So wo mmerɛbo mu srade dodo? Momma yensua din foforo a wɔde frɛ mmerɛbo mu yare a srade wom (Steatotic Liver Disease) no ho ade!

“Oh, oduruyɛfo, mewɔ srade a ɛwɔ me mmerɛbo mu...” So woate biribi te sɛ eyi? Anaasɛ wo nso wowɔ saa tebea yi? Nha wo ho. Ɛnnɛ yɛreka saa yareɛ yi a ɛfa sradeɛ a ɛwɔ mmerɛboɔ mu, anaa ɔkwan foforɔ so no, Steatotic Liver Disease ho asɛm. Bere bi a atwam no, na yɛfrɛ eyi “mrɛbo a srade wom.” Dɛn ankasa ne eyi? Dɛn nti na wɔtoo no din foforo? Momma yɛnka eyinom nyinaa ho asɛm tiawa.

Dɛn nti na edin "Fatty Liver" no sesae?

Ná yɛtaa frɛ saa tebea yi “mrɛbo mu yare a srade wom.” Nanso afe 2023 mu no, aduruyɛ ho abenfo sii gyinae sɛ wɔbɛsesa din no ayɛ no “steatotic liver disease.” Nneɛma atitiriw abien nti na ɛte saa. Biako ne sɛ edin foforo no kyerɛkyerɛ nea ɛde tebea no ba no mu pɛpɛɛpɛ. Sɛ nhwɛso no, bere a kɛseyɛ mmoroso yɛ ade biako a ɛde ba no, asiane afoforo wɔ hɔ a ɛne mu duru nni hwee yɛ. Ade foforo nti a ɛte saa ne sɛ ɛtɔ mmere bi a asɛmfua “mrɛbo a srade wom” no betumi ayɛ aniwu ne animtiaabu ama nnipa a wɔwɔ yare no, enti edin a wɔsesaa no boae ma wɔansi saa asɛm no so dua. Sɛ yɛbɛka no tiawa a, “steatosis” yɛ asɛmfua a nnuruyɛfo de kyerɛ srade a ɛboaboa ano wɔ akwaa bi mu (mpɛn pii no mmerɛbo mu). Srade kakraa bi na ɛwɔ mmerɛbo a ɛte apɔw a ɛyɛ adwuma yiye mu. Saa srade a ɛboaboa ano yi bɛyɛ ɔhaw sɛ ɛboro mmerɛbo no mu duru 5% a.

Dɛn ne mmerɛbo mu yare a srade wom (SLD)?

Nnuruyɛfo gyina nea ɛde ba ne tebea horow a ɛbata ho so kyekyɛ SLD mu. Momma yɛnhwɛ ahorow atitiriw no.

1. mmerɛbo mu yare a nsa de ba (ALD) .

Nea ɛba ne sɛ, sɛ wonom nsa pii a, srade boaboa ano wɔ wo mmerɛbo mu. Susuw ho hwɛ, sɛ wonom nsa a, wo mmerɛbo na ɛyi mu. Wɔ saa adeyɛ no mu no, mmerɛbo mu nkwammoaa no bi wuwu. Mpɛn pii no, mmerɛbo no tumi yɛ nkwammoaa foforo de si nea ayera no ananmu. Nanso sɛ wokɔ so nom nsa pii a, mmerɛbo no ntumi nyɛ adwuma yi yiye. Ɛno ne bere a srade fi ase boaboa ano wɔ wo mmerɛbo mu, tebea bi a wɔfrɛ no steatosis .

2. mmerɛbo mu yare a ɛma nipadua no yɛ adwuma yiye (MASLD) .

Kan no na wɔfrɛ eyi mmerɛbo mu srade a ɛnyɛ nsa (NAFLD). Nea enti a ɛte saa ne sɛ ɛnyɛ nsa a wɔnom boro so na ɛde srade a ɛwɔ mmerɛbo mu no ba. Edin foforo no ka sɛ nneɛma atitiriw a ɛma mmerɛbo a srade wom nya ne koma ne ntini ne nipadua mu nneɛma a ɛsakra no ho asiane ahorow . Sɛ yɛbɛka no tiawa a, tebea ne su ahorow bi a ɛka wo koma akwahosan na ɛde ba.

