Ingaba isibindi sakho sinamafutha? Masithethe ngeMetabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Ngaba wakha wacinga ukuba ubunzima obongezelelekileyo onabo okanye imeko efana nesifo seswekile onayo inokuchaphazela isibindi sakho? Ngamanye amaxesha, singazi siqala ukuqokelela amafutha esibindini sethu. Le yenye yeemeko esiza kuthetha ngazo namhlanje, ebizwa ngokuba yiMASLD. Ungakhathazeki, masiyiqonde le nto ngokulula.

Yintoni le MASLD?

Ngamafutshane, i-MASLD (iMetabolic Dysfunction-Associated Steatotic Liver Disease) sisifo sesibindi esibangelwa kukuqokelelwa kwamafutha amaninzi ngaphakathi kweeseli zesibindi sakho. Sikwabizwa ngokuba sisifo sesibindi esinamafutha amaninzi (i-SLD) . Ngaphambili sasibizwa ngokuba yi-NAFLD (iSifo seSibilini esiNganxilisayo), oko kuthetha ukuba amafutha aqokelelana esibindini ngezizathu *hayi* ngenxa yokusela utywala. Kodwa ngoku eli gama litshintshiwe laba yi-MASLD, kuba kufunyenwe ukuba linxulumene ngokuthe ngqo nokungahambi kakuhle kwindlela umzimba wethu osebenza ngayo.

Njengokuba inkunkuma iqokeleleka emakhayeni ethu, xa amafutha eqokelelana esibindini, ngokuhamba kwexesha inokubangela i-hepatitis, oku kukudumba kwesibindi. Le meko yenye yezona zifo zesibindi ezingapheliyo ezixhaphakileyo ehlabathini. Ixhaphake kakhulu kubantu abatyebe kakhulu kunye nesifo seswekile sohlobo lwesibini. Njengoko ezi meko zisanda, iingcali ziqikelela ukuba ngaphezulu kwama-30% abemi behlabathi banokuba ne-MASLD. Ukuba ayinyangwa, i-MASLD inokukhokelela kwizifo zesibindi ezinzulu ngakumbi. Ke ngoko, ukufunyaniswa kwangoko kunye nonyango kunokuthintela le meko ukuba ibe mandundu.

Zithini iimpawu ze-MASLD?

Rhoqo, le meko ibizwa ngokuba yiMASLD inokukhula iminyaka emininzi ngaphandle kokubonisa zimpawu kwizigaba zokuqala. Oku kuthetha ukuba esi sifo singabakho emzimbeni wakho ngaphandle kokuba uve mahluko. Cinga ngaso njengengxaki ekhula ngokufihlakeleyo.

Nangona kunjalo, ezinye iimpawu ziqala ukubonakala xa le meko ifikelela kwinqanaba elibi kakhulu elibizwa ngokuba yi-MASH (Metabolic Dysfunction-Associated Steatohepatitis). I-MASH kuxa amafutha eqokelelana esibindini aze aqale ukonakalisa isibindi kunye nokudumba. Oku kunokukhokelela kwiimeko ezifana ne-liver fibrosis, eyenzeka ngenxa yokwakheka kwezicubu ezibomvu, okanye i-cirrhosis. Ukuba oku kuyenzeka, unokufumana iimpawu ezifana nezi:

• Unentlungu okanye ukungakhululeki kwinxalenye ephezulu ngasekunene yesisu sakho, apho isibindi sakho sikhoyo .
• Ukuziva udiniwe ngendlela engaqhelekanga kwaye ungenabomi.
• Ukutya akunancasa.
• Ukuziva ngathi isisu sakho sidumbile.
• Ukuba mncane ngaphandle kwesizathu.
• Ulusu lwakho kunye namehlo amhlophe ajika abe tyheli (njenge-jaundice, oogqirha bakwabiza oku ngokuba yi-scleral icterus ).

Ukuba unenye okanye ngaphezulu kwezi mpawu, kubalulekile ukufuna ingcebiso kagqirha.

Zithini izizathu ze-MASLD?

