Fatty liver, is a lesion caused by excessive accumulation of fat in liver cells due to various reasons. Fatty liver disease is seriously threatening 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. Fatty liver is a common clinical phenomenon rather than an independent disease. Its clinical manifestations are asymptomatic in mild cases and aggressive in severe cases. In general, fatty liver is a reversible disease, and early diagnosis and timely treatment can often restore normalcy. The causes are
I. Obesity type fatty liver
The degree of fat accumulation in the liver is proportional to body weight. 30% to 50% of obesity is combined with fatty liver, and the rate of fatty liver lesions is as high as 61% to 94% in those who are severely obese. When the weight of obese people is controlled, their fatty infiltration is also reduced or disappears. In chronic alcoholics, 75% to 95% of liver puncture biopsies have fatty infiltrates. There are also observations that the incidence of alcoholic fatty liver increases 5 to 25 times when drinking more than 80 to 160 grams of alcohol per day.
Second, alcoholic fatty liver
In long-term alcoholics, 75% to 95% of liver puncture biopsies have fatty infiltration. Others observed that the incidence of alcoholic fatty liver increased by 5 to 25 times when drinking more than 80 to 160 grams of alcohol per day.
III. Rapid weight loss fatty liver
Fasting, excessive dieting or other rapid weight loss measures can cause a large increase in lipolysis in a short period of time, consuming glutathione (GSH) in the liver, causing a large increase in malondialdehyde and lipid peroxides in the liver, damaging liver cells and leading to fatty liver.
Fourth, malnutrition fatty liver
Malnutrition leading to protein deficiency is an important cause of fatty liver, mostly due to insufficient food intake or digestive disorders, which can not synthesize apolipoproteins, resulting in the accumulation of triglycerides in the liver, resulting in fatty liver.
V. Diabetic fatty liver
About 50% of diabetic patients can occur fatty liver, which is more adult patients. Because 50% to 80% of adult diabetic patients are obese, their plasma insulin levels and plasma fatty acid increases, fatty liver change is related to both the degree of obesity, and eating too much fat or sugar related.
Sixth, drug fatty liver
Certain drugs or chemical toxins cause fatty liver by inhibiting protein synthesis, such as tetracycline, adrenocorticotropic hormone, puromycin, cyclamate, thujone, and arsenic, lead, silver, mercury, etc. Lipid-lowering drugs can also cause fatty liver by interfering with the metabolism of lipoproteins.
VII. Fatty liver in pregnancy
The disease is serious and has a poor prognosis, with maternal and infant mortality rates of 80% and 70%, respectively.
VIII. Fatty liver caused by other diseases
Fatty liver can also occur during infections such as tuberculosis, bacterial pneumonia and sepsis. Patients with viral hepatitis who excessively restrict their activities and consume a high-sugar, high-calorie diet tend to accumulate fat in liver cells; after receiving corticosteroid therapy, fatty liver is more likely to occur. Fatty liver improves rapidly after controlling the infection or removing the cause, and there are also so-called extra-gastrointestinal hypertrophic fatty liver, toxic fatty liver, and fatty liver caused by hereditary diseases.
Clinical manifestations
The clinical manifestations of fatty liver are diverse. Only fatigue is present, while most patients with fatty liver are fat. Most patients with fatty liver are found by chance during physical examination. Moderate to severe fatty liver has similar manifestations to chronic hepatitis, including loss of appetite, fatigue, nausea, vomiting, and vague pain in the liver area or right upper abdomen. Mild enlargement of the liver may be painful to touch, with a slightly tough texture, blunt edges, and smooth surface, and a few patients may have splenomegaly and liver palms. When there is excessive fat deposition in the liver, it can cause severe pain or pressure in the right upper abdomen, fever, increased white blood cell count, and misdiagnosis as acute abdomen and caesarean operation. In addition, patients with fatty liver also often have changes of peripheral neuritis such as tongue inflammation, stomatitis, skin bruising, numbness in the extremities, and abnormal sensation in the extremities. A few patients may also have gastrointestinal bleeding, gum bleeding, epistaxis, etc. Patients with severe fatty liver can have peritoneal effusion and lower limb edema, electrolyte disorders such as hyponatremia and hypokalemia, etc. The manifestations of fatty liver are varied, and in case of diagnostic difficulties, liver biopsy can be done to confirm the diagnosis. Diagnosis.
