Update: December 2018
Among many other pathological conditions of the human body
одно из главных мест занимают заболевания the liver. Among them, in his
queue, recently the most common fatty hepatosis,
который носит еще названия «жировая дистрофия the liver», «стеатоз
the liver». The essence of the disease lies in the pathological intracellular
accumulation of fat drops. About the symptoms of fatty hepatosis and major
The reasons for its occurrence will be discussed in this article.
Causes of disease
AT большинстве случаев признаки гепатоза the liver отсутствуют, в
due to the benign course of the disease or do not manifest themselves on
background of other diseases.
However, in 30% of patients, fatty hepatosis causes
steatohepatitis, that is chronically proceeding inflammatory
process, which in 20 – 25% is transformed into a progressive
фиброз или цирроз the liver — замещение нормальной печеночной
the structure of the connecting body (for understanding – cicatricial)
Цирроз the liver в 10% заканчивается смертельным исходом. Fatty
hepatosis occurs at different ages, but most often they
people over 45 years old are affected.
The liver has a large supply of regenerative possibilities.
Therefore, understanding causal factors and early detection
pathological changes, timely elimination of their causes
the occurrence and adequate treatment allow you to recover
the physiological structure of the organ or stop the pathological
the process at the stage when the liver is still able to perform in
full all your functions.
AT зависимости от причин жировой гепатоз (жировую дистрофию
the liver) подразделяют на:
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- Primary hepatosis.
- ATторичный жировой hepatosis.
Primary fatty hepatosis can be caused by:
- insulin resistance (decreased sensitivity) of cells
the liver и жира к инсулину;
- type II diabetes;
- obesity associated with the use of high-calorie foods,
containing a large percentage of fats and carbohydrates;
- high content of lipid fractions in the blood;
- excessive formation and absorption of triglycerides in
ATторичная жировая дистрофия the liver развивается в результате:
- long-term use of hepatotoxic drugs
(estrogen, amiodarone, tranquilizers, etc.);
- chronic chemical intoxication (alcoholic and
energy drinks, pesticides, phosphoric and some
carbon compounds, household chemicals);
- long-term use of some antibiotics and narcotic
- chronic diseases – ulcerative colitis,
chronic pancreatitis, autoimmune diseases of connective
tissue (collagen), chronic heart or pulmonary heart
failure with coronary heart disease and heart defects,
chronic lung diseases;
- viral hepatitis (especially hepatitis “C” and “D”), hypothyroidism,
adrenal cortex disease;
In men, in the first place among the causes of fatty
дистрофии the liver является злоупотребление алкоголем, активно
способствуя воспалению ткани the liver, обострениям, которые
join hepatosis and lead to cirrhosis and fibrosis. therefore
alcohol lovers have the greatest risk of acquiring fatty
- rapid weight loss during fasting, which leads to
возникновению воспалительных процессов в the liver;
- irregular food or consumption of foods with low
- drastically changing a high carbohydrate diet to
low carb and vice versa.
- высок риск развития жировой дистрофии the liver у лиц, любителей
alcohol in conjunction with fatty, high-calorie foods, with plenty
- According to statistics, fatty hepatosis is more common in affluent
people than those who rarely indulge themselves with delicacies and live
Таким образом, симптомы жирового гепатоза the liver могут быть
�“Masked” by the clinical picture of other diseases and
detected by chance during a survey about another
symptomatology. Sometimes the cause of the disease to establish
The results of one study
AT Европейских странах неалкогольной жировой дистрофией the liver
10% of children, 20-30% of adults suffer. AT британском исследовании в
the hospital of one of the children’s colleges by the staff of Surrey
The university analyzed the medical records of 120 children.
The goal of the study was to detect a link between vitamin D deficiency and
fatty hepatosis in children.
Patients examined were found to have a low content.
vitamin D in the blood all year round and a variant of the gene was discovered
NADSYN1, который ассоциируется с тяжестью жирового hepatosis.
ATсеобщая эпидемия ожирения населения развитых стран, а также
sedentary lifestyle, food is not healthy foods
(fast food, soda, chips, products with preservatives and enhancers
taste, limited intake of fruits and vegetables), excessive
the use of sunscreens leads to vitamin D deficiency,
rickets in children and fatty hepatosis.