Isizathu esiphambili sokuphuhlisa i-MASLD kukuvela kwezinto ezingaqhelekanga kwinkqubo ye-metabolism yomzimba wakho. Le metabolism yinkqubo apho ukutya esikutyayo kuguqulwa kube ngamandla. Ukuba kukho ingxaki kule nkqubo, i-MASLD inokwenzeka. Nazi ezinye zezinto eziphambili ezichaphazela oku:

• I-Dyslipidemia: Kulapho amanqanaba amafutha egazini lakho, ingakumbi amafutha anjenge-cholesterol, ephezulu kunesiqhelo.
• Ukutyeba kakhulu: Ukuba i-Body Mass Index (BMI) yakho ingama-30 nangaphezulu, uthathwa njengomntu otyebileyo kakhulu. Abantu abanamafutha amaninzi, ingakumbi ajikeleze isisu, basengozini enkulu yokufumana i-MASLD.
• Ukuxhathisa i-insulin: I-insulin yi-hormone elawula inqanaba leswekile (i-glucose) egazini lethu. Ukuxhathisa i-insulin kuthetha ukuba izihlunu zakho, iiseli zamafutha, kunye neeseli zesibindi aziphenduli ngokufanelekileyo kwi-insulin. Oku kwenza kube nzima ukulawula amanqanaba eswekile egazini.
• Isifo seswekile sohlobo lwesibini: Esi sisifo esihlala ixesha elide. Okwenzekayo apha kukuba amanqanaba eswekile egazini ahlala ephezulu (i-hyperglycemia).

Ukongeza kwezi zinto, uphando lufumanise ukuba utshintsho oluthile lwemfuza lunokwandisa umngcipheko wokufumana i-MASLD.

Ziziphi iingxaki ezinokubakho ze-MASLD?

Sele sithethe ngendlela abanye abantu abane-MASLD abanokuba nesifo esibizwa ngokuba yi-MASH. Ukuba le meko ye-MASH iba mandundu ngakumbi, ezi ngxaki zilandelayo zinokwenzeka:

• I-MASH ene-fibrosis yesibindi: I-Fibrosis kukwakheka kwezicubu zesilonda esibindini. Olu silonda lwenzeka xa iiseli zesibindi zonakele kwaye zizama ukuzilungisa.
• I-cirrhosis enxulumene ne-MASH: I-Cirrhosis yimeko apho isibindi sonakala kakhulu size siphelelwe ngamandla aso okusebenza. Oku kuyingozi kakhulu kwaye kunokuba yingozi ebomini.
• I-Hepatocellular carcinoma: Olu luhlobo lomhlaza wesibindi olunokubangelwa yi-MASH.

I-MASLD ayinakubangela nje kuphela ezi ngxaki ezinxulumene nesibindi, kodwa inokunyusa nomngcipheko wezinye izifo ezinzulu. Umzekelo:

• Umhlaza: Iintlobo zomhlaza ezifana nomhlaza webele kunye nomhlaza we-colorectal.
• Isifo sentliziyo: Izifo ezinxulumene nentliziyo kunye nemithambo yegazi.
• Isifo Seswekile: Abantu abangenaso isifo seswekile ngoku banokufumana isifo seswekile esitsha.

Ifunyanwa njani i-MASLD?

Ukuze baqiniseke ukuba unayo i-MASLD, oogqirha badla ngokwenza uvavanyo lwegazi oluninzi kunye novavanyo lwemifanekiso. Ngamanye amaxesha, banokufuna ukuthatha iqhekeza elincinci lesibindi ukuze livavanywe (i-biopsy yesibindi).

