Only fat people will have fatty liver? Can taking "liver protection tablets" protect the liver? Don't believe these 7 liver rumors anymore!

March 18 is National Liver Care Day. The liver is the largest gland in the human body, the only organ that can regenerate, and the largest substantial organ in the human body. The liver is brown-red, roughly triangular in shape, and consists of two lobes. There are many types of liver diseases, including viral hepatitis, fatty liver, cirrhosis, and liver cancer.

The main functions of the liver are: production of bile, absorption and metabolism of bilirubin, support of the coagulation process, fat metabolism, storage of glycogen, storage of vitamins and minerals, protein metabolism, filtering of blood, immune function, production of albumin, etc.

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The liver is so important, but there are endless rumors about it. Let’s take a look at it today.

1. Normal liver function

Does it mean the liver is normal?

Analysis: Routine physical examinations include liver function tests, of which alanine aminotransferase and aspartate aminotransferase are two main indicators. Many people believe that as long as the liver function test is normal, it means that the liver is definitely healthy and liver problems can be ruled out. However, normal liver function tests only mean that the test indicators are normal. The liver function tests of many patients with early liver disease will not show any problems.

The liver has a very strong compensatory function. As long as 1/3 of the normal liver cells remain, it can still carry out various life activities normally. In fact, there is something wrong with the liver at this time! For example, in the early or middle stages of liver cancer, only the liver tissue around the cancer cells will be compressed or invaded, and in early cirrhosis, the transaminase in liver function may only be slightly elevated, or even normal.

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Chronic viral hepatitis is the most direct cause of cirrhosis and liver cancer. Therefore, people with chronic hepatitis infection, family history of liver cancer, obesity, diabetes, alcoholism, and especially men over 40 years old are at greater risk.

Therefore, it is recommended to screen for liver diseases regularly. In addition to liver function, the following examination items should be selectively performed according to the patient's condition:

The main examinations include imaging examinations (B-ultrasound, abdominal enhanced CT/MRI when necessary), blood tests for tumor markers (such as alpha-fetoprotein), quantitative testing for hepatitis virus, etc.

The truth: Normal liver function does not mean that the liver is completely normal. Routine liver function tests can only indirectly reflect the functional status of the liver. It is only one of the auxiliary examination methods for clinicians to judge the disease. For the integrity of the liver, other examinations such as imaging are still needed for further diagnosis.

2. Prevent liver problems,

Is it enough to just take “liver protection tablets”?

Analysis: Liver protection tablets have become a must-have for people who work overtime, stay up late, and drink alcohol, and have become a popular health food. Modern people often have liver problems due to alcohol, obesity, etc. The correct way to protect the liver is to first reduce bad habits that damage the liver, such as not drinking too much, not staying up late, and sitting less and moving more.

For people who already have liver problems, such as those caused by obesity, drinking, viral infection, etc., they should seek medical attention in time to identify the cause and carry out causal treatment. If the cause is not removed, the transaminase level is likely to rebound after stopping the medication.

The effect of "liver protection tablets" in protecting liver and reducing enzymes is limited. No matter what kind of "liver protection tablets" you use, they will not fight against the damage caused by staying up late, drinking, etc. Never expect to rely on health care products to prevent and treat liver disease. Sometimes taking health care products incorrectly may even aggravate the condition.

The truth: It is not advisable to rely on "liver protection tablets" to "protect the liver". It is recommended that people develop a healthy lifestyle, have regular physical examinations, and diagnose and treat diseases early. For healthy young people with good living habits, there is no need to take liver protection health products.

3. Hepatic hemangioma

Will it develop into liver cancer?

Analysis: Many people are found to have hepatic hemangioma during B-ultrasound during physical examination. Hepatic hemangioma is a relatively common benign liver tumor. The most common clinical case is cavernous hemangioma. Most patients have no obvious discomfort symptoms. It is mainly caused by abnormal development of blood vessels during embryonic development. Most of them grow slowly, and only a few will grow suddenly, followed by symptoms such as discomfort in the liver area, loss of appetite, and indigestion.

Liver cancer is a malignant tumor that develops rapidly. If not diagnosed and treated in time, it may be life-threatening within a year from the onset of symptoms. Hepatic hemangioma is a relatively common benign liver tumor with a long course and mild symptoms.

The truth: Hepatic hemangioma will not develop into liver cancer. They are two different diseases. Hepatic hemangioma is the most common benign tumor in the liver. Liver cancer is a malignant tumor of the liver, which is a highly prevalent and extremely harmful malignant tumor in my country.

4. Will you definitely feel pain if you have liver cancer?

Analysis: Liver cancer has become a serious threat to the health and life of the Chinese people. When liver cancer lesions gradually increase in size and number, they pull on the liver capsule, which can easily cause pain in the liver area, usually in the form of persistent distending pain and dull pain. The tumor invades the diaphragm and may also cause radiating pain in the right shoulder and back. In the late stage of liver cancer, rupture and bleeding will cause severe abdominal pain accompanied by a drop in blood pressure and anemia.

