Fatty liver is a lesion caused by excessive accumulation of fat in liver cells due to various reasons. Fatty liver disease is posing a serious threat to the health of the nation, becoming the second most common liver disease after viral hepatitis, and has been recognized as a common cause of insidious cirrhosis. It has been shown that fatty liver can shorten life expectancy by 4 years for those under 50 years old and 10 years for those over 50 years old. The prevalence of fatty liver in Shanghai is increasing year by year and is getting younger. It is now almost 1 in 3 people, which is already on par with European and American countries.
I. Definition.
Fatty liver refers to excessive fat accumulation in liver cells due to various causes, with fat content exceeding 5% of the liver weight.
II. Etiology.
The risk factors that induce fatty liver include, unreasonable dietary structure, obesity, alcoholism, and a sedentary lifestyle. The disease used to occur mainly in the affluent Western countries, but now the Chinese are also facing this “disease of affluence”
1, drinking alcohol. The most important thing is that the liver is not only a source of fatty acids, but also a source of fatty acids. 75%-90% of chronic alcoholics have fatty liver, while 20%-30% of alcoholic fatty liver patients have fatty liver. 30% of alcoholic fatty liver will eventually develop into liver cirrhosis, or even liver cancer.
2, excessive nutrition. Eating large fish and meat, fried food and sweets for a long time will make the liver synthesize too much fat. It increases the burden on the liver, interferes with the metabolism of fat, breaks the balance of input and output of the liver, and fat will accumulate in the liver, forming a fatty liver.
3.Obesity. About half of the obese people have the tendency to combine fatty liver, the main reason is that the obese blood contains a large number of free fatty acids, constantly transported to the liver, greatly exceeding the metabolic capacity of the liver, causing fat accumulation in the liver and causing obese fatty liver.
4.Diabetes. About half of type 2 diabetic patients have fatty liver, which is because glucose and fatty acid in the body of diabetic patients cannot be well utilized, and lipoprotein synthesis is also impaired, and most glucose and fatty acid are turned into fat in the liver, which eventually makes fat accumulate in the liver and causes fatty liver. Post-hepatitis fatty liver is due to excessive food intake and reduced exercise, coupled with the fact that liver function has not yet fully recovered, it is very easy to cause fat accumulation in the liver.
III. Classification
Classification according to the degree of physical alteration
Classified according to the degree of histopathological changes in the liver, there are four general conditions as follows.
1. Simple fatty liver. The lesion of the liver is only fatty degeneration of hepatocytes.
2. Steatohepatitis. It is the inflammation of hepatocytes that occurs on the basis of steatosis of hepatocytes.
3.Fatty liver fibrosis. It refers to fibrotic changes around the hepatocytes, and the degree of fibrosis is related to the persistence of causative factors and the severity of fatty liver.
4.Fatty cirrhosis. Fatty cirrhosis is the result of the progressive development of fatty liver disease to an advanced stage. The incidence of cirrhosis in alcoholic hepatitis is more than 50%.
Classification according to the severity
1.Mild fatty liver clinical symptoms. Fatty liver often has no conscious symptoms, sometimes only a mild increase in transaminases, some similar to mild hepatitis.
2.Moderate to severe fatty liver clinical symptoms. There are similar manifestations of chronic hepatitis.
3.Severe fatty liver. Severe fatty liver is a more serious disease.
IV. Diagnosis
The examination of fatty liver is actually relatively simple, and most liver hospitals currently use imaging and liver function tests.
1. Ultrasound (B-ultrasound) examination. The easiest way to check fatty liver at present is ultrasound. According to research, the accuracy of ultrasonography in diagnosing fatty liver can be as high as ninety-seven percent.
2. Liver function (GOT, GPT) test. In general, the GOT and GPT values of fatty liver patients who are over-nourished will be slightly elevated, but in general, the index is still maintained below 100. If the GOT and GPT values are higher than 100, we should consider whether the fatty liver is caused by other reasons.
V. Hazards
Early warning signs: Whenever there is a physical examination, there are many people who are found to have fatty liver, just like “beer belly”, it is common. And mild fatty liver does not hurt, eating and drinking is not affected, so many people do not consider it as a disease, simply do not pay attention.
Experts point out that the danger of fatty liver should not be ignored, and it is important to fully understand that fatty liver is a disease. It is not only a disease, if it is not effectively treated for a long time, patients will step by step take the path of no return to cirrhosis or even liver cancer, so once diagnosed, it must be treated symptomatically.
Fatty liver is an imbalance of liver lipid metabolism, resulting in the accumulation of lipids in the liver, which makes liver cells unable to carry out normal physiological functions – degeneration and necrosis, and the long-term development of liver fibrosis and cirrhosis, which is often followed by liver cancer.
Induced hyperlipidemia, atherosclerosis liver fat accumulation, lipid metabolism imbalance, then the blood triglycerides will rise, blood viscosity increased, will promote the formation of atherosclerosis.
Decrease the immunity of the body, as well as increase the burden of detoxification and detoxification of the kidneys As we all know, the liver and kidneys are the two main detoxification and detoxification organs of the human body, fatty liver patients with degeneration and necrosis of liver cells, resulting in the decline of liver immune function, the “human chemical plant” power is blocked, detoxification and detoxification capacity is reduced, then the detoxification pressure will naturally shift to the kidneys The kidneys will be overloaded for a long time, and kidney diseases such as uric acid will often occur.
The liver is responsible for the metabolism of three major nutrients in the body – lipids, sugars and proteins. Type 2 diabetes mellitus is often caused by a lack of insulin secretion and insulin resistance, and is secondary to lipid metabolism.
VI. Treatment methods
Diet therapy. Dietary habits, should be firmly abstain from alcohol. At the same time, do not take all kinds of health care drugs and nutritional drugs when they are not necessary. Three meals should be regular, because excessive ingestion, snacking, night eating, intermittent eating and excessive pursuit of high-grade, high-calorie food will certainly cause excessive accumulation of body fat, causing obesity and inducing fatty liver.
Irregular eating style, such as often do not eat breakfast, or three meals full hunger unevenly will disrupt the body’s metabolic dynamics, providing conditions for the onset of obesity and fatty liver. Those who eat too fast do not easily feel full, and it is difficult to digest, resulting in excessive energy intake and inadequate metabolic absorption, etc., which promotes the development of obesity fatty liver.
Exercise treatment
1, the type of exercise: mainly should choose aerobic exercise, such as jogging, brisk walking, cycling, up and down the stairs, playing badminton, jumping rope and swimming, etc., this kind of exercise for fatty liver people to lower fat and weight loss, promote the fat in the liver to subside the effect is better.
2, exercise intensity: people with fatty liver should choose the appropriate amount of exercise according to the degree of exertion and heart rate (pulse) after exercise, to exercise with a pulse of 100 to 160 times / minute (to 170 minus the actual age), lasting twenty to thirty minutes, and fatigue after exercise disappears within one or twenty minutes is appropriate.
3, the time zone and frequency of exercise implementation: According to research, the same exercise program and exercise intensity, afternoon or evening exercise than the morning exercise to consume 20% more energy. Therefore, the best time to choose to exercise exercise in the afternoon or evening; the best time to walk is 45 minutes after dinner, when the maximum calorie consumption, the effectiveness of weight loss is also the best. The frequency of exercise implementation to 3 to 5 days a week is more appropriate.