Rumor:
Fatty liver is only for fat people. As long as the weight is not over the standard, thin people can eat and drink with confidence and will not get fatty liver.
Rumors refuted:
Fatty liver most often affects obese and overweight patients. However, thin people can also get fatty liver, and fatty liver is not exclusive to fat people!
1. Common causes of fatty liver
The liver is an important place for fat metabolism. Under certain pathological conditions, there are too many sources of fat or there is a disorder of fat metabolism. A large number of lipid droplets (mainly triglycerides) will accumulate and fatty changes will occur. Fatty liver can be diagnosed when more than 5 liver cells undergo fatty change. Clinically, fatty liver is divided into alcoholic fatty liver, non-alcoholic fatty liver and special types of fatty liver according to the cause.
With economic development and changes in lifestyle, the number of patients with fatty liver disease in my country has increased rapidly, with the prevalence reaching 12.5-35.4. Fatty liver has now replaced viral hepatitis as the number one chronic liver disease in my country. Obesity and metabolic syndrome caused by obesity (obesity, hypertension, hyperlipidemia, hyperglycemia, hyperuric acid, etc.) are the primary causes of fatty liver and abnormal liver enzyme indicators. With the increase in the prevalence of obesity and diabetes, the prevalence of non-alcoholic fatty liver disease (NAFLD) in adults in my country has reached more than 25%, which means that there are 5 patients with non-alcoholic fatty liver disease for every 20 people. About 1 in 5 patients will develop more severe steatohepatitis.
Alcoholic fatty liver is also a problem that cannot be ignored. The proportion of inpatients with liver disease is increasing year by year. The severity of liver damage is closely related to the amount and duration of drinking.
In general, the main reasons for the rapid increase in the prevalence of fatty liver are obesity, diabetes and excessive alcohol consumption.
2. Why do thin people get fatty liver?
Thin people usually get fatty liver in the following three situations:
The first situation is seen in dieting Or thin people who are malnourished for other reasons. Dieting can lead to insufficient nutrition in lean people, lack of heat energy sources, and increased heat production from lipolysis; while in a long-term state of hunger, hypoglycemia stimulates hypersympathetic nerve function, aggravates lipolysis, and increases fatty acid production; malnutrition leads to hypoalbuminemia, Insufficient lipoproteins prevent a large amount of fatty acids in the liver from being transported into the blood by apolipoproteins, and accumulate in the liver to cause fatty liver.
The second situation is seen in thin people who do not like to exercise, but like to drink drinks or honey, and like to eat sweet fruits. These foods contain a lot of fructose, which is a simple sugar that is easily absorbed by the body and has a high sweetness (1.6 times that of sucrose). Because fructose is not metabolized by the pancreas, compared with glucose, it does not stimulate the rise of insulin and has less impact on blood sugar. It was once advertised as a "good sugar", but this is not the case.
The main harm of fructose to the body is that it can be used as a raw material for fat synthesis, which is directly stored into fat through the liver, and then triggers a series of biochemical reactions, such as increased triglycerides, increased insulin resistance, and obesity. Liver etc. In layman's terms, the sugar content in food is very complex and needs to be carefully digested by the body and then absorbed and utilized. Fructose can be directly used to accumulate fat without being digested. A study on healthy men showed that a high-fructose diet increased hepatic fatty acid synthesis by six times, decreased sensitivity to insulin, and abnormal blood lipid levels, making abdominal obesity more likely to occur and other metabolic diseases increased. Risk of disease, including fatty liver, diabetes, etc. In this case, even if the patient suffers from fatty liver disease, he may not be overweight.
The third condition is seen in patients who use certain drugs, are infected with certain viruses, and suffer from certain inherited metabolic liver diseases. Long-term use of some drugs with liver side effects, such as common hormone drugs, arrhythmia drugs such as amiodarone, anti-epileptic drugs such as sodium valproate, and anti-tumor drug methotrexate, may lead to fatty liver. ; In addition, hepatitis C virus infection with genotype 3 may also manifest as fatty liver in the early stages; some autoimmune liver diseases and genetic metabolic liver diseases such as hepatolenticular degeneration may also manifest as hepatocellular steatosis.
Fatty liver caused by these conditions does not distinguish between fat and thin people.
It can be seen that fatty liver is not exclusive to fat people. Fatty liver can still occur in thin people if they eat and drink indiscriminately, lose weight unscientifically, or suffer from malnutrition.
Rumor-refuting expert: Wang Fang, director and chief physician of the Second Department of Hepatology, Shenzhen Third People's Hospital
Review expert: Yang Binghui, former president and professor of Zhongshan Hospital Affiliated to Fudan University
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