Mu maka go mulimu abantu abafunye obulwadde bw’omutima nga tebannakaddiwa, kwe kugamba, ku myaka 40-50? Oba kya bulijjo abantu mu maka go okugamba buli kiseera nti, "High cholesterol, high cholesterol"? Ebiseera ebisinga, tulowooza nti ekivaako kino bye bintu nga bye tulya ne bye tunywa, n’obutakola dduyiro. Ekyo kituufu era ekyo nakyo kirina kye kikola. Naye oluusi, ensonga entuufu emabega wa kolesterol ono omungi eyinza okuba ekizibu munda mu mubiri gwaffe, mu buzaale bwaffe. Ekyo kye tuyita `Familial Hypercholesterolemia` oba `FH` mu ddagala. Leero, kino tugenda kukyogerako mu ngeri ennyangu, mu ngeri gy’osobola okutegeera.
Mu ngeri ennyangu, obulwadde bwa Family Hypercholesterolemia (FH) kye ki?
Famire Hypercholesterolemia mbeera ya buzaale esikira okuva ku maama w’omuntu, kitaawe oba bombi. Wano kolesterol "omubi" oba LDL cholesterol mu mibiri gyaffe bw'abeera mungi nnyo okuva lwe twazaalibwa.
Lowooza ku misuwa gyaffe ng’emisuwa. Cholesterol ono eya `LDL` alinga oluwuzi olwa kyenvu, olwa waxy olunywerera ku bisenge by’emisuwa egyo. Mu budde obwa bulijjo, bino bizimba mpolampola. Naye mu muntu alina `FH`, `LDL` cholesterol level eri waggulu nnyo nga layer eno eya waxy etandika okuzimba mangu nnyo era nga nnyogovu nnyo munda mu misuwa. Kino tukiyita `obulwadde bw'emisuwa`. Ekiseera bwe kigenda kiyitawo, oluwuzi luno lukula ne lufunda emisuwa, oluusi ne gizibikira ddala. Wano ebintu ebiyinza okutta obulamu ng’okulwala omutima n’okusannyalala we bibaawo.
Omutindo gwa kolesterol ogwa `LDL` ogw'omuntu omulamu owa bulijjo gulina okuba wansi wa 100 mg/dL. Naye mu muntu alina `FH`, omuwendo guno guyinza okuba waggulu ennyo, nga 160 mg/dL, 190 mg/dL . Mu mbeera ezimu ez’amaanyi, kiyinza n’okusukka 400 mg/dL. Ekisinga okuba eky’obulabe kiri nti okuva embeera eno bw’ebaddewo okuva mu buto, singa tejjanjabibwa, emikisa gy’okufuna obulwadde bw’omutima buba bungi nnyo ku myaka emito ennyo okusinga omuntu wa bulijjo.
Emboozi eno eyinza okuwulikika ng’etiisa katono, naye amawulire amalungi gali nti bw’ogizuula nga bukyali, n’omira eddagala ettuufu, n’okola enkyukakyuka mu bulamu, kumpi osobola okugifuga ddala n’obeera n’obulamu obulungi.
Waliwo ebika bya FH ebikulu bibiri.
Embeera eno egabanyizibwamu ebika bibiri ebikulu okusinziira ku ngeri gye tugisikira. Kino kyangu nnyo okutegeera.
Teebereza nti emibiri gyaffe girina ‘ebiragiro’ bibiri eby’okufuga kolesterol. Ekimu tukifuna ku maama waffe, ate ekirala ku kitaffe.
1. Heterozygous FH: Kino kye kika ekisinga okubeerawo. Ekibaawo wano kiri nti waliwo ekikyamu mu ‘kitabo ky’ebiragiro’ (gene) ekisikira okuva ku muzadde omu yekka , oba maama oba taata. Kino kitegeeza nti ekitabo ekimu kirungi, ate ekirala kirina ensobi entono. Kino kireetera okufuga kolesterol okubeera katono okuva mu mbeera.
2. Homozygous FH: Kino tekitera kubaawo nnyo, ate era kya maanyi nnyo.Okuwandiika. Ekibaawo wano nti ‘ebiragiro’ byombi ebifunibwa okuva eri maama ne taata byombi birimu ensobi. Olwo enkola efuga kolesterol n’efuuka nnafu nnyo. Omuwendo gwa kolesterol ogwa `LDL` mu bantu bano guli waggulu nnyo.
`FH` bulwadde bwa buzaale mu kiti kya `autosomal dominant`. Kino kitegeeza kyokka nti omwana teyeetaaga kusikira buzaale buno okuva mu bazadde bombi okusobola okusikira obulwadde buno, kimala okubusikira okuva ku muzadde omu yekka .
Kino kitegeeza nti bwoba olina `FH`, waliwo emikisa gya 50% nti omwana wo asikira embeera eno. Mu ngeri y’emu, emikisa 50% nti ne baganda bo nabo bajja kuba n’embeera eno.
Embeera eno ya bulijjo etya? Obubonero bwe buliwa?
