Strictly speaking, fatty liver is a common clinical phenomenon, not an independent disease.
Normal intrahepatic fat accounts for 3% to 5% of the wet weight of the liver, of which 2/3 is phospholipids and 1/3 is triglycerides, cholesterol, and fatty acids. Due to various reasons such as increased supply of exogenous fatty acids, hyper-synthesis of fatty acids in the liver, decreased oxidation of fatty acids in the liver, and impaired clearance of triglycerides from the liver by low-density lipoproteins. If the accumulated fat (mainly triglycerides) exceeds 5% of the wet weight of the liver, or if more than 50% of the hepatocytes are histologically steatized, the liver is called fatty liver. In most cases, hepatic fat deposition is reversible, and the majority of fatty liver cases have a good prognosis. However, some cases of fatty liver are in fact steatohepatitis, which can cause liver fibrosis and even cirrhosis, such as alcoholic fatty liver and some cases of non-alcoholic fatty liver.
What methods are used to diagnose fatty liver?
Currently the easiest way to check for fatty liver is an ultrasound examination. Ultrasound can detect fatty liver with more than 30% liver fat and fatty liver with more than 50% liver fat, so the sensitivity of ultrasound can be more than 90%.
CT scans are highly sensitive to density differences and allow for measurement of CT values. The literature reports that the CT value can decrease by 1.6Hu per gram of liver tissue with an increase of 1mg of triglyceride, and the higher the fat content in hepatocytes, the lower the CT value, and in severe cases it even becomes negative.CT diagnostic criteria for fatty liver generally refer to the CT value of the spleen, and regardless of individual differences, the CT value of the liver is always higher than that of the spleen. Some authors suggest that the diagnosis of hepatic fatty infiltration is based on a liver/spleen density ratio <0.85 and hepatomegaly, and that a liver/spleen density ratio below 0.4 is considered severe hepatic fatty infiltration, 0.61-0.85 is considered mild, and 0.41-0.6 is considered moderate, with corresponding CT values below 20Hu for severe, 21-35Hu for moderate, and 36 The corresponding CT values are below 20 Hu for severe, 21-35 Hu for moderate, and 36 -46 Hu for mild, which usually do not affect the vascular distribution within the hypointense area and have no occupational effect.
This diagnosis is highly suspected after other causes of hepatitis have been excluded. A history of drug and alcohol use should be asked. Careful family history and appropriate investigations should be performed to exclude metabolic diseases. If autoimmune liver disease is suspected, serum protein spotting and autoantibody measurement should be performed. If the patient has had elevated serum transaminases for more than 6 months, a liver biopsy should be performed to diagnose fatty liver.
Risk factors of fatty liver
1. Alcohol: Fatty liver is one of the most common pathological changes in alcoholic liver disease. Alcoholic hepatitis and fatty liver occur in 40% of people who drink 160g of alcohol per day, and it is generally believed that drinking more than 80g/day can cause damage to the liver. The incidence of fatty liver is significantly higher in drinkers than in non-drinkers, and increases with alcohol consumption. The incidence of fatty liver was significantly higher in obese people plus alcohol drinkers than in obese non-drinkers. Multiple regression analysis results suggest that male drinking patients are significantly associated with the occurrence of fatty liver.
2, obesity: obesity is the most common and more certain risk factors for non-alcoholic fatty liver. Moderately obese people (more than 10% of the standard weight) 75% have non-alcoholic fatty liver. Canada a group of 351 cases of non-alcoholic population autopsy information suggests that the fatty liver detection rate (18.5%) in obese people is 9 times the detection rate (2.7%) in lean people. If obesity is divided into grade 0 (more than 10% of standard body weight or less), grade 1 (more than 10 to 39%) abdominal fat thickness 1 to 3 cm, and grade 2 (more than at least 40% of standard body weight, abdominal fat > 3 cm), the results suggest that the incidence of fatty liver is significantly correlated with the degree of obesity. Taiwan reported that TG, height and weight, glucose tolerance test and B ultrasound of 873 people over 30 years of age resulted in a body surface area index (BMI) > 115%, which can be used as a threshold value to predict fatty liver. Another report in the normal BMI (22 ~ 23.2) of 45 to 54-year-old men, waist circumference / height ratio ≥ 0.5 group fatty liver incidence (30.5%) is significantly higher than waist circumference / height < 0.5 group (15.7%), so it is believed that similar to the risk factors of coronary heart disease, waist circumference / height ratio increase and fatty liver occurrence of the relationship is more closely than the obesity of simple BMI increase.
