liver?

Alcoholic fatty liver disease occurs due to the heavy drinking of alcohols while the non-alcoholic fatty liver disease is not caused due to alcohols. Diabetes, or pre-diabetes, being overweight or obese, elevated blood lipids such as cholesterol and triglycerides and high blood pressure are the major causes of non-alcoholic fatty liver disease. So, this is the key difference between alcoholic and non-alcoholic fatty liver.

The below infographic shows the main differences between alcoholic and non-alcoholic fatty liver in tabular form for side by side comparison.

Summary – Alcoholic vs Non-alcoholic Fatty Liver

There are two types of fatty liver disease as alcoholic fatty liver and non-alcoholic fatty liver. Both diseases are due to the accumulation of excess fat in the liver. Alcoholic fatty liver arises due to excessive alcohol consumption. Non-alcoholic fatty liver is not due to alcohols, but due to factors such as diabetes, or pre-diabetes, being overweight or obese, elevated blood lipids such as cholesterol and triglycerides and high blood pressure, etc. Thus, this is the summary of the difference between alcoholic and non-alcoholic fatty liver.

Reference:

1. Toshikuni, Nobuyuki, et al. “Clinical Differences between Alcoholic Liver Disease and Nonalcoholic Fatty Liver Disease.” World Journal of Gastroenterology, Baishideng Publishing Group Inc, 14 July 2014, Available here.
2. “Fatty Liver Disease.” MedlinePlus, U.S. National Library of Medicine, 23 July 2020, Available here.

Image Courtesy:

1. “Alcoholic hepatitis” By original uploader was Countincr at English Wikipedia. – Transferred from en.wikipedia to Commons (CC BY-SA 2.5) via Commons Wikimedia
2. “NAFLD liver progression” By Signimu – Own work (CC BY-SA 3.0) via Commons Wikimedia

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