“What should I do? The doctor said that I have fatty liver, will I have cirrhosis?”, a netizen sent me a private message, it turned out that he had read my previous articles, and the proportion of modern people who have been found to have fatty liver is increasing. The more, and because there are relatively many liver diseases in China, as long as the liver is involved, everyone will be very nervous, immediately think of liver cirrhosis and liver cancer, and worry that their future life will become dark.

How high is the incidence of fatty liver in China?

According to different surveys, the incidence rate ranges from 15% to 41%, and the average should exceed 30%, which means that one out of every three people may have fatty liver, which is not low.

As I mentioned in the previous article, fatty liver may be transformed into liver cirrhosis, which is also the most worrying problem for many patients with fatty liver, but whether fatty liver will evolve to the worst level, there are many other factors to consider.

According to the cause, fatty liver can be divided into alcoholic fatty liver and non-alcoholic fatty liver. The incidence of the former is relatively high in Europe and the United States, but less in China. Non-alcoholic fatty liver disease is more common in China. Even if there is no viral hepatitis, fatty liver may occur if overeating and obesity. But it is worth noting that chronic hepatitis C may also cause fatty liver in patients.

Fatty liver may indeed turn into liver fibrosis, but it must go through a long development process, which is similar to the reason why alcoholic hepatitis and viral hepatitis such as hepatitis B and C cause liver fibrosis. If it is confirmed that there is no alcoholic liver disease, no hepatitis B or C, and the liver function is all normal, generally there is no need to worry too much about the development of liver cirrhosis, but the patient needs to have regular inspections to understand the liver condition, especially the alanine aminotransferase and aspartate aminotransferase.

Ultrasound diagnosis with high accuracy

Fatty liver refers to a situation in which the content of fat in the liver exceeds 5% of the total weight of the liver, or the slice of liver tissue shows that more than 10% of the liver cells have fat accumulation.

However, such an approach may not be acceptable to patients, so biopsy biopsy should be considered unless there are special problems. At present, the accuracy rate of ultrasound diagnosis of fatty liver has exceeded 90%, and it is the most convenient and accurate clinical examination tool.

Ultrasonography compares the surface brightness of the liver and kidneys, and uses the clarity of images of blood vessels in the liver to grade fatty liver, according to which the severity of fatty liver can be divided into mild, moderate, and severe.

Mild: There is an extensive but mild increase in the brightness of the liver relative to the kidney, and intrahepatic blood vessels can still be seen clearly.

Moderate: There is an extensive, moderate increase in the brightness of the liver, and the image of the intrahepatic blood vessels is less clear.

Severe: There is an extensive and very pronounced increase in liver brightness, at which point images of intrahepatic vessels and deep liver are almost invisible.

Can a blood draw detect fatty liver?

the answer is negative.

A blood draw cannot detect fatty liver. Blood draws can only be done by testing blood for triglycerides, cholesterol, LDL cholesterol, and high density lipoprotein cholesterol; that is, blood draws only check for fat content in the blood.

Clinically, few patients need biopsy to confirm whether they have fatty liver, but most of them can diagnose fatty liver by abdominal ultrasound and other imaging examinations.

Fatty liver 80% have no symptoms

When many people begin to feel tired or have a poor appetite, they suspect that it may be a symptom of fatty liver disease or other liver disease. In fact, more than 80% of patients with fatty liver are asymptomatic, and most people discover that they have fatty liver accidentally during physical examination.

Some people with symptoms are mostly non-specific gastrointestinal symptoms, not necessarily directly related to the liver, such as upper abdominal discomfort or mild pain; some people also experience loss of appetite, fatigue, abdominal distension, epigastric pain Symptoms such as pressure, nausea, and vomiting. However, a few studies have found that some people have hepatomegaly and some patients have abnormal liver function.

Identify high-risk groups for fatty liver

1. Obesity: Obesity is one of the most important health problems in developed countries, and China is gradually facing the same threat. The degree of obesity (usually expressed by the value of BMI (body mass index), BMI=weight (kg)/height (square of meters), BMI<23 is normal) has been confirmed to be related to the incidence and degree of fatty liver. People with central obesity are more prone to the disease. Central obesity refers to excessive waist circumference. In China, the waist circumference of men is greater than 90cm or the waist circumference of women is greater than 80cm. Studies have shown that waist fat is easily stimulated and sends its fatty acids to the liver to form fatty liver.

2. Alcoholism: In the United States, alcoholic hepatitis is the main cause of fatty liver, because the oxidation products of alcohol will interact with lipid metabolism in the liver, and alcohol will damage the liver, thus affecting the oxidation of fatty acids, resulting in hypertriglyceridemia form fatty liver. In recent years, the drinking population in China has increased, and we should also be careful that alcoholic hepatitis can cause fatty liver and liver cirrhosis.

3. Drugs: such as steroids or undergoing chemotherapy, may cause fatty liver. Clinically, there are also acute fatty livers with Reye’s syndrome caused by taking aspirin.