3, type 2 diabetes: 1/3 of non-obese diabetic patients were found to have fatty liver at autopsy, and most patients with fatty liver had abnormal glucose tolerance tests and elevated basal levels of insulin, indicating that type 2 diabetes is also an independent risk factor for fatty liver. The occurrence of fatty liver is associated with chronic elevated insulin levels rather than with diabetes mellitus.
4, hyperlipidemia: 60% to 81% of fatty liver patients have elevated TG. Hangzhou reported that the cases of single TG elevation with fatty liver were significantly higher than those with normal TG levels. In our investigation, the results of logistic multifactor analysis showed that both hypercholesterolemia and hyper-TGemia are risk factors for fatty liver.
5. exposure to substances toxic to the liver: the ratio of exposure to substances clearly toxic to the liver and potentially toxic substances as risk factors for causing fatty liver (OR) were 8 and 4.5, respectively. the results of multiple regression analysis suggested that exposure to substances toxic to the liver was an independent risk factor for causing fatty liver. The following drugs, such as the anti-anginal drug Perhexiline maleate and the antimalarial drug Amodiaquine, can cause NAFLD.
6. Long-term intravenous nutrition (TPN): Adults given fat-free intravenous nutrition for more than 2 weeks have liver biopsies showing steatosis and periportal bruising. Hepatic steatosis is most likely to occur when large amounts of glucose are given and the infusion rate exceeds the oxidative capacity of the liver, resulting in intrahepatic fat synthesis. Hepatic complications, including steatosis, biliary sludge and gallstone formation, occur in approximately 15% of patients on intravenous nutrition, especially in patients given high glucose low-fat intravenous nutrition 1 to 2 weeks after the start of treatment.
7, gender: autopsy data suggest that in obese patients female / male for 2.1:1, moderate obese patients (level 2) female / male for 4.4:1, in fatty liver patients female / male for 1.75 / 1, heavy obese fatty liver patients female / male for 3 / 1, but for any degree of obesity, male and female don’t have the same possibility of fatty liver.
What factors can induce fatty liver
1, dietary factors: first of all, long-term malnutrition, hunger or long-term consumption containing high fat, high cholesterol (such as fatty meat, egg yolk, cream, chocolate, etc.) is an important reason for the formation of fatty liver. Also want to emphasize the point that many patients, once infected with liver disease or other chronic diseases, in the stationary phase, are given unrestrainedly increased nutrition and high-calorie diet, or long-term continuous intravenous drip high concentration of glucose, resulting in excess nutrition, which will eventually lead to fatty liver.
2, long-term heavy drinking: the role of alcohol can also make the liver fat metabolism disorders, fat cell accumulation, “chronic alcoholic fatty liver”.
3, obesity: about half of the obese patients can be seen with mild fatty liver: in patients with severe obesity, the incidence of fatty liver can be as high as 60%-90%. Obese patients can be seen to have a significant tendency to fatty liver.
4, drugs or chemical toxins: such as steroid hormones, growth hormone, salicylic acid preparations (such as aspirin), certain sedative sleeping drugs, industrial or laboratory commonly used benzene, arsenic, alcohol, iodoform, carbon tetrachloride, antimony, etc. are prone to induce fatty liver.
5, infection: such as tuberculosis, chronic ulcerative colitis, chronic bronchitis, chronic liver, biliary and kidney diseases can often be accompanied by fatty liver.
6, endocrine diseases: diabetes, anterior pituitary and hyperthyroidism, especially in patients with diabetes, the incidence of fatty liver reaches 20%-80% (average 50%), while patients with fatty liver have diabetes also account for 4%-46% (average 25%).
7, chronic hypoxia: such as severe anemia, cardiovascular and respiratory diseases and high-altitude, plateau operations, etc., often because of severe hypoxia, affecting the fat metabolism function of the liver, and thus fatty liver occurs.
8, other: people who do not love exercise, long-term sitting work, etc. may also occur fatty liver.
The consequences of fatty liver
Depending on the causes of fatty liver formation, the consequences are different. Fatty liver caused by overnutrition and obesity can be reduced or even disappeared by adjusting the diet or scientific weight loss measures. However, fatty liver caused by long-term use of liver-damaging drugs, or chronic alcoholism combined with chronic hepatitis has a poor prognosis and can lead to cirrhosis, which must be treated systematically.
