So nnipa bi wɔ w’abusua mu a wɔanya komayare ansa na wɔrebɔ akwakoraa ne aberewa, kyerɛ sɛ, wɔadi mfe 40-50? Anaasɛ ɛtaa ba sɛ nnipa a wɔwɔ w'abusua mu bɛka bere nyinaa sɛ, "High cholesterol, high cholesterol"? Mpɛn pii no, yesusuw sɛ nea enti a yɛyɛ eyi ne nneɛma te sɛ nea yedi ne nea yɛnom, ne apɔw-mu-teɛteɛ. Ɛno yɛ nokware, na ɛno nso nya nkɛntɛnso. Nanso ɛtɔ mmere bi a, nea enti ankasa a ɛma srade a ɛdɔɔso yi ba no betumi ayɛ ɔhaw bi a ɛwɔ yɛn nipadua mu, wɔ yɛn awosu mu. Ɛno ne nea yɛfrɛ no `Familial Hypercholesterolemia` anaa `FH` wɔ nnuruyɛ mu. Ɛnnɛ, yɛbɛka eyi ho asɛm tiawa, wɔ ɔkwan a wubetumi ate ase so.
Sɛ yɛbɛka no tiawa a, dɛn ne Abusua mu Cholesterolemia (FH)?
Abusua mu Hypercholesterolemia yɛ awosu mu yare a obi nya fi ne maame, ne papa, anaa n’abien nyinaa hɔ. Eyi ne bere a srade "bɔne" anaa LDL srade a ɛwɔ yɛn nipadua mu no dɔɔso yiye fi awo mu.
Fa yɛn mogya ntini no sɛ ntini ahorow. Saa `LDL` srade yi te sɛ kɔkɔɔ, waxy layer a ɛbata saa ntini ahorow no afasu ho. Mpɛn pii no, eyinom boaboa ano nkakrankakra. Nanso wɔ obi a ɔwɔ `FH` mu no, `LDL` srade dodow no dɔɔso araa ma saa waxy layer yi fi ase boaboa ano ntɛmntɛm yiye na ɛyɛ den yiye wɔ mogya ntini no mu. Yɛfrɛ eyi `atherosclerosis`. Bere kɔ so no, saa ade yi nyin na ɛma mogya ntini no yɛ teateaa, na ɛtɔ mmere bi a esiw ano koraa. Ɛno ne bere a nneɛma a ɛde nkwa to asiane mu te sɛ komayare ne akisikuru ba.
Ɛsɛ sɛ `LDL` srade dodow a ɛwɔ onipa a ɔwɔ apɔwmuden a ɛteɛ mu no nnu 100 mg/dL. Nanso, wɔ obi a ɔwɔ `FH` mu no, saa bo yi betumi akɔ soro kɛse, te sɛ 160 mg/dL, 190 mg/dL . Wɔ tebea horow bi a emu yɛ den mu no, ebetumi aboro 400 mg/dL mpo. Ade a ɛyɛ hu sen biara ne sɛ esiane sɛ tebea yi wɔ hɔ fi mmofraase nti, sɛ wɔansa a, asiane a ɛwɔ hɔ sɛ obi benya komayare no yɛ kɛse yiye wɔ ne mfe a onnyinii koraa mu sen onipa a ɔte ase no.
Ebia saa asɛm yi bɛyɛ te sɛ nea ɛyɛ hu kakra, nanso asɛmpa no ne sɛ, sɛ wuhu no ntɛm, fa nnuru a ɛfata, na woyɛ nsakrae wɔ w’asetra mu a, ɛkame ayɛ sɛ wubetumi adi so koraa na woatra ase a ahoɔden wom.
FH ahorow atitiriw abien na ɛwɔ hɔ.
Wɔakyekyɛ tebea yi mu ayɛ no ahorow atitiriw abien a egyina sɛnea yenya fi awo mu so. Eyi yɛ mmerɛw yiye sɛ yɛbɛte ase.
Fa no sɛ yɛn nipadua no wɔ ‘akwankyerɛ’ abien a yɛde siw srade a ɛwɔ nipadua no mu so. Baako na yenya fi yɛn maame hɔ, na biako nso fi yɛn papa hɔ.
