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 been rapidly increasing in recent years in Europe, America and China, becoming the second most common liver disease after viral hepatitis. In China, it is the most prevalent liver disease.
The average incidence of fatty liver in certain occupational groups (white-collar workers, cab drivers, professional managers, individual owners, government officials, senior intellectuals, etc.) is 25%; the incidence of fatty liver in obese people and type II diabetic patients is 50%; the incidence of fatty liver in sub-healthy people with frequent insomnia, fatigue, lack of food and drink, and gastrointestinal dysfunction is about 60%. In recent years, the age of people with fatty liver has also been decreasing, with an average age of only 40 years old, and more and more patients around 30 years old, with more men under 45 years old with fatty liver than women.
What are the common causes of fatty liver?
1.Obesity fatty liver
The degree of fat accumulation in the liver is proportional to the weight. 30% to 50% of obesity is combined with fatty liver, and 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.Fast weight loss fatty liver
Fasting, excessive dieting or other rapid weight loss measures can cause a large increase in lipolysis in the short term, consuming glutathione (GSH) in the liver, causing a large increase in malondialdehyde and lipid peroxides in the liver, damaging liver cells and leading to 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, which cannot 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, about 1,5% to 8,0% of patients can progress 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 a proper nutritional mix during diet control and to avoid some common misconceptions.
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 beneficial to health, but exercise for special populations needs to be done under the guidance of a physician or health manager, such as those with combined bone and joint disease, cardiovascular disease, diabetes, and excessive obesity.
Are there any specific medications for fatty liver?
Numerous studies have shown that antioxidant medications are effective in treating fatty liver hepatitis. For example, vitamin E, silymarin, polyene-phosphatidylcholine, etc., as well as the characteristic Chinese medicine. However, these drugs should be applied under the guidance of a physician. For example, high doses of vitamin E have the most reliable effect, but long-term use should be wary of its effects on vision, blood clotting, and endocrine function.
What are the methods to treat 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 is alcoholic liver disease?
AlcoholicHepatitis (ALD) is a liver disease caused by long-term heavy alcohol consumption. From the initial manifestation of alcoholic fatty liver, it can develop into alcoholic hepatitis, liver fibrosis, cirrhosis and even liver failure and liver cancer.
How many types of alcoholic liver disease can be classified?
1, mild alcoholic liver disease: liver biochemical indicators, imaging and histopathological examination are basically normal or slightly abnormal.
2.Alcoholic fatty liver: imaging diagnosis meets the criteria of fatty liver, and serum ALT, AST or GGT can be slightly abnormal.
3.Alcoholic hepatitis: it is a group of clinicopathological syndrome caused by massive necrosis of hepatocytes in a short period of time, which can occur with or without cirrhosis, mainly manifested as elevated serum ALT, AST and significantly increased serum TBiL, which can be accompanied by fever and elevated peripheral blood neutrophils.
4.Alcoholic cirrhosis: There are clinical manifestations of cirrhosis and changes of serum biochemical indexes. It can be complicated by gastrointestinal bleeding, hepatic encephalopathy, and even develop into liver cancer.
What is alcohol dependence?
Alcohol dependence is a chronic disease, and quitting alcohol is not a matter of perseverance or morality, but a medical problem.
Alcohol dependence is defined in the ICD-10 criteria
1.Strong craving or urge to drink alcohol: addiction of the mind (stealing material alcohol)
2.Impaired control over drinking behavior.
3.Physiological withdrawal: body addiction (morning drinking, shaking hands at 11:00)
4.Tolerance to alcohol.
5.Neglecting or giving up other recreational activities because of drinking.
6.Continue to drink despite clear evidence that drinking has caused harm.
Alcohol dependence is when three of the above six items are met.
Criteria for recovery from alcohol dependence
1. Completely and totally stop using alcohol.
2. Admit that there is nothing you can do about alcohol.
3. Understand that alcohol dependence is a chronic disease.
4. Make the necessary changes to your lifestyle.
5. Seek help from others.
6. Be patient.
Is alcohol dependence harmful?
The harms of alcohol dependence include: physical damage, mental damage, personality change, and social harm.
Physical damage
1.Somatic damage: nervous system: central and peripheral system.
2.Digestive system: liver, gastrointestinal tract.
3.Cardiovascular system.
4.Urinary system.
5. Blood system.
6, reproductive system: fertility, sexual function decline.
7. Other: fat.
Mental impairment
1.Sensory perception: hallucinations, hallucinations, delusions.
2, delusions: jealous delusions, belligerent delusions, delusions of victimization.
3, attention.
4, memory: distant and near memory loss, misconceptions, fiction.
5.Intellect.
6, Mood disorders: depression, impulsivity, instability.
7, volitional behavior: impulsivity, loss of responsibility for work and family life (diminished higher volitional activity), alcohol-seeking behavior.
8.Sleep disorder.