The Cholesterol and Liver: What You Should Know
Balanced cholesterol levels are important to maintaining good health. The liver is an underrecognized part of that effort.
The liver is the largest gland in the body, located in the upper right part of the belly. It is the body’s master detoxer of drugs and other foreign substances. It stores glycogen, which the body uses for energy. It’s also important in metabolizing fat, carbohydrates, and proteins. A healthy liver does all this unnoticed.
An important function of the liver is to produce and clear cholesterol in the body. Most of the attention focused on cholesterol describes its potential for harmful health effects. But cholesterol is necessary for the creation of hormones, vitamin D, and enzymes needed for digestion.
Bundles called lipoproteins carry cholesterol throughout the body. Two important types are high-density lipoproteins (HDL) and low-density lipoproteins (LDL). “High” and “low” refer to the relative proportion of protein to fat in the bundle. The body needs both types in regulated proportions.
Healthy levels of cholesterol in the body
It’s important to know the levels of HDL (“good” cholesterol), LDL (“bad” cholesterol), and total cholesterol in your body. A rough estimate of total cholesterol is HDL, plus LDL, plus one-fifth of a third type of fat called triglyceride.
The National Heart, Lung, and Blood Institute recommends the following levels:
HDL levels of at least 40 milligrams per deciliter (mg/dL) of blood. Anything less than that increases your risk of heart disease. A level of at least 60 mg/dL helps lower your risk for heart disease.
|
LDL cholesterol levels |
|
|
Less than 100 mg/dL |
optimal |
|
100-129 mg/dL |
near optimal/above optimal |
|
130-159 mg/dL |
borderline high |
|
160-189 mg/dL |
high |
|
Total cholesterol |
|
|
Less than 200 mg/dL |
desirable |
|
200-239 mg/dL |
borderline high |
|
240 mg/dL and above |
high |
Liver function complications
Liver function complications can hinder the organ’s ability to produce or clear cholesterol. Both conditions can create a spike in cholesterol and affect a person’s health. The following conditions can affect the liver in a way that causes cholesterol levels to be abnormal.
Nonalcoholic fatty liver disease
The most common form of liver malfunction is nonalcoholic fatty liver disease (NAFLD). It affects approximately one-quarter of the population. It’s often seen among people who are overweight or have diabetes.
NAFLD is associated with dyslipidemia, abnormal levels of cholesterol and similar compounds in the blood. NAFLD also can trigger lipodystrophy, irregularities in how the body distributes fat.
NAFLD covers a spectrum of conditions. Within NAFLD is the more serious non-alcoholic steatohepatitis (NASH). A diagnosis of NASH often leads to cirrhosis, liver failure, and hepatocellular carcinoma.
Cirrhosis
Cirrhosis can cause scarring and prevent the liver from carrying out basic metabolic functions. The condition is a reaction to long-term injury to the organ. The injury can include inflammation from a disease such a hepatitis C. After hepatitis C, long-term alcohol abuse is the most common cause of cirrhosis in the United States.
Drugs
Another significant cause of liver problems is damage from drugs. The liver’s job is to metabolize chemicals in the body. That makes it susceptible to injury from prescription, over-the-counter, or recreational drugs.
Common drug-induced liver injuries and the drugs associated with these conditions include:
Acute hepatitis
Associated drugs:
- acetaminophen
- bromfenac
- isoniazid
- nevirapine
- ritonavir
- troglitazone
Chronic hepatitis
Associated drugs:
- dantrolene
- diclofenac
- methyldopa
- minocycline
- nitrofurantoin
Mixed pattern or atypical hepatitis
Associated drugs:
- ACE inhibitors
- amoxicillin-clavulanic acid
- chlorpromazine
- erythromycin
- sulindac
Nonalcoholic steatohepatitis
Associated drugs:
- amiodarone
- tamoxifen
Microvesicular steatosis
Associated drugs:
- NRTIs
- valproic acid
Veno-occlusive disease
Associated drugs:
- busulfan
- cyclophosphamide
After discontinuing the drug, liver damage is typically not severe and often subsides. In rare cases, the damage can be severe or permanent.