1. Heterozygous FH: Eyi ne ɔkwan a ɛtaa ba. Nea ɛkɔ so wɔ ha ne sɛ sintɔ bi wɔ ‘nkyerɛkyerɛ nhoma’ (gene) no mu a wonya fi ɔwofo biako pɛ hɔ , ɛna no anaa agya no. Eyi kyerɛ sɛ nhoma biako ye, na nhoma foforo no nso wɔ mfomso kakra. Eyi ma srade a wɔde di dwuma no yɛ nea ɛnyɛ yiye kakra.
2. Homozygous FH: Eyi ho yɛ na yiye, na emu yɛ den yiye nso.Korɔ. Nea ɛkɔ so wɔ ha ne sɛ ‘akwankyerɛ’ a wonya fi maame ne papa nyinaa hɔ no nyinaa yɛ mfomso. Afei adwinnade a ɛhwɛ srade so no yɛ mmerɛw kɛse. `LDL` cholesterol dodow a ɛwɔ saa nnipa yi mu no dɔɔso yiye.
`FH` yɛ awosu mu yare a ɛwɔ `autosomal dominant` kuw no mu. Eyi kyerɛ ara ne sɛ enhia sɛ abofra nya awosu mu abɔde a ɛtɔ sin no fi awofo baanu no nyinaa hɔ na ama wanya yare no, ɛdɔɔso sɛ obenya afi ɔwofo biako pɛ hɔ .
Wei kyerε sε, sε wowɔ `FH` a, 50% na εwɔ hɔ sε wo ba no benya tebea no. Saa ara nso na hokwan wɔ hɔ 50% sɛ wo nuanom nso benya tebea no.
Saa tebea yi abu so dɛn? Dɛn ne sɛnkyerɛnne ahorow no?
Wobu akontaa sɛ nnipa 250 biara mu biako wɔ tebea a ɛtaa ba `Heterozygous FH`. Nanso nea ɛyɛ awerɛhow sen biara ne sɛ nnipa yi mu 10 biara mu 9 nnim sɛ wɔwɔ yare no .
Mpɛn pii no, FH nkyerɛ sɛnkyerɛnne pɔtee biara wɔ ne mfiase. Ebia wunnim sɛ wowɔ FH kosi sɛ wubenya komayare te sɛ wo koko mu yaw. Nanso afei ebia ɛbɛkyɛ dodo. Nea enti a ɛte saa ne sɛ srade a ɛwɔ obi a ɔwɔ FH mogya ntini mu no fi ase fi da a wɔwoo no no.
Bere kɔ so no, srade a ɛkɔ soro no betumi ama wanya sɛnkyerɛnne ahorow a edidi so yi.
| Nsɛnkyerɛnne a ɛkyerɛ | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Koma mu yare wɔ mmofraase | Koko mu yaw (angina) a ɛba bere a wɔreyɛ apɔw-mu-teɛteɛ anaa bere a wɔregye wɔn ahome, komayare anaasɛ ɔyare a ɛma obi hwe ase wɔ ne mmofraase (mmarima - a wonnii mfe 55, mmea - a wonnii mfe 65). |
| Xanthomas a wɔfrɛ no Xanthomas na ɔkyerɛwee | Nkurukuru kɔkɔɔ a srade a ɛwɔ honam ani no de ba. Wɔtaa hu eyinom wɔ nsateaa, nkotodwe, nsateaa nkwaa, ne Achilles ntini (a ɛwɔ nan ase atifi) no ho. |
| Xanthelasmas a wɔde di dwuma | Cholesterol kɔkɔɔ a ɛwɔ honam ani a ɛtwa aniwa no ho hyia no ase. |
| Aniwa no mu Arcus | Nkatabo fitaa, fitaa, anaa bruu a ɛtwa aniwa tuntum no ho hyia. Eyi taa ba nnipa a wɔn mfe akɔ anim mu, nanso sɛ wohu wɔ obi a onnii mfe 45 mu a, ebetumi ayɛ FH ho sɛnkyerɛnne. |
| Sika no a wɔredannan no | Ɛyaw a ɛba nan ase, titiriw bere a wonam no. Ebia eyi fi ntini a ɛma mogya kɔ nan no mu a ɛyɛ teateaa. |
Ɔkwan bɛn so na wohu sɛ ɔwɔ FH?
Sɛ wo duruyɛfo susuw sɛ wowɔ FH a, wɔbɛhwɛ nneɛma pii de asi nea wɔahu no so dua.