Classification of fatty liver
Fatty liver can be divided into two types according to the cause, namely alcoholic fatty liver and non-alcoholic fatty liver. In China, pure alcoholic fatty liver is rare. Most alcoholics often have fatty liver due to a combination of nutritional disorders, excess energy, low activity, poor life rhythm or drug abuse. It is generally believed that drinking more than 80 grams of alcohol per day can cause damage to the liver. Among those who drink 160 grams of alcohol per day, 40% have alcoholic hepatitis and fatty liver occurrence. Statistics show that the incidence of fatty liver is significantly higher in drinkers than in non-drinkers, and the incidence increases with the increase in alcohol consumption. Nonalcoholic fatty liver contains several types, mainly.
(1) obese fatty liver.
(2) diabetic fatty liver.
(3) overnutrition and malnutrition fatty liver.
(4) Pregnancy fatty liver.
(5) drug-related fatty liver.
(6) hyperlipidemic fatty liver.
(7) Fatty liver in middle-aged and elderly people.
(8) Other types of fatty liver.
What is obese fatty liver? Obese fatty liver is a pathological process in which the synthesis of triglycerides in the liver is much greater than the breakdown of triglycerides due to a serious excess of energy in the body, thus causing some fat to be deposited in the liver cells. Obesity is the most common and more certain risk factor for NAFLD. Moderately obese people (more than 10% above standard weight) suffer from NAFLD in 75%. Survey data show that obese people in China’s population has more than 70 million, and more than 20 % of primary and secondary school students in urban areas. It is worth paying attention to the number of obese people in society is doubling the rate of 5 years, the prevention and treatment of fatty liver can not be ignored. The simple calculation of standard weight is: standard weight (kg) = height (cm) – 105.
Characteristic treatment of fatty liver
At present, the incidence of fatty liver is significantly increasing, according to our hospital in recent year on 10666 healthy people physical examination found that the incidence of fatty liver is 18.62%. The effect of single method of fatty liver treatment is not ideal, and our individualized comprehensive therapy shows good effect and prospect.
Through more than ten years of exploration, we have concluded a set of individualized therapies for different patients, using a combination of Chinese and Western medicine based on diet and exercise, and a combination of medicine, acupuncture and physical therapy. The most important cause of fatty liver at present is poor lifestyle. This includes alcohol consumption, high sugar and high fat diet. On the other hand, exercise is reduced, resulting in excess calories stored. So the treatment starts with adjusting the diet and exercise first.
I. Adjustment of diet
The daily calorie requirement for adults is 9250-10090 kilojoules (2210-2412 kcal) for men and 7980-8820 kilojoules (1907-2108 kcal) for women. The daily calorie requirement varies with each person’s activity level. Food should provide at least 5,000 kJ to 7,500 kJ (1195-1793 kcal) of calories per day. Daily caloric requirement for adults = 1.1 x (basic caloric requirement of the body for basal metabolism + caloric requirement for physical activity).
In order to achieve better results, we use a precise algorithm to calculate the daily caloric needs for each patient and then prescribe individualized healthy recipes based on the food calorie chart. The diet is based on the principle of low sugar and low fat. Staple foods that conform to this principle include flour products such as steamed buns and noodles, mixed grains and rice, but the total amount must be strictly controlled, as too much eating can still lead to calorie storage mainly in the form of fat. Most vegetables are low-sugar, low-fat foods, but peanut kernels, melon seed kernels and other nuts contain more fat, providing greater calories, should not eat more. Ninety percent of the alcohol absorbed into the blood is metabolized in the liver, which can damage liver cells and lead to reduced fatty acid oxidation, increased blood lipids, fatty liver, hepatitis, liver fibrosis, and even cirrhosis. Therefore, fatty liver patients who drink alcohol must quit drinking.
Second, increase exercise
The energy needed for muscle movement comes from two parts: sugar and fat in the body. When a person performs a short period of strenuous exercise, the sugar in the body is broken down in large quantities to produce energy for the muscles. When a person exercises for a long time, the calories provided by sugar in the body are far from enough to meet the needs, so the body’s fat is oxidized and decomposed to produce heat energy for the body to use. According to the way the body metabolizes substances during exercise, the exercise program can be divided into two categories: aerobic and anaerobic exercise.
