How to treat fatty liver?

 Tiejun Tang       

Fatty liver also known as hepatic steatosis, is a growing health concern worldwide. It is estimated that 25% of the global population has fatty liver disease, with prevalence rates as high as 60% in some countries ^[1].

Many people ignore the dangers of fatty liver and leave it untreated, in fact excess fat in the liver can lead to liver damage and negatively affect your health.

The main hazards of fatty liver are as follows:

1) Inflammation: As the liver becomes fatty, it becomes inflamed, which can lead to liver damage and scarring.

2) Liver dysfunction: When the liver becomes inflamed and damaged, it impairs its ability to function properly. This can cause problems with the liver's ability to detoxify blood, produce important proteins, and regulate hormones.

3) Increased risk of type 2 diabetes: Fatty liver disease is associated with insulin resistance, which increases the risk of type 2 diabetes.

4) Cardiovascular disease: Fatty liver disease is also associated with an increased risk of cardiovascular disease, including heart attack and stroke.

5) Liver cancer: In severe cases, fatty liver can develop into liver cancer.

There is no specific medication or treatment specifically approved for fatty liver in Western medicine. Treatment is typically focused on managing any underlying conditions and making lifestyle changes to improve liver health

In Traditional Chinese Medicine (TCM) the liver is regarded as one of the most important organs in the body, responsible for storing blood and regulating the flow of Qi (vital energy) throughout the body. The liver is also associated with the emotion of anger. According to TCM theory, liver Qi stagnation and blood stasis are the main pathological mechanisms of fatty liver disease. This stagnation and stasis can result from various factors, such as overeating, alcohol consumption, and emotional stress, leading to a buildup of fat in the liver ^[2].

In the clinical TCM has been used to treat fatty liver disease for centuries, and clinical studies have shown promising results. For example, a randomized controlled trial involving 80 patients with non-alcoholic fatty liver disease (NAFLD) found that a combination of acupuncture and Chinese herbal medicine resulted in significant improvements in liver function and a reduction in liver fat content compared to the control group ^[3]. Another study involving 60 patients with NAFLD found that treatment with a TCM formula for 12 weeks led to significant reductions in liver fat content and improved liver function ^[4].

The mechanisms of Chinese herbal medicine were investigated through modern pharmacology research. Laboratory research has shown that certain TCM formulas and extracts can reduce fat accumulation in liver cells and improve liver function. For example, a study found that a TCM formula containing rhubarb, baicalin, and choline bitartrate was able to reduce liver fat content and improve liver function in rats with NAFLD ^[5]. Another study found that curcumin, a compound found in turmeric and commonly used in TCM, was able to reduce liver fat accumulation and improve liver function in mice with NAFLD ^[6].

Molecular mechanism research has shown that TCM and its extracts can affect various signaling pathways involved in the development and progression of fatty liver disease. For example, one study found that berberine, a compound found in various TCM herbs, was able to improve liver function and reduce liver fat accumulation by regulating the AMPK/mTOR signaling pathway ^[7].

Overall, the use of TCM for the treatment of fatty liver disease has shown promising results in both clinical practice and scientific research. Further studies are needed to fully understand the mechanisms by which TCM treats fatty liver disease and to optimize its clinical use.

References:

1.   Younossi, Z. M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016; 64(1), 73-84.

2.    Xiong, J. Traditional Chinese medicine for the treatment of nonalcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials. Journal of Traditional Chinese Medicine. 2019; 39(5), 677-689.

3.    Wu, J., Clinical observation of acupuncture combined with Chinese medicine for the treatment of non-alcoholic fatty liver disease. Chinese Journal of Integrative Medicine, 2016; 22(5), 341-346.

4.   Li, Q. Clinical observation of traditional Chinese medicine formula for the treatment of nonalcoholic fatty liver disease: A prospective, multicenter, observational study. Medicine, 2019; 98(23), e15906.

5.   Wang, Y. Protective effect of rhubarb, baicalin, and choline bitartrate on nonalcoholic fatty liver in rats. Journal of Cellular Biochemistry. 2019; 120(11), 18219-18226.

6.   Wu, L. Curcumin suppresses expression of adipogenic genes in 3T3-L1 adipocytes and high-fat diet-induced obese mice. Phytotherapy Research. 2018; 32(8), 1533-1542.

7. Li, T. Mechanisms of action of berberine and its derivatives: A review of research progress in the past decade. Pharmacological Reports. 2018; 70(5), 925-937.