Something a bit different for you this week. I want to talk the liver and some markers on a standard blood chemistry that can help predict the onset of fatty liver and Type 2 diabetes. Maybe you've noticed that your fasted blood glucose is consistently above 85 mg/dL. This elevation could be because your liver is not getting the message that there's sufficient glucose and is continually making it via a process called gluconeogenesis.

The first paper I mention is Liver transplantation for nonalcoholic fatty liver disease: New challenges and new opportunities.

Pull out your old blood work and have a look at these two markers:

ALT is an enzyme present in high concentrations in the liver and to a lesser extent skeletal muscle, the heart, and kidney. ALT will be liberated into the bloodstream following cell damage or destruction. Any condition or situation that causes damage to the hepatocytes will cause a leakage of ALT into the bloodstream. These would be exposure to chemicals, viruses (viral hepatitis, mononucleosis, cytomegalovirus, Epstein Barr, etc.), alcoholic hepatitis.

AST is an enzyme present in highly metabolic tissues such as skeletal muscle, the liver, the heart, kidney, and lungs. This enzyme is at times released into the bloodstream following cell damage or destruction.

Here are my numbers. August 2013 on the right in red (long after I was feeling better) and January 2015 on the left. Note that I'm always riding my bike and training, so I don't think the damage was due to that alone.

Have a look at figure 3 in this paper titled Banting Memorial Lecture 2012 Reversing the twin cycles of Type 2 diabetes:

Send me your liver questions to [email protected]