Why do I get fatty liver even though I am not fat at all? Learn more about the "not simple" fatty liver

Zhou Zhou is a beauty-loving lady. She is well-proportioned and does not drink. She rarely takes medicine and has never had hepatitis. However, she was diagnosed with fatty liver and elevated triglycerides during a physical examination, which made her very distressed. Here is some information for friends who have similar situations: What are fatty liver and hypertriglyceridemia ?

The fat content of a healthy liver is only 3%-5% of the total liver weight. Fatty liver, as the name suggests, is excessive accumulation of liver fat. When more than 5% of liver cells are fatty under an optical microscope, fatty liver can be diagnosed. In my country, the prevalence of fatty liver in adults is between 12.5% ​​and 35.4%. Fatty liver has replaced viral hepatitis as the number one liver disease among Chinese residents, with more than 200 million people suffering from the disease. In my country, the number of people with dyslipidemia is even higher, exceeding 400 million, with a prevalence rate of 40.4%. It is very common for fatty liver to have dyslipidemia clinically. According to epidemiological surveys, the co-existence rate is as high as 69.2%. Both hypertriglyceridemia and hypercholesterolemia can be called hyperlipidemia. Elevated triglycerides alone are more common in fatty liver, diabetes, atherosclerosis, and nephrotic syndrome. Therefore, the real culprit of fatty liver is fat! The accumulation of fat in the blood leads to hyperlipidemia, and the accumulation of fat in the liver forms fatty liver.

How to distinguish the severity of fatty liver?

In my country, it is mainly divided into alcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD). NAFLD is divided into two categories: primary and secondary. Primary is related to insulin resistance and genetic susceptibility, while secondary is caused by excessive weight gain, obesity, diabetes, hyperlipidemia, etc. due to overnutrition. Mild fatty liver means that the fat content of liver tissue pathological sections is 5% when stained, and moderate fatty liver means that the fat content of liver tissue pathological sections is greater than 10% and less than 25%. Severe fatty liver means that the fat content exceeds 25%. If the abdominal plain scan CT is used to judge, the CT density value of the liver is mild compared to the CT density value of the spleen between 0.7-1.0, between 0.5-0.7 for moderate, and less than 0.5 for severe. If fatty liver is not controlled, it can lead to fatty hepatitis, liver fibrosis, cirrhosis, hepatocellular carcinoma, and may also cause other chronic diseases, such as type 2 diabetes and atherosclerosis.

How to determine whether you have hyperlipidemia or fatty liver through laboratory test indicators?

The simplest way is to judge through the blood lipid report (4 results) in the blood test: total cholesterol (TCHO), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Careful friends will compare their results with the normal reference range provided on the report to judge the high and low. When total cholesterol>5.2mmol/L is elevated, and more than 5.7mmol/L is hypercholesterolemia. Triglycerides>1.7mmol/L is elevated, and more than 2.1mmol/L is hypertriglyceridemia. If it exceeds 5.6mmol/L, it is a high-risk factor for pancreatitis. High-density lipoprotein cholesterol is also known as anti-atherosclerotic protein, commonly known as "vascular scavenger". Its increase is beneficial to the dredging of human blood vessels. Low-density lipoprotein cholesterol needs to be lower than 3.4mmol/L for normal people, lower than 2.6mmol/L for patients with coronary heart disease, and patients with coronary heart disease who have heart stents placed are required to drop even lower, lower than 1.8mmol/L.

The economical and affordable abdominal ultrasound examination is the first choice for diagnosing fatty liver. Generally speaking, when the liver parenchyma has enhanced echoes and local patchy low-echo areas, it is often considered to be non-uniform fatty liver, but the diagnostic sensitivity of ultrasound for mild fatty liver is low. Secondly, it can be determined by abdominal plain scan CT. When the density of the liver at the same level is less than that of the spleen, fatty liver can be diagnosed. In addition, liver tissue biopsy is the gold standard for determining fatty liver. If the blood liver function: alanine aminotransferase (ALT), aspartate aminotransferase (AST), r-glutamine transpeptidase (r-GT) values ​​are increased at the same time, it indicates that the liver cells are damaged, which may have developed to the level of fatty liver hepatitis.

How to eliminate fatty liver?

For the treatment of mild fatty liver, the main approach is to change the lifestyle, reduce staying up late, have a regular work and rest schedule, and reduce the intake of fat and sugar in the diet. For patients with moderate to severe fatty liver and those with abnormal liver function (over 6 months), comprehensive treatment is required, as follows:

1. Adhere to intermittent, high-intensity exercise for more than 3 hours a week, such as running, skipping rope, swimming, aerobics, aerobic fitness and other physical resistance exercises to quickly burn visceral fat.

2. Adjust diet. Patients with non-alcoholic fatty liver disease and obesity should control their daily calorie intake within 1000-1200 kcal and avoid eating the following foods: fried foods, fatty meat, animal offal, and high-sugar foods. For patients with alcoholic fatty liver disease, it is very important to quit drinking. At the same time, they should eat more high-protein, low-fat foods. At the same time, they can take deep-sea fish oil, because fish oil is rich in omega-3 fatty acids, which have the effect of lowering blood lipids and preventing platelet aggregation.

Drug treatment: Overweight people should control their weight, control blood sugar, and lose weight. Commonly used weight loss drugs: Orlistat capsules. Patients with non-alcoholic fatty liver caused by diabetes can take hypoglycemic drugs: Metformin. Patients with combined hyperlipidemia can take lipid-lowering drugs: statins, fibrates, omega-3 fatty acids. Patients with abnormal liver function can also use anti-inflammatory and liver-protecting drugs: polyene phosphatidylcholine, milk thistle. The above drugs must be taken under the guidance of a doctor.