Kī tonu tō ate i te ngako? Me kōrero tātou mō te Mate Ate Matepukupuku e pā ana ki te ngoikore o te pūnaha io (MASLD)

Kua whakaaro koe i mua ko te taumaha nui e mau ana i a koe, ko te mate huka rānei, ka pā ki tō ate? I ētahi wā, ka tīmata tātou ki te kohikohi ngako i roto i tō tātou ate, kāore i te mōhiotia. Koinei tētahi o ngā mate ka kōrerohia e tātou i tēnei rā, ko te MASLD te ingoa. Kaua e manukanuka, kia mārama noa tātou ki tēnei.

He aha tēnei MASLD?

I te whakarapopototanga, ko te MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) he mate ate e puta mai ana i te nui rawa o te ngako e kohia ana i roto i ngā pūtau ate. Ka kiia hoki ko te mate ate steatotic (ngako) (SLD) . I mua ko te ingoa NAFLD (Nona alcoholic Fatty Liver Disease), ko te tikanga ka kohia te ngako i roto i te ate mō ngā take *ehara* i te mea nā te inu waipiro. Engari kua hurihia tēnei ingoa ki te MASLD, nā te mea kua kitea he hononga tika ki ētahi āhuatanga rerekē o te pākia o te tinana.

Pērā i te kohikohinga o ngā para i roto i ō tātou kāinga, ina kohikohi te ngako i roto i te ate, ka roa te wā ka puta te mate hepatitis, arā, te mumura o te ate. Ko tēnei mate tētahi o ngā mate ate mau tonu o te ao. He mea tino kitea i waenga i te hunga momona me te mate huka momo 2. I te piki haere o ēnei mate, e whakatau ana ngā tohunga neke atu i te 30% o te taupori o te ao ka pāngia e te MASLD. Ki te kore e rongoatia, ka taea e te MASLD te arahi ki ngā mate ate kino ake. Nō reira, mā te kitenga wawe me te maimoatanga ka ārai i te kino haere o tēnei mate.

He aha ngā tohu o te MASLD?

He maha ngā wā, ka taea e tēnei āhuatanga e kiia nei ko te MASLD te whanake mō ngā tau maha , me te kore e whakaatu i ngā tohu i ngā wāhanga tōmua. Ko te tikanga o tēnei, ka taea e te mate te noho i roto i tō tinana, me te kore e rongo i tētahi rerekētanga. Whakaarohia he raruraru e tipu haere ana.

Heoi, ka tīmata ētahi tohumate te puta ina tae tēnei mate ki tētahi wāhanga kino ake e kiia nei ko te MASH (Metabolic Dysfunction-Associated Steatohepatitis). Ko te MASH te wā e kohia ai te ngako i roto i te ate, ā, ka tīmata te kino o te ate me te mumura. Ka taea e tēnei te arahi ki ngā āhuatanga pēnei i te fibrosis ate, arā, te hanganga o te kiko whara, te cirrhosis rānei. Ki te tupu tēnei, ka pāngia pea koe e ngā tohumate pēnei i:

• He mamae, he koretake rānei tōu i te taha matau o runga o tō puku, te wāhi kei reira tō ate .
• Te ngenge nui, te kore ora, me te kore ora e taea te whakaaro.
• Kāore he reka o te kai.
• Te āhua nei kua pupuhi tō puku.
• Te hiroki noa iho , kāore he take.
• Ka kōwhai tō kiri me te mā o ō kanohi (pērā i te jaundice, e kīia ana tēnei e ngā tākuta he scleral icterus ).

Mena kei a koe tētahi, neke atu rānei o ēnei tohu, he mea nui kia rapu tohutohu hauora koe.

He aha ngā pūtake o te MASLD?

Ko te take matua mō te whanaketanga o te MASLD ko te puta mai o ētahi āhuatanga rerekē i roto i te tukanga pākia o tō tinana. Ko tēnei pākia te tukanga e hurihia ai te kai e kainga ana e tātou hei pūngao. Mena he raruraru kei roto i tēnei tukanga, ka puta pea te MASLD. Anei ētahi o ngā āhuatanga matua e pā ana ki tēnei:

