Fatty liver is not simple

This is the 3977th article of Da Yi Xiao Hu

With the development of economy and the improvement of people's living standard, overweight and obesity have become very common. Although the current aesthetic view is that thinness is beautiful, people generally do not mind obesity, unless it is too fat to move. Among some overweight and obese middle-aged and elderly people, the "three highs" of high blood pressure, high blood lipids and high blood sugar are quite common, and people are mainly concerned about the "three highs" rather than overweight and obesity.

Fatty liver is more common in some overweight and obese young and middle-aged people. Nowadays, physical examinations are quite popular. Ultrasound examination of the liver can effectively detect fatty liver. It is common for 20% to 30% of people to be found to have fatty liver after a physical examination. Fortunately, these people with fatty liver have almost no symptoms, and most of them have normal liver function, so people don't mind it. Some people consult doctors for drug treatment. Most doctors answer: fatty liver with normal liver function is "simple fatty liver", no medication is needed, just "control your mouth and move your legs". What the doctor said is not wrong, but the information patients often get is: simple fatty liver is simple fatty liver; no medication means no treatment. In other words: don't take it seriously.

Medical technology is constantly developing. In recent years, more and more studies have proved that fatty liver includes alcoholic fatty liver and non-alcoholic fatty liver. The former is caused by excessive drinking, while the latter is part of the metabolic syndrome together with the "three highs", that is, the manifestation of metabolic syndrome in the liver. Fatty liver found in general physical examinations, if not caused by excessive drinking, belongs to this category. Therefore, if this type of fatty liver is found, even if it is the so-called simple fatty liver with normal liver function, it should not be taken lightly. First, we cannot discuss the matter at hand or "discuss the liver", but once fatty liver is found, we should delve into other manifestations of metabolic syndrome, such as whether there are manifestations or trends such as hypertension, hyperlipidemia, hyperglycemia, and even hyperuricemia. If there are any, they should be treated or prevented. Second, the so-called simple fatty liver, if you do not pay attention to improving your lifestyle and correcting it, will also progress to fatty hepatitis, fatty liver cirrhosis and even liver cancer. For this reason, the academic community has begun to rename non-alcoholic fatty liver disease as "metabolic-related fatty liver disease" to emphasize its essence as part of metabolic syndrome, and no longer uses the name "simple fatty liver" to avoid being ignored by the public.

Metabolic-related fatty liver disease is a part of metabolic syndrome, which has been known for a long time and needs no further explanation. In recent years, more and more studies have found that this liver disease is related to liver cancer. More than 90% of liver cancer is hepatocellular carcinoma, which is mainly related to chronic hepatitis, cirrhosis and alcoholic cirrhosis caused by hepatitis B and C virus infection in my country. Since the use of hepatitis B vaccine to prevent hepatitis B virus infection and effective antiviral drugs for treatment, the mortality rate of liver cancer caused by hepatitis B and hepatitis C virus infection has been controlled, but the global liver cancer mortality rate is still rising. The increase in liver cancer mortality in the United States actually ranks first among the increase in mortality rates of various tumors. The reason is that liver cancer caused by this metabolic-related fatty liver disease is increasing significantly.

The obvious increase in liver cancer caused by "fatty liver" has sounded the alarm for the world: this fatty liver is not simple.

Of course, this kind of fatty liver with normal liver function, which is found by ultrasound examination during physical examination, has a very low possibility of directly developing liver cancer, which can be almost ignored. Therefore, patients with this kind of fatty liver do not need to be too nervous. However, although there is no need to be nervous, it needs to be taken seriously, because such patients may develop fatty hepatitis, when liver function is impaired. Not only do they need to work hard to improve their lifestyle, but they also need to take certain medications to prevent it from turning into liver fibrosis and cirrhosis. When this metabolic-related fatty liver disease progresses to liver fibrosis and cirrhosis, the incidence of liver cancer has reached 10 to 15 cases per 1,000 people per year, which is no different from the incidence of liver cancer in alcoholic cirrhosis. If there is also infection with hepatitis B or C virus, or diabetes, the incidence of liver cancer will be higher.

In addition to the above-mentioned fatty hepatitis, liver fibrosis, cirrhosis, combined hepatitis B, hepatitis C virus infection and diabetes, male, old age, obesity, smoking, drinking and other factors that lead to liver cancer in patients with metabolic-related fatty liver disease are all risk factors for liver cancer. In order to detect liver cancer early, patients with this type of liver disease who have progressed to fatty hepatitis, progressive liver fibrosis, cirrhosis and combined hepatitis B, hepatitis C virus infection and diabetes should undergo regular liver cancer screening. In order to avoid the occurrence of liver cancer, patients with this type of liver disease should strive to improve their lifestyle: in addition to "controlling their mouths and moving their legs", they should also quit smoking and drinking. Obese people should work hard to lose weight. According to research, weight loss of more than 5% can help the liver inflammation subside, and weight loss of more than 10% can even alleviate liver fibrosis to a certain extent. Patients with combined hepatitis B, hepatitis C virus infection and diabetes should be actively treated to reduce the risk factors for cancer.

Non-alcoholic fatty liver disease, even so-called simple fatty liver disease, should not be taken lightly. Everything needs to be taken seriously, especially matters related to one's own health.

Author: Yang Binghui