Asiane titiriw a ɛma obi nya MASLD ne:

• Obolo
• Asikreyare a Ɛto so 2
• Mogya mmoroso
• Lipid abnormalities – Eyinom yɛ srade ahorow a ɛwɔ wo mogya mu te sɛ cholesterol ne triglycerides a ɛnkari pɛ.

Sɛ mpo wonom nsa kakraa bi dapɛn biara, kyerɛ sɛ, ennu gram 140 dapɛn biara ma mmea na ennu gram 210 dapɛn biara ma mmarima a, wobetumi akɔ so abu wo sɛ MASLD. (Sɛ nhwɛso no, wɔ United States no, nsa bɛyɛ gram 14 wɔ beer toa a emu duru yɛ ɔuns 12 a wɔtaa de di dwuma mu.)

3. Srade a ɛwɔ mmerɛbo mu ne ɔfe a ɛba mmerɛbo mu esiane nipadua mu nneɛma a ɛnyɛ adwuma yiye nti (Metabolic-associated steatohepatitis – MASH) .

MASH yɛ MASLD a ɛyɛ aniberesɛm kɛse. Wɔ saa tebea yi mu no, mmerɛbo no hohoro na ɛyɛ hyew esiane srade a ɛboaboa ano wɔ mmerɛbo no mu nti. Afei, mmerɛbo no mu ntini no sɛe na efi ase yɛ akuru (fibrosis) . Kan no, na wɔfrɛ eyi steatohepatitis a ɛnyɛ nsa (NASH).

4. MASLD ne nsa a wɔnom boro so (MetALD) .

Sɛ wowɔ MetALD a, ɛkyerɛ sɛ nneɛma a ɛde asiane ba wɔ nipadua mu nneɛma a ɛsakra mu ne nsa a wɔnom nyinaa na ama srade aboaboa ano wɔ wo mmerɛbo mu. Wɔ eyi mu no, wowɔ asiane ahorow a ɛde koma ne ntini ne nipadua mu nneɛma a ɛsakra no ba, na wonom nsa bɛboro gram 140 dapɛn biara ma mmea ne bɛboro gram 210 ma mmarima.

Sɛ́ ebia nsa anaa nneɛma a ɛde asiane ba wɔ nipadua mu nneɛma a ɛsakra mu no betumi ama srade aboaboa ano wɔ mmerɛbo no mu no betumi ayɛ soronko wɔ onipa biara ho.

5. SLD ahorow afoforo

SLD betumi aba a wɔmfa nsa anaa nneɛma a ɛde asiane ba wɔ nipadua mu nneɛma mu nni dwuma. Sɛ nhwɛso no, nnuru bi ne nyarewa afoforo betumi ama srade ayɛ kɛse wɔ mmerɛbo no mu. Ɛtɔ mmere bi a nnuruyɛfo ntumi nhu nea ɛde ba pefee. Wɔfrɛ SLD a enni nea ɛde ba pefee no cryptogenic SLD .

So srade mmerɛbo mu yare (SLD) yɛ ɔhaw kɛse?

Mpɛn pii no, srade a ɛwɔ mmerɛbo no mu no mfa ɔhaw kɛse biara mma anaasɛ ɛmma mmerɛbo no nyɛ adwuma sɛnea ɛsɛ. Nanso, ɛtɔ mmere bi a, tebea yi betumi asɛe nkakrankakra na abɛyɛ mmerɛbo mu yare. Eyi taa si wɔ akwan horow pii so:

• Hepatitis : Mmerɛbo a mfiase no srade ahyɛ mu ma no hohoro na ɛyɛ hyew. Saa ɔfe yi sɛe mmerɛbo no mu ntini. Wɔfrɛ saa tebea yi steatohepatitis. Sɛ nhwɛso no, MASLD bɛyɛ MASH sɛnea edidi so yi.
• Fibrosis: Akuru ntini fi ase yɛ wɔ mmeae a mmerɛbo no sɛe esiane ɔfe nti. Eyi ma mmerɛbo no yɛ den kakra. Wɔfrɛ saa adeyɛ yi fibrosis .
• Cirrhosis of the liver: Eyi ne bere a wɔde akuru ntini pii si mmerɛbo mu ntini a ɛte apɔw ananmu. Eyi ne bere a yɛfrɛ no mmerɛbo mu yare a ɛma obi ho kyere no. Sɛ wɔansa akisikuru yiye a, ebetumi ama obi anya tebea horow a ɛde ne nkwa to asiane mu te sɛ mmerɛbo a entumi nyɛ adwuma yiye ne mmerɛbo mu kokoram. Sɛ nhwɛso no, nnipa a wonya hepatocellular carcinoma (HCC) , mmerɛbo mu kokoram bi no mu bɛyɛ 90% wɔ akisikuru.

Dɛn ne mmerɛbo mu yare a srade wom (SLD) ho sɛnkyerɛnne?

Ɛnyɛ obiara a ɔwɔ SLD na obenya yare no ho sɛnkyerɛnne. Ɛtɔ mmere bi a, sɛ sɛnkyerɛnne ahorow no ba ampa a, nea ɛka ho ne:

• Yafunu mu yaw anaasɛ te nka sɛ yafunu no atifi nifa so ayɛ ma.
• Ɔbrɛ anaa mmerɛwyɛ kɛse a wɔte nka (ɔbrɛ).

Nanso, nnipa dodow no ara hu sɛnkyerɛnne ahorow bere a SLD akɔ anim akodu akisikuru akyi nkutoo . Sɛ cirrhosis ba a, sɛnkyerɛnne te sɛ:

• Abofono.
• Aduan no nyɛ dɛ.
• Sɛ́ wobɛyɛ teateaa a ntease biara nnim.
• Wora a ɛyɛ kɔkɔɔ ne aniwa fitaa (jaundice).
• Ascites – Wei kyerɛ sɛ nsuo ahyɛ yafunu no ma.
• Nan, nsa, anaa nansoaa a ɛho ahonhon (edema).
• Mogya a ɛretu (oduruyɛfo betumi ahu eyi wɔ wo menewam, yafunu, anaa wo akyi berɛmo mu).

Dɛn na ɛde mmerɛbo mu yare a srade wom (SLD) ba?

Nneɛma pii nti na SLD tumi nya nkɔso. Nanso, sɛ wowɔ koma ne ntini ne nipadua mu nneɛma a ɛde asiane ba , sɛ wode nsa di dwuma wɔ ɔkwan a ɛmfata so, anaasɛ wowɔ abien no nyinaa a, ɛda adi sɛ wubenya SLD.

Wowɔ asiane kɛse mu sɛ wubenya SLD sɛ wowɔ saa nneɛma yi a:

• Nsã a wɔde di dwuma ho haw – kyerɛ sɛ, nsa a wɔtaa nom anaasɛ wɔnom boro so.
• Metabolic syndrome – Eyi ka insulin a ɛko tia, mogya mmoroso, srade a ɛkɔ soro, ne triglyceride dodow a ɛkɔ soro.
• Asikreyare a ɛto so abien.
• Mu duru boro so – Wei kyerɛ sɛ wo nipadua mu duru (BMI) yɛ 25 kosi 29.9 kg/m2.
• Kɛse mmoroso – BMI yɛ 30 kg/m2 anaa nea ɛboro saa.
• Polycystic ovary syndrome (PCOS) a ɛma obi nya awotwaa mu ntini pii.
• Dae mu ahomegye a esiw kwan.
• Hypothyroidism a ɛma mogya tu.
• Pituitary hormone dodow a ɛso tew (Hypopituitarism).
• Ɔbarima ne ɔbea nna mu nkwaadɔm a ɛso tew (Hypogonadism).
• Nnuru bi a wɔbɛkɔ so anom. Sɛ nhwɛso no, Amiodarone (Amiodarone – Cordarone®), Diltiazem (Diltiazem – Cardizem®), Tamoxifen (Tamoxifen – Nolvadex®) anaa nnuru a wɔde yɛ steroid. (Nnuru bi betumi ama srade ayɛ kɛse wɔ mmerɛbo no mu sɛ nea efi mu ba.)

