Professor Silvia Fargion, Professor Policlinico di Milano: "Fatty liver or fatty liver disease is the cause of many diseases, including diabetes, and it also causes life-threatening diseases such as liver cancer and cardiovascular disease such as stroke or heart attack." Lancet In recent studies published in the wine consumption is excluded.
Milan, November 13, 2018 – A breakthrough breakthrough in the "Second Young Gastroenterologist's Day" and "Ibd" meeting will be held today at the University of Milan. Two paths followed, depending on the environment the Congress chairman wanted. Maurizio Vecchi, Milan Policlinico General Hospital and the University of Milan Depellisation School of Milan: First, a general approach to gastroscopy in the impact of intra-regional colon cancer screening Lombardia is the diagnosis and treatment of NASH Approach to the weight of gastroenterology in European health.
The second strand focuses on chronic inflammatory bowel disease and external manifestations of systems and other devices. "Modern disease management should be based on the use of a comprehensive team of specialists able to cope with the diverse needs of patients, therefore Congress focuses on key innovations in the field of diagnosis and therapy.
Local: causes and characteristics
In light of the circumstances of the incident, the actual epidemic in Italy is now considered NAFLD, a fatty liver or nonalcoholic fatty liver disease, although we have paid particular attention to underestimated pathology. In Italy, it affects about 30% of people with higher peaks in the south. In Lombardy there is an approximate estimate of 25-30%.
"In general, about 5 percent of hepatocytes and hepatocytes contain fat," explains Silvia Fargion, MD, a professor of internal medicine at the University of Milan.
The causes of fatty liver are nutrition and lifestyle. If you are overweight, the likelihood of fatty liver is much higher. However, there is no genetic factor: the gene adiponutrin has been shown to promote a strong tendency towards fatty liver. In certain groups such as obesity or diabetes, the disease is 80-90%.
The easiest way to detect fatty liver is to see if the liver is excessively reflected by ultrasound. Diagnosis does not always correspond to an increase in transaminases, which is a test of liver relevance to indicate the presence of necrosis, which makes the activity of specialists more difficult.
Local: What are the results?
"The problem of fatty liver is a series of clinical correlations that can occur outside of liver disease," explains Fargion. In fact, in addition to causing nonalcoholic fatty liver, NAFLD is the most likely form of evolution, cirrhosis and cancer. Patients with hepatitis have a higher risk of major cardiovascular disease (heart attack, stroke). "
Fatty liver is a sign of overweight / obesity, metabolic syndrome characterized by diabetes, hypertension, elevated triglycerides, and good cholesterol (HDL) reduction. For these reasons, patients with fatty liver should be evaluated for hypertension, dyslipidemia, glucose intolerance / diabetes.
Insulin resistance at the base of the liver causes the pancreas to produce more insulin to maintain normal blood glucose levels and lead to long-term diabetes. Patients with fatty liver are three to four times more likely to develop diabetes, and diabetes plays an important role in the development of vascular problems.
"To date, the only treatment for metabolic fatty liver disease is a healthy lifestyle," explains Fargion. Ideally, proper nutrition depends on Mediterranean diet with low saturated fat, cheese, meat, sweets, fruit, Vegetables, legumes and fish. "When it comes to overweight and regular physical activity, it is definitely important to reduce calories. There are a number of medicines being studied, but no one has received clinical care."
Alcohol requires a separate discussion. In fact, diabetes can be a metabolic or alcohol addiction. Women who take less than 20 grams per day for men and less than 30 years for men or fewer than 2 to 3 wines will develop metabolic allergies. When we exceed this value, we can not tell non-alcoholic steatosis. However, in the presence of metabolic alopecia, small amounts of alcohol can proliferate in some cases with proliferative liver damage.
"There are cases where a small amount of wine is claimed to be a form of cardiovascular disease prevention," Fargion concluded in a recent study published in the Lancet, which states that the only alcohol that is not harmful to health is zero.
Wines and alcohols already have metabolic damage to fat and do not work properly. Therefore, in such cases, simple alcohol use should be prohibited to avoid further complications. It is also known that eating a proper wine from a normal subject can have a beneficial effect. Therefore, advice on categories of overweight, diabetic and dyslipidemic patients is to use ultrasonography to closely assess the liver status to identify this condition.