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Although hepatitis is primarily caused by viruses and alcohol, "fat" appears as the leading cause of hepatitis. Hepatitis B and hepatitis C become less risky due to the development of preventive vaccines and new drugs, but the risk of nonalcoholic steatohepatitis (people with fatty liver who drink less than 2 or 3 bottles of soju a week) increases with the growth of obesity. I think that the fatty liver is not very common and often overlooked, but the progress towards fatty hepatitis is different. In the United States, non-alcoholic steatohepatitis is the third leading cause of liver transplantation.
How fat acts as a poison
The fatty liver is a liver fat, and the prevalence of nonalcoholic fatty liver disease is about 25% (based on the adult age of 30 years or older). It is estimated that about 10% of patients with fatty liver are hepatic steatosis. Oily hepatitis is diagnosed when inflammation and hepatocyte lesions accompany a lot of liver fat. In recent years, the presence of fibrosis, including rigid hepatocytes, is also used as a criterion for determining the severity of hepatitis. Because the fatty liver is not diagnosed by ultrasound and the liver biopsy must be done, most patients in the liver now have a fatty liver
Although not eating much alcohol, fatty liver and hepatitis are caused by excessive consumption of calories. "If there are enough calories in the body, they will be stored as liver," says Professor Jang Byeong-guk, a professor of digestive medicine at Dongsan University's Keimyung Medical Center. "Free fatty acids in adipocytes are released into the liver."
When they accumulate in the liver, they increase active oxygen and activate the inflammatory gene to cause inflammation. The prognosis is completely different from that of foie gras and fatty liver, which are simply fat. According to the American Journal of Hepatology, the liver mortality rate is 1.94 times higher than that of the general population and the total mortality rate is 1.05 times higher than that of the general population and 2.56 times higher.
◇ Obesity, diabetic patients, vulnerable fatty hepatitis
The problem is that even if you have hepatic steatosis, there are no particular symptoms, this does not Not going to be a big problem. However, for people who have metabolic diseases such as obesity, diabetes, hyperlipidemia and hypertension, fatty liver is more likely to be fatty liver, not the simple foie gras. "If a person with a metabolic disease is diagnosed with a fatty liver by ultrasound, they should suspect hepatic steatosis and start taking care of it faster," said Jang. Non-alcoholic fatty liver disease itself is an independent risk factor for cardiovascular disease. In Sweden, 229 patients with nonalcoholic steatohepatitis were followed up to 33 years. After badyzing the causes of their deaths, 43% of patients died from cardiovascular disease (CVD). Already, patients with hepatitis B or hepatitis C or alcoholic liver disease are not free of the risk of hepatic steatosis. If they are obese, they also increase the risk of fatty liver and accelerate liver damage.
◇ Weight loss is the number one …
The most important thing in the treatment of hepatitis is "weight loss". According to guidelines issued by the American Liver Association this year, daily caloric intake should be reduced from 500 to 1,000 pounds. At least 3 to 5 percent of body weight should be reduced to reduce liver fat. To improve inflammation and fibrosis, lose 7 to 10% of body weight.
Non-alcoholic fatty liver disease does not contain any special medicine. In 2010, pioglitazone, a high-dose vitamin E, was reported to improve hepatitis.
Park Sang-hoon, director of the digestive center of Sacred Heart Hospital of Hallym University, said: "Pioglitazone improves fat and inflammation .The side effects, vitamin E high-grade can be used by patients without diabetes, but side effects such as cerebral hemorrhage are reported, "he said. There are currently four candidates for Phase III clinical trials and more than 20 Phase II clinical trials. Park Sang-hoon, president of the Center, said, "The drug for hepatitis non-alcoholic hepatitis should be a quick target for the US FDA." By 2020, new drugs will be developed . "
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