Kodi chiwindi chanu chili ndi mafuta ambiri? Tiyeni tiphunzire za dzina latsopano la matenda a chiwindi onenepa (Steatotic Liver Disease)!

“Adokotala, ndili ndi mafuta ambiri m’chiwindi mwanga…” Kodi mwamvapo izi? Kapena mulinso ndi vutoli? Musadandaule. Lero tikulankhula za matenda awa a mafuta ambiri m’chiwindi, kapena mwa kuyankhula kwina, Matenda a Chiwindi a Steatotic. Kale, tinkatcha ichi “chiwindi chamafuta.” Kodi ichi ndi chiyani kwenikweni? N’chifukwa chiyani chinapatsidwa dzina latsopano? Tiyeni tikambirane zonsezi mosavuta.

N’chifukwa chiyani dzina lakuti “Fatty Liver” linasintha?

Tinkatchula vutoli kuti “matenda a chiwindi onenepa.” Koma mu 2023, akatswiri azachipatala adaganiza zosintha dzinali kukhala “matenda a chiwindi onenepa.” Pali zifukwa ziwiri zazikulu zomwe zimapangitsa izi. Choyamba ndichakuti dzina latsopanoli limafotokoza bwino zomwe zimayambitsa vutoli. Mwachitsanzo, ngakhale kunenepa kwambiri ndi chifukwa chimodzi, pali zinthu zina zomwe sizikugwirizana ndi kulemera. Chifukwa china ndichakuti mawu oti “chiwindi chonenepa” nthawi zina amatha kukhala ochititsa manyazi komanso onyoza anthu omwe ali ndi vutoli, kotero kusintha dzinalo kunathandiza kuchepetsa kugogomezera zimenezo. Mwachidule, “steatosis” ndi mawu omwe madokotala amagwiritsa ntchito pofotokoza kuchulukana kwa mafuta m'chiwalo (nthawi zambiri chiwindi). Chiwindi chathanzi komanso chogwira ntchito bwino chimakhala ndi mafuta ochepa. Kuchulukana kwa mafuta kumeneku kumakhala vuto ngati kupitirira 5% ya kulemera kwa chiwindi.

Kodi matenda a chiwindi onenepa (SLD) ndi ati?

Madokotala amagawa SLD m'magulu kutengera zomwe zimayambitsa komanso matenda ena. Tiyeni tiwone mitundu ikuluikulu.

1. Matenda a chiwindi okhudzana ndi mowa (ALD)

Chomwe chimachitika n'chakuti ngati mumwa mowa wambiri, mafuta amaunjikana m'chiwindi mwanu. Taganizirani izi, mukamwa mowa, chiwindi chanu ndi chomwe chimachisefa. Pakachitika izi, maselo ena a chiwindi amafa. Nthawi zambiri, chiwindi chimapanga maselo atsopano kuti alowe m'malo mwa omwe atayika. Koma ngati mupitiliza kumwa mowa wambiri, chiwindi sichingathe kuchita bwino ntchitoyi. Pamenepo ndi pomwe mafuta amayamba kuunjikana m'chiwindi mwanu, matenda otchedwa steatosis .

2. Matenda a chiwindi a steatotic omwe amayambitsidwa ndi vuto la kagayidwe kachakudya (MASLD)

Izi kale zinkatchedwa matenda a chiwindi amafuta osamwa mowa (NAFLD). Izi zili choncho chifukwa mafuta omwe ali m'chiwindi samachitika chifukwa chomwa mowa mopitirira muyeso. Dzina latsopanoli limati zinthu zazikulu zomwe zimathandiza kuti chiwindi chikhale ndi mafuta ndi zinthu zomwe zimayambitsa matenda a mtima ndi kagayidwe kachakudya . Mwachidule, izi zimachitika chifukwa cha matenda enaake ndi makhalidwe ena omwe amakhudza thanzi la mtima wanu.

Zinthu zazikulu zomwe zimayambitsa MASLD ndi izi:

• Kunenepa kwambiri
• Matenda a Shuga a Mtundu Wachiwiri
• Kuthamanga kwa magazi
• Kusakhazikika kwa mafuta m'thupi - Izi ndi kusalingana kwa mitundu ya mafuta m'magazi, monga cholesterol ndi triglycerides.