We prescribe individualized exercise for different patients (e.g. age, health status, exercise experience, obesity, living environment, etc.) and seasons, and then separately according to the exercise scale. The exercise prescription includes the preparation before exercise, the heart rate and duration that should be achieved during exercise, the interval between two sets of exercise, the exercise mode, and the total daily or weekly exercise time. The mode of exercise should be chosen from sports that interest you, which will help to stick to it for a long period of time. Since the amount of exercise is directly proportional to the total oxygen consumption of the body, and the total oxygen consumption is directly proportional to the heart rate. Therefore, heart rate is a valid physiological indicator of the amount of exercise. The amount of exercise to choose the right amount of exercise is the key to achieve satisfactory results. If the amount of exercise is too small, the excess calories cannot be burned off and the therapeutic effect will not be satisfactory. Too much exercise, more than the body’s ability to bear, and will cause excessive fatigue, causing adverse reactions, affecting health. So, how to master the appropriate amount of exercise? The following two methods are commonly used.
1, measuring the pulse: the frequency of the pulse is generally proportional to the amount of physiological burden on the body. Pulse is a sensitive indicator of the state of body function, by measuring the pulse before and after exercise to grasp the size of the exercise is more scientific. The method of measurement is: before waking up in the morning, measure the number of quiet pulse, the offspring into the following formula for calculation: (200 – quiet pulse per minute) × 70% of the number of quiet pulse per minute, the result is the number of appropriate pulse per minute after exercise. If the number of pulse after exercise is similar to this score, it means that the exercise is appropriate. If it is more than 5 times lower than this score, it means that the exercise volume is small. If higher than the number of 5 times, that the amount of exercise is large.
2, body feeling: if the exercise after the fatigue, but good mental state, physical strength, good sleep, good appetite, that the amount of exercise is appropriate. If you feel very tired after exercise, limbs sore and heavy, the next morning is still very fatigue, and feel dizzy, weakness, poor appetite, sleep, bored with the feeling of exercise, indicating that the amount of exercise is too much, need to be adjusted in a timely manner. In determining whether the size of exercise is appropriate, the combination of these two measures, both objective criteria, but also by subjective feelings, it is more reliable. Maximum safe exercise heart rate = 220 – age, generally require exercise heart rate to reach about 60% to 70% of the maximum safe exercise heart rate is appropriate (i.e. 170 – age), if the situation is good, can gradually increase, everything to the body can tolerate, there is no adverse reaction, to achieve the purpose of healthy exercise as degree.
Walking, running, swimming, are all good methods suitable for people to exercise. Different methods, exercise intensity is not the same, according to the specific circumstances of the individual to select their own exercise program. Exercise to pay attention to the gradual, on the basis of the amount of exercise they have adapted to, and constantly beyond to adapt again, so that physical health to a higher level. General adults should not exceed the highest heart rate of 180 beats per minute when first practicing
1, sports exercise to ensure at least 3 to 5 times a week.
2, exercise time should be no less than 20 to 30 minutes, generally not more than 1 hour.
3, using heart rate and body feeling to determine the appropriate amount of exercise.
Measure the amount of exercise you have enough
How much exercise is appropriate for each person every day, which is really difficult to grasp. But an associate professor at Oklahoma State University has designed a method to determine the amount of personal exercise after years of intensive research. This is a simple and easy to use way to measure, you can also try it sometime.
Sleep: 0.85 points for each hour of sleep. Calculate how many hours you sleep per day, and keep score by the product of this unit.
Stationary activities: including desk work, reading, eating, watching TV, sitting in the car, etc. These activities have the lowest amount of movement, add up the time consumed in these activities and calculate by recording 1.5 points per hour.
Walking: 3 points per hour if it is a leisurely and slow walk; 5 points per hour if it is a brisk walk.
Outdoor activities: 6 points per hour for jogging, 7 points per hour for fast running; 8 points per hour for swimming and skating; 9 points per hour for various ball games and track and field sports; 4 points per hour for cycling; 3 points per hour for gymnastics and dancing.
Household chores: 5 points per hour.
Whenever you finish each activity of the day, you can add up the above points. If you get a total score of 45 points or less, it means that you are not exercising enough and should try to increase the amount of activity. If your total score is between 45 and 60, it means that you are exercising at the right amount. If your total score exceeds this limit, it can only mean that your activity level has been excessive and not more beneficial to your body, and it is time to adjust the exercise scale.
