It has been reported that the prevalence of fatty liver has been increasing year by year in recent years. In developed countries such as Europe, America and Japan, its prevalence is increasing year by year and showing a trend of low age, and has become the primary cause of chronic liver disease in developed countries. Experts predict that in the next ten or twenty years, fatty liver will become the main object of liver disease prevention and treatment in China, which fully illustrates the urgency and necessity of prevention and treatment of fatty liver. However, in actual life, some people do not pay attention to their dietary habits and rely excessively on drugs after suffering from fatty liver, while neglecting basic treatment such as exercise and diet, resulting in organ damage and prolonged illness. Therefore, the reasonable prevention and treatment of fatty liver is particularly important.
The current situation is not optimistic
Fatty liver is related to metabolic disorders
Fatty liver disease, or fatty liver for short, is a clinicopathological syndrome in which multiple factors lead to impaired fat metabolism in the liver and imbalance in the dynamic balance of lipid substances, resulting in excessive fat accumulation in the hepatocytes and diffuse fat infiltration (steatosis) and a series of pathophysiological changes in the liver. According to the degree of progression of pathological changes, there are four stages: simple fatty liver, steatohepatitis, fatty liver fibrosis, and fatty cirrhosis. Fatty liver is a common clinical phenomenon rather than an independent disease, and its clinical manifestations are asymptomatic in mild cases and aggressive in severe cases. About 15-25% of steatohepatitis progress to fatty cirrhosis in 10-15 years, while 30%-40% of the latter die of liver cancer, liver failure and recurrence after liver transplantation in about 10 years.
Metabolic syndrome is a group of metabolic disorders with obesity and insulin resistance as the central link. Metabolic syndrome mainly manifests as obesity, dyslipidemia, increased blood pressure, impaired glucose regulation or type 2 diabetes mellitus. Current studies have shown that fatty liver and metabolic syndrome have a significant correlation. Patients with fatty liver tend to have abnormal metabolic diseases such as obesity, hypertension, hyperlipidemia, and diabetes. Fatty liver and metabolic syndrome have a common pathogenetic basis and mutual synergistic effects, and their mutual synergistic effects are mainly reflected in the following: on the one hand, the incidence and prevalence of metabolic syndrome in the population with non-alcoholic fatty liver is very high; on the other hand, the incidence of non-alcoholic fatty liver in patients with metabolic syndrome is higher than that in the population without metabolic syndrome, and such patients with non-alcoholic fatty liver are more likely to develop serious liver cirrhosis and other pathological changes. Fatty liver may be a part of the metabolic syndrome. Therefore, the prevention and treatment of fatty liver with manifestations of the metabolic syndrome should pay due attention to the intervention of the metabolic syndrome.
The prevalence is on the rise
In recent years, the prevalence of fatty liver has rapidly increased in Europe, the United States and China, becoming the second most common liver disease after viral hepatitis. In some occupational groups (white-collar workers, cab drivers, professional managers, individual owners, government officials, senior intellectuals, etc.), the average incidence of fatty liver is 25%; in obese people and type II diabetics, the incidence of fatty liver is 50%; in alcoholics and alcoholics, the incidence of fatty liver is 58%; in sub-healthy people with frequent insomnia, fatigue, lack of food and drink, and gastrointestinal dysfunction The prevalence of fatty liver is about 60%. In recent years, the age of people with fatty liver has been decreasing, with an average age of 40 years old and an increasing number of patients around 30 years old. 45 years old and younger are significantly more likely to have fatty liver than women.
Thin people may also suffer from fatty liver
Many people think in general terms that only obese people can develop fatty liver. In fact, 35% of patients with NAFLD are not obese, and 5% of patients do not have risk factors such as obesity, insulin resistance, or hyperlipidemia. Because it is so complex, the pathogenesis of fatty liver has not been systematically elucidated.
