What’s the matter with fatty liver
1. Fatty liver of obesity
The degree of fat accumulation in the liver is proportional to body weight. 30% to 50% of obesity is associated with fatty liver, and the rate of fatty liver disease in severely obese patients is as high as 61% to 94%. After the weight of obese people is controlled, the fat infiltration also decreases or disappears.
2. Alcoholic fatty liver
For long-term alcoholics, 75% to 95% have fatty infiltration. It was also observed that the incidence of alcoholic fatty liver increased by 5 to 25 times when drinking more than 80 to 160 grams per day.
3. Rapid Weight Loss Fatty Liver
Fasting, excessive dieting, or other rapid weight loss measures can cause a large increase in lipolysis in the short term and consume Intrahepatic glutathione (GSH) increases malondialdehyde and lipid peroxides in the liver, damages liver cells, and leads to fatty liver.
4. Malnutrition fatty liver
The lack of protein caused by malnutrition is an important cause of fatty liver. Synthesis of apolipoprotein, so that triglycerides accumulate in the liver, resulting in fatty liver.
5. Diabetic fatty liver
About 50% of diabetic patients can develop fatty liver, and most of them are adult patients. Because 50% to 80% of adults with diabetes are obese, their plasma insulin levels and plasma fatty acids are increased, and fatty liver change is not only related to the degree of obesity, but also to eating too much fat or sugar.
6. Drug-induced fatty liver
Certain drugs or chemical poisons cause fatty liver by inhibiting protein synthesis, such as tetracycline, adrenocortical hormone, Puromycin, cyclohexylamine, ipecine, arsenic, lead, silver, mercury, etc. Lipid-lowering drugs can also form fatty liver by interfering with lipoprotein metabolism.
7. Fatty liver of pregnancy
It usually occurs at 34-40 weeks of the first pregnancy, with severe disease, poor prognosis, and maternal and infant mortality. 80% and 70% respectively.
8. Fatty liver caused by other diseases
Fatty liver can also occur during infections such as tuberculosis, bacterial pneumonia and sepsis. Excessive restriction of activities, coupled with the intake of high-sugar and high-calorie diets, can easily accumulate fat in liver cells; after receiving corticosteroid treatment, fatty liver is more likely to occur. Fatty liver improves rapidly after infection control or removal of the cause, as well as so-called parenteral hypertrophic fatty liver, toxic fatty liver, and fatty liver caused by hereditary diseases.
Symptoms of fatty liver
The clinical manifestations of fatty liver are diverse, and mild fatty liver is often asymptomatic , only fatigue, and most fatty liver patients are obese. Fatty liver patients are more often found incidentally during physical examination. Moderate and severe fatty liver has similar manifestations to chronic hepatitis, which may include loss of appetite, fatigue, nausea, vomiting, dull pain in liver area or right upper quadrant, etc. Mild liver enlargement may be tender, slightly tough texture, blunt edge, smooth surface, a few patients may have splenomegaly and liver palm. When there is too much fat deposition in the liver, the liver capsule will expand and the hepatic ligament will be stretched, causing severe pain or tenderness in the right upper quadrant, fever, and increased white blood cell count.
In addition, fatty liver patients often have peripheral neuritis changes such as glossitis, angular stomatitis, skin ecchymosis, numbness of limbs, and paresthesia of limbs. A small number of patients may also have gastrointestinal bleeding, bleeding gums, epistaxis and so on. Patients with severe fatty liver may have ascites, lower extremity edema, electrolyte disturbances such as hyponatremia, hypokalemia, etc. Fatty liver has various manifestations. When diagnosis is difficult, liver biopsy can be done to confirm the diagnosis.
How to treat fatty liver best
1. Remove the cause and treat the primary disease
Removing the cause and controlling the primary disease are very important for the prevention and treatment of fatty liver.
Particular attention should be paid to neglected causes such as drug side effects, poisoning, carnitine deficiency, hyper or hypothyroidism, hepatolenticular degeneration (Wilson disease), severe anemia, and cardiopulmonary insufficiency of chronic hypoxia, etc.
2. Adjust diet to correct nutritional imbalances
Diet adjustment is the most important step in the treatment of fatty liver.
In principle, fresh vegetables, lean meats (mainly beef and mutton) and diets rich in lipophilic substances should be consumed to keep the body weight close to normal. It should be noted that the diet of patients with fatty liver should still contain an appropriate amount of fat, and pay attention to control the intake of sugar. Because when consuming fat-free food, the body can still synthesize fat from carbohydrates and amino acid precursors, and excessive intake of carbohydrates (especially sweets) can increase insulin secretion and promote the conversion of sugar into fat. In addition to ensuring the correct intake of the diet, it is also necessary to choose different diets according to different causes of fatty liver.
3. Increase exercise
Education to correct bad behavior and self-care awareness to maintain ideal body weight and relatively normal blood lipid and blood sugar levels. Regular exercise, exercise therapy is particularly important for the regression of fatty liver caused by obesity, diabetes, hyperlipidemia, etc.
4. Drug treatment
to promote the regression of intrahepatic fat and prevent liver cell necrosis, inflammation and liver fibrosis. Choline, methionine, vitamin B group and some blood lipid adjusting drugs are often used to treat fatty liver, but most of them have inaccurate curative effects and large side effects. If used improperly, it can aggravate the deposition of fat in the liver, and even lead to insufficiency or deterioration of the patient’s liver function.
Therefore, the treatment of fatty liver should focus on removing the cause, controlling diet, increasing exercise, and reducing body weight. Drug treatment only plays an auxiliary role, and do not put the cart before the horse.
How to prevent fatty liver
1. Pay attention to eating habits
Eat regularly, don’t Overeating, overeating.
2. Insist on exercising
Don’t sleep late, get up in the morning to exercise, which has a good effect on preventing fatty liver.
3. Eat less eggs
Especially the yolk of eggs should not be eaten too much, as eating too much will increase the occurrence of fatty liver.
4. Don’t stay up late to drink alcohol often
This will make the liver very hard and cause various liver diseases.
5. Eat less animal oil
Fatty foods, all of which have adverse effects on the prevention of fatty liver.
6. Exercise more
Lifestyle habits such as weight loss and diet control are important reasons for fatty liver.
