With the continuous improvement of people’s living standard, fatty liver has become a common disease in daily life. The content of fat in the liver of normal people accounts for about 4% to 5% of the wet weight of the liver, of which 2/3 is phospholipid and the rest is neutral fat, cholesterol, cholesterol esters, etc.. When fat accumulation in the liver is caused by various reasons, the fat content can even be as high as 40% to 50% of the liver weight, and the accumulation of fat in the liver exceeds 5% of the liver weight is called fatty liver. If fat accumulates in the liver, it is bound to affect liver function and increase the burden on the liver, bringing damage to health. Therefore, fatty liver should not be taken lightly. Strictly speaking, fatty liver is not a separate disease, but a pathological term. In most cases, it is only one of the manifestations of various metabolic disorders in the body. Fatty liver can be caused by a variety of factors, such as chronic alcoholism, nutritional deficiency or excess, diabetes, obesity, drug or chemical poisoning, chronic infection or hypoxia, endocrine disorders, etc. Fatty liver of different etiologies also has their own different characteristics. Such as.
1.Obesity fatty liver
It is mostly seen in middle-aged and elderly people who are over-nourished and overweight. The degree of fat accumulation in the liver is proportional to the weight, and the rate of fatty liver degeneration is as high as 61% to 94% in severe obesity; after the weight of obese people is controlled, their fat infiltration also decreases or disappears, and the treatment of this kind of fatty liver should be based on adjusting the diet, and the basic principle is “one suitable and two low”, that is, moderate protein, low sugar and low fat. The basic principle is “one moderate and two low”, that is, moderate protein, low sugar and low fat. The usual diet should be light, not too full, eat more fresh vegetables and fruits, and limit the intake of calories. At the same time, we should strengthen exercise and actively lose weight. As long as the weight drops, the fatty infiltration in the liver is obviously improved, and generally no drug treatment is needed, and if necessary, it can be supplemented by symptomatic treatment with lipid removing drugs.
2.Hypolipidemic fatty liver
The increase of cholesterol and triglyceride content in blood is called “hyperlipidemia”. Hyperlipidemia can cause fatty liver. This kind of fatty liver patients have obvious abnormalities in blood lipid metabolism, and often accompanied by atherosclerosis, coronary heart disease, etc.
3.Alcoholic fatty liver
Most often seen in long-term alcoholics. After alcohol enters the liver cells, it is transformed into acetaldehyde and then into acetic acid under the action of related enzymes. When the ratio between enzymes and reductase in the above metabolic process is out of balance, thus reducing the oxidation ability of fatty acids in liver cells, it can cause fat to accumulate in the liver and form fatty liver. According to liver puncture biopsies of long-term alcoholics, 75% to 95% had fatty infiltrates. It has also been observed that the incidence of alcoholic fatty liver increases by 5 to 25 times when more than 80 to 160 grams of alcohol is consumed daily. After drinking alcohol, ethanol replaces fatty acids, causing the accumulation of fatty acids and ketone bodies in the body, which increases the ratio of lactic acid and pyruvic acid in the body, and too much lactic acid inhibits uric acid excretion by the kidneys, causing hyperuricemia; it reduces liver glycogen isogenesis, leading to hypoglycemia and sudden death in some patients.
4.Diabetic fatty liver
Due to the lack of insulin in the body of diabetic patients, sugar metabolism cannot be carried out smoothly, and the body mobilizes a large amount of fat decomposition, releasing free fatty acids into the liver to form a fatty liver. According to statistics, about 50% of diabetic patients suffer from fatty liver, including adults, because 50% to 80% of adults suffering from diabetes are obese, their plasma insulin levels and plasma fatty acid increases, fatty liver change is related to both the degree of obesity, but also with eating too much fat or sugar. On the one hand, these patients actively treat diabetes, on the other hand, they require low-fat, low-calorie and high-protein diet, and it is appropriate to keep the patient’s fat calories accounting for less than 25% of the total calories.
