So wo mmerɛbo nso yɛ srade? Momma yɛnka Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) ho asɛm .

So woasusuw pɛn sɛ mu duru a ɛboro so a wosoa anaa tebea bi te sɛ asikreyare a wowɔ nso betumi aka wo mmerɛbo? Ɛtɔ mmere bi a, yefi ase boaboa srade ano wɔ yɛn mmerɛbo mu a yennim. Ɛno ne tebea a yɛrebɛka ho asɛm nnɛ no mu biako, a wɔfrɛ no MASLD. Mma ɛnhaw wo, momma yɛnte eyi ase kɛkɛ.

Dɛn ne saa MASLD yi?

Sɛ yɛbɛka no tiawa a, MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) yɛ mmerɛbo mu yare a srade a ɛboaboa ano dodo wɔ wo mmerɛbo mu nkwammoaa mu na ɛde ba. Wɔsan frɛ no mmerɛbo mu yare a ɛma mogya tu (srade) (SLD) . Kan no na wɔfrɛ no NAFLD (Nonalcoholic Fatty Liver Disease), a ɛkyerɛ sɛ srade boaboa ano wɔ mmerɛbo no mu esiane nneɛma bi nti *ɛnyɛ* esiane nsa a wɔnom nti. Nanso seesei wɔasesa saa din yi ayɛ no MASLD, efisɛ wɔahu sɛ ɛne nneɛma bi a ɛnteɛ wɔ yɛn nipadua mu nneɛma a ɛsakra no mu wɔ abusuabɔ tẽẽ.

Te sɛ nwura a ɛboaboa ano wɔ yɛn afie mu no, sɛ srade boaboa ano wɔ mmerɛbo mu a, bere kɔ so no, ebetumi ama obi anya mmerɛbo mu yare, a ɛyɛ mmerɛbo mu ɔfe. Saa tebea yi yɛ mmerɛbo mu nyarewa a enni sabea a abu so sen biara wɔ wiase no mu biako. Ɛtaa ba nnipa a wɔayɛ kɛse mmoroso ne asikreyare a ɛto so abien mu titiriw. Bere a tebea horow yi kɔ soro no, abenfo bu akontaa sɛ ebia wiase nnipa bɛboro 30% na wɔwɔ MASLD. Sɛ wɔansa MASLD a, ebetumi ama obi anya mmerɛbo mu nyarewa a emu yɛ den kɛse. Enti, sɛ wohu ntɛm na wɔsa yare a, ebetumi asiw tebea yi ano.

Dɛn ne MASLD ho sɛnkyerɛnne ahorow?

Mpɛn pii no, tebea a wɔfrɛ no MASLD yi betumi aba mfe pii a ɛnkyerɛ sɛnkyerɛnne biara wɔ ne mfiase. Eyi kyerɛ sɛ yare no betumi aba wo nipadua mu a wonte nsonsonoe biara nka. Fa no sɛ ɔhaw bi a enyin wɔ anifere kwan so.

Nanso, sɛnkyerɛnne ahorow bi fi ase da adi bere a tebea yi du baabi a emu yɛ den kɛse a wɔfrɛ no MASH (Metabolic Dysfunction-Associated Steatohepatitis) no. MASH yɛ bere a srade boaboa ano wɔ mmerɛbo no mu na efi ase sɛe mmerɛbo no ka ɔfe ho. Eyi betumi de tebea horow te sɛ mmerɛbo mu ntini a ɛyɛ mmerɛw a ɛyɛ akuru ntini a ɛba, anaasɛ mmerɛbo mu yare aba. Sɛ eyi ba a, wubetumi anya yare no ho sɛnkyerɛnne te sɛ:

• Wowɔ ɛyaw anaasɛ wo ho nyɛ wo dɛ kakra wɔ wo yafunu no atifi nifa so, baabi a wo mmerɛbo no wɔ no .
• Ɔbrɛ a wontumi nsusuw ho a wɔte nka sɛ wonni nkwa.
• Aduan no nyɛ dɛ.
• Sɛ wote nka sɛ wo yafunu ayɛ hyew.
• Sɛ́ wobɛyɛ teateaa a ntease biara nnim.
• Wo honam ani ne w’ani fitaa dan kɔkɔɔ (te sɛ jaundice, nnuruyɛfo nso frɛ eyi scleral icterus ).