- Mogya mu nhwehwɛmu: Eyi ne nea ɛho hia sen biara. Mogya mu nhwehwɛmu a wɔfrɛ no `Lipid Profile`, a ɛhwɛ wo srade dodow no, hwehwɛ `LDL` srade dodow a ɛkɔ soro wɔ ɔkwan a ɛnteɛ so. Sɛ ɛboro 190 mg/dL wɔ ɔpanyin mu, anaasɛ ɛboro 160 mg/dL wɔ abofra mu a, wosusuw sɛ `FH`.
- Abusua aduruyɛ ho abakɔsɛm: Eyi ho hia yiye. Akyinnye biara nni ho sɛ wo duruyɛfo bebisa wo nsɛm te sɛ, "So wo papa, wo maame, wo nananom, anaa wo nuanom anya komayare pɛn wɔ wo mmofraase?" "So obi wɔ w'abusua mu a ɔwɔ srade a ɛdɔɔso?"
- Nipadua mu nhwehwɛmu: Oduruyɛfo no bɛhwɛ wo nipadua mu sɛ ebia xanthomas (honam ani akisikuru) anaa corneal arcus (ani kurukuruwa) a yɛadi kan aka ho asɛm no ho sɛnkyerɛnne biara nni hɔ anaa.
- Awosu mu nhwehwɛmu (DNA sɔhwɛ): Wɔ tebea horow bi mu no, wobetumi ayɛ awosu mu nhwehwɛmu de asi yare no so dua koraa. Eyi betumi ahwɛ sɛ sintɔ ahorow bi wɔ awosu mu nkwaadɔm atitiriw a ɛde FH ba (te sɛ APOB, LDLR, anaa PCSK9) no mu.
Dɛn ne ayaresa ahorow no?
`FH` nnyɛ yareɛ a yɛbɛtumi asa. Efisɛ ɛyɛ biribi a ɛne yɛn awosu mu nkwaadɔm ba. Nanso wobetumi adi so yiye paa . Botae titiriw a ɛwɔ ayaresa mu ne sɛ ɛbɛtew `LDL` srade dodow so sɛnea ɛbɛyɛ yiye biara, na ɛbɛtew asiane a ɛwɔ hɔ sɛ wobenya komayare no so.
1. Nnuru (nnuru ahorow) .
Asetra mu nsakrae nkutoo nnɔɔso sɛ ɛbɛhyɛ mogya mu srade so ama obi a ɔwɔ `FH`. Enti ɛsɛ sɛ wɔnom nnuru biako anaa nea ɛboro saa wɔ wɔn nkwa nna nyinaa mu .
- Statin ahorow:Eyinom ne nnuru a wɔtaa de di dwuma ne nea edi kan. Wɔnam srade a mmerɛbo no yɛ so tew so na ɛyɛ adwuma.
- PCSK9 inhibitors: Eyinom yɛ nnuru a wɔde twitwiw nipadua mu a ɛyɛ foforo koraa. Wɔyɛ adwuma yiye ma nnipa a wontumi mfa statin nkutoo nsiw wɔn srade dodow ano.
- Ezetimibe: Saa aduru yi yɛ adwuma denam srade a ɛwɔ nnuan a yedi mu a ɛtew so no so. Wɔtaa de ka statin ho ma.
- Nnuru foforɔ: Bio nso, nnuru foforɔ te sɛ `Bile acid sequestrants` ne `Fibrates` wɔ hɔ. Wo duruyɛfo na obesi aduru a ɛfata wo kɛse ho gyinae.
2. Asetra mu nsakrae
Nea ɛka nnuru a wɔnom ho no, ɛho hia nso sɛ wodi asetra a ahoɔden wom akyi. Ɛnyɛ sɛ eyi ma aduru no tumi yɛ kɛse nko, na mmom ebetumi atew asiane a ɛwɔ hɔ sɛ obi benya komayare no so bio.
