He momona rawa tō ate? Me ako tātou mō te ingoa hou mō te mate ate momona (Steatotic Liver Disease)!

"Āe, e te tākuta, he ngako kei roto i taku ate..." Kua rongo koe i tētahi mea pēnei? Kei a koe anō rānei tēnei mate? Kaua e manukanuka. I tēnei rā kei te kōrero tātou mō tēnei mate o ngā ngako kei roto i te ate, arā, ko te Mate Ate Matepukupuku. I mua, i tapaina tēnei e tātou ko te "ate momona." He aha rawa tēnei? He aha i tapaina ai he ingoa hou? Me kōrero noa iho tātou mō ēnei mea katoa.

He aha i huri ai te ingoa "Fatty Liver"?

I mua, i tapaina tēnei mate ko te "mate ate momona." Engari i te tau 2023, i whakatau ngā tohunga hauora ki te huri i te ingoa ki te "mate ate steatotic." E rua ngā take matua mō tēnei. Ko tētahi ko te whakaahua tika ake o te ingoa hou i ngā take o te mate. Hei tauira, ahakoa ko te momona tetahi o ngā take, tera atu ētahi atu āhuatanga mōrearea kāore he pānga ki te taumaha. Ko tētahi atu take ko te kupu "ate momona" ka whakama, ka whakakino hoki i te hunga whai mate, nō reira i āwhina te huri i te ingoa ki te whakaiti i te whakanui i tēnā. Ki te kī noa, ko te "steatosis" he kupu e whakamahia ana e ngā tākuta hei whakaahua i te kohikohinga o te ngako i roto i tētahi okana (ko te ate te nuinga). He iti noa te ngako kei roto i tētahi ate hauora, e mahi pai ana. Ka noho hei raruraru tēnei kohikohinga ngako mēnā ka neke atu i te 5% o te taumaha o te ate.

He aha ngā momo mate ate momona (SLD)?

Ka whakarōpūhia e ngā tākuta te SLD i runga i ōna pūtake me ngā āhuatanga e pā ana. Me titiro tātou ki ngā momo matua.

1. Te mate ate e pā ana ki te waipiro (ALD)

Ko te mea ka tupu, ki te nui rawa te waipiro e inuhia ana e koe, ka nui haere te ngako i roto i tō ate. Whakaarohia, ina inu koe i te waipiro, ko tō ate te mea e tātari ana i taua mea. I roto i taua tukanga, ka mate ētahi o ngā pūtau ate. I te nuinga o te wā, ka taea e te ate te hanga pūtau hou hei whakakapi i ngā mea kua ngaro. Engari ki te inu tonu koe i te nui rawa o te waipiro, kāore e taea e te ate te mahi tika i tēnei mahi. Ko te wā tēnā ka tīmata te nui haere o te ngako i roto i tō ate, he mate e kiia nei ko te steatosis .

2. Te mate ate steatotic e pā ana ki te ngoikore o te pūnaha io (MASLD)

I mua, i huaina tēnei ko te mate ate ngako kore-waipiro (NAFLD). Nā te mea ehara te ngako i roto i te ate i te mea i nui rawa te inu waipiro. E ai ki te ingoa hou, ko ngā mea matua e whai wāhi ana ki te whanaketanga o te ate ngako ko ngā mea mōrearea o te pūnaha cardiovascular me te pūnaha metabolic . I te kī poto, ka puta mai i ētahi āhuatanga me ngā āhuatanga e pā ana ki te hauora o tō ngākau.

Ko ngā āhuatanga mōrearea matua mō te whakawhanaketanga o te MASLD ko:

• Momonatanga
• Mate Huka Momo 2
• toto toto tiketike
• Ngā rerekētanga o te lipid – He kore taurite ēnei o ngā momo ngako i roto i ō toto, pērā i te cholesterol me te triglycerides.

Ahakoa he iti noa te waipiro e inuhia ana e koe i ia wiki, arā, he iti iho i te 140 karamu ia wiki mō ngā wāhine, ā, he iti iho i te 210 karamu ia wiki mō ngā tāne, ka taea tonu te kī he MASLD koe. (Hei tauira, i te Hononga o Amerika, he 14 karamu te waipiro kei roto i tētahi kēne pia 12-aune noa.)

3. Ngā putunga ngako me te mumura i roto i te ate nā te ngoikore o te pūnaha io (Metabolic-associated steatohepatitis – MASH)

He momo MASLD kino ake te MASH. I roto i tēnei āhuatanga, ka pupuhi te ate, ka mumura hoki nā te kohi ngako i roto i te ate. Kātahi ka pakaru te kiko o te ate, ka tīmata te hanga i ngā koha (fibrosis) . I mua, i huaina tēnei ko te non-alcoholic steatohepatitis (NASH).

