I. What is fatty liver
Excessive accumulation of fat in the liver caused by various internal and external factors, with fat content in the liver exceeding 5%, is medically known as fatty liver. Some other diseases of human body can affect the fat metabolism of liver and cause fat accumulation in liver, so in the past, fatty liver was only regarded as a pathological state and pathological process, but not as an independent disease listed in the category of chronic liver disease. In recent years, with the development of medical impact technology and in-depth research on fatty liver, fatty liver has been diagnosed as an independent disease. The fat in the liver is mainly neutral fat, i.e. triglycerides, but also a small amount of cholesterol and lecithin.
Second, how fatty liver is formed
The liver is an important digestive organ of the human body, which plays a very important role in the digestion, absorption, oxidation, decomposition, synthesis and transport of fat, and maintains its dynamic balance. Fat accumulation in the liver can be compared to a processing middle, how does it produce the accumulation of products and raw materials? Experience tells us: first, too much raw material into the shop, more than the processing capacity of the shop to produce a pile; second, the shop efficiency decline to produce a pile; third, the product can not be transported out in time also produce a pile. In fact, the formation of fatty liver is also the same reason. Excessive intake of fatty food, reduced function of liver to metabolize fat or reduced ability to transfer fat, reduced human activity and reduced fat consumption will all cause the accumulation of fat in the liver, the key is to find the main contradiction and seize the main contradiction to treat the disease in the village in order to get twice the result with half the effort.
Third, what people are easy to get fatty liver
1, middle-aged and elderly people are prone to fatty liver. Ageing metabolic function gradually decline, the amount of exercise to reduce the formation of fatty liver.
2, obese people are prone to fatty liver. Research shows that in more than 10% of the standard weight of the population, liver fat deposits <72%, fat highly deposited 20%. On the one hand, the obese blood free fatty acids greatly increased, and a constant source of transport to the liver, on the other hand, some obese people have hyperinsulinemia, promote the liver synthesis of fatty acids, and eventually turn. Transformed into neutral fat deposits in the liver.
3, gluttonous people are vulnerable to fatty liver. All day long chicken, duck, fish and meat, thick and thick taste, the intake of fatty foods too much. Increase the metabolic burden of the liver, resulting in excessive fat deposition in the liver.
4, greedy drinkers are prone to fatty liver. Alcohol into the body, the vast majority of the liver metabolism, decomposition, its intermediate metabolites acetaldehyde damage to liver cells, resulting in fatty acid metabolic dysfunction, the more alcohol consumption of fatty acid accumulation in the liver. The three steps of alcoholic liver disease: alcoholic fatty liver – alcoholic hepatitis an alcoholic cirrhosis.
5, less active people are prone to fatty liver. Less activity leads to excess nutrients in the body into fatty liver, these fat deposits in the subcutaneous manifestation of obesity, deposited in the liver manifestation of fatty liver.
6, high blood lipid people are prone to fatty liver. The high concentration of cholesterol and triglycerides in the blood reaches the liver with the blood circulation and exceeds the metabolic capacity of the liver, easily causing fatty liver.
7, diabetic patients are prone to fatty liver. Diabetes is a metabolic disease caused by absolute or relative insulin deficiency. Sexual diseases, characterized by increased blood sugar, can also cause protein and lipid metabolism disorders. The decrease in sugar utilization promotes the release of free fatty acid into the bloodstream by adipose tissue, resulting in the formation of fatty liver by synthesizing and storing triglycerides in the liver. Studies have shown that type l diabetes
Patients with combined fatty liver and the degree of weight gain is closely related.
8. People with a family history of fatty liver are prone to develop fatty liver. This is mainly related to genetic factors.
9, long-term dieting and weight loss or long-term hunger resulting in malnutrition, also prone to the formation of fatty liver.
Four, the classification of fatty liver
According to the causes of fatty liver formation, fatty liver can be classified as follows: obese fatty liver, alcoholic fatty liver, hyperlipidemic fatty liver, post-hepatitis fatty liver, diabetic fatty liver, drug fatty liver, toxic fatty liver, pregnancy fatty liver, malnutrition fatty liver, hyperthyroid fatty liver, cortisol fatty liver, inflammatory fatty liver, genetic fatty liver, etc. According to According to the proportion of fat composition, it is divided into neutral fatty liver, oval fatty liver and cholesterol fatty liver.
V. Classification of fatty liver
According to the ultrasound examination combined with clinicopathological characteristics, fatty liver is classified into diffuse fatty liver and non-uniform (focal) fatty liver. According to the size of lipid droplets in hepatocytes, fatty liver is divided into large-vesicular, small-vesicular and mixed fatty liver. Large-vesicular fatty liver has a slow onset, mild symptoms, and a large liver. Small vesicular fatty liver has a rapid onset and is serious and even life-threatening.