1, no history of alcohol consumption or alcohol consumption equivalent to 140 grams of ethanol per week for men and 70 grams for women.
2.Exclude viral hepatitis, drug-related liver disease, total parenteral nutrition, hepatomegaly and other specific diseases that can lead to fatty liver.
3.In addition to the clinical manifestations of the primary disease, there are non-specific symptoms and signs such as weakness, dyspepsia, vague pain in the liver area, and hepatosplenomegaly.
4, There may be metabolic syndrome such as overweight/visceral obesity, increased fasting glucose, dyslipidemia, hypertension, etc.
5.Serum aminotransferase and glutamyl transpeptidase levels may be mildly to moderately increased, usually with elevated alanine aminotransferase as the main cause
6.The liver imaging performance meets the imaging diagnostic criteria of diffuse fatty liver
7. Histological changes of liver biopsy meet the pathological diagnostic criteria of fatty liver disease.
Fatty liver can be diagnosed by having any of the above items 1 to 5 and 6 or 7.
Fatty liver can also occur when treating infections such as tuberculosis, bacterial pneumonia and sepsis. Patients with viral hepatitis who overly restrict their activities, combined with a high sugar and high calorie diet, tend to accumulate fat in the liver cells; fatty liver is more likely to occur after receiving corticosteroid therapy. Fatty liver improves rapidly after controlling the infection or removing the cause, and there are also the so-called extra-gastrointestinal hypertrophic fatty liver, toxic fatty liver, fatty liver caused by hereditary diseases, etc..
1.General treatment.
(1) Identify the cause of the disease and take targeted measures. Such as long-term heavy drinkers should stop drinking. Excess nutrition, obese people should strictly control the diet, so that the physical ability to restore normal. Diabetic patients with fatty liver should actively and effectively control blood sugar. Patients with malnutrition fatty liver should increase nutrition appropriately, especially the intake of protein and vitamins. In short, removing the cause of the disease is conducive to curing fatty liver.
(2) Adjust the diet structure to advocate high protein, high vitamin, low sugar and low fat diet. Do not eat or eat less animal fat, sweet food (including sugary drinks). Eat more green vegetables, fruits and fiber-rich foods, as well as lean meat, river fish and soy products with high protein, no snacking and no extra meals before bedtime.
(3) Increase exercise appropriately Promote the consumption of body fat. Moderate amount of aerobic exercise (such as fast walking, cycling, swimming, dancing, etc.), more than 4 times a week, with a cumulative time of at least 150-250 minutes, preferably twice a week for light or moderate resistance muscle exercise (push-ups or lifting, etc.).
(4) selenium supplementation can make the activity of glutathione peroxidase in liver reach normal level, which plays a good role in nourishing liver and protecting liver, selenium malt powder and schisandra as the main raw material made of liver support tablets, which has the health care function of immunomodulation and has the auxiliary protection effect on chemical liver injury, and has the effect of nourishing liver, protecting liver and protecting liver.
2.Drug treatment
Western medicine is often used to protect liver cells, de-lipidizing drugs and antioxidants, such as vitamins B, C, E, lecithin, ursodeoxycholic acid, silymarin, inosine, coenzyme A, reduced glutathione, taurine, carnitine orotate, hepatocyte, and certain lipid-lowering drugs, etc.
Prevention.
1.Rational diet: three meals a day should be reasonably well-distributed, to achieve a balance of coarse and fine nutrition, a sufficient amount of protein can remove fat in the liver.
2, appropriate exercise: adhere to daily physical exercise, depending on their own physical fitness to choose the appropriate sports, such as jogging playing table tennis badminton and other sports. To start with a small amount of exercise gradually and gradually reach the appropriate amount of exercise to strengthen the consumption of body fat.
3, careful use of drugs: any drugs into the body have to go through the liver detoxification, in the choice of drugs should be more careful, beware of the toxic side effects of drugs, especially on the liver damage drugs should never be used to avoid further aggravation of liver damage.
4, in addition to the mood to be cheerful, not angry, less irritated, pay attention to the combination of work and rest is also quite important.