That is why obesity could soon overtake alcohol and even cigarettes as the top lifestyle disease source. Up to 20 percent of people could soon have fatty liver disease and a third of those may develop non-alcoholic steatohepatitis (NASH) that can progress to cirrhosis and end-stage liver disease, or even liver cancer.
Researchers have shown that the levels of the NOX4 protein change as the disease progresses, rising in the early stages of the disease to protect the liver, but declining as the liver disease gets worse, and it may explain why some people remain relatively healthy with fatty liver disease and some go onto potentially life-threatening illness.
The researchers found that removing NOX4 in obese mice led to NASH and liver damage. And when NOX4 levels were artificially raised in these mice they were protected from NASH and liver damage. The authors believe this is because NOX4 is induced when the liver first starts to accumulate fat and activates a complex adaptive program that protects the liver. It is only when NOX4 levels decline and this adaptive program is abrogated that obese patients with fatty liver progress to NASH and liver damage.
In the future, that could mean compounds that bolster the activity of NOX4, or the adaptive program that NOX4 instigates, may be highly beneficial - but mice are not little people, so this needs to be in the EXPLORATORY pile.
Exploratory research like this will never really be a quick fix some seek, any more than dangerous celebrity gimmicks like Ozempic diets are. The one key thing you can do is simply eat less or exercise more. That's it. No special pill needed.
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