• Dyslipidemia: Koinei te wā e teitei ake ai ngā taumata o te ngako i roto i tō toto, inā koa ko ngā lipid pēnei i te cholesterol, i te mea noa.
• Momona: Mena he 30, neke atu rānei tō Taupū Papatipu Tinana (BMI), ka kiia koe he momona. Ko te hunga he nui rawa te ngako, inā koa kei te taha o te puku, ka nui ake te mōrearea ki te whakawhanake i te MASLD.
• Te ātete ki te insulin: He homoni te insulin e whakahaere ana i te taumata huka (glucose) i roto i ō tātou toto. Ko te tikanga o te ātete ki te insulin, kāore ō uaua, ō pūtau ngako, me ō pūtau ate e aro tika ki te insulin. Nā tēnei ka uaua te whakahaere i ngā taumata huka toto.
• Mate huka momo 2: He mate roa hoki tēnei. Ko te mea e tupu ana i konei ko te tiketike tonu o te taumata huka toto (hyperglycemia).

Haunga ēnei āhuatanga, kua kitea e ngā rangahau ka piki ake pea te mōrearea o te whakawhanake i te MASLD i ētahi rerekētanga ira .

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

Kua kōrero kē tātou mō te āhua o te whakawhanaketanga o te mate MASH i ētahi tāngata whai MASLD. Mēnā ka kaha ake te mate MASH, ka puta pea ēnei raruraru:

• MASH me te fibrosis ate: Ko te fibrosis te hanganga o te kiko whara i roto i te ate. Ka puta tēnei whara ina pakaru ngā pūtau ate, ā, ka ngana ki te whakatika i a rātou anō.
• Te mate ate e pā ana ki te MASH: Ko te mate ate he mate e tino kino ai te ate, ā, ka ngaro tōna kaha ki te mahi. He tino kino tēnei, ā, ka tūpono pea te ora.
• Matepukupuku ate: He momo matepukupuku ate tēnei ka puta mai i te MASH.

Ehara i te mea ka puta noa ēnei raruraru e pā ana ki te ate i te MASLD, engari ka taea hoki e ia te whakanui ake i te mōrearea o ētahi atu mate kino. Hei tauira:

• Matepukupuku: Ngā momo matepukupuku pēnei i te matepukupuku ū me te matepukupuku koroni.
• Ngā mate o te ngākau me te toto: Ngā mate e pā ana ki te ngākau me ngā oko toto.
• Mate huka: Ka pāngia pea te hunga kāore he mate huka e te mate huka hou.

Me pēhea te tautuhi i te MASLD?

Hei whakatau tika mēnā kei a koe te MASLD, he maha ngā whakamātautau toto me ngā whakamātautau whakaahua e mahia ana e ngā tākuta. I ētahi wā, me tango pea e rātou tētahi wāhanga iti o te ate hei whakamātautau (he koiora ate).

Ngā whakamātautau toto

Ka taea e te tākuta te whakahaere i ētahi whakamātautau toto, pēnei i:

• Whakamātautau A1C: Ka ine tēnei i ō taumata huka toto toharite mō ngā marama e rua ki te toru kua hipa.
• Tatau Toto Katoa (CBC): Mā tēnei ka tirohia te nui me ngā āhuatanga o ngā momo pūtau rerekē i roto i tō toto.
• Paewhiri Pūnaha Whakaora Katoa (CMP): Ka whakamātautauhia e tēnei ngā taumata o te 14 ngā mea i roto i tō toto, pērā i ngā pūmua me ngā irahiko.
• Paewhiri ngako: He whakamātautau tēnei mō ngā mate ngakau. Ka ine i ngā taumata o ngā matūriki ngako (cholesterol, triglycerides) i roto i tō toto.
• Ngā whakamātautau mahi ate: Ka inehia e ēnei whakamātautau toto ngā matū maha (ngā whākōkī, ngā pūmua) i hangaia e te ate hei whakaatu i te hauora o te ate.

Ngā whakamātautau whakaahua

Tērā pea ka whakahaerehia e tō tākuta ngā matawai pēnei hei tirotiro i ngā tohu o te MASLD i roto i tō ate:

• FibroScan®: Ka taea e tēnei matawai te whakaatu i te nui o te ngako e whakatakotoria ana ki roto i tō ate me te whānuitanga o te fibrosis.
• Te Ine i te Resonance Elastography me te Ira Ngako Pūmua (MRE-PDFF): He momo matawai motuhake anō hoki tēnei. Ka taea e ia te ine tika i te ōrau o te ngako i roto i te ate me te nui o te fibrosis.