Dɛn ne nsɛnnennen a ebetumi afi SLD mu aba?

Sɛ wɔansa mmerɛbo a ɛyɛ steatotic no yare a, ebetumi akɔ so abɛyɛ cirrhosis , a ebetumi ama mmerɛbo no ayɛ adwuma yiye, mmerɛbo mu kokoram, ne kokoram afoforo a ɛwɔ mmerɛbo no akyi. Nnipa a wɔwɔ MASLD no wɔ asiane mu titiriw sɛ wobenya komayare. Ɛho hia sɛ yɛkae sɛ komayare na ɛma nnipa a wɔwɔ MASLD wuwu titiriw, na ɛnyɛ mmerɛbo mu yare.

Ɔkwan bɛn so na wohu mmerɛbo mu yare a srade wom (SLD)?

Esiane sɛ mpɛn pii no SLD nni sɛnkyerɛnne biara nti, ebia wo duruyɛfo na obedi kan ahu ɔhaw no. Sɛ wo mmerɛbo mu enzymes kɔ soro bere a woreyɛ mogya mu nhwehwɛmu ahu tebea afoforo a, ebetumi ayɛ kɔkɔbɔ sɛnkyerɛnne. Mmerɛbo mu enzymes a ɛkɔ soro no betumi akyerɛ sɛ wo mmerɛbo no asɛe.

Sɛnea ɛbɛyɛ na woahu yare no, wo duruyɛfo betumi ayɛ nea edidi so yi:

• Aduruyɛ ho abakɔsɛm: Wobebisa w’ayaresa tebea horow, nsa dodow a wonom, ne nnuru a wode di dwuma.
• Nipadua mu nhwehwɛmu: Hwɛ sɛ ebia mmerɛbo mu yare ho sɛnkyerɛnne te sɛ mmerɛbo a ayɛ kɛse ne akisikuru .
• Mfoninitwa akwan: Wɔde sɔhwɛ ahorow te sɛ ultrasound , CT scan (Computed Tomography scan) , anaa MRI (Magnetic Resonance Imaging) scan di dwuma de hwehwɛ ɔfe ne akuru wɔ mmerɛbo no mu. Wobetumi de ultrasound nhwehwɛmu titiriw bi a wɔfrɛ no FibroScan® adi dwuma de ahu srade ne akuru ntini dodow a ɛwɔ mmerɛbo no mu.
• Berɛbo mu nhwehwɛmu: Wɔyɛ nhwehwɛmu yi de hu sɛnea mmerɛbo mu yare no akɔ anim pɛpɛɛpɛ. Ɔkwan biako pɛ a wobetumi afa so ahu nsonsonoe a ɛda MASLD ne MASH ntam pɛpɛɛpɛ ne sɛ wɔbɛyɛ mmerɛbo mu nhwehwɛmu .

Ɔkwan bɛn so na wɔsa mmerɛbo mu yare a srade wom (SLD)?

Ayaresa anaa aduru pɔtee biara nni hɔ a wɔde sa tebea yi. Mmom no, nnuruyɛfo de wɔn adwene si so sɛ wɔbɛboa wo ma woadi asiane ahorow a ɛde tebea no ba no so. Nea ɛka eyi ho ne nsakrae a wobɛyɛ wɔ w’asetra mu a ebetumi ama w’akwahosan atu mpɔn.

