Ua momona loa kou akepaʻa? E aʻo kākou e pili ana i ka inoa hou no ka maʻi akepaʻa momona (Steatotic Liver Disease)!

"Auē, e ke kauka, he mau waihona momona koʻu i loko o koʻu ake..." Ua lohe anei ʻoe i kekahi mea e like me kēia? A i ʻole he maʻi kēia kou? Mai hopohopo. I kēia lā, ke kamaʻilio nei mākou e pili ana i kēia maʻi o nā waihona momona i loko o ke ake, a i ʻole ma nā huaʻōlelo ʻē aʻe, ʻo ka maʻi Steatotic Liver. I ka wā ma mua, ua kapa mākou i kēia "ake momona." He aha kēia? No ke aha i hāʻawi ʻia ai kahi inoa hou? E kamaʻilio maʻalahi kākou e pili ana i kēia mau mea a pau.

No ke aha i loli ai ka inoa ʻo "Fatty Liver"?

Ua kapa mākou i kēia maʻi he "maʻi akepaʻa momona." Akā i ka makahiki 2023, ua hoʻoholo nā loea lapaʻau e hoʻololi i ka inoa i "maʻi akepaʻa steatotic." ʻElua kumu nui no kēia. ʻO kekahi, ʻo ka inoa hou e wehewehe pono ana i nā kumu o ke ʻano. No ka laʻana, ʻoiai ʻo ka momona kekahi kumu, aia kekahi mau mea pilikia ʻē aʻe ʻaʻohe pili i ke kaumaha. ʻO kekahi kumu, ʻo ka huaʻōlelo "akepaʻa momona" i kekahi manawa hiki ke hilahila a hoʻohilahila i ka poʻe me ke ʻano, no laila ua kōkua ka hoʻololi ʻana i ka inoa e hōʻemi i kēlā. I ka ʻōlelo maʻalahi, ʻo "steatosis" kahi huaʻōlelo i hoʻohana ʻia e nā kauka e wehewehe i ka hōʻiliʻili ʻana o ka momona i loko o kahi ʻōkana (ʻo ia hoʻi ke akepaʻa). ʻO kahi akepaʻa olakino a hana maikaʻi hoʻi, aia kahi liʻiliʻi o ka momona. Lilo kēia hōʻiliʻili momona i pilikia inā ʻoi aku ia ma mua o 5% o ke kaumaha o ke akepaʻa.

He aha nā ʻano maʻi akepaʻa momona (SLD)?

Hoʻokaʻawale nā ​​kauka i ka SLD ma muli o kona mau kumu a me nā kūlana pili. E nānā kākou i nā ʻano nui.

1. Maʻi akepaʻa e pili ana i ka waiʻona (ALD)

ʻO ka mea e hana ʻia, inā ʻoe e inu nui i ka waiʻona, e hōʻiliʻili ka momona i loko o kou ake. E noʻonoʻo e pili ana i ia mea, ke inu ʻoe i ka waiʻona, ʻo kou ake ka mea e kānana iā ia. I ke kaʻina hana, make kekahi o nā hunaola ake. ʻO ka maʻamau, hiki i ke ake ke hana i nā hunaola hou e pani i nā mea i nalowale. Akā inā ʻoe e hoʻomau i ka inu nui ʻana i ka waiʻona, ʻaʻole hiki i ke ake ke hana pono i kēia hana. ʻO ia ka manawa e hoʻomaka ai ka momona e hōʻiliʻili i loko o kou ake, kahi maʻi i kapa ʻia ʻo steatosis .

2. ʻO ka maʻi ate steatotic e pili ana i ka hana metabolic (MASLD)

Ua kapa ʻia kēia ma mua he maʻi momona ʻole-waiʻona (NAFLD). ʻO kēia no ka mea ʻaʻole i hoʻokumu ʻia ka momona i loko o ke akepaʻa e ka inu nui ʻana i ka waiʻona. Wahi a ka inoa hou, ʻo nā kumu nui e kōkua ai i ka ulu ʻana o ke akepaʻa momona he mau mea pilikia cardiovascular a me metabolic . I ka ʻōlelo maʻalahi, hoʻokumu ʻia ia e kekahi mau kūlana a me nā ʻano e hoʻopilikia ai i ke olakino o kou puʻuwai.