4. Hepatitis: Chronic hepatitis C may also cause fat accumulation in the liver. In contrast, hepatitis B is not associated with fatty liver.

5. Diabetes: The blood sugar control mechanism of diabetic patients is abnormal, and the function of the liver to manufacture and metabolize fat is also abnormal, resulting in the accumulation of fat in the liver. Studies have shown that fatty liver disease is more serious in obese diabetic patients.

6. Surgery or weight loss too fast: People who undergo surgery or lose weight too fast may affect the body’s metabolism of fat, which may cause excessive accumulation of fat in the liver and form fatty liver. Therefore, weight loss should not be too fast. According to expert opinions, weight loss should not exceed 0.5 kg per week.

If a person is very thin, he must not have fatty liver?

Wrong, thin people may also have fatty liver.

Although fatty liver caused by obesity is the most common, it does not mean that thin people will not have fatty liver. Most of the body’s fat sources are produced by the body, and the liver is the factory that produces fat.

Generally speaking, 4-6 hours after eating, the fat will be digested and absorbed, and sent to all parts of the body through the blood for use. When humans are fasting or unable to eat, the liver can convert the sugars in it into triglycerides and release them into the blood, so there will still be enough fatty acids for the body to use. But it is also possible to cause fatty liver because the triglycerides in the liver cannot be excreted.

An autopsy was conducted in the United States, and it was found that 70% of obese patients had fatty infiltration of the liver, while 3.5% of normal people had fatty infiltration of the liver, and a small number of them were found to have fatty liver hepatitis.

Fatty liver often means abnormal health

In fact, the significance of finding fatty liver is greater than the diagnostic significance. Because fatty liver is often a sign of many health problems; this indicates that the patient may have developed problems such as high blood sugar, abnormal blood fat, high uric acid, or obesity, or may have contracted viral hepatitis without knowing it. Among them, the cause of hyperglycemia is mostly caused by insulin resistance. These patients have poor response to insulin and cannot effectively lower blood sugar. Therefore, when fatty liver is found, you should further check whether you have other problems.

Too much fat can damage the liver

People with fatty liver who do not have viral or alcoholic hepatitis, who were usually considered to be fine and do not need to worry too much in the past, have discovered in recent years that this type of fatty liver may still be a threat to health. A research report by the American Society of Liver Diseases has pointed out that 5%-10% of people in the United States have abnormal liver function due to fatty liver, indicating that they have hepatitis. tissue is at risk of fibrosis.

There are four possible reasons why fat in the liver damages the liver. The first is that fat activates special receptors on the cell surface to send out death signals, leading to cell apoptosis; the second is that fat makes the mitochondria that supply energy to cells abnormal, resulting in cell death; the third is Insulin resistance produced by fat makes fat metabolism abnormal, leading to a vicious circle of fatty liver; fourth, because too much fat can also cause an increase in cytokines that cause cell death, resulting in necrosis of liver cells.

Long-term follow-up found that if the patient only has excess fat, the probability of future deterioration is extremely small, but if the fatty liver is accompanied by hepatitis, after 20-30 years, 1 to 20% will become liver cirrhosis, or even some. Risk of progression to liver cancer.

Is there any medication for fatty liver?

When should fatty liver be treated? When patients with fatty liver have abnormal liver function and liver fibrosis is found, drug control is required.

Drugs currently in clinical trials for the treatment of nonalcoholic hepatitis, such as metformin, improve insulin resistance, reduce inflammation in the liver, and improve liver histology; gemfibrozil improves liver function ; In addition, the antioxidant effect of vitamin E also has the effect of delaying liver inflammation.

However, these drugs only have short-term studies, and there is no long-term efficacy report. Therefore, for fatty liver, prevention is more important than treatment, and improvement of life and diet is more important than drug treatment.

Cellulite and liver protection should start with weight loss

Many medical institutions and experts suggest: fatty liver, diet and life control are better than drug control, because there is currently no drug that has a long-term good effect on fatty liver. Usually, as long as the calories are controlled, the amount of exercise is increased, and the weight is reduced, the phenomenon of fatty liver will be reduced or even disappear, and the phenomenon of liver inflammation will also disappear.

Studies have shown that liver inflammation can be significantly improved as long as 5% of body weight is lost, so when it comes to eliminating fatty liver, almost all doctors will tell patients to start with weight loss. However, you should also pay attention to weight loss, and it is more appropriate to do so at a rate of no more than 0.5 kg per week.

A moderate diet is a must for weight loss. Since all foods will be converted into fat as long as the calories exceed the required amount, regardless of the type of food intake, attention must be paid to avoid excessive calories; in addition, continuous and regular exercise is to solve the problem of insulin The best prescription for resistance, exercise can strengthen the use of insulin by muscles, effectively consume blood sugar and fatty acids in the blood, and promote the metabolism of fat in the liver.

Therefore, if the fatty liver is not caused by alcoholic hepatitis or viral hepatitis, as long as the adjustment of life and diet, most of the fatty liver can be gradually improved, and even the liver function can return to normal.