Te koiora

He tino onge, ki te whakapae tō tākuta kei te puta mai ō tohumate i tētahi mea ehara i te MASLD, ki te hiahia rānei rātou ki ētahi atu kōrero i muri i tētahi whakamātautau pēnei i te fibroscan, ka tangohia pea e rātou tētahi wahi iti o te kiko mai i tō ate (he koiora ate) ka tirotirohia i raro i te karuārai.

Me pēhea te rongoā mō te MASLD?

I te rongoā i te MASLD, ko te arotahi tuatahi ko te whakaiti i te taumaha . Hei tāpiri, ka rongoāhia hoki ngā āhuatanga matua i puta ai te MASLD, pērā i te mate huka, te cholesterol teitei, me te toto toto tiketike.

Ina hoki, he nui te pānga o te whakaiti i te taumaha ki te hauora o tō ate. Mā te whakaiti i te ngako nui i roto i te ate ka āwhina i te whakahaere i te mumura ka arahi pea ki ngā mate pēnei i te cirrhosis. Tērā pea ka tūtohu tō tākuta i tētahi mahere kai motuhake, pērā i te kai Mediterranean, te kai DASH rānei. Ka kōrerohia ēnei kai i roto i tētahi atu tuhinga.

Mā te whakakori tinana ngāwari mō te 30 meneti pea i te rā, e toru ngā rā i te wiki, ka āwhina i a koe ki te whakaiti i tō taumaha. Tērā pea ka kī atu tō tākuta kia whakaitihia e koe te 10%, neke atu rānei, o tō taumaha tinana katoa. Heoi anō, ahakoa te whakaiti i te 3% ki te 5% o tō taumaha tinana, ka nui te rerekētanga .

Rongoā whakaiti taumaha

Mena he mate huka koe, he momona rānei, ka tohua pea e tō tākuta he rongoā whakaiti taumaha, pērā i ngā agonists GLP-1. Ka whakaitihia e ēnei rongoā ō taumata huka toto, ā, ka āwhina i a koe ki te whakaiti i tō taumaha. Ko ētahi tauira ko:

• Semaglutide (Semaglutide - Ozempic®, Wegovy® rānei)
• Liraglutide (Liraglutide - Victoza®, Saxenda® rānei)
• Tirzepatide (Mounjaro®, Zepbound® rānei)

Pokanga Bariatric

I ētahi wā ka kōrero pea tō tākuta ki a koe mō te pokanga bariatric. Mena ka kitea tō mate MASLD i mua i te whanaketanga o te cirrhosis, ka taea e tēnei pokanga whakaheke taumaha te whakakore i te āhua.

Ka taea te huri i te āhua o te MASLD?

Ae, ka taea! Engari kei tō āhua. I te nuinga o te wā, ki te kore koe e pāngia e te mate ate e pā ana ki te MASH, ka taea e te maimoatanga te whakakore i te MASLD.

He mea nui kia kitea wawetia tēnei mate . Mā tēnei ka āwhina i te whakahaere i te kino o te ate i mua i te kino rawa. Mā te whakaiti i te taumaha me te huri i te āhua noho ka āwhina i te whakakore i te kino o te ate i puta mai i te MASLD. Heoi, kei tō hauora whānui tēnei. Nō reira, pātai atu ki tō tākuta mēnā ka taea e te whakaiti i te taumaha te whakakore i tō āhua.

Ka taea te ārai i te MASLD?

He maha ngā wā ka pāngia te hunga momona me te hunga mate huka momo 2 e tēnei mate. Tērā pea kāore e taea te ārai katoa i te whanaketanga o ēnei mate. Heoi, mā te kitenga wawe me ngā huringa momo noho ka āwhina i te aukati, te whakahaere rānei i te whanaketanga o te MASLD.

Mena he momona koe, he mate huka momo 2 rānei, ka tūtohu pea tō tākuta kia whakamātauria he whakamātautau toto me he matawai hei tirotiro i ngā tohu o te mate. Ki te kitea wawetia, ka taea e koe te whakarerekē i tō momo noho hei whakaiti i tō mōrearea.

Kia pēhea te roa ka taea e koe te ora me te MASLD?

E whakaatu ana ngā rangahau ka pā te MASLD ki tō roanga o te ora. Hei tauira, i kitea i roto i tētahi rangahau, ko te hunga whai MASLD ka ora pea i te toharite o te 2.8 tau te iti iho i te hunga kāore i te mate.