There are ways to prevent and treat
Early detection and treatment
Fatty liver is considered mild when the amount of fat exceeds 5%, moderate when it exceeds 10%, and severe when it exceeds 25%. When the total fat amount in the liver exceeds 30%, it can be detected by ultrasound and diagnosed as “fatty liver” by ultrasound. In patients with fatty liver, the total fat amount can reach 40% to 50%, and some reach more than 60%. The key to cure fatty liver is early detection and early treatment. Fatty liver is not terrible, early detection and active treatment, generally can be cured, and does not leave after-effects.
In addition, to control the increasing harm of fatty liver to the population, we should also base on prevention and develop appropriate prevention and treatment measures for the risk factors or related diseases that exist.
Focus on basic treatment
Some patients are overly dependent on drugs and neglect basic treatment. The main manifestation is the reliance on or abuse of liver-protective drugs, weight-loss drugs or lipid-lowering drugs, while neglecting basic treatment such as diet and exercise. It should be pointed out that drugs are not the only measures for treating fatty liver, nor are they the first choice. A comprehensive program should be adopted that varies from disease to disease and from person to person, giving full attention to basic treatment, combined with the necessary drug-assisted or intensive treatment.
1.Identify the cause of the disease and take targeted measures. For example, long-term heavy drinkers should abstain from alcohol. Excess nutrition, obesity should be strictly controlled 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.
2.Adjust the diet structure. Advocate high protein, high vitamin, low sugar, low fat diet. Do not eat or eat less animal fat, sweets (including sugary carbonated drinks). Eat more green vegetables, fruits and fiber-rich foods, as well as high protein lean meat, river fish, soy products, etc., no snacks and no extra meals before bedtime. It is worth pointing out that the prevention of fatty liver should start with children, especially only children, what they want to eat to give what, and less activity, once they become “little fat dun”, fear of fatty liver has been.
3, the development of scientific exercise program. Specialist physicians according to the specific circumstances of the patient (gender, age, weight, the size of the usual activity, the conditions of the exercise site, the special nature of the work and whether accompanied by other diseases, etc.) to make an objective, comprehensive assessment of the patient, the development of a scientific exercise program, in terms of exercise methods, time, intensity, frequency and amount of exercise to make specific quantitative indicators, and then the patient’s adaptability and efficacy of The program should be evaluated in stages, with continuous adjustment and improvement.
Patients with fatty liver should focus on whole-body low-intensity dynamic exercise aimed at exercising whole-body strength and endurance, i.e. aerobic exercise, such as jogging, moderate to fast walking (115~125/min), bicycling, going up and down stairs, climbing, playing badminton, shuttlecock, dancing, radio gymnastics, rope skipping and swimming, etc., which can cause sympathetic excitation and decrease plasma insulin, while catecholamines, glucagon and Growth hormone secretion increases, which inhibits triglyceride synthesis and promotes lipolysis.
Exercise time and frequency are appropriate. Each exercise must complete the prescribed exercise indicators. Take walking as an example, from 5000 steps / day, gradually increase to 7000 ~ 10000 steps of walking, and then fast walking, phase by phase to increase the amount of exercise; can follow the “3, 5, 7” principle, that is, 3000 meters per day (within 30 minutes), 5 times a week, the sum of pulse and age after each walk is 170.
4, do not abuse drug treatment. At present, there are many kinds of drugs used for fatty liver treatment. However, because the cause of fatty liver is complex and the pathogenesis has not been fully elucidated, at present, there are no specific drugs for the treatment. Western medicine is often used to protect hepatocytes, lipid removing drugs and antioxidants, such as vitamin B, C, E, lecithin, ursodeoxycholic acid, reduced glutathione and certain lipid-lowering drugs. Although there are many drugs mentioned above, most of them need further verification of their efficacy and safety, therefore, they should be used properly under the guidance of doctors and should not be abused. For those who are not effective in drug treatment, serious morbid obesity can be considered for bariatric surgery such as gastroplasty, intestinal bypass and liposuction.