Kiteeberezebwa nti omuntu omu ku buli bantu 250 mu nsi yonna alina embeera eya bulijjo eya `Heterozygous FH`. Naye ekisinga okunaku nti abantu 9 ku 10 ku bantu bano tebamanyi nti balina obulwadde buno .
Ebiseera ebisinga, FH telaga bubonero bwonna obw’enjawulo mu biseera ebisooka. Oyinza obutamanya nti olina FH okutuusa ng’olina obulwadde bw’omutima, gamba ng’okulumwa mu kifuba. Naye ate kiyinza okuba nga kikeeredde nnyo. Kino kiri bwe kityo kubanga ebitereke bya kolesterol mu misuwa gy’omuntu alina FH bitandika okutondebwa okuva ku lunaku lw’azaalibwa.
Ekiseera bwe kigenda kiyitawo, okuzimba kolesterol kiyinza okuvaako obubonero buno wammanga.
| Obubonero | Ennyinyonnyola ennyangu |
|---|---|
| Obulwadde bw’omutima mu myaka emito | Obulumi mu kifuba (angina) obubaawo nga bakola dduyiro oba nga bawummudde, omutima oba okusannyalala ku myaka emito (abasajja - abali wansi w’emyaka 55, abakazi - abali wansi w’emyaka 65). |
| Xanthomas ekika kya Xanthomas | Ebizimba ebya kyenvu ebiva ku kolesterol okubeera wansi w’olususu. Bino bisinga kulabibwa ku bikoona, amaviivi, ennyondo z’engalo, n’okwetooloola omusuwa gwa Achilles (waggulu w’ekisinziiro). |
| Xanthelasmas (Ekiwuka kya Xanthelasmas). | Ebitereke bya kolesterol ebya kyenvu ebikolebwa wansi w’olususu okwetooloola ebikoola by’amaaso. |
| Ekitundu ky’amaaso ekiyitibwa Corneal Arcus | Empeta enjeru, enzirugavu oba bbululu okwetooloola eriiso eriddugavu. Kino kisinga kubeera mu bakadde, naye singa kirabibwa mu muntu atali wansi w’emyaka 45 , kiyinza okuba akabonero ka FH. |
| Okufuumuula ekinusu | Obulumi mu magulu aga wansi naddala ng’otambula. Kino kiyinza okuba nga kiva ku kufunda kw’emisuwa egigabira omusaayi mu magulu. |
FH ezuulibwa etya?
Singa omusawo ateebereza nti olina FH, ajja kutunuulira ebintu ebiwerako okukakasa nti ozudde.
- Okukebera omusaayi: Kino kye kisinga obukulu. Okukebera omusaayi okuyitibwa `Lipid Profile`, okukebera kolesterol wo, kunoonya kolesterol omungi mu ngeri etaali ya bulijjo eya `LDL`. Singa esukka 190 mg/dL mu muntu omukulu, oba esukka 160 mg/dL mu mwana, `FH` eteeberezebwa.
- Ebyafaayo by’obujjanjabi bw’amaka: Kino kikulu nnyo. Omusawo wo mazima ddala ajja kukubuuza ebibuuzo nga, "Taata wo, maama wo, bajjajja wo, oba baganda bo baali bafunye obulwadde bw'omutima ku myaka emito?" "Waliwo omuntu yenna mu maka go alina kolesterol omungi?"
- Okukebera omubiri: Omusawo ajja kukebera omubiri gwo okulaba oba temuli bubonero bwonna bwa xanthomas (ebizimba by’olususu) oba corneal arcus (eye circles) obwogeddwako emabegako.
- Okukebera obuzaale (DNA test): Mu mbeera ezimu, okukebera obuzaale kuyinza okukolebwa okukakasa obulwadde mu ngeri enkakafu. Kino kiyinza okukebera obulema mu buzaale obukulu obuleeta FH (nga APOB, LDLR, oba PCSK9).
Obujjanjabi bwe buruwa?
`FH` si bulwadde bwetusobola okuwonya. Kubanga kintu ekijja n’obuzaale bwaffe. Naye kiyinza okufugibwa obulungi ennyo . Ekigendererwa ekikulu eky'obujjanjabi kwe kukendeeza ku `LDL` cholesterol levels nga bwe kisoboka, okukendeeza ku bulabe bw'endwadde z'omutima.
1. Eddagala (ebika by’eddagala) .
Enkyukakyuka mu bulamu zokka tezimala kufuga kolesterol eri omuntu alina `FH`. N'olwekyo eddagala limu oba okusingawo lirina okumira obulamu bwabwe bwonna .
- Ebirungo ebiyitibwa Statins:Lino lye ddagala erisinga okukozesebwa era ery’olunyiriri olusooka. Zikola nga zikendeeza ku kolesterol ekibumba kye kikola.
- PCSK9 inhibitors: Zino kiraasi mpya nnyo ey’eddagala eriweebwa mu mpiso. Zikola nnyo eri abantu abatasobola kufugibwa kolesterol na ddagala lya statins zokka.