| Nea ɛsɛ sɛ wɔyɛ | Nea ɛsɛ sɛ yɛkwati |
|---|---|
| Nnuan a ɛma koma nya ahoɔden: Nnuadewa, nnuaba, atoko, aburow a wɔde nhama ayɛ (aburow a ɛyɛ bruu, oats), mpataa (salmon, mackerel, herring), nufusu a srade nnim ne nam. | Saturated ne trans fats: Nnuan a wɔayam, nnuan a wɔde di ntɛmntɛm, nneɛma a wɔde yɛ paanoo (keeki, patties), nam a srade wom, akutu ngo ne mmɛw ngo a wɔde di dwuma dodo. |
| Apɔw-mu-teɛteɛ daa: Fa wo ho hyɛ apɔw-mu-teɛteɛ te sɛ nantew a ɛyɛ ntɛmntɛm, mmirikatu, anaa sakre so anyɛ yiye koraa no simma 30 da biara, anyɛ yiye koraa no nnafua 5 dapɛn biara. | Sigaretnom ne nsa: Ɛsɛ sɛ wogyae sigaretnom koraa. Ɛsɛe mogya ntini no kɛse. Ɛsɛ sɛ wɔtew nsa a wɔnom so. |
| Mu duru a ɛfata a wobɛkɔ so akura mu: Nipadua mu duru a wobɛhwɛ so no betumi atew nhyɛso a ɛba koma no so no so. | Nsã a ɛyɛ dɛ ne nnuan a asikre pii wom: Eyinom betumi ama obi mu duru ayɛ kɛse na wahyia akwahosan ho haw afoforo. |
3. Ayaresa pɔtee afoforo
Wɔ nnipa a wɔwɔ homozygous FH a emu yɛ den yiye fam no, ebia nnuru nkutoo rentumi nni wɔn srade so. Wɔ saa nnipa yi fam no, wɔyɛ ayaresa bi a wɔfrɛ no LDL apheresis. Eyi te sɛ dialysis. Wɔfa mogya kakraa bi, de fa afiri bi mu, na eyi LDL srade bɔne no fi hɔ, na afei ɛsan de gu nipadua no mu bio. Wɔyɛ eyi pɛnkoro anaa mprenu dapɛn biara.
Sɛ wowɔ FH a, dɛn na ɛsɛ sɛ woyɛ?
Sɛ wohu sɛ wowɔ `FH` a, ɛnyɛ wo nko ara na ɛfa ho. Ɛyɛ nkrasɛm a ɛho hia ma w’abusua nyinaa.
Sɛ wowɔ FH a, ɛyɛ w’asɛyɛde sɛ wobɛma wɔayɛ w’awofo, wo nuanom, ne wo mma nhwehwɛmu sɛ ebia srade wom anaa. Yɛfrɛ eyi ‘cascade screening’. Eyi betumi aboa ma wɔahu abusua no mufo afoforo ansa na yare no ho sɛnkyerɛnne ada adi na wɔafi ase asa wɔn nso.
Sɛ abofra bi wɔ abusua abakɔsɛm a ɛwɔ `FH` a, wobetumi asɔ srade ahwɛ fi bere a wadi mfe 2 mpo. Efisɛ dodow a wofi ase sa yare yi ntɛm no, dodow no ara na wobetumi atew nsɛnnennen a ɛbɛba no so daakye.
Sɛ wowɔ `FH` a, mma wo ho nnyɛ wo hu. Kɔ so ne wo duruyɛfo nni nkitaho. Nom w’aduru no wɔ bere ano. Yɛ nsakrae wɔ w’asetra mu. Afei wo nso wubetumi atra ase akyɛ na apɔwmuden te sɛ obiara.
Nkrasɛm a Wɔde Kɔ Fie
- Abusua mu srade a ɛkɔ soro (FH) yɛ awosu mu yare a efi awo ntoatoaso so kɔ awo ntoatoaso so na ɛma mogya mu srade bɔne (LDL) kɔ soro fi awo mu.
- Sɛ obi a ɔwɔ w’abusua mu anya komayare wɔ ne mmofraase anaasɛ ne srade dɔɔso a, ɛho hia yiye sɛ wobɛyɛ FH nhwehwɛmu.
- Nnipa pii a wɔwɔ saa tebea yi nnim sɛ wɔwɔ yare no. Sɛ wohu ntɛm a, ebetumi agye nnipa nkwa.
- Nnuru a wɔde di dwuma wɔ nkwa nna nyinaa mu ne asetra a ahoɔden wom ho hia na ama wɔatumi adi FH ho dwuma.
- Sɛ wohu sɛ wowɔ `FH` a, ma wɔnyɛ w'awofo, wo nuanom, ne wo mma nso nhwehwɛmu. Ɛbɛboa ma wɔagye wɔn nkwa.
- Sɛ wosa wo yare yiye a, wubetumi anya apɔwmuden koraa na woatra ase akyɛ. Enti nsuro, kɔ wo duruyɛfo nkyɛn na nya ayaresa.
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