While we still don’t know exactly why fat builds up in the liver of some people, we do know that fat in the liver is more likely to be present in people who have other health conditions. 

Some of the most common links to liver steatosis (fat build up in the liver) are metabolic conditions. These are conditions that interfere with how your metabolism works and often occur together. When you have three or more of these conditions, it’s known as metabolic syndrome. 

Weight 

Being a heavier weight is a risk factor for many health conditions especially if you have excess abdominal (belly) fat. In Australia, two in three people (67%) are a heavier weight. ^xxiv 

Having an increased waist circumference is one of the factors that increases your risk for insulin resistance and metabolic syndrome. This in turn increases your risk for steatotic liver disease. 

Your waist circumference will give you a good idea on whether you have high levels of abdominal fat. 

Women should aim for a waist measurement of no more than 80 cm. 

Men should aim for a waist measurement of no more than 94 cm. 

* Please note that the suggested waist measurements above are general guidelines and may not be accurate for all cultural groups. Healthy waist measurements can vary amongst different ethnic groups, for example Aboriginal and Torres Strait Islanders and people of Asian descent. They may also be different in situations such as pregnancy or if you have another medical condition. Ask your doctor what a healthy waist measurement should be for you.  

Learn about waist measurements for different ethnic groups. 

Learn more about achieving a healthy weight. 

Cholesterol 

Cholesterol is a fatty substance found in the blood. It’s used to build cells, make hormones, and produce vitamin D. Cholesterol is made naturally in your body, and is found in some foods. Your body needs some cholesterol to work properly, but too much is bad for your health and will increase the risk for liver steatosis. 

Having high levels of triglycerides (a type of fat in your blood) also increases your risk for SLD. 

Learn more about healthy cholesterol levels. 

High blood pressure (hypertension) 

Blood pressure is the pressure of blood on the walls of your arteries when your heart pumps. It’s normal for blood pressure to go up and down during the day. 

High blood pressure (hypertension) is when blood pressure is higher than normal, all the time. High blood pressure is a risk for many health conditions, including steatotic liver disease. 

Learn more about blood pressure. 

Diabetes and insulin resistance 

Diabetes is a condition where there is too much glucose (sugar) in the blood. Your body uses glucose for energy, but you need a hormone called insulin to which acts as a key to allow glucose to leave the bloodstream and enter our cells to be used for energy.^xxv Insulin resistance occurs when insulin is not working effectively. This allows higher levels of glucose to remain in the blood, causing high blood glucose (sugar) levels.  

There are two main types of diabetes: 

• Type 1 diabetes is an autoimmune condition where the body can’t produce insulin. Currently, there is no known way to prevent this condition. 
• Type 2 diabetes is where the body becomes resistant to the normal effects of insulin over time. It has both strong genetic risk factors and lifestyle risk factors. 

Pre-diabetes is when blood glucose levels are higher than normal but not high enough to be diagnosed with type 2 diabetes. 

Around one in 20 people in Australia have diabetes.xxvi Having type 1 or type 2 diabetes increases your risk for steatotic liver disease.^{xxvii xxviii}

Learn how to reduce your risk and manage diabetes. 

Action: 

Use a tape measure to check your waist circumference or ask your doctor what a healthy waist measurement is for you. (Healthy waist measurements may vary between different ethnic groups.) 

Ask your doctor to check your metabolic risk factors for SLD such as blood pressure, blood glucose levels and cholesterol levels. 

Polycystic Ovary Syndrome (PCOS) 

Polycystic Ovary Syndrome (PCOS) is a hormonal condition that affects 10% of women.xxix PCOS is associated with increased levels of insulin and androgens (male-type hormones) in your body. The most common symptoms of PCOS include: 

• irregular or no periods 
• excess hair (hirsutism) 
• hair loss (alopecia) 
• skin conditions such as acne and skin tags 
• stress, anxiety and depression 
• being overweight. 

Learn more about PCOS including causes, diagnosis and treatment and management.  

Sleep apnoea 

Sleep apnoea (also called obstructive sleep apnoea) is a sleep disorder that causes repeated interruptions to your breathing while you sleep. ^xxx Partial or complete obstruction of your upper airway during sleep can interrupt your breathing for anywhere between 10 seconds up to a minute or longer. These interruptions can happen hundreds of times during the night without people being aware.  

Symptoms of sleep apnoea include: 

• pauses in your breathing while you sleep that others notice 
• tossing and turning during sleep 
• loud snoring 
• waking up gasping or choking 
• feeling tired during the day and unrefreshed after sleep. 

Left untreated, sleep apnoea can increase your risk for several conditions including heart disease and stroke. It’s also linked to SLD. 

Learn more about sleep apnoea. 

Thyroid conditions 

The thyroid gland is a small butterfly-shaped gland located in the front of your neck. The thyroid makes hormones that help regulate many processes in the body including growth and development, body temperature and metabolic functions. Sometimes the thyroid may not work properly.  

Two thyroid conditions linked to SLD are ^{xxxi xxxii}:  

• Hypothyroidism (underactive thyroid) — when your thyroid gland doesn’t make enough thyroid hormone 
• Hyperthyroidism (overactive thyroid) – when your thyroid gland makes too much thyroid hormone. 

If you’re concerned about thyroid issues, talk to your doctor. They may suggest you have a blood test to check levels of thyroid hormones. 

Learn more about thyroid conditions. 

Action: 

Talk to your doctor if you have any symptoms of PCOS or sleep apnoea. 

Ask your doctor to check your thyroid function. 

If you have been diagnosed with PCOS, sleep apnoea or a thyroid condition, ask your doctor to check your liver health.