The effects of high cholesterol
When a person has high levels of LDL, they are often referred to as having “high cholesterol.” This condition can increase the risk of developing several health problems.
Cholesterol can build up in the arteries, which are the major blood vessels in the body. They can become narrower, as a result, which restricts the supply of blood and oxygen to the organs.
Narrowing of the arteries can also increase the risk of blood clots.
If blood flow to the heart is restricted, it can increase the risk for coronary heart disease. This includes angina, heart attacks, and heart failure.
If blood flow to the brain is restricted, it can increase the risk of stroke.
Can liver disease cause high cholesterol?
There are many different liver diseases.
Hepatitis, alcohol-related liver disease, and non-alcoholic fatty liver disease or NAFLD are some of the most common liver diseases.
Liver disease causes damage to the liver, which can mean that it is not able to work as well.
One of the functions of the liver is to break down cholesterol. If the liver is not working properly, it can cause cholesterol to build up in the body.
How does cholesterol impact the liver?
A diet can create fat around the liver if it is high in cholesterol. This scenario can lead to NAFLD, which may result in liver damage long-term.
NAFLD can increase the risk of health problems, such as a stroke or diabetes. If the condition is found and treated at an early stage, it is often possible to stop it from getting worse.
A person can also reduce the amount of fat in their liver at an early stage.
Usually, high cholesterol does not cause any symptoms.
But a simple blood test measures cholesterol levels.
A doctor may recommend a cholesterol test if a person has a family history of heart disease, a medical condition such as diabetes, or if they are overweight.
A liver biopsy or liver function test is usually used to diagnose liver disease.
A biopsy will remove a tiny piece of liver tissue to test for disease. A liver function test is a blood test that can measure proteins and enzymes in the blood.
The levels of these proteins and enzymes can show if the liver is damaged.
What are the treatment options?
A person can make lifestyle changes and sometimes take medication to treat high cholesterol. Usually, they will be encouraged to make changes to diet and exercise first. If they are overweight, they may be advised to lose weight.
A doctor may prescribe medication if these changes do not lower cholesterol after a few months.
The most common medication is statins, which a person needs to take for life. Statins are drugs that block a chemical in the liver that makes cholesterol.
Treatment for liver disease depends on what type of liver disease a person is experiencing. It will usually involve lifestyle changes, medication, or sometimes, a liver transplant if the liver is too damaged to function.
Diet
Diet can help to cut the risk of developing liver disease and may reduce its impact. Keeping to a healthy weight is an essential way to maintain good overall health.
What a person is recommended to eat or drink may be different for each specific liver disease. A doctor will be able to advise on diet and exercise.
Alcohol
A person who has alcohol-related liver disease will usually be advised to stop drinking alcohol. Eating enough protein and carbohydrates as part of a balanced diet can help maintain a healthy weight.
Foods to eat and avoid
Cutting down on fatty foods may reduce the impact of a fatty liver or NAFLD. Eating plenty of fruits and vegetables, and foods such as bread and potatoes that release energy slowly can help.
A diet with plenty of protein is a way of obtaining adequate energy supplies without eating high-cholesterol foods. Eggs, nuts, chicken breast, and pulses are excellent sources of protein.
Eating regularly and snacking between meals can be a healthful way for a person to get enough fuel.
Prevention
They can lower cholesterol by eating a healthful diet, with plenty of fruits and vegetables.Saturated fats contain a high level of cholesterol.Many fast foods, cakes, butter, fatty meats such as sausages, full-fat cheese, and cream contain saturated fats.Taking regular exercise can help to lower a person’s cholesterol. Giving up smoking can also be beneficial.
Takeaway
Making changes to diet and exercise are ways a person can manage high cholesterol. And they will need to maintain these changes to avoid high cholesterol returning.
The liver can repair itself up to a certain point. This means that someone may be able to reduce the damage that has been done if they discover liver disease at an early stage.Losing weight if needed, eating a healthful diet, exercising, and cutting down on alcohol can help to reduce the impact of liver disease.
References：
1. Cholesterol & Fatty Livers | Healthy Eating | SF Gate
2. The Liver and Cholesterol: What You Should Know
3. Liver and cholesterol: What's the link? - Medical News
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