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, ɛho hia sɛ wohwehwɛ aduruyɛfo afotu.

Dɛn ne nneɛma a ɛde MASLD ba?

Ade titiriw nti a wunya MASLD ne sɛ nneɛma bi a ɛnteɛ ba wo nipadua no mu nneɛma a ɛsakra no mu . Saa nipadua mu nneɛma a ɛsakra yi ne ɔkwan a wɔfa so dan aduan a yedi no ma ɛbɛyɛ ahoɔden. Sɛ ɔhaw bi wɔ saa adeyɛ yi mu a, MASLD betumi aba. Nneɛma atitiriw a ɛka eyi ni:

• Dyslipidemia: Eyi ne bere a srade a ɛwɔ wo mogya mu, titiriw srade te sɛ srade, dɔɔso sen sɛnea ɛte daa no.
• Kɛse mmoroso: Sɛ wo Body Mass Index (BMI) yɛ 30 anaa nea ɛboro saa a, wobu wo sɛ woayɛ kɛse mmoroso. Nnipa a srade dɔɔso dodo, titiriw wɔ yafunu ho no wɔ asiane kɛse mu sɛ wobenya MASLD.
• Insulin a ɛko tia: Insulin yɛ hormone a ɛhwɛ asikre (glucose) dodow a ɛwɔ yɛn mogya mu so. Insulin a ɛko tia no kyerɛ sɛ wo ntini, srade nkwammoaa, ne mmerɛbo mu nkwammoaa ntumi nyɛ insulin ho adwuma yiye. Eyi ma ɛyɛ den sɛ wobedi asikre dodow a ɛwɔ mogya mu no so.
• Asikreyare a ɛto so abien: Eyi nso yɛ tebea a ɛtra hɔ kyɛ. Nea ɛkɔ so wɔ ha ne sɛ asikre dodow a ɛwɔ mogya mu no kɔ soro bere nyinaa (hyperglycemia).

Wɔ nneɛma yi akyi no, nhwehwɛmu ada no adi sɛ awosu mu nsakrae ahorow bi nso betumi ama asiane a ɛwɔ hɔ sɛ obi benya MASLD no ayɛ kɛse.

Dɛn ne nsɛnnennen a ebetumi afi MASLD mu aba?

Yɛaka sɛnea nnipa binom a wɔwɔ MASLD betumi anya tebea bi a wɔfrɛ no MASH ho asɛm dedaw. Sɛ MASH tebea yi mu yɛ den kɛse a, ɔhaw ahorow a edidi so yi betumi aba:

• MASH a mmerɛbo mu ntini a ɛyɛ mmerɛw: Fibrosis yɛ akuru ntini a ɛba mmerɛbo no mu. Saa akuru yi ba bere a mmerɛbo mu nkwammoaa asɛe na wɔbɔ mmɔden sɛ wobesiesie wɔn ho no.
• Akisikuru a ɛfa MASH ho: Akisikuru yɛ tebea a ɛma mmerɛbo no sɛe kɛse na ɛhwere tumi a ɛde yɛ adwuma. Eyi yɛ aniberesɛm paa na ebetumi de nkwa ato asiane mu.
• Berɛbo mu kokoram (Hepatocellular carcinoma): Eyi yɛ mmerɛbo mu kokoram bi a ebetumi afi MASH mu aba.

Ɛnyɛ sɛ MASLD betumi de ɔhaw ahorow a ɛfa mmerɛbo ho yi aba nko, na mmom ebetumi ama asiane a ɛwɔ hɔ sɛ obi benya nyarewa afoforo a emu yɛ den nso ayɛ kɛse. Nhwɛsoɔ:

• Kokoram: Kokoram ahorow te sɛ nufu mu kokoram ne kokoram a ɛwɔ akyi berɛmo mu.
• Koma ne ntini mu yare: Nyarewa a ɛfa koma ne mogya ntini ho.
• Asikreyare: Nnipa a wonni asikreyare mprempren no betumi anya asikreyare foforo.

Ɔkwan bɛn so na wohu MASLD?

Nea ɛbɛyɛ na nnuruyɛfo ahu sɛ wowɔ MASLD no yiye no, wɔtaa yɛ mogya mu nhwehwɛmu ne mfoniniyɛ mu nhwehwɛmu mpɛn pii. Ɛtɔ da bi a, ebia ɛho behia nso sɛ wɔfa mmerɛbo no fã ketewaa bi de yɛ nhwehwɛmu (mrɛbo mu nhwehwɛmu).