Ebia wo duruyɛfo bɛkamfo nea edidi so yi akyerɛ wo:

• Gyae nsanom koraa: Sɛ ɛnyɛ nsa a wonom na ɛde wo SLD no bae mpo a, kwati nsa koraa.
• Tew wo mu duru so: Apɔw-mu-teɛteɛ, aduan mu nsakrae a wobɛyɛ wɔ aduannuru ho ɔbenfo hwɛ ase, ne nnuru bi te sɛ GLP-1RA betumi aboa wo ma wo mu duru so atew. Wubetumi asusuw oprehyɛn a wobɛtew wo mu duru so nso ho.(Bariatric surgery) nso betumi afata.
• Nom nnuru a wode bedi nipadua mu nneɛma a ɛsakra no so: Nom nnuru a wɔakyerɛw ama wo de siw asikreyare, srade a ɛwɔ mogya mu, ne mogya mu srade (triglycerides) ano. Wɔ tebea horow bi mu no, ebia ebehia nso sɛ wonom vitamin E ne thiazolidinediones (nnuru a wɔde sa asikreyare te sɛ Actos® ne Avandia® ).
• Nya Hepatitis A ne Hepatitis B ho ban : Saa mmoawa a wɔde nyarewa ba yi yɛ asiane titiriw sɛ wowɔ mmerɛbo mu yare dedaw a.

Sɛ aduru bi a worenom rema srade ayɛ kɛse wɔ wo mmerɛbo mu a, ebia wo duruyɛfo bɛsesa nnuru a wɔakyerɛw ama wo.

Ɔkwan bɛn so na wobetumi asiw mmerɛbo mu yare a srade wom (SLD) ano?

Ɔkwan pa a wobɛfa so akwati SLD ne sɛ wobɛkɔ so akura w’akwahosan nyinaa mu:

• Yɛ apɔw-mu-teɛteɛ daa.
• To nsa a wonom no ano hye.
• Kura mu duru a ɛfata mu ma wo.
• Sɛ wowɔ asikreyare a ɛto so abien anaa metabolic syndrome a, fa nnuru a wɔakyerɛw ama wo no sɛnea wɔakyerɛ wo no pɛpɛɛpɛ.

So wotumi sa mmerɛbo mu yare a srade wom (SLD)?

Ɛdenam sɛnea wo tebea no mu yɛ den so no, wobetumi asan SLD na wobetumi asiesie akuru bi mpo. Wo mmerɛbo no wɔ tumi a ɛyɛ nwonwa a ɛde sa ne ho yare. Sɛ wudi wo duruyɛfo ayaresa nhyehyɛe akyi pɛpɛɛpɛ a, wubetumi atew srade ne ɔfe a ɛwɔ wo mmerɛbo mu no so. Wubetumi asiw ɔsɛe no ano na ansɛe, na wɔ tebea horow bi mu mpo, wobɛdan mmerɛbo a ɛsɛe ntɛm no.

So SLD betumi ama obi awu?

Wɔ nnipa dodow no ara fam no, SLD mfa ɔhaw akɛse mma gye sɛ ɛkɔ so yɛ akisikuru a ɛkɔ akyiri . Nnipa pii a wɔwɔ SLD no tra ase sɛnea ɛsɛ.

Nanso, mmerɛbo mu akisikuru a wɔansa no betumi ama awiei koraa no mmerɛbo no adi huammɔ anaasɛ mmerɛbo mu kokoram. Mmɛn yɛ akwaa a ɛho hia ma wo. Ɛno nti na ɛho hia paa sɛ wobɛbɔ wo mmerɛbo ho ban sɛ wuhu sɛ wowɔ SLD a.

Dɛn ne aduan pa ma obi a ɔwɔ SLD?

Sɛ wo SLD no ne wo mu duru a ɛkɔ soro wɔ abusuabɔ a, di aduan a ɛkari pɛ akyi na ama wo mu duru so atew nkakrankakra nanso nkakrankakra. Nnuruyɛfo taa kamfo kyerɛ sɛ wɔnkwati nnuan a asikre wom. Wɔkamfo kyerɛ nso sɛ sɔ Mediterranea aduan no hwɛ . Nnuadewa, nnuaba, ne srade pa pii wom. Afei nso, nneɛma te sɛ nnuaba, atoko, aburow a wɔayam, mpataa, ne akokɔ yɛ aduan pa a nnipa a wɔwɔ SLD betumi apaw. Ɛho hia paa nso sɛ wobɛkwati nam kɔkɔɔ pii a wobedi ne anonne a asikre wom a wobɛnom.

