Text: Su Ziqian (Chinese and Western physician)
(Hong Kong News) Fatty liver is becoming more and more common in developed Western societies. Many people do not know that severe fatty liver can cause cirrhosis and even liver cancer!
Western-style fast food culture and high-calorie foods coupled with many people drinking a lot of alcohol and diabetes are common, so fatty liver disease is very common. However, in Asian societies, including Hong Kong, with the westernization of living habits and diet, coupled with the affluence of society, more and more people are suffering from the problem of fatty liver.
Some patients even have fatty liver when they are around 30 years old. What are the causes of fatty liver?
First of all, we must understand that the liver itself is a detoxification organ. Excess fatty acids and cholesterol in the body will reach the liver through the blood and be broken down by liver cells. But if the body eats too much fat and carbohydrates (excessive carbohydrates will be converted into fat in the liver when they are properly broken down), fat will accumulate in the liver cells beyond the ability of the liver to break it down. This is the cause of the first part. .
Part 2: When fat accumulates in the liver, it will produce a lot of oxidative free radicals, which further weakens the normal decomposition work of liver cells, thereby making fatty liver more serious and forming a vicious cycle.
Of course, whether the formation of fatty liver is really that simple, the scientific community has not fully understood the mechanism involved. But generally it can be summed up as too many calories (usually eating too many carbohydrates and too much sugar and too much fat), and oxidative free radicals in liver cells.
After understanding the above two points, the following common causes of fatty liver will be easy to understand. The two most common causes of fatty liver are excessive drinking and diabetes.
A few decades ago, fatty liver disease was most common caused by drinking alcohol. The reason is that alcohol is actually a little toxic to the liver and damages the ability of liver cells to break down fatty acids. In addition, alcohol will cause liver cells to store fat. But what is more common in today’s society is non-alcoholic fatty liver disease. That is, these fatty livers do not appear in people who drink alcohol. The vast majority of these patients have both type 2 diabetes and central obesity.
For patients with type 2 diabetes, reduced insulin sensitivity will reduce the ability of the liver to decompose fatty acids and will also make the skin cells prone to fat accumulation. Since type 2 diabetes generally occurs together with obesity, fatty liver, high blood pressure, high cholesterol, etc., it is now generally referred to as metabolic syndrome in the academic community. The so-called metabolic syndrome is when the calories inhaled are greater than consumed, until body obesity causes a series of related body changes.
However, in recent years, it has been found that fatty liver has a trend of getting younger. Recently, a patient in his 30s was treated. He did not have diabetes, but his blood sugar was slightly high, which was pre-diabetes. In addition, in recent years, he exercised less and was busy at work and had insufficient rest time. Because of the pressure at work, I often eat a lot of snacks, and I also drink with friends on weekdays and Saturdays. My body became more obese and I accidentally discovered that I also had fatty liver.
This seems to be the life of ordinary wage earners! The most important reason for the rejuvenation of fatty liver is that most people do not exercise enough to consume energy, but on the other hand, they often eat large amounts of carbohydrates, desserts, sweet drinks, or fatty foods. Therefore, it can be expected that more and more urbanites will suffer from fatty liver disease.
can be divided into three stages
Many people will be surprised that their liver function tests are normal when they take blood tests, but they accidentally find fatty liver through computer sketch or ultrasound?
Yes, in fact, fatty liver can be roughly divided into three stages. The first stage is when fat accumulates in the liver to form fatty liver. The second stage is when fat accumulates too much, the liver will formally produce an inflammatory reaction and form hepatitis.
During the second stage, liver function tests will reveal an increase in certain liver enzymes. This kind of liver inflammation is a chronic inflammation, so the liver enzymes will not be very, very high, but only several times higher. But in fact, this chronic liver inflammation will slowly damage the liver. In severe cases, it reaches the third stage of liver cirrhosis. Of course, liver cirrhosis also has degrees and severity. Some patients have reached the stage of cirrhosis, but the increase in liver enzymes is not so obvious.
The above three stages can coexist. On the one hand, there can be a lot of fatty liver, and on the other hand, there can be mild cirrhosis.
Abdominal ultrasound is the most accurate and 4 magic weapons for patient self-rescue
Of course, the consequences of severe cirrhosis can be fatal. In addition, when cirrhosis develops, large or small liver cancers can also occur.
In recent years, liver cancer caused by cirrhosis of fatty liver has begun to be seen in Hong Kong. However, it should be noted that recent studies have found that even if the liver has not reached the third stage of cirrhosis, fatty liver in the first stage can actually cause liver cancer. However, the chance is far lower than that of liver cancer caused by cirrhosis in the third stage.
So how to diagnose fatty liver? Fatty liver disease is mostly discovered by ordinary people because of inadvertent abdominal ultrasound or magnetic resonance imaging of the abdomen. These imaging methods are correct for seeing fatty liver. But if you want to truly know the degree of fatty liver or liver cirrhosis, the most accurate way is to use a special ultrasound technology called liver fiber sketching.
Liver fiber sketch can measure the accumulation of fat in the liver and the degree of cirrhosis, and display it as a score, which is much better than ordinary ultrasound for tracking the disease and treatment effects.
The traditional gold standard method for diagnosing fatty liver is to extract liver tissue and then observe whether there is fat accumulation under a microscope. But in reality very few people do this, and there is no great need. Liver tissue is generally extracted for research use only.
Okay, now that I’ve written this, it’s time to explain the most important part. How to treat fatty liver? Fatty liver can be reversed, and treatment methods will be discussed in the next issue.
But here we can reveal in advance the four magic weapons for self-help DIY for patients with fatty liver disease!
1. Exercise more
2. Quit drinking (or at least reduce your drinking)
3. Reduce excess sugar, carbohydrates and fat (reduce calories, in fact, the human body is not designed to bear eating so much.)
4. Get at least 7 hours of sleep every day
The fourth point is something that many people overlook, and it is indeed supported by research.