ʻO nā kumu pilikia nui no ka hoʻomohala ʻana i ka MASLD :

• Momona
• ʻAno 2 Diabetes
• Ke koko kiʻekiʻe
• Nā ʻano lipid ʻē - ʻO kēia nā kaulike ʻole o nā ʻano momona i loko o kou koko, e like me ka cholesterol a me nā triglycerides.

ʻOiai inā inu ʻoe i kahi waiʻona liʻiliʻi i kēlā me kēia pule, ʻo ia hoʻi, ʻaʻole i emi iho ma mua o 140 grams i kēlā me kēia pule no nā wahine a ʻaʻole i emi iho ma mua o 210 grams i kēlā me kēia pule no nā kāne, hiki nō ke manaʻo ʻia ʻoe he MASLD. (No ka laʻana, ma ʻAmelika Hui Pū ʻIa, aia i loko o kahi kini pia 12-auneke maʻamau he 14 grams o ka waiʻona.)

3. Nā waihona momona a me ka mumū i loko o ke akepaʻa ma muli o ka hana ʻole o ka metabolic (Metabolic-associated steatohepatitis - MASH)

ʻO MASH kahi ʻano koʻikoʻi o ka MASLD. I kēia kūlana, pehu a mumū ke akepaʻa ma muli o ka hōʻiliʻili ʻana o ka momona i loko o ke ake. A laila, ua hōʻino ʻia nā ʻiʻo o ke akepaʻa a hoʻomaka i ka ʻōpala (fibrosis) . Ma mua, ua kapa ʻia kēia ʻo non-alcoholic steatohepatitis (NASH).

4. MASLD a me ka hoʻohana nui ʻana i ka waiʻona (MetALD)

Inā loaʻa iā ʻoe ʻo MetALD, ʻo ia hoʻi ua kōkua nā kumu pilikia metabolic a me ka hoʻohana ʻana i ka waiʻona i ka hōʻiliʻili ʻana o ka momona i loko o kou ake. I kēia hihia, loaʻa iā ʻoe nā kumu pilikia cardiovascular a me metabolic, a ʻoi aku ʻoe i ka 140 grams o ka waiʻona i kēlā me kēia pule no nā wahine a ʻoi aku ma mua o 210 grams no nā kāne.

ʻOkoʻa paha kēlā me kēia kanaka i ka wā e ʻoi aku ai ka nui o ka waiʻona a i ʻole nā ​​​​​​mea pilikia metabolic e kōkua ai i ka hōʻiliʻili ʻana o ka momona i loko o ke ake.

5. Nā ʻano SLD ʻē aʻe

Hiki ke hana ʻia ka SLD me ka ʻole o ka hoʻohana ʻana i ka waiʻona a i ʻole nā ​​​​​​mea pilikia metabolic. No ka laʻana, hiki i kekahi mau lāʻau lapaʻau a me nā maʻi ʻē aʻe ke hoʻoulu i ka momona e hōʻiliʻili i loko o ke ake. I kekahi manawa ʻaʻole hiki i nā kauka ke loaʻa kahi kumu maopopo. ʻO ka SLD me ke kumu ʻole ua kapa ʻia ʻo cryptogenic SLD .

He pilikia koʻikoʻi anei ka maʻi akepaʻa momona (SLD)?

I ka hapanui o nā hihia, ʻaʻole nā ​​waihona momona i loko o ke akepaʻa e hoʻoulu i nā pilikia nui a i ʻole e hoʻopilikia i ka hana maʻamau o ke akepaʻa. Eia nō naʻe, i kekahi manawa hiki i kēia kūlana ke ʻoi aku ka ʻino a lilo i maʻi akepaʻa. Hana pinepine kēia i kekahi mau pae:

• Hepatitis : ʻO ke akepaʻa, ka mea i piha mua i ka momona, e pehu a mumū. Hoʻopōʻino kēia mumū i nā ʻiʻo o ke akepaʻa. Ua kapa ʻia kēia maʻi ʻo steatohepatitis. No ka laʻana, lilo ʻo MASLD i MASH penei.
• Fibrosis: Hoʻomaka ka hana ʻana o nā ʻiʻo ʻeha ma nā wahi i hōʻino ʻia ai ke akepaʻa i hana ʻia e ka mumū. ʻO kēia ke kumu e lilo ai ke akepaʻa i mea ʻoʻoleʻa iki. Ua kapa ʻia kēia kaʻina hana he fibrosis .
• ʻO ka Cirrhosis o ke akepaʻa: ʻO kēia ka manawa e pani ʻia ai nā ʻiʻo akepaʻa olakino e ka nui o nā ʻiʻo ʻeha. ʻO kēia ka manawa a mākou e kapa ai he cirrhosis o ke akepaʻa. Inā ʻaʻole mālama pono ʻia, hiki i ka cirrhosis ke alakaʻi i nā kūlana hoʻoweliweli ola e like me ka hāʻule ʻana o ke akepaʻa a me ke kanesa o ke akepaʻa. No ka laʻana, ma kahi o 90% o ka poʻe e loaʻa ana i ka hepatocellular carcinoma (HCC) , kahi ʻano kanesa o ke akepaʻa, loaʻa iā lākou ka cirrhosis.

He aha nā hōʻailona o ka maʻi akepaʻa momona (SLD)?

ʻAʻole nā ​​​​kānaka a pau me SLD e ʻike i nā hōʻailona. I kekahi manawa, inā loaʻa nā hōʻailona, ​​​​hiki iā lākou ke komo pū me:

• ʻEha ka ʻōpū a i ʻole ka manaʻo o ka piha ma ka ʻaoʻao ʻākau o luna o ka ʻōpū.
• Manaʻo luhi loa a nāwaliwali paha (luhi).

Eia nō naʻe, ʻike ka hapa nui o ka poʻe i nā hōʻailona ma hope o ka holomua ʻana o SLD i ka cirrhosis . Ke ulu ka cirrhosis, ʻike ʻia nā hōʻailona e like me:

• Ka luaʻi.
• ʻAʻohe ʻono o ka meaʻai.
• Ka wiwi ʻana me ke kumu ʻole.
• Melemele o ka ʻili a me nā keʻokeʻo o nā maka (jaundice).
• ʻO Ascites - ʻO ke ʻano kēia ua piha ka ʻōpū i ka wai.
• Ka pehu ʻana (edema) o nā wāwae, nā lima, a i ʻole nā ​​kuʻekuʻe wāwae.
• Ke kahe ʻana o ke koko (hiki i ke kauka ke ʻike i kēia ma kou esophagus, ʻōpū, a i ʻole rectum).

He aha nā kumu o ka maʻi akepaʻa momona (SLD)?

Aia kekahi mau kumu e hiki ai ke ulu aʻe ka SLD. Eia nō naʻe, inā he mau kumu pilikia cardiovascular a me metabolic kou, inā hoʻohana ʻoe i ka waiʻona ma ke ʻano maikaʻi ʻole, a inā loaʻa iā ʻoe nā mea ʻelua, ʻoi aku ka nui o ka loaʻa ʻana o ka SLD.

Aia ʻoe i ka pilikia kiʻekiʻe o ka hoʻomohala ʻana i ka SLD inā loaʻa iā ʻoe kēia mau mea:

• ka maʻi hoʻohana ʻona - ʻo ia hoʻi, ka inu pinepine ʻana i ka waiʻona a nui paha.
• ʻO ka maʻi metabolic - ʻO kēia ka pale ʻana o ka insulin, ke koko kiʻekiʻe, ka cholesterol kiʻekiʻe, a me nā pae triglyceride kiʻekiʻe.
• ʻO ka maʻi diabetes ʻano 2.
• Kaumaha Loa - ʻO ke ʻano kēia, ʻo kou helu nui o ke kino (BMI) ma waena o 25 a me 29.9 kg/m2.
• Momona - ʻO ka BMI he 30 kg/m2 a ʻoi aku paha.
• ʻO ka maʻi ovarian polycystic (PCOS).
• ʻO ka apnea hiamoe obstructive.
• ʻO ka hypothyroidism.
• Ka emi ʻana o ka nui o ka hormone pituitary (Hypopituitarism).
• Ka emi ʻana o nā hormones wahine (Hypogonadism).
• Ke hoʻomau nei i ka lawe ʻana i kekahi mau lāʻau lapaʻau. No ka laʻana, ʻo Amiodarone (Amiodarone - Cordarone®), Diltiazem (Diltiazem - Cardizem®), Tamoxifen (Tamoxifen - Nolvadex®) a i ʻole nā ​​steroids. (Hiki i kekahi mau lāʻau lapaʻau ke hoʻoulu i ka momona e hōʻiliʻili i loko o ke akepaʻa ma ke ʻano he hopena ʻaoʻao.)