VI. Staging of fatty liver
According to blood biochemistry and ultrasound examination combined with clinicopathological characteristics, there are three stages: simple fatty liver. Steatohepatitis. Fatty cirrhosis. Simple fatty liver generally has no obvious clinical symptoms and signs, normal or slightly elevated liver function index, normal or mildly elevated lipid index, and mild or moderate changes in ultrasound; fatty hepatitis has more obvious clinical symptoms and signs, with weakness, shortness of breath. Anorexia, discomfort in the liver area, hepatosplenomegaly, etc., with obvious abnormal liver function and moderate changes in ultrasound; fatty cirrhosis with obvious clinical symptoms and signs, liver tang, spider nevus, and hepatosplenomegaly. The texture is hard, the tongue is purple and dark with petechial hemorrhagic spots, varices at the base of the tongue, abnormal liver function, widening of portal vein and splenic vein, abnormal blood clotting mechanism, esophageal veins, and the ultrasound is often “bright liver”.
VII. Classification of fatty liver
According to ultrasound examination or pathological examination, it is divided into mild, moderate and severe. Mild liver fat content is 5-10%; moderate liver fat content is 10-25%; severe liver fat content is more than 25%.
Mild fatty liver: slightly thickened and enhanced echogenicity in the anterior half of the ultrasound liver section, reduced echogenicity in the posterior half of the liver section, and the presence of light bands on the liver surface.
Moderate fatty liver: the echogenicity of the anterior half of the ultrasound liver section is thick and strong, the echogenicity of the posterior half of the liver section is significantly reduced, and the light band on the liver surface is decreased.
Severe fatty liver: ultrasound echogenicity in the anterior half of the liver section is obviously thickened and enhanced, the echogenicity in the posterior half of the liver section disappears, and the light band on the liver surface is not obvious.
Eight, one of the hazards of fatty liver: damage to the liver
Fatty liver is a product of dysfunction of liver lipid metabolism, and at the same time, it is a causative factor that aggravates liver damage, which is a mutually causative and vicious circle development. The increase of lipid droplets in hepatocytes causes fatty degeneration and enlargement of hepatocytes, and the nuclei are squeezed off-center. The accumulation of fat in the hepatocytes further burdens the mitochondria and endoplasmic reticulum reducing their function, which in turn affects the metabolism of other nutrients, hormones and vitamins. Long-term hepatocyte degeneration can lead to regeneration disorders and necrosis of liver cells, which in turn form liver fibrosis and cirrhosis.
Nine, fatty liver harm two: promote the formation of atherosclerosis
Fatty liver patients are often accompanied by hyperlipidemia and increased blood viscosity, in which low-density lipoprotein (LDL), because of its very small molecular weight, can easily cross the inner membrane of the arteries and settle in the vessel wall, making the arteries less elastic, narrowing the diameter and weakening the flexibility, eventually leading to impaired blood circulation and rupture of blood vessels, endangering life.
Ten, fatty liver harm of three: induce or aggravate hypertension, coronary heart disease
Arteriosclerosis and hypertension, coronary heart disease is very close, research shows that alcoholic fatty liver patients combined with hypertension, coronary heart disease, easily lead to myocardial infarction and sudden death.
Eleven, the dangers of fatty liver four: encephalopathy fatty liver syndrome (Reye’s syndrome)
Also known as visceral steatosis encephalopathy. Its pathogenesis is unclear, mitochondrial damage and loss of enzymatic activity is the basis of its pathology. The pathological changes are mainly diffuse cerebral edema and severe hepatic steatosis, with an enlarged liver and firm texture. It is accompanied by significant cerebral symptoms: convulsions, progressive impairment of consciousness and even coma, with a morbidity and mortality rate of 70-80%.
Twelve, fatty liver harm five: lead to cirrhosis, liver failure, liver cancer
The final result of various liver diseases is often cirrhosis, and fatty liver is no exception, and the chance of cirrhosis secondary to hepatocellular carcinoma is higher. Liver cirrhosis is further divided into compensated and decompensated stages. Once cirrhosis develops to the decompensated stage, liver coma, liver ascites, gastrointestinal hemorrhage, liver failure, liver and kidney syndrome are likely to occur, which is not far from the end of life.
