I don’t drink, but I’m diagnosed with fatty liver… Beware of ‘skinny obesity’

[이데일리 이순용 기자] People who like to drink often worry regarding ‘alcoholic fatty liver’. Alcoholic fatty liver disease occurs more often the more alcohol is consumed. However, recently, more and more people are worried regarding fatty liver even though they do not enjoy alcohol.

A normal liver contains less than 5% fat. A condition in which more fat than this is accumulated is called fatty liver. Fatty liver can be divided into alcoholic fatty liver and non-alcoholic fatty liver. Alcoholic fatty liver occurs when a lot of alcohol is consumed, fat synthesis is promoted in the liver, and normal energy metabolism is not performed.

According to the Health Insurance Review and Assessment Service, the number of patients with alcoholic fatty liver decreased from 120,000 in 2018 to 106,000 last year. On the other hand, the number of patients with nonalcoholic fatty liver increased from 310,000 to 400,000 during the same period. The male and female sex ratio of non-alcoholic fatty liver patients was similar.

Non-alcoholic fatty liver occurs when a large amount of fat is consumed regardless of alcohol, or when a large amount of fat is synthesized in the liver or is not excreted well. It also occurs in cases of obesity, hyperlipidemia, or diabetes. Non-alcoholic fatty liver may progress to non-alcoholic steatohepatitis.

The increase in patients with non-alcoholic fatty liver disease is due to westernized eating habits, lack of exercise, lifestyle changes, and an increase in the obese population. While eating a lot of high-calorie meals, there are few opportunities to move the body, so the calories that are not consumed are stored in the liver.

Nonalcoholic fatty liver disease does not present with specific symptoms. However, some patients experience right upper abdominal discomfort and fatigue. If non-alcoholic fatty liver progresses to cirrhosis, various symptoms are caused by the cirrhosis itself.

To diagnose non-alcoholic liver disease, radiological examination or liver biopsy is performed for patients who consume less than 210 g (regarding 3 bottles of soju) and 140 g (2 bottles of soju) of alcohol per week for men and negative hepatitis test. enforce Blood tests may show liver function abnormalities. The most common finding is an increase in liver levels (AST/ALT) 2 to 5 times the normal level.

Non-alcoholic fatty liver disease is more common in men in their 30s and 40s, but more often in women in their 50s and 60s. This is because adult diseases such as obesity are risk factors for non-alcoholic fatty liver disease. In particular, people who are ‘skinny and overweight’ can be diagnosed with non-alcoholic fatty liver.

For women, age and menopause are also important risk factors. Middle-aged patients need active management because they are also related to diabetes, cerebrovascular disease, and cardiovascular disease. To date, there is no drug treatment that has been proven effective for non-alcoholic fatty liver disease. Choi Hyuk-soo, head of Internal Medicine at Seran Hospital, said, “It is necessary to control obesity and hyperlipidemia that accompany fatty liver, and to change lifestyle habits such as exercise.”

He added, “You should also improve your diet to avoid overeating and have a balanced diet. Most patients with non-alcoholic fatty liver have a good course, but some of them can lead to cirrhosis or steatohepatitis, so weight loss and active management are necessary.” .

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