He aha nā pilikia e hiki ke loaʻa mai i ka SLD?

Inā ʻaʻole mālama ʻia, hiki i ke akepaʻa steatotic ke holomua i ka cirrhosis , hiki ke alakaʻi i ka hāʻule ʻana o ke akepaʻa, ka maʻi kanesa o ke akepaʻa, a me nā maʻi kanesa ʻē aʻe ma waho o ke akepaʻa. ʻO ka poʻe me MASLD ka mea nui i ka maʻi puʻuwai. He mea nui e hoʻomanaʻo ʻo ka maʻi puʻuwai, ʻaʻole ka maʻi akepaʻa, ke kumu nui o ka make ma waena o ka poʻe me MASLD.

Pehea e ʻike ʻia ai ka maʻi akepaʻa momona (SLD)?

No ka mea, ʻaʻohe hōʻailona o ka SLD, ʻo kāu kauka paha ka mea mua e ʻike i ka pilikia. Inā kiʻekiʻe nā enzymes o kou ake i ka wā o ka hoʻāʻo koko no nā kūlana ʻē aʻe, hiki iā ia ke lilo i hōʻailona hōʻailona. ʻO nā enzymes o ke ake i kiʻekiʻe ʻia ke ʻano ua hōʻino ʻia kou ake.

No ka hana ʻana i kahi hōʻailona, ​​​​hiki i kāu kauka ke hana i kēia mau mea:

• Mōʻaukala lapaʻau: Ke nīnau nei e pili ana i kou kūlana olakino, ka nui o ka waiʻona āu e inu ai, a me nā lāʻau lapaʻau āu e hoʻohana ai.
• Hoʻokolohua kino: E nānā i nā hōʻailona o ka cirrhosis, e like me ka ate i hoʻonui ʻia a me ka jaundice .
• Nā kaʻina hana kiʻi: Hoʻohana ʻia nā hoʻāʻo e like me ka ultrasound , CT scan (Computed Tomography scan) , a i ʻole MRI (Magnetic Resonance Imaging) scan e nānā i ka mumū a me ka ʻōpala i loko o ke ake. Hiki ke hoʻohana ʻia kahi hoʻāʻo ultrasound kūikawā i kapa ʻia ʻo FibroScan® e hoʻoholo ai i ka nui o ka momona a me nā ʻiʻo ʻōpala i loko o ke ake.
• ʻO ka biopsy akepaʻa: Hana ʻia kēia hoʻāʻo e hoʻoholo pono i ka holomua o ka maʻi akepaʻa. ʻO ke ala wale nō e hoʻokaʻawale pololei ai ma waena o MASLD a me MASH ʻo ia ka loaʻa ʻana o kahi biopsy akepaʻa .

Pehea e mālama ʻia ai ka maʻi akepaʻa momona (SLD)?

ʻAʻohe lāʻau lapaʻau a lāʻau lapaʻau paha no kēia maʻi. Akā, ke kālele nei nā kauka i ke kōkua ʻana iā ʻoe e kāohi i nā mea pilikia e kōkua ai i ke ʻano. Hoʻokomo pū kēia i ka hana ʻana i nā hoʻololi ʻana i ke ʻano o ka nohona e hiki ai ke hoʻomaikaʻi i kou olakino.