Ngakhale mutamwa mowa pang'ono pa sabata, kutanthauza kuti, osachepera magalamu 140 pa sabata kwa akazi ndi osachepera magalamu 210 pa sabata kwa amuna, mutha kuonedwabe ngati MASLD. (Mwachitsanzo, ku United States, chitini cha mowa cha ma ounces 12 chimakhala ndi magalamu pafupifupi 14 a mowa.)

3. Kuchuluka kwa mafuta m'chiwindi ndi kutupa chifukwa cha kusagwira bwino ntchito kwa kagayidwe kachakudya (Steatohepatitis yokhudzana ndi kagayidwe kachakudya - MASH)

MASH ndi mtundu woopsa kwambiri wa MASLD. Pa vutoli, chiwindi chimatupa ndi kutupa chifukwa cha mafuta omwe amasonkhana m'chiwindi. Kenako, minofu ya chiwindi imawonongeka ndikuyamba kukhala ndi zipsera (fibrosis) . Poyamba, izi zimatchedwa non-alcoholic steatohepatitis (NASH).

4. MASLD ndi kumwa mowa mopitirira muyeso (MetalALD)

Ngati muli ndi MetalALD, zikutanthauza kuti zinthu zomwe zimayambitsa matenda a kagayidwe kachakudya komanso kumwa mowa zathandizira kuti mafuta azichulukana m'chiwindi. Pankhaniyi, muli ndi zinthu zomwe zimayambitsa matenda a mtima ndi kagayidwe kachakudya, ndipo mumamwa mowa woposa magalamu 140 pa sabata kwa akazi ndi woposa magalamu 210 kwa amuna.

Kaya mowa kapena zinthu zomwe zimayambitsa matenda a kagayidwe kachakudya m'thupi ndi zomwe zimayambitsa mafuta m'chiwindi zimatha kusiyana malinga ndi munthu aliyense.

5. Mitundu ina ya SLD

Matenda a SLD amatha kuchitika popanda kumwa mowa kapena zinthu zomwe zimayambitsa matenda a kagayidwe kachakudya. Mwachitsanzo, mankhwala ena ndi matenda ena angayambitse mafuta kudziunjikira m'chiwindi. Nthawi zina madokotala sangapeze chifukwa chomveka bwino. Matenda a SLD opanda chifukwa chomveka bwino amatchedwa cryptogenic SLD .

Kodi matenda a chiwindi onenepa (SLD) ndi vuto lalikulu?

Nthawi zambiri, mafuta m'chiwindi samayambitsa mavuto aakulu kapena kusokoneza magwiridwe antchito a chiwindi. Komabe, nthawi zina vutoli limatha kuipiraipira pang'onopang'ono n'kukhala matenda a chiwindi. Izi nthawi zambiri zimachitika m'magawo angapo:

• Chiwindi cha chiwindi : Chiwindi, chomwe poyamba chimadzaza ndi mafuta, chimatupa ndi kutupa. Kutupa kumeneku kumawononga minofu ya chiwindi. Matendawa amatchedwa steatohepatitis. Mwachitsanzo, MASLD imakhala MASH motere.
• Fibrosis: Minofu ya zipsera imayamba kupangika m'malo omwe chiwindi chawonongeka chifukwa cha kutupa. Izi zimapangitsa kuti chiwindi chikhale cholimba pang'ono. Njira imeneyi imatchedwa fibrosis .
• Matenda a chiwindi: Apa ndi pamene minofu ya chiwindi yathanzi imalowetsedwa m'malo ndi minofu yambiri ya zipsera. Apa ndi pamene timatcha matenda a chiwindi. Ngati sichinachiritsidwe bwino, matenda a chiwindi amatha kubweretsa matenda oopsa monga kulephera kwa chiwindi ndi khansa ya chiwindi. Mwachitsanzo, pafupifupi 90% ya anthu omwe amadwala khansa ya chiwindi (HCC) , mtundu wa khansa ya chiwindi, amakhala ndi matenda a chiwindi.

Kodi zizindikiro za matenda a chiwindi chamafuta (SLD) ndi ziti?

