In recent years, more and more patients are being seen in outpatient clinics for fatty liver, accounting for almost 50% of the outpatient volume, and their age has a tendency to be younger and younger. According to epidemiological surveys, obesity, type 2 diabetes, hyperlipidemia and alcoholism are the main reasons for the rapid increase of fatty liver, which has become an accomplice of fatty liver and seriously affects human health. Let’s take a look at how these accomplices hurt the human body and how we can take countermeasures? (1) obesity: excessive fat accumulation in the human body, weight more than 20% of the normal standard weight is called obesity. Normal standard weight (kg) = [height (cm) – 100] × 0.9. When eating more calories than consumption, excess nutrients in the form of fat stored in the body is formed obesity. Obesity leads to the body fat layer is too thick, especially triglyceride accumulation too much and cause human body pathology, physiological changes. Evaluation standard: obesity = (actual weight – standard weight) ÷ standard weight × ± 100%. 50% of adult obese people suffer from fatty liver, and the detection rate of fatty liver of heavy obese people can be as high as 90%. Obesity is the main cause of fatty liver because the fat content in the liver increases while fat accumulates in the whole body. Due to excessive intake of lipids and sweets and lack of exercise, the excess nutrition increases the surrounding adipose tissue, and the free fatty acids released into the blood increase one after another, and a large amount of fatty acids are constantly transported to the liver; on the other hand, because some obese people have hyperinsulinemia, which promotes the synthesis of fatty acids by the liver, as a result, a large amount of fatty acids accumulate in the liver, far exceeding the transport and processing capacity of the liver, so they are The result is that a large amount of fatty acids accumulate in the liver, far exceeding the transport capacity of the liver, and are then converted into neutral fat deposits in the liver, thus forming a fatty liver. Therefore, obesity is an independent risk factor for fatty liver, and it is also the culprit of diabetes, hypertension and coronary heart disease. In addition to family genetic factors, drugs and endocrine disorders, the most important thing is that obesity is closely related to dietary habits and lifestyle. In today’s society, there is a wide variety of food, all kinds of food often lure you, plus “eat a meal” has become almost a common entertainment, which of course becomes the main reason for obesity. In addition, in daily life, with the development of transportation, the mechanization of the work environment, the reduction of the amount of domestic work, etc., so that the body consumes less and less calories, but the intake of energy is not reduced, and the formation of obesity. Obesity leads to daily activities more and more slow, lazy, more again reduce the consumption of calories, leading to a vicious circle, to promote the occurrence of obesity. Response: First of all, we must have strong perseverance and motivation to lose weight, which is very important. Second, to control the amount of diet and the quality of the diet, you can take a meal before drinking soup or porridge, chew food slowly, each bite of food to chew 30-50 times, so that you can have a sense of satiety, in order to reduce the amount of food. For the quality of the diet to eat more coarse grains, such as mixed grains, a variety of beans, buckwheat, oats, brown rice, seaweed, kelp, vegetables, etc. Try not to eat fried, high-fat, high-sugar, creamy foods, do not drink drinks, and firmly eliminate the “midnight snack”. Develop a good lifestyle and regular exercise habits. In addition, it should be noted that weight loss should not be rushed, but should be gradual, with a weight loss of no more than 1.5 kg per week. In addition, for young people who are becoming increasingly affluent, it is important to be vigilant and control the increase in the ratio of abdominal circumference to hip circumference to avoid the appearance of a large abdominal “general belly” to prevent fatty liver. (2) Hyperlipidemia: The concentration of lipids in the blood exceeds the normal range. Lipids are the general term for the lipids contained in human blood, the most important of which include cholesterol and triglycerides. When cholesterol and triglycerides exceed the normal range, they are collectively referred to as hyperlipidemia. Hyperlipidemia is an “invisible killer” and a major factor in the development of atherosclerosis. It often causes serious consequences by invading vital organs, such as fatty