Fatty liver without taking lipid-lowering drugs?
With the ultrasonic examination in the examination of a large number of applications, found that the rate of fatty liver is increasing. That some patients, fatty liver since it is a kind of excessive lipid deposition in liver disease, then it should be taking lipid-lowering medication. This understanding correct? I encountered in clinical practice, two patients, it is representative.
34-year-old Mr. Zhang, non-drinking history, body mass index of 27. Two years ago, upper abdominal B-ultrasound of fatty liver was found, it has been taking lipid-lowering drugs, a recent review, no significant decline in body weight, B is still super-fatty liver, and abnormal liver function in the transaminase.
58-year-old Lee teacher, no drinking history, body mass index 32. A year ago, by B-ultrasonography and CT examination revealed fatty liver, while patients with hypertension, hyperlipidemia and diabetes, had abnormal liver function. Later, under the guidance of a doctor through diet control and physical activity, supplemented by liver protection therapy, weight loss within one year about 10%, liver function returned to normal, CT showed the liver fat deposition significantly better than before.
Why is the fatty liver but there are different endings then? To answer this question, must understand the following two points.
First of all, to understand how the body fat and blood lipids matter. We say that a person’s body organizations there a certain amount of adipose tissue, the liver is no exception, it is rich in fat tissue of the organ, but with normal levels within a certain range, more than this quantity can cause fatty liver. The lipid transport is a state of fat, fat in the intestine after digestion, absorption from the small intestine into the bloodstream, in the blood re-synthesis of triacylglycerol, cholesterol and a variety of lipoproteins, lipids are mobile and continually updated, and normal conditions to maintain homeostasis. However, genetic or acquired factors, such as hobbies high-fat diet, less exercise and other unhealthy lifestyle can lead to hyperlipidemia. Hyperlipidemia is a long-term high blood pressure, coronary heart disease and other cardiovascular and cerebrovascular diseases and other metabolic syndrome risk factors, doctors often under the elevated level of blood lipids for lipid-lowering drugs, in the hope that by lowering blood lipids to reduce the incidence of the disease for more than .
Secondly, we must understand the liver’s role in fat metabolism. End-use parts of fat in the liver through the hepatic cells, consumption of β-oxidation of fat, provide energy for the body, a reduction in peripheral adipose tissue and reduce blood lipids, but also through the mobilization of peripheral adipose tissue and lipids to the liver achieved, so the liver is fatty the metabolism of vital organs. Fatty liver is the fat in the liver caused by the use of obstacles, in this case, if the abuse of lipid-lowering drugs, the consequences must be to peripheral adipose tissue and lipids to the liver expelled, not only increased the burden on the liver, even increase the already existing fatty liver, resulting in varying degrees of abnormal liver function. In addition, a number of lipid-lowering drugs in itself have a certain damage of liver function. This is not difficult to understand, Mr. Zhang after the long-term application of lipid-lowering drugs, why abnormal liver function.
Of course, if patients with fatty liver with hyperlipidemia application of lipid-lowering treatment is still necessary, because hyperlipidemia is a risk factor for many diseases. Now have a better consensus is, first and basic treatment, that is, to behavior and lifestyle intervention, diet adjustments and exercise therapy three basic measures to reduce the sources of fat and increase fat consumption, to peripheral fat, blood lipids and liver fat were reduced in目的. If after 3 to 6 months after the intervention of the basis of the treatment, the patient still showed mixed hyperlipidemia (low-density lipoprotein cholesterol greater than or equal to 4.16 cents Mount / l, triglycerides 2.82 ~ 5.65 cents in the Mount / L) or serious third year triglycerides hyperlipidemia (triglycerides greater than or equal to 5.65 cents Mount / l), consider the use of liver function with fewer lipid-lowering medication.
In summary, fatty liver were not accompanied by hyperlipidemia, without lipid-lowering treatment; and fatty liver with hyperlipidemia who should be the basis of the first treatment. Some patients after this treatment, the fatty liver improved significantly, such as a teacher although not with the lipid-lowering drug Lee, but the emphasis on the basis of a comprehensive treatment, better effect. If the patient has high blood lipids, after the above treatment results are poor, the doctor may consider the use of lipid-lowering drugs under the guidance of adjuvant therapy. Note that the use of lipid-lowering drugs during the period, requiring regular monitoring of liver function.