Si aliyense amene ali ndi SLD amene amakumana ndi zizindikiro. Nthawi zina, ngati zizindikirozo zachitika, zingaphatikizepo:

• Kupweteka m'mimba kapena kumva kukhuta m'mimba pamwamba pa kumanja.
• Kumva kutopa kwambiri kapena kufooka (kutopa).

Komabe, anthu ambiri amazindikira zizindikiro zokha SLD ikayamba kukhala cirrhosis . Cirrhosis ikayamba, zizindikiro monga:

• Kusanza.
• Chakudyacho sichikoma.
• Kukhala woonda popanda chifukwa.
• Kuoneka kwachikasu pakhungu ndi maso oyera (jaundice).
• Ascites - Izi zikutanthauza kuti mimba yadzaza ndi madzi.
• Kutupa (edema) kwa miyendo, manja, kapena akakolo.
• Kutuluka magazi (dokotala angaone izi m'mero, m'mimba, kapena m'matumbo).

Kodi ndi zifukwa ziti zomwe zimayambitsa matenda a chiwindi chamafuta (SLD)?

Pali zifukwa zingapo zomwe SLD ingakulire. Komabe, ngati muli ndi zinthu zomwe zimayambitsa matenda a mtima ndi kagayidwe kachakudya , ngati mumwa mowa mopanda thanzi, kapena ngati muli ndi zonsezi, muli ndi mwayi waukulu wopeza SLD.

Muli pachiopsezo chachikulu chotenga matenda a SLD ngati muli ndi zinthu izi:

• Kusokonezeka kwa kugwiritsa ntchito mowa - kutanthauza kumwa mowa pafupipafupi kapena mopitirira muyeso.
• Matenda a Kagayidwe kachakudya - Izi zikuphatikizapo kukana insulini, kuthamanga kwa magazi, cholesterol yambiri, ndi kuchuluka kwa triglycerides.
• Matenda a shuga amtundu wachiwiri.
• Kunenepa kwambiri - Izi zikutanthauza kuti index ya kulemera kwa thupi lanu (BMI) ili pakati pa 25 ndi 29.9 kg/m2.
• Kunenepa kwambiri - BMI ndi 30 kg/m2 kapena kuposerapo.
• Matenda a ovary a Polycystic (PCOS).
• Kulephera kugona mokwanira.
• Hypothyroidism.
• Kuchepa kwa mahomoni a pituitary (Hypopituitarism).
• Kuchepa kwa mahomoni ogonana (Hypogonadism).
• Kupitiriza kumwa mankhwala enaake. Mwachitsanzo, Amiodarone (Amiodarone - Cordarone®), Diltiazem (Diltiazem - Cardizem®), Tamoxifen (Tamoxifen - Nolvadex®) kapena ma steroids. (Mankhwala ena angayambitse mafuta kudziunjikana m'chiwindi ngati zotsatira zoyipa.)

Kodi mavuto omwe angakhalepo chifukwa cha SLD ndi ati?

Ngati sichinachiritsidwe, chiwindi cha steatotic chikhoza kupitirira kukhala cirrhosis , zomwe zingayambitse kulephera kwa chiwindi, khansa ya chiwindi, ndi khansa zina kunja kwa chiwindi. Anthu omwe ali ndi MASLD ali pachiwopsezo chachikulu cha matenda a mtima. Ndikofunikira kukumbukira kuti matenda a mtima, osati matenda a chiwindi, ndi omwe amachititsa imfa pakati pa anthu omwe ali ndi MASLD.

Kodi matenda a chiwindi onenepa (SLD) amapezeka bwanji?

Popeza SLD nthawi zambiri siikhala ndi zizindikiro, dokotala wanu akhoza kukhala woyamba kuzindikira vutoli. Ngati ma enzyme a chiwindi chanu akwera panthawi yoyezetsa magazi chifukwa cha matenda ena, izi zitha kukhala chizindikiro chochenjeza. Ma enzyme a chiwindi okwera angatanthauze kuti chiwindi chanu chawonongeka.

