Manager Li began to gain weight 10 years ago, physical examination found to have fatty liver and transaminases mildly increased, hepatitis B mark negative, think that only fatty liver, no big deal, fat is a blessing. Therefore, he did not pay any attention to it, although the doctor advised him to stop drinking and lose weight, but “people in the jungle, can’t help it”, smoking, drinking and socializing, eating and drinking is still a daily routine, as a result, obesity and fatty liver degree is getting heavier and heavier. Recently, he was hospitalized in an emergency due to the development of cirrhosis and the rupture of esophageal varices, and his life could not be saved despite active resuscitation. Tong Fuyi, Department of Hepatology, Suzhou Fifth People’s Hospital
Perhaps you were told you had fatty liver during a health checkup and didn’t know what to do.
Maybe, you have been suffering from fatty liver for many years and have not been getting better and are a bit discouraged.
Maybe you don’t have fatty liver yet, but your doctor has warned you that it’s not far away.
Maybe you’ve heard people say that fatty liver is a disease of wealth and affluence, that it doesn’t hurt, that it’s not harmful, and that you don’t need to treat it.
Perhaps, you have heard people say that if fatty liver is not properly treated, it will also turn into cirrhosis and liver cancer, a little fear.
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1.What is fatty liver
Fatty liver disease (FLD) is a genetic-environmental-metabolic stress-related disease, including alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD) two categories. Currently, the prevalence of ALD remains high, while the incidence of NAFLD is increasing and the onset of the disease is becoming younger, and it has become the number one cause of chronic liver disease in developed countries and regions, and ALD can be combined with NAFLD and FLD with viral hepatitis. More seriously, NAFLD, like ALD, can lead to disability and death from liver disease, but is also closely related to type 2 diabetes, metabolic syndrome and its related cardiovascular and cerebrovascular events.
2. Prevalence of fatty liver
The World Health Organization said in its report that the world’s obese population has proliferated due to many factors such as unhealthy diet and unscientific lifestyles. The organization predicted that by 2015, the world’s total obese population will swell rapidly from 2005, 1.6 billion to 2.3 billion. Among the 6 billion people in the world, according to the NAFLD prevalence rate of 20%, there are 1.2 billion suffering from NAFLD, according to the NAFLD 5-year survival rate of 67%, the annual death due to NAFLD reaches 80 million. About 50% of obese patients have fatty liver, and a domestic survey found that 8 out of 10 obese people even have fatty liver.
China is a large country with viral hepatitis, but the incidence of viral hepatitis will drop significantly after the planned immunization of hepatitis B vaccine, while the incidence of non-alcoholic fatty liver disease associated with metabolic syndrome will have a significant increase in 10 years, the impact of obesity on fatty liver is more serious than excessive alcohol consumption, and the increasing number of non-alcoholic fatty liver, and the trend of low age and popularization, has seriously threatened the people It has become a serious threat to people’s health. The prevalence of fatty liver in China is about 17%, 90% of which are non-alcoholic fatty liver, fatty liver has become the second largest liver disease after viral hepatitis, and about 2.5% to 5% of patients can develop into cirrhosis. With the prevalence of obesity and diabetes, the prevalence of fatty liver in China is growing rapidly. Children’s obesity rate, overweight rate is doubling every 5 years, children NAFLD is also becoming one of the prominent problems of children and adolescents.
3.Harm of fatty liver
Early symptoms of fatty liver are mild or asymptomatic, and thus are often overlooked. This insidious nature makes some people’s fatty liver develop to a serious degree when they are just discovered and not treated effectively in time. This is because the liver does not complain well; it is highly compensated and usually only 30% of the liver cells are performing their functions. Unlike other liver diseases, the damage of obesity-associated fatty liver is not limited to the liver; the systemic effects of liver obesity (fatty liver) are usually more severe than the liver disease itself. In terms of the effects of obesity on systemic health, the Chinese are more intolerant of fat than European and American races, and a mild increase in body weight and waist circumference can cause disruptions in glucolipid metabolism. Body fat content is more likely to cause steatosis and metabolic syndrome than simple weight gain (body mass index), abdominal visceral fat (waist circumference) than subcutaneous fat of the buttocks (hip circumference), and fat deposited ectopically in the liver (fatty liver) than fat in adipose tissue. Fatty liver and metabolic disorders are mutually causal, and there is a vicious circle between the two.