Hiki i kāu kauka ke ʻōlelo i kēia mau mea:

• E ho'ōki loa i ka inu ʻana i ka waiʻona: ʻOiai inā ʻaʻole i hoʻokumu ʻia kāu SLD e ka hoʻohana ʻana i ka waiʻona, e pale loa i ka waiʻona.
• E hoʻemi i ke kaumaha: ʻO ka hoʻoikaika kino, nā hoʻololi ʻana i ka ʻai ma lalo o ka nānā ʻana a kahi meaʻai loea, a me kekahi mau lāʻau lapaʻau, e like me GLP-1RA, hiki ke kōkua iā ʻoe e hoʻemi i ke kaumaha. Hiki iā ʻoe ke noʻonoʻo i ke ʻoki kino no ka hoʻemi kaumaha.(ʻoki kino Bariatric) hiki nō hoʻi ke kūpono.
• E lawe i nā lāʻau lapaʻau e kāohi i nā kūlana metabolic: E lawe i kāu mau lāʻau lapaʻau i kuhikuhi ʻia e kāohi i ka maʻi diabetes, cholesterol, a me nā momona koko (triglycerides). I kekahi mau hihia, pono paha ʻoe e lawe i ka huaora E a me nā thiazolidinediones (nā lāʻau lapaʻau no ka maʻi diabetes e like me Actos® a me Avandia® ).
• E loaʻa i ka lāʻau pale no ka Hepatitis A a me ka Hepatitis B : He mea weliweli loa kēia mau maʻi viral inā loaʻa iā ʻoe ka maʻi ate.

Inā ʻo ka lāʻau lapaʻau āu e lawe nei ke kumu o ka hōʻiliʻili ʻana o ka momona i loko o kou ake, hiki i kāu kauka ke hoʻololi i kāu lāʻau lapaʻau.

Pehea e pale aku ai i ka maʻi akepaʻa momona (SLD)?

ʻO ke ala maikaʻi loa e pale aku ai i ka SLD, ʻo ia ka mālama ʻana i kou olakino holoʻokoʻa:

• E hoʻoikaika kino i nā manawa a pau.
• E hōʻemi i kāu inu ʻona.
• E mālama i ke kaumaha olakino nou.
• Inā loaʻa iā ʻoe ka maʻi diabetes type 2 a i ʻole ka metabolic syndrome, e lawe i kāu lāʻau lapaʻau i kuhikuhi ʻia e like me ke kauoha.

Hiki ke ho'ōla ʻia ka maʻi akepaʻa momona (SLD)?

Ma muli o ke koʻikoʻi o kou kūlana, hiki ke hoʻohuli ʻia ka SLD a hiki ke hoʻoponopono ʻia kekahi mau ʻōpala. He hiki kupaianaha ko kou akepaʻa e ho'ōla iā ia iho. Inā ʻoe e hahai pololei i ka hoʻolālā lapaʻau a kāu kauka, hiki iā ʻoe ke hōʻemi i ka nui o ka momona a me ka mumū i loko o kou akepaʻa. Hiki iā ʻoe ke pale i ka hōʻino ʻana mai ka ʻino ʻana, a i kekahi mau hihia, hiki ke hoʻohuli i ka hōʻino mua ʻana o ke akepaʻa.

Hiki i ka SLD ke hoʻoulu i ka make?

No ka hapa nui o nā kānaka, ʻaʻole hana ka SLD i nā pilikia nui ke ʻole ia e holomua i ka cirrhosis holomua . He nui ka poʻe me SLD e ola i kahi ola maʻamau.

Eia nō naʻe, ʻo ka cirrhosis o ke akepaʻa i mālama ʻole ʻia hiki ke alakaʻi i ka hāʻule ʻana o ke akepaʻa a i ʻole ke kanesa o ke akepaʻa. He ʻōkana koʻikoʻi ke akepaʻa nou. ʻO ia ke kumu he mea nui loa ka pale ʻana i kou akepaʻa inā ʻike ʻoe he SLD kou.

He aha ka papaʻai maikaʻi no kekahi me SLD?