Mogya mu nhwehwɛmu

Oduruyɛfo no betumi ayɛ mogya mu nhwehwɛmu pii, te sɛ:

• A1C nhwehwɛmu: Eyi kyerɛ asikre dodow a ɛwɔ wo mogya mu wɔ asram abien kosi abiɛsa a atwam no mu.
• Mogya Dodow a Edi Mu (CBC): Eyi hwɛ sɛnea nkwammoaa ahorow a ɛwɔ wo mogya mu no dodow ne wɔn su te.
• Comprehensive Metabolic Panel (CMP): Eyi sɔ nneɛma bɛyɛ 14 a ɛwɔ wo mogya mu te sɛ protein ne electrolytes dodow hwɛ.
• Lipid panel: Eyi yɛ sɔhwɛ a wɔde hwehwɛ koma ne ntini mu yare. Ɛkyerɛ srade nketenkete (cholesterol, triglycerides) dodow a ɛwɔ wo mogya mu.
• Mmɛn dwumadi ho nhwehwɛmu: Saa mogya mu nhwehwɛmu yi susuw nneɛma ahorow (enzymes, proteins) a mmerɛbo no yɛ de ma wonya adwene wɔ mmerɛbo no akwahosan ho.

Mfoninitwa sɔhwɛ ahorow

Ebia wo duruyɛfo bɛyɛ scan ahorow te sɛ eyinom de ahwɛ sɛ ebia MASLD ho sɛnkyerɛnne bi wɔ wo mmerɛbo mu:

• FibroScan®: Saa scan yi betumi ama woanya srade dodow a ɛwɔ wo mmerɛbo mu ne baabi a fibrosis no kodu ho adwene.
• Magnetic Resonance Elastography ne Proton Density Fat Fraction (MRE-PDFF): Eyi nso yɛ scan soronko bi. Etumi susuw srade ɔha biara mu nkyem 100 wɔ mmerɛbo no mu ne sɛnea fibrosis no te no pɛpɛɛpɛ.

Biopsy a wɔde hwehwɛ nipadua mu

Ɛntaa mma koraa, sɛ wo duruyɛfo susuw sɛ biribi foforo a ɛnyɛ MASLD na ɛde wo sɛnkyerɛnne ahorow no ba, anaasɛ wohia nsɛm pii wɔ nhwehwɛmu te sɛ fibroscan akyi a, ebia obegye ntini ketewaa bi afi wo mmerɛbo mu (mrɛbo mu nhwehwɛmu) na wahwɛ mu wɔ afiri a wɔde hwɛ nneɛma nketenkete mu.

Ɔkwan bɛn so na wɔsa MASLD?

Sɛ wɔresa MASLD a, nea edi kan a wɔde wɔn adwene si so ne sɛ wɔbɛtew wɔn mu duru so . Nea ɛka ho no, wɔsa tebea horow a ɛde MASLD bae te sɛ asikreyare, srade a ɛdɔɔso, ne mogya mmoroso nso.

Nokwarem no, sɛ wo mu duru so tew a, ebetumi ama nsakrae kɛse aba wo mmerɛbo akwahosan mu. Srade a ɛboro so a ɛwɔ mmerɛbo no mu a wɔbɛtew so no betumi aboa ma wɔadi ɔfe a ebetumi de tebea horow te sɛ mmerɛbo mu yare aba no so. Ebia wo duruyɛfo bɛkamfo aduan ho nhyehyɛe titiriw bi akyerɛ wo, te sɛ Mediterranea aduan anaa DASH aduan. Yɛbɛka saa nnuan ahorow yi ho asɛm wɔ asɛm foforo mu.

Anyɛ yiye koraa no, apɔw-mu-teɛteɛ a ɛfata simma 30 da biara, nnansa dapɛn biara, betumi aboa ma wo mu duru so atew. Ebia wo duruyɛfo bɛka akyerɛ wo sɛ so tew wo nipadua mu duru nyinaa mu 10% anaa nea ɛboro saa. Nanso, sɛ wo nipadua mu duru so tew 3% kosi 5% mpo a, ebetumi ama nsonsonoe kɛse aba .