Third, drug treatment We use Chinese and Western medicine for different patients’ health conditions. The focus is on the cause of the disease and the accompanying diseases. For example, patients with fatty liver are often accompanied by hyperlipidemia, obesity, diabetes, hypertension, etc. Nowadays, there are many Chinese and Western medicines for fatty liver treatment. One of our specialties is to prescribe individualized Chinese and Western medicines through evidence-based treatment.
Fatty liver Chinese medicine treatment
1. Etiology and pathogenesis of fatty liver.
Fatty liver is not discussed in Chinese medicine, but according to its clinical manifestations, it should belong to the category of “phlegm, dampness, dampness, pain and accumulation” in Chinese medicine. The etiology of fatty liver is mainly due to dietary disorders, emotional and mental stagnation, and prolonged disorders. The disease location mainly involves the liver and spleen, and the pathogenesis mainly involves the loss of drainage of the liver, poor qi flow, and stagnation of liver ligaments; the loss of health and movement of the spleen, and internal accumulation of phlegm and dampness. The disease is characterized by stagnation of Qi, dampness and blood stasis.
2. Identification and treatment.
(1) Liver stagnation and qi stagnation type, with symptoms of fullness or distension in the liver, belching, emotional and mental discomfort, chest tightness and less nasal discharge, thin coating, and stringy pulse. The main treatment is to dredge the liver and regulate qi, supplemented by resolving dampness and eliminating blood stasis. The formula is based on Chai Hu Dredging Liver San with addition and subtraction, using Chai Hu, Citrus Aurantium, Fructus, Yu Jin, Yuan Hu, Bai Shao, Poria, Salvia, Shanzha, Jiang Huang, and Pendula.
(2) Spleen deficiency and dampness obstruction type, the symptoms are fatigue, no color or atrophy, little food and loose stool, light fat tongue, slippery moss, thin pulse. Treatment is to strengthen the spleen and resolve dampness, supplemented by draining the liver and invigorating blood. The formula is Ginseng and Atractylodes macrocephala with addition and subtraction, using Astragalus, Radix Codonopsis, Atractylodes, Poria, Radix Bupleurum, Eucommia, Radix Angelicae Sinensis, Salviae Sinensis, Hawthorn, etc.
(3) Phlegm and dampness are contained within the type, and the symptoms include abdominal and cavity fullness, plumpness, heavy limbs, shortness of breath, easy sweating, unpleasant bowel movements, white and greasy coating, and slippery pulse. Treatment is to expel phlegm and resolve dampness, supplemented by draining the liver and strengthening the spleen. The formula uses Er Chen Tang with flavour, and the medicines are mostly used in the form of Semen, Chen Pi, Yin Chen, Atractylodes, Atractylodes, Acorus calamus, Poria, Chai Hu, Yu Jin, Ze Xie, Cao Zhi Ming, Dan Shen and Shan Zha.
(4) Liver and kidney yin deficiency type, the symptoms are dry mouth and throat, dizziness, tinnitus and forgetfulness, lumbago and leg weakness, five heartburn, insomnia and dreaminess, spermatorrhea in men and menstruation in women, red tongue with little coating and fine pulse. Treatment is to nourish the liver and kidney, supplemented by draining the liver and invigorating blood. The formula uses Liu Wei Di Huang Tang with flavor, and the drugs used are Di Huang, Huang Jing, Fructus Lycii, Fu Ling, Chai Hu, Yu Jin, Ze Xie, Angelica, Dan Shen, Dan Pi, Hawthorn, etc.
(5) Blood stasis blocking the ligaments type, the symptoms are pain in the liver area, or even stabbing pain, pain with a fixed location, enlarged liver or/and spleen, with pressure pain, dark or purple tongue, thin and astringent pulse or thin string. Treatment is to activate blood circulation and eliminate blood stasis, supplemented by draining liver and Qi. The formula is based on the addition and subtraction of Diaphragmatic Stasis Removal Soup, which mostly uses Chuanxiong, Jianghuang, Angelicae, Tao Ren, Yimu Cao, Chai Hu, Citrus Aurantium, Yu Jin, Yuan Hu, Bai Shao, Fu Ling, Dan Shen, Shanzha, and Pendant Cao.
