What is fatty liver? Fatty liver is a lesion caused by excessive accumulation of fat in liver cells due to various reasons. According to the latest survey data, the incidence of fatty liver has increased rapidly in recent years in Europe, America and China, becoming the second most common liver disease after viral hepatitis. It is the most prevalent liver disease in China. What are the common causes of fatty liver? 1, obese fatty liver The degree of fat accumulation in the liver is proportional to the weight. 30% to 50% of obesity combined with fatty liver, the rate of fatty liver lesion in heavy obese people is as high as 61% to 94%. After the obese person’s weight is controlled, his fat infiltration is also reduced or disappeared. 2, rapid weight loss fatty liver fasting, excessive dieting or other rapid weight loss measures can cause a large increase in lipolysis in the short term, consumption of glutathione (GSH) in the liver, so that a large increase in malondialdehyde and lipid peroxides in the liver, damage to liver cells, resulting in fatty liver. 3, malnutrition fatty liver Malnutrition leading to protein deficiency is an important cause of fatty liver, mostly due to insufficient food intake or digestive disorders, unable to synthesize apolipoproteins, resulting in the accumulation of triglycerides in the liver, resulting in fatty liver. 4, 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 changes both with the degree of obesity, but also with the consumption of fat or sugar too much related. Can fatty liver develop into liver cirrhosis? Long-term excessive accumulation of fat in the liver, severe swelling of hepatocytes and infiltration of inflammatory cells lead to the destruction of the normal lobular structure of the liver, which is repaired by the liver through the proliferation of fibrous tissue, and this fibrous deposition becomes more and more frequent, and liver fibrosis may develop into cirrhosis. However, simple fatty liver has a lower chance of developing cirrhosis, and the development process is relatively slow, with about 1.5% to 8.0% of patients progressing to cirrhosis. Steatohepatitis (elevated transaminases) has a significantly higher chance of developing into cirrhosis, reaching 10%. Patients with age >50 years, obesity (especially visceral obesity), hypertension, type 2 diabetes, increased ALT, AST to ALT ratio >1, and abnormal platelet count are more likely to develop cirrhosis. Do all cases of fatty liver require drug treatment? There is no single effective medication for fatty liver. The need for treatment and how to treat fatty liver requires a professional evaluation by a physician. Elevated aminotransferases often indicate inflammatory damage to the liver and require special attention and systematic treatment. Patients with normal transaminases are often referred to as “simple fatty liver” and may not appear to need treatment, but some of these patients may develop liver fibrosis and cirrhosis, so careful evaluation is still needed to determine if treatment is needed. Can fatty liver be treated by weight loss alone? The treatment of fatty liver is very complex. Each patient needs an individualized treatment plan based on his or her specific condition and treatment goals are determined based on the severity. For example, whether the patient is obese, has combined diabetes and abnormal glucose tolerance, hyperlipidemia, hypertension, coronary artery disease, etc. Treatment is divided into basic treatment, treatment of liver disease and treatment of comorbidities. Weight loss is only one of the means of basic treatment. What does the basic treatment for fatty liver include? The basic treatment therapy mainly includes diet control (low-fat diet, balanced nutrition, etc.) and exercise therapy (aerobic exercise mainly). In particular, it is important to pay attention to the proper nutrition and to avoid some common misconceptions in the process of diet control. The most common one is the excessive control of protein, which leads to the loss of protein more than the reduction of fat, resulting in the decline of physical fitness. Exercise at all intensities is good for health, but exercise for special groups of people needs to be done under the guidance of a doctor or health manager, such as those with combined bone and joint disease, cardiovascular disease, diabetes, and excessive obesity. What are the treatments for fatty liver? The main methods are: etiological treatment (proper control of blood sugar and lipids, etc.), and pharmacological treatment (lipid-lowering drugs, liver protection drugs, antioxidant drugs). The prognosis depends mainly on the degree of liver damage. Steatosis alone is usually a benign disease, and the development of cirrhosis is relatively rare. However, compared to the general population, the incidence of cirrhosis is higher in patients with combined diabetes, progressive weight gain, the elderly, and those with an AST/ALT ratio > 1. What should I pay attention to in treating fatty liver? The following points should be noted in the treatment: 1. Health promotion and education, lifestyle change, treatment for the primary disease and risk factors respectively, such as weight loss, reasonable control of blood sugar and lipids, correction of nutritional imbalance, etc., adjustment of diet and exercise, control of body mass and reduction of waist circumference. 2.Improve insulin resistance and correct metabolic disorders. 3, reduce additional strikes to avoid aggravating liver damage. For example, avoid rapid weight loss, avoid exposure to hepatotoxic substances, and strictly prohibit excessive alcohol consumption. 4.Auxiliary application of liver-protective drugs when necessary. 5.Actively deal with the complications of cirrhosis. When patients with non-alcoholic steatohepatitis are combined with liver failure, decompensated cirrhosis or liver cancer, liver transplantation treatment can be considered.