Thirteen, the danger of fatty liver six: acute pregnancy fatty liver, high mortality rate
This disease, also known as obstetric acute yellow liver atrophy, is a relatively rare and dangerous prognosis of pregnancy complications. It occurs mostly in the last trimester of pregnancy and is often clinically similar to acute severe liver disease, which can lead to acute liver failure, pancreatitis, renal failure, systemic coagulation abnormalities and rapid death, mostly in first-time pregnant women. Typical cases are characterized by rapid onset, nausea, vomiting, epigastric pain, back pain, varying degrees of hypertension, edema, progressive increase in jaundice, coma, ascites, large skin petechiae, blood in the stool and blood in the urine within a short period of time. Once the diagnosis is clear, the pregnancy should be terminated immediately, which is the only effective way, if the liver failure and coagulation dysfunction in the late stage, and then perform caesarean section or induction of labor, there may be postpartum hemorrhage, endangering the life of mother and child.
Fourteen, the danger of fatty liver seven: induce or aggravate diabetes
Diabetes is a chronic systemic metabolic disease of unknown etiology, mainly due to insufficient insulin secretion or insulin resistance and the formation of glucose metabolism disorders, characterized by hyperglycemia, hyperlipidemia and hyperaminoacidemia. According to the survey, about 50% of diabetic patients are combined with fatty liver, and about 30-40% of old people with fatty liver are combined with diabetes. The blood sugar level of fatty liver patients is significantly higher than normal, and if the blood sugar concentration of obese fatty liver patients exceeds the normal level, they are generally considered to be pre-diabetic although they have not reached the diagnostic standard of diabetes. Fatty liver and diabetes are a pair of difficult brothers and sisters, both of them will bring more difficulties to the treatment, losing both and accelerating the development of the disease.
Fifteen, fatty liver hazards of eight: hepatitis B combined with fatty liver to accelerate the development of cirrhosis
Clinical investigation found that chronic viral hepatitis B and C combined with fatty liver will increase the occurrence and development of liver fibrosis, shortening the development of chronic hepatitis to post-hepatitis cirrhosis time. Liver fibrosis is an inevitable pathological process in the development of slow liver to cirrhosis, and liver fibrosis is due to an imbalance in the metabolism of extrahepatocellular collagen matrix and non-collagen matrix to form basement membrane, resulting in capillarization of liver blood sinusoids, which is the molecular pathological basis of liver fibrosis. The fatty liver makes the originally damaged liver cells further decline in function, which is bound to snow seven add frost to accelerate the process of liver fibrosis, prompting the formation of cirrhosis.
Sixteen, the harm of fatty liver B nine: reduce the body’s immune function. Detoxification function
The liver is the largest reticuloendothelial cell phagocytosis system, it can transform the human invasion and endogenous various antigens through phagocytosis, isolation and elimination, hepatocyte steatosis or necrosis, so that the liver’s immune function decreases, fatty liver affected exam often accompanied by hepatosplenomegaly. The spleen is also an important immune organ in the human body, and splenomegaly can cause splenic function to resist advancement. Lymphatic T cells and B cells mature and differentiate in the spleen, and abnormal spleen function inhibits the function of cellular immunity, so patients with fatty liver are more likely to be infected due to reduced immune function and poor resistance. In addition, some harmful wastes and foreign toxins and toxins produced during human metabolism, including the metabolism and decomposition products of drugs, have to be detoxified in the liver, and liver cells change all toxic substances into harmless substances by oxidation, reduction, hydrolysis and binding. After the fatty degeneration of liver cells, the detoxification function is reduced, which easily causes the retention of endotoxins and exotoxins in the body and causes poisoning to the organism.
Seventeen, fatty liver ten: the damage to the body’s digestive system
The stomach, intestines, liver and gallbladder are all important organs of the digestive system. The body takes in three major nutrients (protein, fat and sugar) that have to be metabolized by the liver in order to be used by the body, and fatty liver patients have impaired liver function, which will involve the spleen, gallbladder, stomach and intestines over time. According to Chinese medicine, ‘when we see liver disease, we know that the liver transmits the spleen, so we should first strengthen the spleen’, and ‘the spleen is the master of transportation and transformation’; Chinese medicine also believes that ‘the liver and gallbladder are mutually exclusive’. Liver disease often affects the function of the gallbladder, and clinical studies have confirmed that about 20-30% of fatty liver patients have chronic cholecystitis and cholelithiasis.
