The "Brotherly Relationship" Between Fatty Liver and Hyperlipidemia: A Comprehensive Analysis from Causes to Prevention and Treatment

Fatty liver should be taken seriously: When excessive fat accumulates in the liver, exceeding 5% of its weight (normally, fat in the liver accounts for 2%–4% of its weight), fatty liver develops.

Fatty liver and high blood lipids are closely related. High blood lipids are a systemic lipid metabolism disorder that easily affects the liver; and the liver is the main site of lipid metabolism, so fatty liver also affects systemic lipid metabolism, causing abnormal blood lipids.

Fatty liver is divided into alcoholic fatty liver and non-alcoholic fatty liver. Studies show that 90% of people who frequently drink excessively will develop fatty liver, and 12% of those with alcoholic fatty liver will develop cirrhosis. It has been observed that the amount and duration of alcohol consumption are directly related to the occurrence of alcoholic fatty liver; there is a positive correlation between them.

Research indicates that individuals meeting the following criteria are more prone to fatty liver: hyperlipidemia; diabetes; abdominal fat accumulation; long-term heavy drinkers; obesity; viral hepatitis; and long-term exposure to drugs or toxins.

So, why are people with the above conditions prone to fatty liver? For example, obese individuals, especially those with abdominal fat accumulation, are highly susceptible to fatty liver because their bodies have a relative excess of nutrients, which tend to accumulate in the liver. A staggering 21% to 78% of diabetic patients also develop fatty liver due to insufficient insulin or insulin resistance, leading to endocrine and metabolic disorders, abnormal blood lipids and blood sugar, and excessive fat accumulation in the liver. Thus, fatty liver quietly creeps up on them. Most of them don't experience any symptoms and are often only discovered during physical examinations or when seeking medical attention for other illnesses. As it progresses, symptoms include hepatomegaly, liver area distension and pain, loss of appetite, and elevated transaminase levels. A few may develop mild jaundice and splenomegaly. Approximately 35% of adults with elevated transaminase levels during physical examinations have fatty liver.

The consequences of fatty liver are very serious; it can potentially develop into cirrhosis. Symptoms include jaundice and ascites, and in severe cases, it can be life-threatening. Therefore, the prevention and treatment of fatty liver are crucial for preventing the progression of chronic liver disease and improving prognosis.

Most patients with fatty liver disease are unaware of their symptoms. So how can it be detected early? Abdominal ultrasound is the preferred method. It typically shows diffuse punctate hyperechoic areas in the liver region. This examination is highly accurate and painless. Simultaneously, blood tests for liver function and lipids should be performed. If diagnosed, more detailed examinations such as CT or MRI are needed for definitive diagnosis. In this way, fatty liver can be nipped in the bud, and people should avoid falling into common misconceptions about its treatment.

Regarding the treatment of fatty liver, people generally fall into the following misconceptions:

(1) Treating only when symptoms appear.

Fatty liver sometimes has no symptoms. If this is not taken seriously, it may delay treatment and lead to further deterioration of the condition.

(2) Treating only with lipid-lowering drugs is sufficient.

Lipid-lowering treatment must be based on dietary therapy and lifestyle improvements.

(3) Not selecting lipid-lowering drugs. Bile acid binding resins and nicotinic acid are lipid-lowering drugs that should not be used.