5.Fatty liver after hepatitis
Post-hepatitis fatty liver mostly occurs in the recovery period of hepatitis, due to blindly carry out liver protection treatment after suffering from hepatitis, one-sided emphasis on nutrition, excessive consumption of sweets, excessive emphasis on rest, resulting in excess nutrition and fatty liver. In addition, abnormal liver function causes a decrease in the liver’s ability to oxidize fatty acids and synthesize apolipoproteins, which can also contribute to the accumulation of fat and cause fatty liver.
As with other causes of fatty liver, the treatment of viral hepatitis combined with fatty liver (post-hepatitis fatty liver) mainly includes the treatment of the primary disease, diet therapy and drug therapy.
6.Malnutrition fatty liver
Malnutrition lack of protein 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, forming a fatty liver. If a patient with severe nutritional deficiency shows protein deficiency edema, weight loss, skin pigmentation and fatty liver, the fat in the liver is quickly reduced after a high protein diet is given; or the fatty liver is slowly eliminated after the input of amino acids, as protein synthesis returns to normal.
7.Drug fatty liver
Some drugs or chemical toxins cause fatty liver by inhibiting protein synthesis, such as tetracycline, adrenocorticotropic hormone, puromycin, cyclamate, thujone and arsenic, lead, silver and mercury. This kind of fatty liver should immediately stop the use of the drug, if necessary, supplemented by supportive treatment until the fatty liver recovery.
8.Gestational fatty liver
Most of them develop at 34-40 weeks of gestation in the first child, and the condition is serious. Poor postpartum, maternal and infant mortality rate of 70% to 80%, respectively. Clinical manifestations are severe vomiting, jaundice, epigastric pain, etc. It is difficult to distinguish from fulminant viral hepatitis. Timely termination of pregnancy can reverse the disease, and a few can be rescued by natural delivery or cesarean section.
The most basic treatment for fatty liver is to remove the cause and correct the primary disease, such as active treatment of hepatitis, diabetes and other primary diseases. If the primary disease is cured or improved, the fatty liver can be cured or remitted spontaneously; remove various factors that may cause fatty liver, such as abstaining from alcohol, avoiding exposure to hepatocyte toxins and long-term use of drugs that damage liver cells. Diet modification is important for obese people who are over-nourished. The basic point is to limit sugar, including rice, pasta and other sweets, and to increase the protein in the diet, but not the fat. People with fatty liver must abstain from alcohol, including beer, and it is not helpful to restrict the amount of diet without abstaining from alcohol.
Because of the different causes of fatty liver, the dietary regimen for each type of fatty liver varies. For obese and hyperlipidemic fatty liver, the main thing is to reduce the total calories in the diet, and limit the staple foods such as rice and noodles to less than 400 grams per day, especially dinner should not be too full, too late or too rich. Usually try to eat less animal fat is high cholesterol food, such as egg yolk, cream, animal offal, etc., eat more coarse grains, vegetables and fruits.
The conditioning of fatty liver after hepatitis should be based on the principle of weight reduction. Total dietary calories must be strictly controlled to promote the oxidation of excess fat in the body and reduce the accumulation of fat in the liver. Protein intake should not be reduced, and should be supplied at 1.2 to 1.5 grams per kilogram of body weight. Milk, soybean products, lean meat, fish and shrimp are rich in high-quality protein and can be eaten appropriately.
The diet of diabetic fatty liver is based on the principles of low sugar, low fat, high protein, high vitamin and low calorie. Adherence to physical activity can control weight gain, help prevent elevated blood lipids or lower blood lipid levels and prevent atherosclerosis. Fatty liver patients should choose different programs according to their physical condition. Asymptomatic people can participate in fitness running, ball games, mountain climbing, etc. Those with symptoms can take a walk, do gymnastics, practice qigong, tai chi, etc. Even after hepatitis fatty liver, it is important to promote proper exercise without overemphasizing rest. Patients with asymptomatic fatty liver generally do not need drug treatment. Lipid-lowering drugs are available for symptomatic patients with increased cholesterol in the body.