Nnuru a wɔde ma obi mu duru so tew

Sɛ wowɔ asikreyare ne/anaasɛ woyɛ kɛse mmoroso a, wo duruyɛfo betumi akyerɛw wo nnuru a ɛma wo mu duru so tew, te sɛ GLP-1 agonists. Saa nnuru yi ma asikre dodow a ɛwɔ wo mogya mu no so tew na ɛboa ma wo mu duru so tew. Nhwɛso ahorow bi ne:

• Semaglutide (Semaglutide - Ozempic® anaa Wegovy®) .
• Liraglutide (Liraglutide - Victoza® anaa Saxenda®) .
• Tirzepatide (Mounjaro® anaa Zepbound®) a wɔde yɛ aduru a wɔfrɛ no Tirzepatide (Mounjaro® anaa Zepbound®) .

Bariatric oprehyɛn a wɔyɛ

Ɛtɔ mmere bi a wo duruyɛfo nso betumi ne wo akasa afa bariatric oprehyɛn ho. Sɛ wohu sɛ wowɔ MASLD ansa na cirrhosis aba a, oprehyɛn a wɔde tew wo mu duru so yi betumi asan tebea no.

So wobetumi asan MASLD tebea no?

Yiw, wobetumi ayɛ! Nanso egyina wo tebea no so. Mpɛn pii no, sɛ wunni akisikuru a ɛfa MASH ho a, ayaresa betumi asan MASLD.

Ɛho hia sɛ wuhu yare yi ntɛm . Eyi betumi aboa ma wɔadi ɔhaw a mmerɛbo no asɛe no so ansa na ayɛ kɛse dodo. Sɛ obi mu duru so tew na ɔyɛ nsakrae wɔ w’asetra mu a, ebetumi aboa ma wɔasan asɛe mmerɛbo no a MASLD de ba no. Nanso, eyi gyina w’akwahosan nyinaa so. Enti, bisa wo duruyɛfo sɛ ebia wo mu duru a wobɛtew so no betumi adane wo tebea no anaa.

So wobetumi asiw MASLD ano?

Saa tebea yi taa ka nnipa a wɔayɛ kɛse mmoroso na wɔwɔ asikreyare a ɛto so abien no. Ebia ɛrentumi nyɛ yiye sɛ wobesiw tebea horow yi ano koraa. Nanso, sɛ wohu ntɛm na wɔsakra asetra mu a, ebetumi aboa ma wɔasiw MASLD a ɛbɛba no ano anaasɛ wɔadi so.

Sɛ woyɛ kɛse mmoroso anaasɛ wowɔ asikreyare a ɛto so abien a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ mogya mu nhwehwɛmu na wɔnyɛ scan de ahwɛ sɛ tebea no ho sɛnkyerɛnne bi wɔ hɔ anaa. Sɛ wɔkyere wo ntɛm a, wubetumi ayɛ nsakrae wɔ w’asetra mu na ama asiane a ɛwɔ hɔ no so atew.

Bere tenten ahe na wubetumi ne MASLD atra ase?

Nhwehwɛmu kyerɛ sɛ MASLD a wubenya no betumi aka wo nkwa nna. Sɛ nhwɛso no, nhwehwɛmu bi daa no adi sɛ sɛ wɔkyekyem pɛpɛɛpɛ a, ebia nnipa a wɔwɔ MASLD no tra ase mfe 2.8 a ennu wɔn a wonni yare no.

Nanso, nneɛma pii ka bere tenten a wobɛtra ase ne MASLD. Ebia wo tebea no bɛyɛ soronko wɔ afoforo ho. Enti, wo duruyɛfo no ne nea wubetumi ahwɛ kwan ho nsɛm a eye sen biara.

Mɛyɛ dɛn ahwɛ me ho?