Acupuncture and physiotherapy Individualized acupuncture prescriptions or physiotherapy prescriptions are prescribed according to different patients and conditions. Using the theory of Chinese medicine and modern medical theory, through the combination of different acupuncture points and acupuncture techniques, or the use of biological force pump therapy instrument physical therapy, with the introduction of Chinese medicine ions, to improve the efficiency of liver “transport”, the excess fat out of the liver, reasonably used by the body, for the patient’s liver to do ” The patient’s liver is “cleaned up”. Clinical experiment observation, after 8 minutes of treatment, the average increase of blood flow into and out of the liver per minute is 2-3 times. 4 pairs of electrodes are placed on the right liver Yu, bile Yu, spleen Yu and other acupuncture points, and 30 minutes later, then do the circular path treatment, abdomen “Jin” circular path, back “Chuan” pathway, auricular pressure bean points, etc., or choose to cooperate with the above treatments. After one course of treatment for 30 times, the blood lipid decreased significantly, the rate of liver fat excretion was about 48%, so that the liver pain, abdominal distension, gastrointestinal symptoms, etc. were relieved or disappeared, and some enlarged liver and spleen were reduced to different degrees. The total effective rate of treatment was 90%, and the significant rate was 60%. Multispectral examination found that the blood supply to the liver increased significantly, and the fatty liver changed from moderate or severe to mild.
Eight misconceptions about fatty liver
In recent years, the prevalence of non-alcoholic fatty liver disease is gradually increasing. 8 years ago, a survey was conducted in Shanghai among white-collar workers, and the detection rate of fatty liver was 12.9%; nowadays, the proportion of fatty liver detected among white-collar workers has reached more than 20%, and there is a tendency of gradual under-ageing. However, there are still many misunderstandings about fatty liver.
One of the misconceptions: fatty liver is not a disease, it doesn’t matter if you look at it or not
In the past, people did not take fatty liver seriously, and even the medical profession used to think that fatty liver was at most a subhealth state, not a real disease, and would not cause hepatitis and liver fibrosis. There is no need to treat it at all. So is fatty liver a disease or not, and should it be treated?
Numerous studies in recent years have shown that NAFLD is a chronic disease that is closely related to lifestyle behaviors. The reasons for this are threefold: 1. At least 20% of NAFLD is non-alcoholic steatohepatitis rather than simple fatty liver, which is now clearly an important precursor lesion to cryptogenic cirrhosis and liver cancer and can lead to liver failure. 2. Even simple fatty liver is more fragile than normal liver and is more vulnerable to drugs, industrial toxins, alcohol, ischemia, and viral infections, which 3. For overweight and obese people, the appearance of fatty liver may suggest “malignant obesity”, because such people are prone to hyperlipidemia, diabetes and hypertension, and eventually the probability of coronary heart disease and stroke will increase significantly. For this reason, non-alcoholic fatty liver disease should be considered as a disease from the perspective of both liver disease and prevention of diabetes and cardiovascular diseases, and should be named non-alcoholic fatty liver disease. Therefore, even asymptomatic fatty liver found in health check-ups should not be taken lightly and should be treated in hospital in time.
Myth No. 2: Fatty liver is not curable at all
Clinically, many patients with fatty liver have visited many hospitals for a long time and tried a lot of drugs, but they do not see any improvement, so they pessimistically believe that fatty liver cannot be cured.
In fact, simple fatty liver is an early manifestation of various hepatotoxic injuries, and if the cause is removed and the primary disease is controlled in a timely manner, the fatty deposits in the liver can be completely eliminated within a few months. For example, alcoholic fatty liver is absolutely effective in abstaining from alcohol. Most drug and industrial toxicity fatty liver can be recovered after timely discontinuation of drugs or removal from toxic working environment. Obesity fatty liver can also subside quickly if weight control and waist circumference reduction are effective. However, if simple fatty liver has developed into steatohepatitis, it often takes half a year or even more than a few years for the lesion to fully recover, and in a few cases, even if the cause is removed, it can still progress to irreversible cirrhosis. Therefore, early diagnosis and treatment of fatty liver should be strengthened. Some patients with fatty liver may have difficulty recovering because of untimely treatment or inappropriate treatment methods and insufficient treatment courses.
Myth No. 3: Treatment of fatty liver mainly relies on drugs
Many patients often turn to major hospitals or pharmacies for special drugs to treat fatty liver, but in fact, no special drugs for fatty liver have been found at home and abroad. In fact, no specific medicine has been found for fatty liver treatment at home and abroad. The comprehensive therapy based on diet adjustment and proper exercise, combined with medicine, physiotherapy and acupuncture is a better method at present. Therefore, fatty liver patients must understand the importance of active participation in treatment and strive to identify and correct their poor diet and lifestyle habits, and never think that they can get healthy simply by spending money on medication.