4. Te MASLD me te nui o te inu waipiro (MetALD)

Mena kei a koe te MetALD, ko te tikanga kua whai wāhi ngā āhuatanga mōrearea pākia me te inu waipiro ki te kohikohinga o te ngako i roto i tō ate. I tēnei wā, kei a koe ngā āhuatanga mōrearea mō te ngakau me te pākia o te tinana, ā, neke atu i te 140 karamu o te waipiro e inu ana koe i ia wiki mō ngā wāhine, neke atu i te 210 karamu mō ngā tāne.

He rerekē pea i ia tangata, i ia tangata te nui ake o te tūponotanga o te waipiro, o ngā āhuatanga mōrearea pākia rānei ki te kohi ngako i roto i te ate.

5. Ētahi atu momo SLD

Ka puta te SLD me te kore e inu waipiro, e kore rānei e pāngia e ngā āhuatanga mōrearea pākia o te tinana. Hei tauira, ka taea e ētahi rongoā me ētahi atu mate te whakaemi i te ngako ki roto i te ate. I ētahi wā, kāore e kitea e ngā tākuta he take mārama. Ko te SLD me te kore he take mārama ka kiia ko te SLD cryptogenic .

He raruraru nui te mate ate momona (SLD)?

I te nuinga o te wā, kāore ngā putunga ngako i roto i te ate e whakararuraru nui, e whakararuraru rānei i te mahi noa o te ate. Heoi, i ētahi wā ka kino haere tēnei āhuatanga, ā, ka huri hei mate ate. He maha ngā wāhanga e puta ai tēnei:

• Hepatitis : Ko te ate, e kī ana i te ngako i te tīmatanga, ka pupuhi, ka mumura. Ka pakaru te kiko o te ate i tēnei mumura. Ka kiia tēnei mate ko te steatohepatitis. Hei tauira, ka huri te MASLD hei MASH penei.
• Fibrosis: Ka tīmata te hanga kiko koha i ngā wāhi kua pakaru te ate nā te mumura. Mā tēnei ka paku mārō te ate. Ka kiia tēnei tukanga ko te fibrosis .
• Te mate ate: Koinei te wā ka whakakapia te kiko ate hauora e te nui o te kiko whara. Koinei te wā e kiia ai ko te mate ate . Ki te kore e rongoatia tika, ka arahi pea te mate ate ki ngā āhuatanga morearea pērā i te ngoikore o te ate me te mate pukupuku ate. Hei tauira, tata ki te 90% o te hunga e pāngia ana e te mate pukupuku ate (HCC) , he momo mate pukupuku ate, he mate ate.

He aha ngā tohu o te mate ate momona (SLD)?

Ehara i te mea ka pāngia te katoa e te SLD e ngā tohu. I ētahi wā, ki te puta ngā tohu, ka uru atu pea ēnei ki:

• Te mamae o te puku, te kī rānei o te puku i te taha matau o runga.
• Te ngenge rawa, te ngoikore rānei (te ngenge nui).

Heoi, ko te nuinga o te iwi ka kite noa i ngā tohu i muri i te whanaketanga o te mate pāwera ki te cirrhosis . Ina puta te cirrhosis, ka puta ngā tohu pēnei i:

• Whakapairuaki.
• Kāore he reka o te kai.
• Te hiroki noa iho, kāore he take.
• Te kōwhai o te kiri me te mā o ngā kanohi (te jaundice).
• Te ascites - Ko te tikanga kua ki tonu te puku i te wai.
• Te pupuhi (edema) o ngā waewae, ringa, pona rānei.
• Te toto (tērā pea ka kitea tēnei e te tākuta i roto i tō korokoro, puku, tō pūkahukahu rānei).

He aha ngā pūtake o te mate ate momona (SLD)?

He maha ngā take ka pāngia ai koe e te SLD. Heoi, ki te mea he āhuatanga mōrearea tōu mō te pūnaha manawa me te pūnaha toto , ki te kore koe e whakamahi i te waipiro i te huarahi hauora, ki te mea rānei kei a koe ngā mea e rua, ka nui ake te tūponotanga ka pāngia koe e te SLD.

He nui ake tō tūponotanga ki te whakawhanake i te SLD mēnā kei a koe ēnei āhuatanga:

• Te mate whakamahi waipiro – arā, te inu pinepine, te nui rawa rānei o te waipiro.
• Te mate pāwera – Kei roto i tēnei ko te ātete ki te insulin, te toto toto tiketike, te cholesterol tiketike, me ngā taumata triglyceride tiketike.
• Mate huka momo 2.
• Taumaha rawa – Ko te tikanga kei waenga i te 25 me te 29.9 kg/m2 tō taupū papatipu tinana (BMI).
• Momona rawa – Ko te BMI he 30 kg/m2, neke atu rānei.
• Te mate ovary polycystic (PCOS).
• Te apnea moe aukati.
• Te mate pūkahukahu.
• Te hekenga o ngā taumata o te homoni pituitary (Hypopituitarism).
• Te hekenga o ngā homoni ira tangata (Hypogonadism).
• Te tango tonu i ētahi rongoā. Hei tauira, Amiodarone (Amiodarone – Cordarone®), Diltiazem (Diltiazem – Cardizem®), Tamoxifen (Tamoxifen – Nolvadex®) me ngā steroids rānei. (Ka taea e ētahi rongoā te whakaemi ngako i roto i te ate hei pānga taha.)