liver, hypertension, coronary heart disease, diabetes, pancreatitis, stone disease, etc. Blood lipids are insoluble in water and combine with proteins to form lipoproteins, which play different roles in the body. Low-density lipoprotein cholesterol (LDL-C) is the primary lipoprotein that causes atherosclerosis. Elevated LDL is harmful to the human body because it means that too much LDL is deposited in the arterial blood vessel walls, forming atheromatous plaque, and the narrowing or rupture of blood vessels with plaque can directly lead to stroke, myocardial infarction, or sudden cardiac death. The higher the level of it in the body, the greater the risk of atherosclerosis, so LDL is a risk factor for coronary heart disease. High-density lipoprotein cholesterol (HDL-C) is a lipoprotein that protects arterial blood vessels. High-density lipoprotein (HDL) is called good cholesterol because the cholesterol it carries is not deposited and there is also the effect of excluding LDL. Its main function is to transfer cholesterol from surrounding tissue cells to liver, metabolize and excrete excessive cholesterol to maintain normal plasma cholesterol level, and it is known as anti-atherosclerotic plasma lipoprotein and a protective factor for coronary heart disease. Countermeasures: A proper diet is an effective and necessary measure to treat and prevent hyperlipidemia. Human lipids include both fats and lipids, mainly from the diet, and only a portion of lipids are synthesized in the body, called endogenous lipids. Diet control is very important for the prevention and treatment of hyperlipidemia. The diet should be light and mainly vegetarian, but it should not be vegetarian for a long time, otherwise the diet composition is not perfect, but can cause endogenous cholesterol increase. It is advisable to limit high-fat, high-calorie, high-cholesterol diet, such as animal brain marrow offal, crab meat, shrimp, butter, etc. Fat intake should be limited to 30-50 grams per day. Sugary foods should also be limited and no sweets and snacks should be eaten. Eat more vegetables and fruits. Three meals should be regular, hunger and satiety in moderation, should not use starvation therapy, excessive hunger instead of accelerating the decomposition of body fat, so that the fat in the blood increases. (3) Diabetes: diabetes is a chronic systemic metabolic disease with persistent hyperglycemia as its basic biochemical characteristics, mainly due to the absolute lack of insulin secretion in the body or the relative lack of insulin caused by the increase in the body’s demand for insulin, insulin resistance, resulting in a comprehensive disease based on disorders of glucose metabolism. Insulin is the only hypoglycemic hormone in the body secreted by the B cells of the human pancreas. Insulin resistance refers to the reduced sensitivity of peripheral tissues in the body to insulin, and the resistance of peripheral tissues such as muscle and fat to insulin to promote glucose absorption, conversion and utilization. Clinical observation insulin resistance is prevalent in type 2 diabetes, up to about 90%. According to epidemiological surveys, 21%-78% of diabetic patients suffer from fatty liver, and type 2 diabetic patients are a high prevalence of fatty liver. When glucose metabolism is abnormal and insulin resistance is present, the release of free fatty acids into the blood increases and hyperlipidemia is likely to occur. The increase in free fatty acids entering the liver and synthesizing triglycerides, which are stored in the liver, leads to disorders of fat metabolism in liver cells and fat deposition in the liver and causes fatty liver. Response: Once diagnosed with fatty liver, in addition to clarifying the cause of fatty liver, blood glucose should be checked in time to clarify whether there is a combination of abnormal sugar metabolism. It should be reminded that many patients with fatty liver only show elevated postprandial glucose and normal fasting glucose, so if only fasting glucose is checked, a large number of people with elevated postprandial glucose will be missed. Therefore, patients with fatty liver should routinely undergo glucose tolerance test and glycated hemoglobin test to understand fasting and postprandial blood glucose respectively, as well as the changes in blood glucose in the past 3 months. Once abnormal glucose tolerance or diabetes is detected, patients should receive immediate treatment to try to control blood glucose in the normal range in order to reduce the occurrence of various complications. Patients with fatty liver with normal blood sugar should not let down their vigilance either, and must go to the hospital to review fasting and 