- Ezetimibe: Eddagala lino likola nga likendeeza ku kolesterol okuyingira mu mmere gye tulya. Kitera okuweebwa nga kigatta wamu ne ddagala lya statins.
- Eddagala eddala: Okugatta ku ekyo, waliwo eddagala eddala nga `Bile acid sequestrants` ne `Fibrates`. Omusawo wo y’ajja okusalawo eddagala erisinga okukusaanira.
2. Enkyukakyuka mu bulamu
Ng’oggyeeko okumira eddagala, kikulu n’okugoberera obulamu obulungi. Kino tekikoma ku kwongera kukola bulungi bwa ddagala, naye era kiyinza okwongera okukendeeza ku bulabe bw’okulwala omutima.
| Eky’okukola | By’olina okwewala |
|---|---|
| Emmere eyamba omutima: Enva endiirwa, ebibala, ebinyeebwa, emmere ey’empeke (brown rice, oats), ebyennyanja (salmon, mackerel, herring), amata agataliimu masavu mangi n’ennyama. | Amasavu amangi n’aga trans: Emmere esiike, emmere ey’amangu, ebiva mu migaati (keeki, patties), ennyama erimu amasavu, okukozesa ennyo amafuta ga muwogo n’amafuta g’enkindu. |
| Dduyiro buli kiseera: Weenyigire dduyiro ng’okutambula amangu, okudduka oba okuvuga obugaali okumala eddakiika ezitakka wansi wa 30 olunaku, waakiri ennaku 5 mu wiiki. | Okunywa sigala n’omwenge: Okunywa sigala kulina okulekebwawo ddala. Kwonoona nnyo emisuwa. Okunywa omwenge kulina okuba nga kutono. |
| Okukuuma obuzito obulungi: Okufuga obuzito bw’omubiri kiyinza okukendeeza ku buzibu ku mutima. | Ebyokunywa ebiwoomerera n’emmere erimu ssukaali omungi: Bino biyinza okuvaako omugejjo n’ebizibu ebirala eby’obulamu. |
3. Obujjanjabi obulala obw’enjawulo
Ku bantu abalina FH ya homozygous ey’amaanyi ennyo, eddagala lyokka liyinza obutasobola kufuga kolesterol waabwe. Ku bantu bano, bakola obujjanjabi obuyitibwa LDL apheresis. Kino kiringa dialysis. Omusaayi omutono guggyibwa, ne guyisibwa mu kyuma ekiggyamu kolesterol omubi owa LDL, oluvannyuma ne kiddamu okumukuba empiso n’edda mu mubiri. Kino kikolebwa omulundi gumu oba ebiri mu wiiki.
Bw’oba olina FH, kiki ky’osaanidde okukola?
Bwoba ozuuliddwa nga olina `FH`, tekikukwatako wekka. Bubaka bukulu eri amaka go gonna.
Bw’oba olina FH, buvunaanyizibwa bwo okukebera bazadde bo, baganda bo n’abaana bo oba balina kolesterol. Kino tukiyita ‘okukebera mu bbanga.’ Kino kiyinza okuyamba okuzuula ab’omu maka abalala ng’obubonero tebunnalabika n’okutandika n’okubajjanjaba.
Singa omwana aba n’ebyafaayo by’amaka ga `FH`, kolesterol asobola okukeberebwa ne bw’ava ku myaka 2. Kubanga obujjanjabi bw’embeera eno gye bukoma okutandika amangu, ebizibu ebiyinza okubaawo gye bikoma okukendeezebwa mu biseera eby’omu maaso.
Bwoba olina `FH`, tosattira. Sigala ng’okwatagana n’omusawo wo. Eddagala lyo limira mu budde. Kola enkyukakyuka mu bulamu. Olwo naawe osobola okubeera n’obulamu obuwanvu era obulungi ng’abantu abalala bonna.
Obubaka Obutwala Awaka
- Familia Hypercholesterolemia (FH) bulwadde bwa buzaale obusiigibwa okuva ku mulembe okudda ku mulala era buleeta emiwendo gya kolesterol omubi (LDL) okulinnya okuva lwe yazaalibwa.
- Singa omuntu yenna mu maka go abadde n’obulwadde bw’omutima ku myaka emito oba ng’alina kolesterol omungi, kikulu nnyo okwekebeza FH.
- Abantu bangi abalina embeera eno tebamanyi nti balina obulwadde buno. Okuzuula amangu kiyinza okutaasa obulamu.
- Eddagala ly’obulamu bwonna n’obulamu obulungi byetaagisa nnyo okusobola okuddukanya FH.
- Bwoba ozuuliddwa nga olina `FH`, bazadde bo, baganda bo, n'abaana nabo bakeberebwe. Kijja kuyamba okutaasa obulamu bwabwe.
- Bw’ofuna obujjanjabi obutuufu, osobola okubeera omulamu obulungi ddala n’obulamu obuwanvu. Kale totya, weebuuze ku musawo ofune obujjanjabi.











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