He aha ngā raruraru pea ka pā mai i te SLD?

Ki te kore e rongoatia, ka taea e te ate steatotic te whanake hei cirrhosis , ka arahi pea ki te ngoikore o te ate, te mate pukupuku ate, me ētahi atu mate pukupuku i waho o te ate. Ko te hunga whai MASLD te hunga tino mōrearea ki te mate ngakau. He mea nui kia mahara ko te mate ngakau, ehara i te mate ate, te tino take o te mate i waenga i te hunga whai MASLD.

Me pēhea te tautuhi i te mate ate momona (SLD)?

Nā te mea kāore he tohu o te SLD, ko tō tākuta pea te tuatahi ki te kite i te raruraru. Mena ka piki ake ō whākōkī ate i te wā e whakamātautau toto ana mō ētahi atu mate, he tohu whakatūpato pea tēnei. Ko te pikinga o ngā whākōkī ate he tohu pea kua pakaru tō ate.

Hei whakatau i te mate, ka taea e tō tākuta te mahi i ēnei e whai ake nei:

• Hītori hauora: Te pātai mō ō āhuatanga hauora, te nui o te waipiro e inuhia ana e koe, me ngā rongoā e whakamahia ana e koe.
• Whakamātautau tinana: Tirohia mēnā he tohu o te cirrhosis, pērā i te ate nui me te jaundice .
• Ngā tikanga whakaahua: Ka whakamahia ngā whakamātautau pēnei i te ultrasound , te CT scan (Computed Tomography scan) , te MRI (Magnetic Resonance Imaging) rānei hei rapu i te mumura me te whara i roto i te ate. Tērā pea ka whakamahia he whakamātautau ultrasound motuhake e kiia nei ko FibroScan® hei whakatau i te nui o te ngako me te kiko whara i roto i te ate.
• Kohikohi ate: Ka mahia tēnei whakamātautau hei whakatau i te kaha o te mate ate. Ko te huarahi anake hei wehewehe tika i waenga i te MASLD me te MASH ko te tango i te kohikohi ate .

Me pēhea te rongoā i te mate ate momona (SLD)?

Kāore he maimoatanga, he rongoā rānei mō tēnei mate. Engari, ka arotahi ngā tākuta ki te āwhina i a koe ki te whakahaere i ngā āhuatanga mōrearea e whai wāhi ana ki te mate. Kei roto i tēnei ko te hanga i ngā huringa āhua noho hei whakapai ake i tō hauora.

Ka tūtohu pea tō tākuta i ēnei e whai ake nei:

• Kati rawa te inu waipiro: Ahakoa kāore tō SLD i puta mai i te inu waipiro, karohia rawatia te waipiro.
• Whakaitihia te taumaha: Mā te whakakori tinana, ngā whakarerekētanga kai i raro i te tirotiro a te tohunga kai, me ētahi rongoā, pērā i te GLP-1RA, ka āwhina i a koe ki te whakaiti i tō taumaha. Ka taea hoki e koe te whakaaro ki te pokanga whakaiti taumaha.(Pokanga Bariatric) tērā pea ka āhei hoki.
• Tangohia ngā rongoā hei whakahaere i ngā āhuatanga pākia o te tinana: Tangohia ngā rongoā kua tohua hei whakahaere i te mate huka, te cholesterol, me ngā ngako toto (triglycerides). I ētahi wā, me tango pea koe i te huaora E me ngā thiazolidinediones (ngā rongoā mō te mate huka pēnei i te Actos® me te Avandia® ).
• Werohia te mate Hepatitis A me te Hepatitis B : He tino morearea ēnei mate huaketo mēnā kua pāngia koe e te mate ate.

Mena kei te hanga ngako i roto i tō ate tētahi rongoā e tangohia ana e koe, ka whakarerekē pea tō tākuta i tō whakahaunga.

Me pēhea te ārai i te mate ate momona (SLD)?

Ko te huarahi pai ki te karo i te SLD ko te pupuri i tō hauora whānui:

• Whakakorikori tinana i ia wā, i ia wā.
• Whakawhāitihia te inu waipiro.
• Kia mau tonu tō taumaha hauora.
• Mena kei a koe te mate huka momo 2, te mate pāwera rānei, me tango e koe te rongoā kua tohua kia rite ki te mea kua tohua.

