When you look at a patient’s abdominal ultrasound report or physical examination report in the clinic, you can often see the diagnosis of fatty liver written on the diagnosis, and some patients often infer that they have hyperlipidemia, is this true? Is it true? What exactly is the connection between hyperlipidemia and fatty liver? Does having a fatty liver mean having hyperlipidemia? Fatty liver is a clinicopathological syndrome in which the main body of the lesion is in the lobules of the liver and diffuse steatosis of the hepatocytes is the main cause. The liver is the main site of lipid synthesis and metabolism, and excessive accumulation of lipids in the liver leads to fatty liver [1]. Statistics from one study found that patients with hyperlipidemia accounted for more than half of all patients with fatty liver, indicating that the development of fatty liver is closely related to the level of blood lipids. In addition related studies have also found that patients with hypertriglycerides account for the major part of patients with fatty liver, while patients with hypercholesterolemia alone account for only a small part. In normal individuals, the amount of intrahepatic fat is 5% of the liver weight, while in patients with fatty liver it can be 40% to 50%, mainly triglycerides and lipoic acids, while phospholipids, cholesterol, and cholesteryl esters are only slightly increased [2]. Thus hyperlipidemia, as an important factor contributing to fatty liver, can promote the development and progression of fatty liver and is mainly associated with high triglycerides. The detection rate of fatty liver was significantly higher in the hyperlipidemic group compared to the normolipidemic group. This may have several reasons: 1, because of the long-term consumption of large amounts of high-fat, high-cholesterol and other high-calorie foods, and the body can not effectively consume the caloric energy, triglyceride intake in the liver and synthesis in the liver increased a lot, more than the liver’s lipidation and oxidation capacity, excessive fat deposition in the liver, the formation of fatty liver; 2, hypertriglyceridemia caused by insulin resistance, as well as obese people at the same time the existence of Insulin resistance, resulting in disorders of lipid metabolism, excessive fat infiltration in the liver, fat particles invade the hepatocytes, making the hepatocytes swollen, compressing the liver blood sinusoid, gradually causing ischemia, degeneration, necrosis, the formation of fatty liver. 3, The fatty degeneration of hepatocytes and the damage of free fatty acids to hepatocytes affect the oxidative metabolism and energy conversion of hepatocytes, resulting in damage to hepatocytes, and with the destruction of hepatocytes, their metabolic functions are affected, which aggravates the disorder of lipid metabolism in the body, forming a vicious circle and promoting the occurrence of fatty liver [3]. Therefore, abdominal ultrasound indicating fatty liver does not necessarily indicate hyperlipidemia, and the two are closely correlated but not absolutely equivalent. But whether it is fatty liver or hyperlipidemia you need to start changing your poor lifestyle, and if the liver function index is not good you may also need to use medication, so pay attention to lipids and fatty liver.