【Common Diseases】Fatty Liver
🥼 What is fatty liver?
Fatty liver refers to the situation where the fat content in liver cells exceeds 5%-10% of the liver weight , which is a manifestation of abnormal liver metabolism.
In Hong Kong, fatty liver disease can be divided into two main categories:
- Alcoholic Fatty Liver (AFL) : caused by long-term heavy drinking.
- Non-alcoholic fatty liver disease (NAFLD) : It is not related to drinking and is common in patients with obesity, diabetes, and hyperlipidemia.
Non-alcoholic fatty liver disease is particularly common in Hong Kong. According to a study by the Faculty of Medicine of the Chinese University of Hong Kong, the prevalence of fatty liver disease in local adults is approximately 27%-30% , and the trend is towards younger people.
🔍 Common causes of fatty liver in Hong Kong
After sorting out local medical information, the common causes include:
- Obesity and excess visceral fat (local BMI ≥ 25 is considered overweight)
- Diabetes and insulin resistance
- Hyperlipidemia (high triglycerides, high cholesterol)
- Unhealthy eating habits (high-sugar, high-fat, high-calorie diet)
- Lack of exercise
- Chronic heavy drinking (> 14 standard drinks per week for men and > 7 standard drinks per week for women)
- Side effects of medications (such as some steroids, chemotherapy drugs, antiviral drugs, etc.)
- Rapid weight loss or malnutrition (which can also paradoxically lead to fatty liver disease)
⚠️ Stages and risks of fatty liver
Fatty liver disease is not just a case of "fat in the liver". It can worsen further:
-
Simple Steatosis
- Early on, there is fat accumulation in the liver but no significant inflammation or fibrosis.
-
Steatohepatitis
- Fat accumulation with liver inflammation (NASH or ASH).
-
Fibrosis
- Long-term inflammation causes liver fibrosis.
-
Cirrhosis
- The liver structure is damaged, its function declines, and it may even develop into liver cancer .
🏥 Treatment of fatty liver in Hong Kong
Editor's reminder : There is currently no specific medicine for fatty liver. The focus of treatment is to improve lifestyle, control the cause, and monitor liver function .
1. Lifestyle and diet adjustments (core treatment)
According to the guidelines of the Hong Kong Hospital Authority and the International Association for the Study of the Liver (AASLD, EASL):
(1) Weight loss
- **It is recommended that a 5%-10% weight loss** can significantly improve liver fat content and inflammation.
- Take a gradual weight loss approach (lose 0.5-1 kg per week) to avoid losing weight too quickly which may worsen the condition.
(2) Balanced diet
- Mediterranean diet : more fruits and vegetables, whole grains, deep-sea fish, olive oil; less red meat and sugary drinks.
- Reduce sugar intake : especially fructose (soda, juice, sugar water).
- Reduce saturated fat and trans fat : Eat less fried foods, cookies, and processed snacks.
- Moderate protein : fish, skinless chicken, beans are optional.
(3) Increase the amount of exercise
- Get at least 150 minutes of moderate-intensity exercise (brisk walking, swimming, cycling) each week .
- Combining aerobic exercise with resistance training can help reduce visceral fat.
2. Quit drinking and avoid hepatotoxic substances
- People with alcoholic fatty liver disease must completely abstain from alcohol .
- Avoid unnecessary medications and Chinese herbal medicines (some Chinese herbal medicines may damage the liver, such as Polygonum multiflorum and Smilax glabra).
3. Control related chronic diseases
- Diabetes : Controlling blood sugar can reduce the worsening of fatty liver disease.
- Hyperlipidemia : The use of lipid-lowering drugs (such as statins) is not only safe but also can reduce cardiovascular risk.
- Hypertension : Keep blood pressure within normal range.
4. Medications and supplements (requires doctor’s evaluation)
Currently, most of the drugs for fatty liver are experimental or auxiliary in nature:
- Vitamin E (for certain non-diabetic NASH patients, requiring doctor's monitoring)
- Insulin sensitizers (such as pioglitazone, for patients with diabetes and NASH)
- Orlistat : Aids weight loss, but be aware of side effects
- Newer drugs (such as GLP-1 receptor agonists) have shown potential for weight loss and improvement of liver fat in clinical trials, but are not yet widely used for fatty liver in Hong Kong.
5. Monitoring and follow-up
- Blood tests : liver function (ALT, AST), blood sugar, blood lipids
- Abdominal ultrasound : assessing the extent of fatty liver
- FibroScan (Transient Elastography) : Checks the degree of liver fibrosis (available in major hospitals and some private clinics in Hong Kong)
- Those at risk of cirrhosis : Ultrasound and alpha-fetoprotein (AFP) tests every 6 months to monitor liver cancer
🏥 Treatment pathways in Hong Kong
-
public hospitals
- Referral from a general practitioner to an internal medicine specialist/liver specialist
- Provide ultrasound, FibroScan, and blood tests
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Private medical care
- The examination is fast and blood tests and imaging examinations can be completed on the same day
- Provide personalized nutrition and exercise plans
🚨 Risks and complications of fatty liver
- Liver fibrosis → Liver cirrhosis → Liver cancer
- Increased risk of cardiovascular disease
- Increased risk of type 2 diabetes
- Liver failure (late stage)
💡 Editor's Tips
- Don’t think that fatty liver is “all right” just because it’s painless ; it could be a prelude to liver cancer.
- Weight loss is the only proven way to reverse the disease ; medication is only an aid.
- The key is to quit drinking alcohol and sugar , especially soda, milk tea, sugar water and other "invisible killers".
- Develop an exercise habit . Even if you are of normal weight but lack exercise, you may have fatty liver.
- Regular check-ups are recommended, especially for patients with diabetes, hyperlipidemia, and hypertension.
💬Editor’s summary :
Fatty liver disease is extremely common in Hong Kong and is closely linked to an urban lifestyle. It not only affects liver health but also increases the risk of cardiovascular disease and diabetes. While there's no cure, most people with fatty liver disease can improve or even reverse their condition through weight loss, a healthy diet, regular exercise, abstaining from alcohol and sugar, and controlling the three highs . The key is to act early and not wait until cirrhosis develops before regret.
📌 Disclaimer <br>This article is for reference only and does not constitute any medical advice. It is sourced from major medical articles.