2-hour postprandial blood sugar every 3 to 6 months, so as to detect the problem early and treat it early. By the same token, for diabetic patients, regular review of liver ultrasound and liver function can help detect fatty liver at an early stage and protect liver function. Controlling blood sugar is the key to preventing and treating diabetes, and stable blood sugar can prevent many complications. In summary, diabetes prevention and control requires a comprehensive approach in five areas, which in China is imaginatively called the “five carriages” of diabetes prevention and control (education and psychotherapy, diet therapy, exercise therapy, medication therapy and disease monitoring). Diet therapy is the basic treatment for diabetes, and the basic principle of its diet is four low, namely low fat, low cholesterol, low carbohydrate (low sugar), low calories. You can eat more foods with low calories and high volume, such as various vegetables: tomatoes, cucumbers, cabbage, vegetable melons, etc., and fruits such as apples, oranges, strawberries, kiwis, etc., which have relatively low sugar content. You can use low-calorie vegetables, half a couple of staple foods or an egg (50g), a glass of milk (150ml), etc., and use coarse grains instead of fine grains to increase the feeling of satiety. Also increase your knowledge of diabetes to reduce the harm caused by ignorance. Moderate exercise can reduce blood sugar, regular monitoring of blood sugar and its related blood pressure, blood lipids, weight, etc. (4) Alcoholism: According to statistics, the incidence of fatty liver among alcoholics accounts for 57.6%, and compared with other types of fatty liver, alcoholic fatty liver has a relatively rapid process of liver fibrosis and cirrhosis, and the incidence is relatively high. The amount and duration of alcohol consumption are directly related to the occurrence of alcoholic fatty liver, and not much related to the type of alcohol. If the alcohol content in alcohol consumption is less than 80 grams per day, alcoholic fatty liver generally does not occur; if it is in the range of 80-160 grams per day, the incidence of fatty liver can increase 5-25 times; if 300 grams are consumed per day, fatty liver can appear in 8 days. The alcohol conversion formula is: g = amount of alcohol consumed (ml) × alcohol content (%) × 0.8. It is the liver that is most damaged by excessive alcohol consumption. The liver is the body’s largest chemical plant, and more than 95 percent of the alcohol consumed in the body has to be metabolized by the liver. If you drink alcohol in an uncontrolled manner, it will not only cause fatty liver, but also alcoholic hepatitis and alcoholic cirrhosis. Mild and moderate fatty liver is mostly asymptomatic, only when it develops into alcoholic hepatitis and cirrhosis, will there be tiredness, less food, bloating, less urination, hand tremor, jaundice, enlarged liver and spleen, ascites, dilated capillaries on the face and forehead, vermilion palm, etc. Response: 1. Quit drinking: alcohol has a strong toxicity to liver cells, 95% of alcohol directly affects the metabolic function of protein and fat, thus reducing the detoxification capacity of the liver and leading to alcoholic fatty liver. Once the appearance of alcoholic liver no matter which phase belongs to the disease in the process of treatment and disease recovery, must be absolutely prohibited from drinking alcohol. For people with liver disease who have been drinking alcohol for a long time, it should be absolutely forbidden to drink. In general, most alcoholic fatty liver is completely reversible after abstaining from alcohol.2. Have strong perseverance to stop drinking.3. Early detection and treatment: For long-term drinkers and people with liver or digestive system diseases, they should go to the hospital regularly for liver function and physical examination. In addition fatty liver accomplices include hypertension, hyperuricemia, cholelithiasis, endothelial vascular disorders, etc. Many scholars believe that fatty liver is a manifestation of the metabolic syndrome in the liver. It is a component of the metabolic syndrome. In short, improving the diet and lifestyle is the only effective way to treat fatty liver and other metabolic syndromes. U.S. Senator George McCowan, in 1977, was the first person to be involved in the treatment of fatty liver disease. In 1977, U.S. Senator George McGovern made an interesting report on food and health, suggesting that “improvements in diet and lifestyle can reduce heart disease by 25 percent, diabetes by 50 percent, obesity by 80 percent and cancer by 20 percent.” Please protect your liver, treat your body well and cherish your life.