National Liver Health Day | I really want to ask: Why do thin people also get fatty liver?

Today is March 18th, which is also National Liver Care Day.

With the continuous improvement of my country's economic conditions, fatty liver, which was previously only common in "developed countries", has gradually become a "regular visitor" on our physical examination lists.

Before 2000, the prevalence of fatty liver in China's first-tier cities such as Beijing and Shanghai was only about 15%. In 2015, we randomly selected 4,000 adults over 20 years old in Beijing's urban area and used B-ultrasound to conduct a fatty liver survey, and found that the prevalence of fatty liver in Beijing's adult citizens was as high as 31%.

Generally speaking, fatty liver is a disease that fat people are prone to, which means that obesity can cause metabolic syndrome, which eventually leads to fatty changes in the liver. However, there is also a term in medicine called "fatty liver in thin people". What is the reason why thin people also get fatty liver?

In fact, "thin people" with fatty liver can be divided into two types: one is "fake thin" and the other is "real thin". Let's talk about it in detail today~

The cause of "fake thin people" is the same as that of obese people

Let’s first look at the first type – “false thinness”. Many people who exercise very little often have a “standard” weight when using weight and BMI to assess whether they are fat or thin, but when using abdominal circumference and waist-to-hip ratio to assess, they are still seriously overweight. This is the so-called “abdominal obesity”.

Copyright images in the gallery. Reprinting and using them may lead to copyright disputes.

The key reason for "abdominal obesity" is that insufficient exercise leads to reduced muscle capacity in the limbs, while the fat content in the internal organs, abdominal cavity and abdominal wall exceeds the standard . The cause of fatty liver in this "fake skinny" person is exactly the same as that of obese people.

The accumulation of fat is an obese state for the whole human body. In other words, we call people with a lot of fat fat. At the same time, in the process of obesity of the whole human body, the liver is also obese.

So when a person becomes fat, it is not just about having big breasts and hips, a round face, and a pot belly. The internal organs, especially the liver, are also filled with fat, thus becoming a plump and swollen liver. Therefore, for patients with fatty liver, the enlarged liver is like an obese person who has become a ball, which is caused by excessive fat filling in liver cells .

The specific reason for liver enlargement is not the increase in the number of liver cells, but the increase in the size of liver cells. The accumulation of fat in the liver makes the liver cells filled with a lot of fat (the kind of fat in animals that we often see in our food).

Copyright images in the gallery. Reprinting and using them may lead to copyright disputes.

If these "fat" grows more and more in liver cells, they can be regarded as a kind of "garbage", which will affect the function of normal components in liver cells, so fatty liver will eventually appear. If it cannot be effectively controlled, it will eventually develop into cirrhosis and liver cancer .

The real reason for fatty liver in “ really thin people ”

As we all know, obesity is the most common cause of fatty liver. Some people wonder, I often lose weight and control my body shape, why do I still get fatty liver? In fact, this kind of people can be said to be "really thin". They often stabilize their weight through some weight loss measures, such as:

① Diet. This means eating less carbohydrate and high-fat foods, such as staple foods such as rice and noodles, and fat-rich foods such as animal fats, fish and meat.

② Perform effective exercise. We call effective exercise that helps lose weight "aerobic exercise", such as brisk walking, jogging, swimming, playing table tennis, playing badminton and other such exercises. Of course, exercise should also be gradual and persistent. Aerobic exercise should be maintained for more than 30 minutes every day, at least 5 days a week, and continued for half a year or even longer to achieve the goal of losing weight and improving fatty liver.

But for "really thin" people, the real reason behind their fatty liver is excessive weight loss.

Copyright images in the gallery. Reprinting and using them may lead to copyright disputes.

After people eat animal fat, it goes to the liver first, where it is synthesized into human fat, and then combines with albumin to synthesize lipoprotein, which is transported out of the liver to all parts of the body. The fat transported to various parts of the human body is stored under the skin or in the internal organs, becoming what we usually call "fat".

If a person loses weight too quickly, or stays hungry for too long, or eats too few carbohydrates, very little fat will be absorbed from the digestive tract. At this time, the fat stored in the body will be transported back to the liver, where it will be converted into glycerol and fatty acids, and then transported out of the liver to be used as energy by the body.

We can understand similar common sense from our life experience: when a tool is used repeatedly to do heavy work, the tool will continue to consume, wear out, and its function will decline. For example, after driving a car for ten or twenty years, the car engine will become less and less useful. The liver is the same. If the liver always metabolizes fat in that place, the liver cells may "make mistakes in a hurry" and fail to completely metabolize the large amount of fat entering the liver, causing the fat to accumulate in the liver cells , which is often stored there like some "garbage", thus forming fatty liver.

Another situation is that when the body is hungry, it will take in very little protein from food. Then, due to the lack of raw materials, the albumin production in the liver will be very low . As a result, the fat that enters the liver cannot form lipoproteins, and ultimately the fat in the liver cannot be transported out of the liver cells, but can only be deposited in the liver, forming fatty liver .

Therefore, dieting should be done in moderation. It does not mean not eating anything. Not eating carbohydrates or protein, such excessive weight loss will often cause "fatty liver in thin people".

Planning and production

Author: Yan Jie, Director of the Department of Liver Diseases, Ditan Hospital

Reviewer: Tang Qin, Director and Researcher of the Science Popularization Department of the Chinese Medical Association

Planning丨Yinuo

Editor: Yinuo

Proofread by Xu Lailinlin