Sɛ wowɔ MASLD a, ɔkwan pa a wobɛfa so ahwɛ wo ho ne sɛ wo ne wo nnuruyɛfo bɛyɛ adwuma de adi tebea horow a ɛde MASLD bae, te sɛ mu duru a ɛboro so, kɛseyɛ mmoroso, ne asikreyare a ɛto so abien no so. Sɛ wo mu duru so tew na wokɔ so yɛ nnam a, ebetumi aboa ma mmerɛbo a asɛe no so atew, na ebia ɛbɛdan akyi.Nyansahyɛ afoforo bi ni:

• Hwɛ w’akwahosan nyinaa yiye. MASLD ma asiane a ɛwɔ hɔ sɛ wubenya asikreyare, komayare, ne kokoram ahorow bi no yɛ kɛse. Enti, bisa w’abusua oduruyɛfo no nhwehwɛmu ahorow a wubetumi ayɛ de atew asiane a ɛwɔ hɔ no so.
• Nya suban ahorow a eye ma wo mmerɛbo. Gyae sigaretnom ne nsanom. Sigaret ne nsa a wɔnom de adwennwen kɛse ba wo mmerɛbo so. Bisa wo duruyɛfo nso fa sɛnea wobɛbɔ wo ho ban afi hepatitis A ne hepatitis B ho.
• Mma w’abaw, kɔ so bɔ mmɔden.

Sɛ́ wobɛtew wo mu duru so no gye bere. Ebia worenhu nsonsonoe kɛse biara ntɛm ara, nanso wubehu nea efi mu ba nkakrankakra. Afei nso, apɔw-mu-teɛteɛ daa yɛ ahofama. Sɛ wote nka sɛ woabrɛ anaasɛ woafono wo wɔ akwantu yi mu a, wo ne wo duruyɛfo nka ho asɛm.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wuhu nsakrae biara wɔ wo nipadua mu, te sɛ ɔbrɛ a wobɛte nka sen sɛnea wotaa yɛ anaasɛ ɛyaw a wobɛte wo yafunu nifa so atifi a, hwɛ hu sɛ wobɛkɔ wo duruyɛfo nkyɛn . Nsakrae ahorow yi betumi akyerɛ sɛ MASH, mmerɛbo mu yare a srade wom a ebetumi akɔ tebea horow a emu yɛ den te sɛ mmerɛbo mu yare ne mmerɛbo mu kokoram a emu yɛ den mu.

So nsa a wɔnom de MASLD ba?

Dabi, nsa a wɔnom mfa MASLD ba tẽẽ. Sɛnea yɛadi kan aka no, kan no na wɔfrɛ eyi mmerɛbo mu srade a ɛnyɛ nsa (NAFLD). Eyi kyerɛ sɛ, sɛ woannom nsa pii mpo a, saa tebea yi betumi aba.

Nanso, adeɛ a ɛho hia paa ne sɛ, sɛ obi a ɔwɔ MASLD nom nsa a, ɛwɔ asiane kɛseɛ mu sɛ ɔbɛnya cirrhosis sene onipa a ɔte aseɛ. Ɛno nti na nnuruyɛfo taa tu nnipa a wɔwɔ MASLD fo sɛ wɔnkwati nsa koraa no.

Nea etwa to no, nneɛma a ɛsɛ sɛ yɛkae

Sɛ mogya mu nhwehwɛmu wɔ w’afe afe nipadua mu apɔw-mu-teɛteɛ mu kyerɛ sɛ wowɔ ɔhaw bi wɔ wo mmerɛbo mu a, wobetumi ayɛ nhwehwɛmu foforo de akyerɛ sɛ wowɔ MASLD. Saa mmerɛbo mu yare yi betumi de ɔhaw ahorow a emu yɛ den aba, sɛ wɔanni ho dwuma yiye a.

Nanso asɛmpa no ne sɛ asetra mu nsakrae te sɛ mu duru a ɛso tew ne nnamyɛ betumi aboa ma MASLD anyɛ kɛse. Wobetumi mpo asan asɛe wo mmerɛbo no. Nanso wo mu duru a wobɛtew so na woayɛ nnam no nyɛ biribi a wubetumi ayɛ anadwo biako pɛ. Egye bere ne ahosohyira. Nna bi wɔ hɔ a, ebia wobɛte nka sɛ worebrɛ wɔ saa nneɛma yi ho. W’akwahosan kuw no te asɛnnennen a ɛwɔ nneɛma a ɛte sɛ nea ɛnyɛ adwuma ntɛm ara a wobɛsɔ ahwɛ no ase. Enti, ntwentwɛn wo nan ase da sɛ wobɛsrɛ mmoa ne mmoa. Wo mmerɛbo som bo ma wo, na ɛyɛ wo na wobɛhwɛ so!

` mmerɛbo mu srade, mmerɛbo a srade wom, asikreyare, kɛseyɛ mmoroso, mmerɛbo mu yare, mmerɛbo akwahosan