Ka taea te rongoā i te mate ate momona (SLD)?

I runga i te kaha o tō mate, ka taea te whakakore i te SLD, ā, ka taea hoki te whakatika i ētahi kōpura. He kaha whakamiharo tō ate ki te whakaora i a ia anō. Ki te whai koe i te mahere maimoatanga a tō tākuta, ka taea e koe te whakaiti i te nui o te ngako me te mumura i roto i tō ate. Ka taea e koe te ārai i te kino haere, ā, i ētahi wā, ka taea te whakakore i te kino o te ate i te wā tōmua.

Ka taea e te SLD te mate?

Mō te nuinga o te iwi, kāore te SLD e puta he raruraru nui ki te kore e whanake hei mate ate . He maha ngā tāngata whai SLD e ora ana i te roanga o te oranga noa.

Heoi, ki te kore e rongoatia te cirrhosis o te ate, ka taea e ia te arahi ki te ngoikore o te ate, ki te mate pukupuku ate rānei. He okana nui te ate māu. Koia te mea nui kia tiakina tō ate mēnā ka kitea e koe he SLD tōu.

He aha te kai pai mō te tangata whai SLD?

Mena kei te hono tō SLD ki te pikinga o te taumaha, me whai i tētahi kai taurite hei whakaiti i te taumaha mārire engari kia pumau. He maha ngā tākuta e kī ana kia karohia ngā kai huka. E kī ana hoki rātou kia whakamātauria te kai Mediterranean . He nui ngā huawhenua, ngā hua, me ngā ngako pai i roto. Waihoki, he pai ngā kai pēnei i te nati, ngā pīni, ngā witi katoa, te ika, me te heihei mā te hunga whai SLD. He mea nui hoki kia kaua e kai nui rawa i te mīti whero me te inu i ngā inu huka.

Ngā Pātai Auau (FAQ)

Pātai: E hia te kino kua pā ki tōku ate?

Whakautu: Ka taea e tō tākuta te kī atu ki a koe me te tino mārama. Ka whakahaerehia e ia he whakamātautau toto, he matawai (Ultrasound, FibroScan) hei tirotiro i te nui o te ngako kei roto i tō ate, me te mea he koha kei roto. Kātahi ka whakamārama ia i te āhuatanga ki a koe.

Pātai: Kia pēhea te roa ka ora ake te kino o te ate?

Whakautu:Kei tō āhua me ō mahi te mea e whakawhirinaki ana. Mena kei ngā wāhanga tōmua, ki te whakahaere koe i tō kai me te whakaiti i tō taumaha, ka kite koe i tētahi panonitanga pai i roto i ētahi marama. Mena he kino rawa, pērā i te mate ate, he uaua ki te whakaora katoa, engari ka taea e koe te aukati i tōna kino haere.

Pātai: Ka pāngia te SLD e ngā rongoā e tangohia ana e au?

Whakautu: Ae, ka taea. Ko ētahi rongoā, hei tauira, ko Amiodarone me Diltiazem, ka pā ki te ate. Koia koe me kōrero ki tō tākuta mō ngā rongoā katoa e tangohia ana e koe. Kātahi ka tirohia e ia mēnā he raruraru kei roto i aua rongoā.

Pātai: He aha te taumaha hauora mōku?

Whakautu: Kei tō teitei me tō tau te tikanga. Ko te mea pai ko te pupuri i tō BMI i raro i te 25. Engari ko te mea pai ko te pātai ki tō tākuta, ki te tohunga kai rānei mō te taumaha tika mōu. Ahakoa te whakaiti i te taumaha, he mea nui tēnei hei whakaora i tō ate.

Pātai: Ka taea e au te tūtaki ki tētahi tohunga kai hei ako i tētahi kai hauora?

Whakautu: Ae! Koinei te mea pai rawa atu. Ka taea e te tohunga kai te āwhina i a koe ki te hanga i tētahi rārangi kai e tika ana māu. Ka taea e rātou te kōrero ki a koe mō ngā mea pēnei i te kai Mediterranean me ngā kai ngāwari ki te taka. Ki te pātai koe ki tō tākuta, ka taea e ia te tuku i a koe.

Pātai: Me pēhea te whiwhi rongoā mō te mate whakamahi waipiro?

Whakautu: Ki te mea kei te raru koe ki te whakamutu i te inu waipiro, kaua e whakama. He mea noa iho. Ko te mea pai ko te kōrero ki tō tākuta mō tēnei mea. Ka taea e ia te āwhina i a koe, ā, ki te tika, ka taea e ia te tuku i a koe ki tētahi ratonga tohutohu, ki tētahi tohunga rānei. Kia maumahara, he mea nui te matara atu i te waipiro hei whakaora i tō ate.