Eighteen fatty liver harm eleven: reduce the quality of life, affect the development of career
When people are checked to have hepatitis B and C, they will be shocked because they know how powerful viral hepatitis is. Classmates, colleagues and family members will be worried about being infected and refuse to approach you, which will affect further education, employment, joining the army, going abroad, getting married and so on, so they will actively treat. When people are found to have fatty liver, they often don’t care and don’t go for treatment. It is this paralysis that causes fatty liver to develop from simple fatty liver to steatohepatitis unknowingly, and once the various clinical symptoms and signs are aggravated and liver function is obviously abnormal, then to “mend the fold” may cost more money and time, which is very It is not wise. Due to the improvement of living conditions, the onset of fatty liver is developing rapidly towards young people and even children; due to the modernization of office conditions, people’s activities are decreasing day by day, and friends’ gatherings, social functions and rich night life are the breeding ground for fatty liver. According to the survey in Shenzhen, Guangzhou and Xiamen, the prevalence of fatty liver in men around 30 years old is about 20-30%. Some of them have symptoms such as dizziness, shortness of breath, loss of energy, decreased physical strength, anorexia, fatigue, reduced sexual function, chest tightness, liver pain, memory loss, irritability, and often no clear fire, which show that they are unable to cope with the fierce competition and affect the development of their career. As the saying goes, a shopping mall is like a battlefield. The winner must be the one with excellent overall quality of energy, physical strength, intelligence and ability. We sincerely hope that your career will not be destroyed by the invisible killer of fatty liver, early diagnosis and early treatment to meet the challenge!
I. Self-diagnosis of fatty liver
1.Whether there is obesity
Mark good weight: male: (height – 105cm) kg, female (height – 100cm) kg
More than 10% of the standard weight Overweight
More than 20% of the standard weight Mild obesity
More than 30% of standard weight Moderate obesity
More than 50% of standard weight Severe obesity
If you belong to obesity, the possibility of developing fatty liver is about 50%.
2.History of alcohol consumption
(1) Drinking 80-120ml of strong alcohol per day for more than 10 years, 90% have fatty liver, 35% have spilled hepatitis, and 10% have alcoholic cirrhosis.
(2) Each sip of alcohol contains 80-100ml of alcohol, (alcohol amount = drinking volume x drinking degree x 0.8) for 5 consecutive years can lead to fatty liver, and 20 consecutive years can lead to cirrhosis of the liver. Some experiments have shown that healthy people with a daily alcohol intake of more than 100ml can form an alcoholic fatty liver for 10-l2 days in a row.
(3) Drinking 3 bottles of beer per day for 5-10 years can also cause fatty liver. The formation of alcoholic fatty liver is related to individual differences. Those with low tolerance are more likely to form fatty liver, and fatty liver can be formed rapidly by drinking large amounts of alcohol in a short period of time.
3. Whether the blood lipid is high during the usual examination.
Hyperlipidemia and fatty liver are mutually beneficial, and about 30-50% of old people with hyperlipidemia have fatty liver in combination. If it is accompanied by elevated transaminases (ALT), it is highly suspected that fatty liver is present.
4. Whether blood sugar is high.
If diabetes or blood sugar exceeds the normal range, about 50% may be combined with fatty liver, and if obesity + diabetes, the possibility of fatty liver is great.
5, rapid weight loss or jejuno-ileal bypass surgery to lose weight.
Obesity caused by excess nutrition is certainly easy to induce fatty liver, artificial dieting, anorexia caused by malnutrition can also be formed fatty liver. This is because low blood sugar stimulates sympathetic nerve function, fat group level mobilization of a large number of fatty acids into the blood to replenish energy, the increase in free fatty acids in the blood, super, over the liver’s lipid metabolism capacity, the formation of fat accumulation in the liver. In addition, the protein intake is insufficient, so that the synthesis of apolipoprotein is impaired, the ability of fat to turn away is reduced, blood lipids are elevated, liver fat can not be transported out in time, resulting in intrahepatic fat accumulation. If the recent weight loss is large and fast (more than 5Kg per month), it is very easy to induce or aggravate fatty liver. The incidence of fatty liver is higher within six months after surgical weight loss, and about 10% develop into cirrhosis after 10 years.
6, the first pregnancy of primigravida such as elevated blood lipids, or commonly used tetracycline disorder is easy to form fatty liver, should be highly alert.
7, drug-induced fatty liver. Such as tetracycline, lactic acid, adrenal cortical stimulation disorder; glance at the purine .
8, childhood obesity. Calculation of children’s body mass index BMI: weight (Kg) / (height cm) generally > 22 can be considered obese, the greater the BMI value, the higher the incidence of fatty liver.
9, on the basis of the above several self-judgment, combined with the presence of clinical symptoms, further comprehensive analysis, such as whether anorexia, fatigue, mental discomfort, dizziness, eyes, abdominal distension and chest tightness, poor sleep, discomfort in the liver area, etc., you can initially analyze whether you or your family is likely to suffer from fatty liver, and then go to the hospital for diagnosis and treatment.