Kuti adziwe matenda, dokotala wanu angachite izi:

• Mbiri ya matenda: Kufunsa za matenda anu, kuchuluka kwa mowa womwe mumamwa, komanso mankhwala omwe mumagwiritsa ntchito.
• Kuyezetsa thupi: Yang'anani zizindikiro za matenda a chiwindi, monga chiwindi chotupa ndi chikasu cha m'mimba .
• Njira zojambulira: Mayeso monga ultrasound , CT scan (Computed Tomography scan) , kapena MRI (Magnetic Resonance Imaging) amagwiritsidwa ntchito kufufuza kutupa ndi zipsera m'chiwindi. Mayeso apadera a ultrasound otchedwa FibroScan® angagwiritsidwe ntchito kudziwa kuchuluka kwa mafuta ndi minofu ya zipsera m'chiwindi.
• Kuyeza chiwindi: Kuyeza kumeneku kumachitika kuti adziwe momwe matenda a chiwindi apitira patsogolo. Njira yokhayo yosiyanitsira bwino MASLD ndi MASH ndikuchita kuyezetsa chiwindi .

Kodi matenda a chiwindi onenepa (SLD) amachiritsidwa bwanji?

Palibe chithandizo kapena mankhwala enieni a vutoli. M'malo mwake, madokotala amayang'ana kwambiri kukuthandizani kuwongolera zinthu zomwe zimayambitsa vutoli. Izi zikuphatikizapo kusintha moyo wanu kuti mukhale ndi thanzi labwino.

Dokotala wanu angakulangizeni izi:

• Siyani kumwa mowa kotheratu: Ngakhale ngati SLD yanu sinayambike chifukwa cha kumwa mowa, pewani mowa kotheratu.
• Kuchepetsa thupi: Kuchita masewera olimbitsa thupi, kusintha zakudya motsogozedwa ndi katswiri wa zakudya, ndi mankhwala ena, monga GLP-1RA, angakuthandizeni kuchepetsa thupi. Mungaganizirenso opaleshoni yochepetsa thupi.(opaleshoni ya Bariatric) ingakhalenso yoyenera.
• Imwani mankhwala oletsa kagayidwe kachakudya m'thupi: Imwani mankhwala omwe mwapatsidwa kuti muchepetse matenda a shuga, cholesterol, ndi mafuta m'magazi (triglycerides). Nthawi zina, mungafunikenso kumwa vitamini E ndi thiazolidinediones (mankhwala a matenda a shuga monga Actos® ndi Avandia® ).
• Katemera wa Hepatitis A ndi Hepatitis B : Matendawa ndi oopsa kwambiri ngati muli kale ndi matenda a chiwindi.

Ngati mankhwala omwe mukumwa akupangitsa kuti mafuta azichulukana m'chiwindi mwanu, dokotala wanu angasinthe mankhwala anu.

Kodi mungapewe bwanji matenda a chiwindi chamafuta (SLD)?

Njira yabwino yopewera SLD ndiyo kukhala ndi thanzi labwino:

• Kuchita masewera olimbitsa thupi nthawi zonse.
• Chepetsani kumwa mowa.
• Khalani ndi kulemera koyenera kwa inu.
• Ngati muli ndi matenda a shuga amtundu wachiwiri kapena matenda a metabolic syndrome, imwani mankhwala omwe mwapatsidwa monga momwe mwalangizidwira.

Kodi matenda a chiwindi onenepa (SLD) amatha kuchiritsidwa?

Kutengera ndi kuopsa kwa vuto lanu, SLD ikhoza kubwezeretsedwa ndipo zipsera zina zimatha kukonzedwa. Chiwindi chanu chili ndi mphamvu zodabwitsa zodzichiritsa chokha. Ngati mutsatira ndondomeko ya chithandizo ya dokotala wanu molondola, mutha kuchepetsa kuchuluka kwa mafuta ndi kutupa m'chiwindi chanu. Mutha kupewa kuwonongekako kuti kusakule kwambiri, ndipo nthawi zina, ngakhale kusintha kuwonongeka kwa chiwindi msanga.

Kodi SLD ingayambitse imfa?

Kwa anthu ambiri, SLD siimayambitsa mavuto akuluakulu pokhapokha ngati yakula kwambiri . Anthu ambiri omwe ali ndi SLD amakhala ndi moyo wabwinobwino.

