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"I was young,
Usually deliberately do not stick to the grease,
Body mass index is normally low,
How can I have a fatty liver? ”
Case playback
Xiao Wu, a 25-year-old graduate of the Art Department, has been working on his favorite hand model in recent years. She is slim, 175 cm tall, weighs 51 kg, and is a standard bone beauty. In order to maintain his figure, Xiao Wu usually pays great attention to his diet, stays away from greasy food, and does not even dare to indulge himself once or twice.
Last month, the company organized a physical examination, Xiao Wu's liver and kidney function, blood lipids, blood sugar and other aspects of the indicators are very good, but B ultrasound shows that there is a moderate fatty liver. Seeing the results of the physical examination, Xiao Wu was surprised and puzzled: "I am young, usually deliberately do not eat greasy, body mass index is lower than normal, how can there be fatty liver?" ”
The doctor learned through the conversation that Xiao Wu usually works hard and seriously, and often works overtime and stays up late in recent times. She originally ate less, and when she was hungry, she only drank some original cucumber juice to deal with it, and from time to time she liked to drink some red wine to eliminate fatigue and regulate her mood. Although she was sometimes dizzy, flustered and hungry, she was restrained by her tenacious perseverance. So, how did her fatty liver come about?
Trace the cause
Many people do not know that if the thin body is in a long-term state of hunger or semi-hunger, just like Xiao Wu, in order to maintain the figure and long-term weight loss or diet, daily life and behavior lack of enough glucose, fat and other energy sources of support, it is bound to consume body fat and protein. These fats and proteins will be converted into heat through the liver as a transit station. As a result, a large number of fatty acids enter the liver, coupled with the lack of necessary enzymes and vitamins for fat metabolism, so that fat accumulates too much in the liver, thus triggering fatty liver.
Thin or emaciated people, because of poor absorption or supply of nutrients, most of them have recessive hypoproteinemia, and the liver's lipoprotein production will also decrease, so fat cannot be transported and metabolized normally in liver cells, which can also cause or aggravate fatty liver. At this time, choline, amino acids, reduced glutathione and other substances involved in the normal metabolism of fat will also be reduced, and malondialdehyde and lipid peroxides in the liver will be produced in large quantities, and the result is a negative impact on liver function.
Thin as Xiao Wu, if she also has a long-term bad habit of drinking, drinking more than 160 grams a day, the probability of fatty liver will be 5 to 25 times higher than that of ordinary people. Low-grade beer, red wine, fruit wine, cocktails, etc., because of the low alcohol content, easy to tolerate or decomposed by the body in time without appearing drunk, it is more likely to become a hidden danger. Many people drink alcohol on an empty stomach or substitute alcohol for food, which is more risky.
The liver is too hard
There is also a situation that fat people finally lose weight after rapid weight loss, for example, after someone learns that they have fatty liver, they will quickly reduce their weight by 10 to 20 kilograms within 1 month, and then their hearts will relax, life will return to their old state, and body fat will suddenly rise and fall like a roller coaster, so that the body will quickly or repeatedly mobilize sebum and visceral fat to enter the liver in large quantities, and accompanied by the production of a large number of lipid peroxides. This will not only exacerbate fatty liver disease, but even develop steatohepatitis, further impairing liver function.
Recently, The Lancet magazine published a systematic review. An evaluation of 932 studies involving 10.576 million people in 24 countries found that about 40% of the world's fatty livers are non-obese, and 1/5 of them are thin.
To discuss the reasons for this, it may be that most thin people like to eat vegetarian food, some picky eaters, long-term diet composition is single, nutritional imbalance, lack of protein, vitamins, mineral intake. Liver synthesis of lipoproteins is severely reduced or insufficient, but the body's nutritional or energy deficiencies will compensate for the increase in the secretion of adrenal glucocorticoids to promote the entry of large amounts of free fatty acids into the blood vessels and liver. After exceeding the operating load of the liver, it is easy to form a fatty liver, or lead to aggravation of fatty liver.
This is controlled
Most patients with fatty liver disease will involuntarily make "diet + exercise" changes within 1 to 3 months of just learning of their condition, and even if they do not do any treatment, their weight and fatty liver will be reduced. But the good times are not long, and after 3 to 6 months, they enter the inert period, and the weight will soon rebound.
Whether fat or thin, cognitive transformation is the most important. The first rule to control fatty liver is to try to avoid drug abuse, especially the abuse of supplements and health care products. As one of the powerful organs of the human body, the liver must be detoxified and decomposed here before it can be used or excreted. After the fatty liver is detected, it is necessary to abuse, multi-use or take various drugs for a long time, which is bound to further increase the burden on the liver.
Second, it is not advisable to over-diet. The metabolic function of the liver must involve fat and protein, and excessive dieting artificially affects this process, which can easily lead to the accumulation of body fat into the liver. Many thin people insist on losing weight for a long time, and intentionally reduce the intake of fat and protein in daily food, which is bound to disrupt the balanced absorption of nutrients and lead to malnutrition.
Third, avoid alcoholism. Long-term or heavy alcohol consumption is easy to induce and aggravate fatty liver, with fatty liver still go their own way without moderation, it is possible to accelerate the transformation of fatty liver into fatty hepatitis and cirrhosis and other more serious conditions. Most fatty livers are reversible, and early detection and proper response can improve and control.
Give advice
It is worth noting that weight loss and fat control, easy to know is difficult to do, expensive in perseverance, wrong in seeing good to receive.
Many people diet, slimming for many years, after achieving results or relapse of alcohol addiction, or eat and drink, fatty liver may come back within 1 to 2 months, years of hard work before the achievements of the past.
In particular, some people have a particularly good appetite, like to eat fat and thick, even no meat is not happy, or the amount of alcohol, wine in the circle of friends is famous, there are always times that can not withstand the temptation, often make the "weight loss cause" failure, halfway abandoned, but also let the fat load of the liver like a roller coaster like ups and downs.
It really shouldn't hurt you like that!
The author | Liver Disease Center of the Third People's Hospital of Guilin, Guangxi
Chief Physician Cheng Shuquan
Audit | expert of the National Health Science Popularization Expert Database
Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine
Chief Physician of the Department of Gastroenterology Fang Jingyuan
Planner | Tan Jia Yu Yunxi
Editor| Yu Yunxi