March 18, 2024 is the 24th "National Liver Love Day".

This year’s publicity theme is “Early Prevention and Early Treatment to Stay Away from Liver Cirrhosis”.

　　Many people think that everyone around them who has a belly has fatty liver.

After each physical examination, these people's liver function indicators only show higher transaminases, and they feel no physical discomfort.

　　It wasn't until one day a few years later that the word "cirrhosis" suddenly appeared on the physical examination report, and symptoms of complications of liver cirrhosis such as vomiting blood, abdominal distension, and edema of the legs suddenly appeared. They were so anxious that they scratched their heads and couldn't help but wonder. When did my liver problem suddenly get worse?

So, how does fatty liver affect physical health?

Where does cirrhosis of the liver come from?

1The

dangers of fatty liver are not small

　　Metabolic-related fatty liver disease used to be called non-alcoholic fatty liver disease, which is what we often call fatty liver.

As the name suggests, the main pathological change of this disease is the accumulation of fat in the liver.

　　The accumulation of lipid droplets in liver cells will gradually affect the function of liver cells and cause liver inflammation.

The repeated inflammatory repair process of the liver will promote the occurrence and development of liver fibrosis.

As damage repair continues, liver fibrosis also progresses, eventually forming cirrhosis.

　　Once cirrhosis progresses, the disease is irreversible.

At this time, the liver function is severely damaged, which can cause complications of liver cirrhosis such as ascites, vomiting blood, urinating black stools, and coma, and may even progress to liver cancer, eventually becoming a "fatal fatty liver."

　　Generally speaking, the prevalence of fatty liver is higher in elderly obese patients and postmenopausal women, but obesity is only one of the risk factors for fatty liver.

When there are factors such as insulin resistance, genetic metabolism problems, excessive visceral fat deposition, specific intestinal flora disorders, hormone disorders, etc., thin people can also develop fatty liver.

　　Especially for people who are emaciated or lose weight rapidly in a short period of time, the fat metabolism of the liver is affected, the synthesis of apolipoprotein is reduced, and the transport of fat from the liver to the outside of the liver is blocked, which can lead to the accumulation of fat in the liver and the occurrence of fatty liver.

2 The development process varies from person to person

　　According to the natural history of metabolic-related fatty liver disease, in the simple fatty liver stage (NFS fibrosis score stage F0) the disease will worsen to the next stage on average 14 years, while in the metabolic-related steatohepatitis stage (stages F1-F2) the disease will progress to the next stage on average 14 years. It will only take 7 years to enter the next stage.

　　Progression to stage F3 is advanced liver fibrosis, and stage F4 is cirrhosis.

In the first 10 years of disease development, patients have no obvious clinical symptoms, so many patients with fatty liver look "pretty normal."

　　In addition, the above-mentioned disease progression rate is only an average level, and the progression of fatty liver is not linear. The patient's personal physical condition, combined with different diseases, etc., will affect the progression rate of the disease.

Clinical trials have shown that when combined with metabolic diseases such as obesity, type 2 diabetes, and hyperlipidemia, or when long-term use of liver-damaging drugs, accompanied by viral hepatitis, frequent alcohol consumption, etc., the rate of liver damage may be higher than average. Much faster.

　　About 20% of patients with advanced liver fibrosis will develop cirrhosis within 2 years, and about 20% of patients with compensated cirrhosis will develop decompensated cirrhosis such as ascites, gastrointestinal bleeding, and hepatic encephalopathy within 2 years. complication.

　　Some patients with fatty liver can also skip the cirrhosis stage and directly progress to liver cancer.

In a study conducted by our team, 273 patients diagnosed with metabolism-related liver cancer were included, approximately 50% of whom had no evidence of cirrhosis.

Therefore, fatty liver disease at every stage cannot be underestimated.

It is crucial to grasp the acceleration point of fatty liver and timely medical intervention.

It is really a pity if controllable and reversible fatty liver develops into cirrhosis or even liver cancer because of your own negligence.

　　Author: Wang Qi, chief physician, and Ren Xinhua, attending physician, Liver Disease Center, Beijing Ditan Hospital Affiliated to Capital Medical University

　　Review: Xie Wen, expert from the National Health Science Popularization Expert Database and Liver Disease Center of Beijing Ditan Hospital Affiliated to Capital Medical University

　　Planning: Tan Jia Zheng Yingfan

　　(Healthy China WeChat public account)