As the saying goes, “fat people are weak, and fat livers are easily damaged”. Diffuse fatty liver is the most common liver disease found in adults and is the main cause of liver enzyme abnormalities. Slight weight gain as well as low body mass index and low waist circumference can lead to metabolic disorders and fatty liver. Fatty liver is harmful to the body, mainly by causing disorders in lipid metabolism and functioning, disturbances in energy metabolism, and a significant decrease in the immune function of the body. Fatty liver may also cause hormone metabolism disorders, female mastication, testicular atrophy and decreased sexual function in men; and elevated androgens, menstrual disorders and even infertility in women. Thus, fatty liver is a potentially lifelong disease that can involve nine systems throughout the body, including cardiovascular, respiratory, endocrine, gastrointestinal, urinary, neurological, musculoskeletal, skin adipose tissue, and immune. When fat accumulates excessively in the liver for a long period of time, the blood supply, oxygen supply and its own metabolism of the liver are continuously affected, resulting in steatohepatitis, which causes massive swelling, inflammatory infiltration and deformation and necrosis of liver cells. More frighteningly, non-alcoholic fatty liver is similar to alcoholic fatty liver in that both can lead to cirrhosis, hepatocellular carcinoma and liver failure. According to current domestic data, the incidence of fibrosis in steatohepatitis is about 25%, and nearly 8% of patients finally develop cirrhosis. Active treatment of obesity and reduction of hepatic fat deposition in patients with chronic liver disease combined with fatty liver is often accompanied by a reduction in liver damage and improvement in progressive liver fibrosis.
In addition, the effect of fatty liver on other liver diseases may be that hepatic iron overload promotes the development of NASH and hepatic steatosis promotes the progression of hepatic fibrosis in chronic hepatitis C and affects its response to antiviral therapy with interferon abroad. In contrast, in China, it may be that hepatic steatosis affects the regression of chronic hepatitis B and promotes the development of drug and toxic liver disease.
Indeed, fat-deposited livers have increased susceptibility to drugs, environmental toxins, ischemia and hypoxia, and patients with fatty liver are more likely than normal to develop drug and toxic liver disease and post-surgical liver injury. More seriously, obesity-related NAFLD can be associated with diabetes, atherosclerotic cardiovascular disease, and increased incidence of cirrhosis and liver cancer in patients with chronic hepatitis B, in addition to directly causing liver disease-related disability and death. Fatty liver is an important disease that threatens the health of our people, and prevention and treatment of fatty liver has become a new challenge in the field of contemporary medicine.
4.The prevention and treatment of fatty liver
In view of the great danger of obesity and fatty liver to human health, therefore, concern for health, can not ignore fatty liver. Only by paying great attention to the harm of fatty liver can we take effective measures to prevent and control its damage to the greatest extent. It is recommended that people maintain a healthy lifestyle, control their weight and reduce their waist circumference, and pay attention to screening and treatment as an effective shortcut to reduce liver disease and improve health.
The principles of fatty liver prevention and treatment can be summarized as follows: ① remove the causes and triggers, actively deal with the primary disease or concomitant diseases; ② adjust the diet plan and correct nutritional imbalance; ③ adhere to the necessary physical exercise to maintain the ideal weight; ④ education of self-care awareness to correct bad behaviors; aim to maintain relatively normal blood lipid and blood glucose levels and insulin sensitivity to promote the regression of fat in the liver; ⑤ supplement with liver-protective drugs when necessary (5) if necessary, hepatoprotective drugs to prevent steatohepatitis from developing in simple fatty liver and to promote recovery from steatohepatitis. However, if the causes and triggers are not removed in a timely manner, it is impossible to effectively stop the progression of liver disease with the best health care products and medications.
Aggressive treatment of obesity and reduction of hepatic fat deposition for patients with chronic liver disease combined with fatty liver is often accompanied by a reduction in liver damage and an improvement in progressive liver fibrosis. If manager Li in this article had listened to his doctor’s advice, quit drinking and reduced socializing in a timely manner, and avoided alcoholism and obesity, he would certainly not have died young due to cirrhosis. Please also note that fatty liver is not the sole property of fat people, and thin people are not immune to fatty liver disease.
I have been in the liver disease fatty liver clinic for many years and have found many heartbreaking cases related to advanced fatty liver disease, so I am writing this article. I hope that all friends can no longer indifferent, now take action! I hope that you can take action now to actively prevent and treat fatty liver disease and improve your quality of life for a healthier and better life!