Kim Hye-ji, general internal medicine specialist at Donggang Hospital
-Increased prevalence of non-alcoholic fatty liver disease in children and adolescents
-Increased risk of metabolic syndrome, diabetes and coronary heart disease
-You need to lose weight and exercise… Walk briskly, ride a bike, etc.
-Reduction of over 500 kcal per day… Consume vegetables, whole grains and fruit
Hyeji Kim, a general internal medicine specialist at Donggang Hospital, is treating a patient. Photo provided by Donggang Hospital
◇Worldwide prevalence of non-alcoholic fatty liver disease in children and adolescents: 3-10%
Nonalcoholic fatty liver disease is defined as a disease with appropriate clinical, biochemical, imaging, and pathological findings without liver disease caused by secondary causes such as excessive alcohol consumption, drug exposure, or viral hepatitis.
There is no absolute standard for significant alcohol consumption to distinguish between non-alcoholic fatty liver disease and alcohol-induced fatty liver disease, but according to the “2021 Korean Liver Association Guidelines for the Treatment of Non-alcoholic Fatty Liver Disease”, significant consumption is 210 g per week for men and 210 g per week for women. Cases were defined as 140 g or more per week.
The prevalence of nonalcoholic fatty liver disease in Korea has recently increased, and the prevalence of nonalcoholic fatty liver disease diagnosed by abdominal ultrasound among national health checks was found to be 16.1–33.3%.
In particular, the prevalence and severity of non-alcoholic fatty liver disease in children and adolescents are increasing alongside the rise in obesity. The global prevalence of non-alcoholic fatty liver disease in children and adolescents is 3-10% and is estimated to be approximately 3-10%. be similar in Korea.
◇Due to the increasing trend of non-alcoholic fatty liver disease and the increasing prevalence of obesity, etc.
Non-alcoholic fatty liver disease is closely related to insulin resistance and increases the risk of metabolic syndrome, type 2 diabetes, and coronary heart disease.
When nonalcoholic fatty liver disease is present, there is a high incidence of not only hepatocellular carcinoma but also extrahepatic esophageal cancer, stomach cancer, colon cancer, prostate cancer, and breast cancer.
Non-alcoholic fatty liver disease generally has a good course, but in 10-20% of cases it can progress to non-alcoholic steatohepatitis.
Some of these patients may progress to more serious liver disease such as cirrhosis or hepatocellular carcinoma, so caution is needed.
Hepatocellular carcinoma caused by non-alcoholic fatty liver disease has recently increased rapidly and, according to a US study, ranks third among all causes of hepatocellular carcinoma and is expected to increase by 9% per year.
This is interpreted as the rapid increase in the prevalence of obesity, a risk factor for non-alcoholic fatty liver disease.
◇Weight loss, diet and exercise are important for the treatment of non-alcoholic fatty liver disease.
Treatment of nonalcoholic fatty liver disease is generally divided into lifestyle improvement, treatment of metabolic syndrome, drug treatment for steatohepatitis or liver fibrosis, and treatment of complications such as cirrhosis related to nonalcoholic fatty liver disease.
For most patients, the most important and cost-effective basic treatment method is weight loss through diet, exercise and lifestyle improvements.
A detailed introduction to improving lifestyle habits is as follows.
This is my first weight loss.
In non-alcoholic fatty liver disease accompanied by overweight or obesity, weight loss of more than 5% reduces the amount of fat in the liver, while weight loss of more than 7-10% is necessary to improve liver inflammation and liver fibrosis .
This is the second diet.
To reduce the amount of fat in the liver, a reduction in total energy intake of more than 500 kcal per day is required.
You should consume plenty of vegetables, fruits, whole grains, and beans, and consume adequate amounts of protein through dairy, fish, and poultry.
The Mediterranean diet, which consumes less red meat or processed meat, has a greater effect on reducing liver fat and improving insulin resistance than a low-fat diet.
The last one is physical therapy.
To reduce the amount of fat in your liver, you need to exercise at a moderate to high intensity for at least 30 minutes at least 3 times a week. Moderate intensity exercise includes brisk walking, dancing, slow cycling, gardening and swimming as hobbies.
There is currently no officially approved pharmacological treatment for at-risk patient groups who fail to improve their lifestyle habits or whose disease does not improve despite improvement.
Consequently, there is an urgent need to develop new drugs based on patient-specific precision medicine in the future, taking into account metabolic and genetic diversity. Summary = Reporter Choi Joo-eun
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