Clinic and diagnosis
Symptoms appear as hepatocyte damage occurs, and
severity of clinical manifestations affects the degree of damage
- Grade I – foci are histologically and instrumentally determined
accumulations of liver cells with a high concentration of fat. Availability
several foci located at a considerable distance from each
another, is a sign of diffuse fatty hepatosis.
- II degree – increase in the area of accumulation of lesions with
reborn cells and the appearance between them connective tissue
- Grade III – large accumulations of fat cells and clearly
pronounced growth of connective tissue strips,
ending with fibrous strands. The latter is a sign of development.
cirrhosis and liver fibrosis.
For grade III, when conservative treatment of fat
гепатоза невозможно, характерны наиболее выраженные симптомы.
Treatment can only be a liver transplant. Therefore very
important early diagnosis and proper treatment of the disease. AT
according to the clinical course, fatty hepatosis is divided into
acute and chronic.
Acute fatty liver
It occurs in acute poisoning (arsenic and phosphoric
compounds, inedible mushrooms – pale grebe and morels;
alcohol substitutes, fern extract; antibiotics
tetracycline series). Steatosis of the liver in the acute form occurs and
as the most difficult, though rare, complication of pregnancy.
Acute fatty hepatosis in pregnant women develops as a result of
lack of cellular enzymes involved in the breakdown of fatty
acids and ATP synthesis, with systemic genetic pathology
Acute dystrophy may start sluggishly, but usually it proceeds
with violent symptoms, manifested nausea, heartburn, vomiting,
discomfort and abdominal pain (usually in the epigastric region),
lethargy, lethargy and adynamia. ATозникает интенсивная или
mild yellowness of the sclera, skin, mucous membranes
shells. The liver has normal or even reduced size.
AT дальнейшем развивается синдром диссеминированного сосудистого
свертывания (ДATС), сопровождающийся усилением изжоги и рвотой с
blood impurity, which is explained by the formation of multiple ulcers in
stomach and esophagus.
The prognosis of the acute course of fatty degeneration of the liver is mainly
adverse due to renal and hepatic failure or
осложнениями ДATС-синдрома (кровотечение, тромбозы, острая
With a more favorable outcome of the acute course of fatty hepatosis
Symptoms of chronic fatty hepatosis
Left – healthy liver, right – fatty hepatosis
The clinical course of the most fatty dystrophy often proceeds
asymptomatic. Sometimes subjective symptoms occur:
- dull pain, feeling of heaviness or discomfort in the right
subcostal area, which may increase when bending,
chest bends, weight lifting;
- anorexia and the development of symptoms of dysbiosis;
- nausea after eating and in the morning, belching air, bitterness
in the mouth;
- flatulence, fatigue, weakness and
- reduced visual acuity;
- deterioration of the skin (becomes dull).
When examined by a doctor, a slight yellowness is sometimes noted.
sclera, is determined by enlarged, slightly painful (rarely) lower
margin of the liver.
Diagnosis is based on patient complaints and
laboratory and instrumental methods. Despite the mandatory
decrease in the functional state of the liver in fatty hepatosis,
confirm this with traditional laboratory tests
Fatty dystrophy, especially arising on the background of alimentary
obesity may be the cause of a slight increase in activity
alkaline phosphatase (alkaline phosphatase) and serum aminotransferases –
glutamine-pyruvic (GPT) and glutamine-oxaloacetic (HPGT).
However, these lab data are not specific to fatty
Ultrasound is also not very informative.
liver echogenicity is usually normal, can sometimes be elevated,
which is more characteristic of liver fibrosis or cirrhosis. More
reliable are computed and magnetic resonance tomography,
which in many cases allow to detect focal infiltration
the liver (clusters, foci of hepatocytes, degenerated into fat
cells), less often – diffusion (widespread) infiltration. Pockets
lesions may disappear after a certain time, especially in the background
treatment, which may also have diagnostic and
Reliably confirm increased fat accumulation in the cells.
liver can only be through histological examination
biopsies. The material is taken as a result of sighting.
liver biopsy using computed tomography.
Timely detection fatty liver, elimination
the reasons that provoked its development, the constant dispensary
observation with periodic courses of treatment with medication
remedies and medicinal plants, diet food and
high physical activity – all this can lead to regression
pathological disorders in the liver or at least stop