Myth No. 4: With fatty liver, you have to take lipid-lowering drugs
Although hyperlipidemia and fatty liver are closely related, the two are usually not causally related, and there are no formal clinical trials at home and abroad on the effectiveness of lipid-lowering drugs in reducing fatty deposits in the liver. For this reason, it is not always necessary to take lipid-lowering drugs when you have a fatty liver, and the improper application of lipid-lowering drugs can sometimes aggravate liver damage instead of reducing fatty liver. The reason for this may be that the appearance of fatty liver represents the limit of the liver’s ability to deal with disorders of lipid metabolism, and at this time, the use of lipid-lowering drugs is equivalent to “whipping a fast cow”, that is, the fatty liver’s tolerance to lipid-lowering drugs is reduced, and improper application is prone to drug-related liver disease. If the fatty liver is not accompanied by hyperlipidemia, do not use lipid-lowering drugs. If hyperlipidemia is present, it is necessary to decide whether to use lipid-lowering drugs according to the cause and degree of hyperlipidemia and the probability of atherosclerotic cardiovascular and cerebrovascular lesions. Those with a family history of hyperlipidemia and a significant increase in blood lipids should be treated with lipid-lowering drugs, because at this time lipid-lowering drugs can play a role in “treating both the symptoms and the root cause”.
Myth No. 5: Fatty liver with elevated transaminases only need to take enzyme-lowering drugs
In the past, people often mistakenly believe that increased serum aminotransferase is hepatitis, and as long as the aminotransferase is reduced to normal, the fatty liver will be fine. This approach may conceal the disease and lead to deterioration of the liver disease by relaxing the basic treatment.
Epidemiological surveys have shown that increased transaminases in adults and children with fatty liver are mainly associated with obesity and fatty liver. A weight loss of 5-10% in 3-6 months can reduce the increased serum transaminases to normal levels in obese fatty liver patients. It has been reported that for every 1% reduction in body weight, transaminases decreased by 8.3%. With a 10% reduction in body weight, the increased transaminases basically return to normal, with the enlarged liver shrinking back and fatty liver reversing. In contrast, transaminases tend to continue to rise in people with high body weight, and even the application of liver-protective and enzyme-lowering drugs is not effective.
Myth No. 6: Fatty liver with elevated transaminases cannot be more active
Unlike viral hepatitis, non-alcoholic fatty liver disease does not require rest and nutrition, nor does it require disinfection and isolation measures. However, many patients with increased serum aminotransferases are less active and more rested, resulting in weight and waist circumference gain, abnormal serum aminotransferases and persistent fatty liver.
Epidemiological surveys have shown that obese fatty liver with elevated transaminases is closely related to a westernized diet and a sedentary lifestyle, and that moderate weekly aerobic exercise is an effective treatment measure along with a moderate diet. Therefore, instead of taking more rest, patients with fatty liver with elevated transaminases need to increase their exercise.
Myth #7: Fatty liver or elevated aminotransferases are contagious
Fatty liver is different from viral hepatitis, it is caused by fat deposition in the liver, fat and increased transaminases are not infectious. Viral hepatitis, on the other hand, is caused by the hepatitis virus and is contagious regardless of whether the transaminases are elevated or not.
Myth No. 8: Fatty liver patients should eat more fruit
Fresh fruit is rich in water, vitamins, fiber and minerals, and it is undoubtedly beneficial to health when consumed regularly. However, the health effects of fruit are not the better. Because fruit contains certain sugars, long-term excessive eating can lead to blood sugar, lipid elevation, and even induce obesity, so obesity, diabetes, hyperlipidemia and fatty liver patients should not eat more fruit. As far as possible, you should choose fruits with low sugar content, and the amount should not be too much, if necessary, to turnip, cucumber, tomatoes and other vegetables instead of fruit. Try to eat fruits before meals or when you are hungry between meals, in order to reduce the amount of regular meals eaten. Similarly, milk rich in protein and calcium is good for health in moderation, but a glass of milk before bedtime may not be appropriate for obese fatty liver patients because it can easily lead to excess calories.
In short, at present, for the masses of people after the solution of food and clothing, what is lacking is not “nutrition (calories)”, but exercise. What is urgently needed is not supplements and drugs, but a scientific lifestyle. As long as we do “eat less, move more, drink less and use drugs carefully”, we will be able to control fatty liver effectively.