Nsɛm a Wɔtaa Bisa (FAQ) .

Asɛmmisa: Nneɛma ahe na wɔasɛe me mmerɛbo?

Mmuae: Wo duruyɛfo betumi aka akyerɛ wo nokwarem. Ɔbɛyɛ mogya mu nhwehwɛmu, scans (Ultrasound, FibroScan) de ahwɛ srade dodow a ɛwɔ wo mmerɛbo mu ne sɛ ebia akuru bi wɔ hɔ anaa. Afei ɔbɛkyerɛkyerɛ tebea no mu akyerɛ wo.

Asɛmmisa: Bere tenten ahe na egye ansa na mmerɛbo a asɛe no asan ayɛ yiye?

Anoyie:Egyina wo tebea ne wo mmɔdenbɔ so ankasa. Sɛ ɛyɛ mfiase a, sɛ wudi w’aduan so na wo mu duru so tew a, wubetumi ahu nsakrae pa wɔ asram kakraa bi mu. Sɛ emu yɛ den te sɛ cirrhosis a, ɛyɛ den sɛ wobɛsa no koraa, nanso wubetumi asiw ano na ansɛe.

Asɛmmisa: So nnuru a menom no ka SLD?

Mmuae: Yiw, ebetumi aba. Nnuru bi, sɛ nhwɛso no, Amiodarone ne Diltiazem, betumi aka mmerɛbo no. Ɛno nti na ɛsɛ sɛ woka nnuru a wonom nyinaa kyerɛ wo duruyɛfo no. Afei ɔbɛhwɛ sɛ ɔhaw bi wɔ saa nnuru no ho anaa.

Asɛmmisa: Dɛn ne mu duru a ɛfata ma me?

Mmuae: Egyina wo tenten ne wo mfe a woadi so. Mpɛn pii no eye sɛ wobɛma wo BMI akɔ fam 25. Nanso ade a eye sen biara a ɛsɛ sɛ woyɛ ne sɛ wubebisa wo duruyɛfo anaa aduannuru ho ɔbenfo bi akyerɛ wo mu duru a ɛfata ma wo. Sɛ wo mu duru so tew kakra mpo a, ebetumi ama wo mmerɛbo no ho atɔ wo kɛse.

Asɛmmisa: So metumi ne obi a onim aduan pa ahyia asua aduan pa ho ade?

Mmuae: Akyinnye biara nni ho! Ɛno ne ade a eye sen biara a ɛsɛ sɛ woyɛ. Aduan pa ho ɔbenfo betumi aboa wo ma woakyerɛw nnuan a ɛfata wo. Wobetumi aka nneɛma te sɛ Mediterranea aduan ne nnuan a ɛnyɛ den sɛ wɔbɛhyehyɛ ho asɛm akyerɛ wo. Sɛ wubisa wo duruyɛfo a, obetumi de wo akɔ.

Asɛmmisa: Mɛyɛ dɛn anya ayaresa wɔ nsanom ho haw ho?

Mmuae: Sɛ worehyia ɔhaw sɛ wubegyae asanom a, mma w’ani nnwu. Ɛyɛ ade a ɛyɛ daa. Ade a eye sen biara a ɛsɛ sɛ woyɛ ne sɛ wo ne wo duruyɛfo bɛkasa afa ho. Obetumi aboa wo, na sɛ ɛho hia a, ɔde wo bɛkɔ afotu adwumayɛbea anaa ɔbenfo bi nkyɛn. Kae sɛ, sɛ wobɛtwe wo ho afi nsa ho a, ɛho hia na ama woagye wo mmerɛbo nkwa.