Komabe, matenda a chiwindi osachiritsidwa amatha kubweretsa kulephera kwa chiwindi kapena khansa ya chiwindi. Chiwindi ndi chiwalo chofunikira kwambiri kwa inu. Ichi ndichifukwa chake ndikofunikira kwambiri kuteteza chiwindi chanu ngati mwapeza kuti muli ndi SLD.

Kodi zakudya zabwino kwa munthu amene ali ndi SLD ndi ziti?

Ngati SLD yanu ikugwirizana ndi kunenepa kwambiri, tsatirani zakudya zoyenera kuti muchepetse thupi pang'onopang'ono koma mosalekeza. Madokotala nthawi zambiri amalimbikitsa kupewa zakudya zokhala ndi shuga. Amalangizanso kuyesa zakudya za ku Mediterranean . Zili ndi ndiwo zamasamba zambiri, zipatso, ndi mafuta abwino. Komanso, zinthu monga mtedza, nyemba, tirigu wonse, nsomba, ndi nkhuku ndi zakudya zabwino kwa anthu omwe ali ndi SLD. Ndikofunikiranso kupewa kudya nyama yofiira yambiri komanso kumwa zakumwa zokhala ndi shuga.

Mafunso Ofunsidwa Kawirikawiri (Mafunso Ofunsidwa Kawirikawiri)

Funso: Kodi chiwindi changa chawonongeka bwanji?

Yankho: Dokotala wanu angakuuzeni motsimikiza. Adzakuyesani magazi, kusanthula (Ultrasound, FibroScan) kuti awone kuchuluka kwa mafuta omwe ali m'chiwindi mwanu komanso ngati pali zipsera zilizonse. Kenako adzakufotokozerani za vutoli.

Funso: Zimatenga nthawi yayitali bwanji kuti chiwindi chibwezeretsedwe?

Yankho:Zimatengeradi vuto lanu komanso khama lanu. Ngati lili pachiyambi, ngati muwongolera zakudya zanu ndikuchepetsa thupi, mutha kuwona kusintha kwabwino pakatha miyezi ingapo. Ngati ndi lalikulu, monga matenda a cirrhosis, zimakhala zovuta kuchiza kwathunthu, koma mutha kuliletsa kuti lisakule kwambiri.

Funso: Kodi mankhwala omwe ndimamwa amakhudza SLD?

Yankho: Inde, zingatheke. Mankhwala ena, mwachitsanzo, Amiodarone ndi Diltiazem, amatha kukhudza chiwindi. Ndicho chifukwa chake muyenera kuuza dokotala wanu za mankhwala onse omwe mumamwa. Kenako adzafufuza ngati pali vuto ndi mankhwalawo.

Funso: Kodi kulemera kwabwino kwa ine n'chiyani?

Yankho: Zimatengera kutalika kwanu ndi zaka zanu. Nthawi zambiri ndi bwino kusunga BMI yanu pansi pa 25. Koma chinthu chabwino kwambiri kuchita ndikufunsa dokotala wanu kapena katswiri wa zakudya za kulemera koyenera kwa inu. Ngakhale kutaya thupi pang'ono kungakhale mpumulo waukulu ku chiwindi chanu.

Funso: Kodi ndingakumane ndi katswiri wa zakudya kuti ndidziwe za zakudya zabwino?

Yankho: Inde! Ndicho chinthu chabwino kwambiri kuchita. Katswiri wa zakudya angakuthandizeni kupanga mndandanda wa zakudya zomwe zili zoyenera kwa inu. Angakuuzeni za zinthu monga zakudya za ku Mediterranean ndi zakudya zosavuta kukonzekera. Mukafunsa dokotala wanu, akhoza kukutumizirani.

Funso: Kodi ndingapeze bwanji chithandizo cha vuto la kumwa mowa?

Yankho: Ngati mukuvutika kusiya kumwa mowa, musachite manyazi. Ndizabwinobwino. Chinthu chabwino kuchita ndikulankhula ndi dokotala wanu za vutoli. Iye angakuthandizeni, ndipo ngati pakufunika, akutumizireni ku upangiri kapena katswiri. Kumbukirani, kupewa kumwa mowa ndikofunikira kuti mupulumutse chiwindi chanu.