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However, if the tumor grows in the center of the liver, far from the surface of the liver, the patient may not feel much pain even if the tumor is large. If the tumor grows close to the surface of the liver, it will be painful even if the tumor is small.

The truth: Having liver cancer does not necessarily mean you will experience pain. Pain is closely related to the location and erosion ability of the tumor.

5. Obese people

Why do you get fatty liver?

Analysis: Abdominal B-ultrasound examination is the preferred method for early diagnosis of fatty liver. Fatty liver is a condition in which fat accumulates in the liver due to problems with fat metabolism in the liver.

There are two types of fatty liver: alcoholic fatty liver, also called alcoholic liver; and non-alcoholic fatty liver, commonly known as fatty liver. In addition to obesity, the cause of fatty liver is also closely related to bad eating habits such as drinking, high-fat diet, fried foods and snacks. People with "three highs" of high blood pressure, high blood lipids and high blood sugar, and people with metabolic problems are also prone to "infection".

Patients who are starving for a long time due to excessive weight loss or anorexia can also suffer from fatty liver. Many thin patients actually have "hidden obesity", that is, visceral fat accumulation. It is related to the patient's eating habits, such as high fructose and high fat diet, PNPLA3 gene polymorphism, insulin resistance, intestinal flora disorders, visceral and ectopic obesity.

The truth: A bad diet is a major cause of fatty liver disease, but fatty liver disease is not exclusive to fat people, thin people can also get it. To prevent and treat fatty liver disease, you need to improve your lifestyle, which simply means "control your mouth and move your legs", and you also need to treat the cause.

6. Don’t people who blush when drinking alcohol have liver damage?

Analysis: The decomposition and metabolism of alcohol in the liver mainly rely on two enzymes - alcohol dehydrogenase and acetaldehyde dehydrogenase. After alcohol is absorbed, it enters the blood, and most of it enters the liver. Therefore, the liver will break down most of the alcohol.

The metabolic process of alcohol consists of two steps:

Step 1: Alcohol (mainly ethanol) is converted into acetaldehyde under the action of alcohol dehydrogenase;

Step 2: Under the action of acetaldehyde dehydrogenase, acetaldehyde is converted into acetic acid and finally decomposed into carbon dioxide and water.

People who blush when drinking alcohol lack acetaldehyde dehydrogenase, which causes abnormalities in the second step of alcohol decomposition. Acetaldehyde remains in the body for a long time and cannot be metabolized well, which in turn damages the body and stimulates blood vessel dilation, causing redness of the face and other parts of the body, rapid heartbeat, nausea and other symptoms of drunkenness.

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Conclusion: People who blush when drinking alcohol will damage their liver more. People who blush easily when drinking alcohol lack acetaldehyde dehydrogenase, which is a kind of alcohol sobering enzyme. The change in complexion after drinking alcohol cannot accurately judge the amount of alcohol consumed, nor does it indicate the liver's tolerance to alcohol. If you drink alcohol for a long time, your risk of liver cancer is much higher than that of normal people. Moreover, drinking alcohol is harmful to health. No matter if your face turns red or pale, you should drink less, or better yet, not drink at all.

7. Elevated alpha-fetoprotein

Is it definitely liver cancer?

Alpha-fetoprotein (AFP) is an important indicator of liver cancer, but not all elevated AFP levels indicate liver cancer. Specific analysis is required. Each laboratory indicator has different clinical significance for different individuals. Elevated AFP levels can be seen in the following situations:

Inflammatory activity in the liver

During active liver inflammation, serum AFP may increase, usually not exceeding 400ng/ml. Its increase is related to the degree of liver cell necrosis and regeneration. AFP can gradually return to normal after liver function improves.

Liver cancer

About 70%~80% of patients with primary liver cancer (except cholangiocarcinoma) may have elevated AFP. If AFP>200ng/ml for more than 8 weeks, or AFP>400ng/ml for more than 4 weeks, primary liver cancer is likely to be the cause.

pregnancy

AFP is produced by the yolk sac and fetal liver. Its concentration is highest during the 3rd to 5th month of pregnancy, but generally does not exceed 200ng/ml and gradually returns to normal levels within 3 weeks after delivery.

Teratoma

Elevated serum AFP may also occur due to abnormal development of germ cells.

The truth: Elevated alpha-fetoprotein ≠ liver cancer, negative alpha-fetoprotein ≠ no liver cancer.

Planning and production

Author: Hu Zhongdong, deputy chief physician, registered dietitian, health manager, and speaker of the Healthy China Action

Reviewer: Yan Jie, Chief Physician of Liver Disease Center, Ditan Hospital, Associate Professor of Peking University School of Medicine

Tang Qin, Director and Researcher of the Science Popularization Department of the Chinese Medical Association

Editor: Zhong Yanping

Proofread by Xu Lailinlin