Inā pili kāu SLD me ka piʻi ʻana o ke kaumaha, e hahai i kahi papaʻai kaulike e hōʻemi mālie i ke kaumaha akā paʻa. Paipai pinepine nā kauka e pale i nā meaʻai kō. Paipai pū lākou e hoʻāʻo i ka papaʻai Mediterranean . He waiwai ia i nā mea kanu, nā huaʻai, a me nā momona maikaʻi. Eia kekahi, ʻo nā mea e like me nā nati, nā legumes, nā palaoa piha, ka iʻa, a me ka moa he mau koho meaʻai maikaʻi no ka poʻe me SLD. He mea nui loa hoʻi e pale i ka ʻai ʻana i ka ʻiʻo ʻulaʻula nui a me ka inu ʻana i nā mea inu kō.

Nā Nīnau i Nīnau Pinepine ʻia (FAQ)

Nīnau: ʻEhia ka nui o ka pōʻino i hana ʻia i koʻu ake?

Pane: Hiki i kāu kauka ke haʻi maopopo iā ʻoe. E hana ʻo ia i nā hoʻokolohua koko, nā scan (Ultrasound, FibroScan) e nānā i ka nui o ka momona i loko o kou akepaʻa a inā he ʻeha. A laila e wehewehe ʻo ia i ke kūlana iā ʻoe.

Nīnau: Pehea ka lōʻihi o ka hoʻōla ʻana o ka hōʻino ʻia o ke akepaʻa?

Pane:Aia maoli nō ia i kou kūlana a me kāu mau hoʻoikaika ʻana. Inā aia i nā pae mua, inā ʻoe e kāohi i kāu ʻai a hoʻemi i ke kaumaha, hiki iā ʻoe ke ʻike i kahi loli maikaʻi i loko o kekahi mau mahina. Inā he koʻikoʻi, e like me ka cirrhosis, he paʻakikī ke ho'ōla loa iā ia, akā hiki iā ʻoe ke pale aku i kona ʻino ʻana.

Nīnau: Ke hoʻopilikia nei nā lāʻau lapaʻau aʻu e lawe ai iā SLD?

Pane: ʻAe, hiki. Hiki i kekahi mau lāʻau lapaʻau, no ka laʻana, ʻo Amiodarone lāua ʻo Diltiazem, ke hoʻopilikia i ke akepaʻa. ʻO ia ke kumu e pono ai ʻoe e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe ai. A laila e nānā ʻo ia e ʻike inā he pilikia me kēlā mau lāʻau lapaʻau.

Nīnau: He aha ke kaumaha olakino noʻu?

Pane: Aia ia i kou kiʻekiʻe a me kou mau makahiki. ʻOi aku ka maikaʻi o ka mālama ʻana i kāu BMI ma lalo o 25. Akā ʻo ka mea maikaʻi loa e hana ai, ʻo ia ke nīnau i kāu kauka a i ʻole kekahi meaʻai meaʻai e pili ana i ke kaumaha kūpono nou. ʻOiai ka emi iki ʻana o ke kaumaha hiki ke lilo i mea hōʻoluʻolu nui no kou akepaʻa.

Nīnau: Hiki iaʻu ke hālāwai me kahi loea meaʻai e aʻo e pili ana i ka papaʻai olakino?

Pane: ʻAe! ʻO ia ka mea maikaʻi loa e hana ai. Hiki i kahi meaʻai meaʻai ke kōkua iā ʻoe e hana i kahi papa inoa o nā meaʻai kūpono iā ʻoe. Hiki iā lākou ke haʻi iā ʻoe e pili ana i nā mea e like me ka ʻai Mediterranean a me nā meaʻai maʻalahi e hoʻomākaukau. Inā ʻoe e nīnau i kāu kauka, hiki iā ia ke kuhikuhi iā ʻoe.

Nīnau: Pehea e loaʻa ai iaʻu ka lāʻau lapaʻau no ka maʻi hoʻohana waiʻona?

Pane: Inā pilikia ʻoe i ka haʻalele ʻana i ka inu ʻana, mai hilahila. He mea maʻamau ia. ʻO ka mea maikaʻi loa e hana ai, ʻo ia ke kamaʻilio me kāu kauka e pili ana i ia mea. Hiki iā ia ke kōkua iā ʻoe, a inā pono, e kuhikuhi iā ʻoe i kahi lawelawe aʻoaʻo a i ʻole kahi loea. E hoʻomanaʻo, he mea nui ka noho ʻana mai ka waiʻona no ka mālama ʻana i kou ake.