Fatty Liver Madrid Dr. Pedro de María Pallarés
Specialist in non-alcoholic fatty liver disease (NAFLD) with over 1,000 procedures performed. Advanced diagnosis and personalized treatment in Madrid.
Medical Experience and Authority
Certified specialist with international training
TopDoctors Award 2024
Recognition for excellence in gastroenterology
European Board Advisor Olympus
European advisor in advanced medical technology
+1,000 Procedures
Proven clinical experience in hepatology
Hospital La Paz
National reference center in gastroenterology
Liver ultrasound showing steatosis - Specialized diagnosis by Dr. Pedro de María
What is Non-Alcoholic Fatty Liver Disease (NAFLD)?
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in developed countries, affecting 25-30% of the adult population. As a hepatology specialist with training at the National Cancer Center in Tokyo, I have treated over 1,000 cases of this condition.
It is characterized by fat accumulation in more than 5% of hepatocytes in the absence of significant alcohol consumption (<20g/day in women, <30g/day in men).
Epidemiology and Risk Factors
Prevalence Worldwide
- 25-30% general adult population
- 70-80% in obese patients
- 90% in type 2 diabetes
- Increasing in under 18 years
Main Risk Factors
- Obesity (BMI >30)
- Type 2 diabetes mellitus
- Metabolic syndrome
- Insulin resistance
- Dyslipidemia
Pathophysiology: Simple Steatosis vs Steatohepatitis
Simple Steatosis (NAFLD)
- • Fat accumulation without inflammation
- • Generally benign course
- • Reversible with lifestyle changes
- • 80-90% of cases
Steatohepatitis (NASH)
- • Fat + inflammation + hepatocellular damage
- • Risk of progression to fibrosis
- • May evolve to cirrhosis
- • 10-20% of cases
Symptoms and Clinical Manifestations
Most patients remain asymptomatic for years
Common Symptoms
- • Chronic fatigue
- • General malaise
- • Right upper quadrant pain
Advanced Signs
- • Hepatomegaly
- • Elevated transaminases
- • Insulin resistance
Complications
- • Hepatic fibrosis
- • Cirrhosis (5-10%)
- • Hepatocellular carcinoma
Specialized Diagnosis
Diagnostic Methods
Liver Ultrasound
First-line diagnostic. Detects steatosis >30%. Performed at Hospital Fuensanta and San Rafael.
Elastography (FibroScan)
Non-invasively evaluates liver fibrosis. Gold standard technique for follow-up.
Liver Biopsy
Reserved for complex cases. Differentiates NAFLD from NASH with histological precision.
Serological Markers
Personalized Treatment
Weight Loss
- • Goal: 7-10% body weight
- • Significant histological improvement
- • 30% reduction in liver fat
- • Specialized nutritional support
Physical Exercise
- • 150 min/week moderate activity
- • Aerobic + resistance exercise
- • Improvement independent of weight loss
- • Reduces liver fibrosis
Diabetes Control
- • HbA1c <7% target
- • Metformin first line
- • GLP-1 agonists beneficial
- • Comorbidity control
Mediterranean Diet and Fructose Restriction
Recommended Foods
- • Extra virgin olive oil
- • Fatty fish (omega-3)
- • Nuts
- • Vegetables and greens
- • Legumes
- • Whole grains
Avoid/Limit
- • Added fructose
- • Sugar-sweetened beverages
- • Ultra-processed foods
- • Trans fats
- • Alcohol
- • Processed meats
New Pharmacological Treatments
As European Board Advisor for Olympus and with training in advanced techniques, I maintain constant updates on the latest therapeutic advances:
In Advanced Research
- • PPAR agonists (elafibranor)
- • FXR agonists (obeticholic acid)
- • ACC inhibitors (firsocostat)
- • GLP-1 agonists (semaglutide)
Current Clinical Use
- • Vitamin E (800 IU/day)
- • Pioglitazone (selected cases)
- • Ursodeoxycholic acid
- • Omega-3 supplements
Follow-up and Prognosis
Progression Risk
Advanced Fibrosis
20-30% of NASH patients develop significant fibrosis in 10-15 years
Liver Cirrhosis
5-10% progression to cirrhosis. Higher risk in diabetes and severe obesity
Hepatocellular Carcinoma
Annual incidence 0.3-2.6% in NAFLD cirrhosis. Screening necessary
INMEQ Follow-up Protocol
- • Clinical control every 6 months
- • Complete blood work every 6 months
- • Annual elastography
- • Liver ultrasound as needed
- • Hepatocellular carcinoma screening if cirrhosis
Specialized Fatty Liver Consultation
Advanced diagnosis and personalized treatment at INMEQ Madrid
Location
INMEQ - Medical Surgical Institute
Calle Marcenado 49
28002 Madrid
Diagnostic Procedures:
Hospital Fuensanta and Hospital San Rafael - Advanced liver imaging technology
Specialized Consultation
Complete in-person consultation
Includes evaluation, diagnostic plan and personalized treatment
Video call available for follow-up
Frequently Asked Questions about Fatty Liver
Is fatty liver reversible?
Yes, simple hepatic steatosis is completely reversible with lifestyle changes. As a specialist in fatty liver, I have observed significant improvements in 70-80% of my patients who achieve 7-10% weight loss and maintain regular exercise.
When should I worry about fatty liver?
You should consult a fatty liver specialist if you have persistently elevated transaminases, type 2 diabetes, obesity, or metabolic syndrome. Early diagnosis allows prevention of progression to steatohepatitis and fibrosis.
What diet is best for fatty liver?
The Mediterranean diet is most effective for fatty liver. I recommend restriction of added fructose, increased omega-3, extra virgin olive oil, and reduction of ultra-processed foods. A personalized nutritional plan is essential.
Can fatty liver progress to cirrhosis?
Simple fatty liver rarely progresses. However, steatohepatitis (NASH) can evolve to advanced fibrosis in 20-30% of cases and cirrhosis in 5-10%. That's why specialized follow-up with elastography is crucial.
What tests are needed to diagnose fatty liver?
For fatty liver diagnosis I use liver ultrasound, elastography (FibroScan), complete blood work with fibrosis markers (FIB-4), and in complex cases, liver biopsy. The approach is personalized for each patient.
Fatty Liver Specialist Madrid
Precise diagnosis, personalized treatment and specialized follow-up with the most advanced techniques
INMEQ - Calle Marcenado 49, 28002 Madrid | Diagnosis: Hospital Fuensanta and San Rafael