Heoi, he maha ngā āhuatanga e pā ana ki te roa o tō oranga me te MASLD. Tērā pea he rerekē tō āhua i tō āhua o ētahi atu. Nō reira, ko tō tākuta te puna mōhiohio pai rawa atu mō ngā mea ka taea e koe te tumanako.

Me pēhea taku tiaki i ahau anō?

Mena kei a koe te MASLD, ko te huarahi pai ki te tiaki i a koe anō ko te mahi tahi me ō tākuta ki te whakahaere i ngā āhuatanga i puta ai te MASLD, pērā i te taumaha rawa, te momona, me te mate huka momo 2. Mā te whakaiti i te taumaha me te noho kaha ka āwhina i te whakaiti, me te whakakore pea i te kino o te ate.Anei ētahi atu whakaaro:

• Kia tūpato ki tō hauora whānui. Ka piki ake te tūponotanga o te mate huka, te mate ngakau, me ētahi momo mate pukupuku i te MASLD. Nō reira, pātai atu ki tō tākuta whānau mō ngā whakamātautau ka taea e koe te mahi hei whakaiti i tō tūponotanga.
• Whakawhanakehia ngā tikanga pai mō tō ate. Kati te momi hikareti me te inu waipiro. Ka nui ake te taumahatanga o te momi hikareti me te waipiro ki tō ate. Pātai atu hoki ki tō tākuta mō te werohanga mō te mate hepatitis A me te hepatitis B.
• Kaua e whakarērea, kia kaha tonu.

He roa te wā e pau ana ki te whakaiti i te taumaha. Kāore pea koe e kite i te rerekētanga nui i te wā tonu, engari ka kite mārire koe i ngā hua. He mea nui hoki te whakakori tinana i ia wā. Ki te ngenge koe, ki te hoha rānei i a koe i tēnei haerenga, kōrero ki tō tākuta mō tēnā.

Āhea ahau me toro atu ki te tākuta?

Ki te kite koe i ētahi panonitanga o tō tinana, pērā i te ngenge nui atu i te tikanga, te mamae rānei i te taha matau o runga o tō puku, me toro atu ki tō tākuta . Tērā pea ka tohu ēnei panonitanga i tētahi take kino o te MASH, he mate ate momona ka taea te whanake ki ngā āhuatanga kino atu pērā i te cirrhosis me te mate pukupuku hepatocellular.

Ka puta te MASLD i te whakamahinga o te waipiro?

Kāo, ehara te inu waipiro i te take tika o te MASLD. E ai ki tā mātou i kōrero ai i mua ake nei, i mua ko te mate ate momona kore-waipiro (NAFLD) tēnei. Ko te tikanga ka taea tēnei mate te puta ahakoa kāore koe e inu nui ana i te waipiro.

Engari, ko te mea nui, ki te inu waipiro te tangata whai MASLD, he nui ake te tūponotanga ki te pāngia e te cirrhosis i te tangata noa. Koia te take e tohutohu ai ngā tākuta ki te hunga whai MASLD kia karo rawa i ngā inu waipiro.

Hei whakamutunga, ngā mea hei maumahara

Mena ka whakaatuhia he raruraru kei tō ate i roto i te whakamātautau toto i tō tirotiro tinana ā-tau, ka mahia pea ētahi atu whakamātautau hei whakaū kei a koe te MASLD. Ka taea e tēnei mate ate te arahi ki ngā raruraru kino atu mena kāore e whakahaerea tika.

Engari ko te rongo pai, mā ngā panonitanga o te noho, pērā i te whakaiti i te taumaha me te noho kaha, ka āwhina i te ārai i te kino haere o te MASLD. Ka taea hoki e rātou te whakakore i te kino o tō ate. Engari ko te whakaiti i te taumaha me te noho kaha ehara i te mea ka taea e koe te mahi i te pō kotahi. Me whai wā me te whakapau kaha. I ētahi rā, ka rongo pea koe kua hoha koe ki ēnei mea. E mārama ana tō tīma hauora ki te wero o te whakamātau i ngā mea kāore e tere te mahi. Nō reira, kaua e mangere ki te tono āwhina me te tautoko. He mea nui tō ate ki a koe, ā, kei a koe te tikanga ki te tiaki!

Ngako ate, ate momona, mate huka, momona nui, cirrhosis, hauora ate