Uvavanyo lwegazi

Ugqirha angenza uvavanyo lwegazi oluninzi, olufana nolu:

• Uvavanyo lwe-A1C: Olu vavanyo lulinganisa amanqanaba akho eswekile egazini kwiinyanga ezimbini ukuya kwezintathu ezidlulileyo.
• Ubalo lweGazi olupheleleyo (CBC): Oku kujonga ubungakanani kunye neempawu zeentlobo ezahlukeneyo zeeseli egazini lakho.
• Iphaneli Epheleleyo Ye-Metabolic (CMP): Oku kuvavanya amanqanaba ezinto ezimalunga ne-14 egazini lakho, njengeeproteni kunye nee-electrolytes.
• Iphaneli yeLipid: Olu luvavanyo lwesifo sentliziyo. Lulinganisa amanqanaba amafutha (i-cholesterol, i-triglycerides) egazini lakho.
• Uvavanyo lokusebenza kwesibindi: Olu vavanyo lwegazi lulinganisa izinto ezahlukeneyo (ii-enzymes, iiproteni) eziveliswa sisibindi ukuze kunikelwe umbono wempilo yesibindi.

Uvavanyo lokufota

Ugqirha wakho unokwenza iiskeni ezifana nezi ukujonga iimpawu ze-MASLD kwisibindi sakho:

• I-FibroScan®: Olu vavanyo lunokunika umbono wobungakanani bamafutha agcinwe kwisibindi sakho kunye nobungakanani be-fibrosis.
• I-Magnetic Resonance Elastography kunye neProton Density Fat Fraction (MRE-PDFF): Olu luhlobo olukhethekileyo lweskeni. Lunokulinganisa ngokuchanekileyo ipesenti yamafutha esibindini kunye nomlinganiselo we-fibrosis.

I-Biopsy

Kunqabile kakhulu, ukuba ugqirha wakho ukrokrela ukuba iimpawu zakho zibangelwa yinto engeyiyo i-MASLD, okanye ukuba bafuna ulwazi oluthe kratya emva kovavanyo olufana ne-fibroscan, banokuthatha iqhekeza elincinci lesicwili esibindini sakho (i-biopsy yesibindi) baze balihlole phantsi kwe-microscope.

Iphathwa njani iMASLD?

Xa kunyangwa i-MASLD, ingqwalasela yokuqala ixhomekeke ekunciphiseni umzimba . Ukongeza, iimeko ezibangela i-MASLD, ezinje ngesifo seswekile, i-cholesterol ephezulu, kunye noxinzelelo lwegazi oluphezulu, nazo ziyanyangwa.

Enyanisweni, ukunciphisa umzimba kunokwenza umahluko omkhulu kwimpilo yesibindi sakho. Ukunciphisa amafutha amaninzi esibindini kunokunceda ukulawula ukudumba okunokubangela izifo ezifana ne-cirrhosis. Ugqirha wakho unokucebisa isicwangciso esikhethekileyo sokutya, esifana nokutya kweMedithera okanye ukutya kwe-DASH. Siza kuthetha ngezi ndlela zokutya kwinqaku elahlukileyo.

Ukuzilolonga okulinganiselweyo ubuncinane imizuzu engama-30 ngosuku, iintsuku ezintathu ngeveki, kunokukunceda unciphise umzimba. Ugqirha wakho angakuxelela ukuba unciphise i-10% okanye ngaphezulu yobunzima bomzimba wakho uphela. Nangona kunjalo, nokunciphisa i-3% ukuya kwi-5% yobunzima bomzimba wakho kunokwenza umahluko omkhulu .

Amayeza okunciphisa umzimba

Ukuba unesifo seswekile kunye/okanye ukutyeba kakhulu, ugqirha wakho unokukunika amayeza okunciphisa umzimba, afana ne-GLP-1 agonists. La mayeza anciphisa amanqanaba eswekile egazini lakho kwaye ancede unciphise umzimba. Eminye imizekelo yile:

• I-Semaglutide (i-Ozempic® okanye i-Wegovy®)
• I-Liraglutide (iLiraglutide - iVictoza® okanye iSaxenda®)
• ITirzepatide (iMounjaro® okanye iZepbound®)

Utyando lweBariatric

Ngamanye amaxesha ugqirha wakho angathetha nawe ngotyando lwe-bariatric. Ukuba ufunyaniswe une-MASLD ngaphambi kokuba i-cirrhosis ivele, olu tyando lokunciphisa umzimba lunokuguqula imeko.

Ngaba imeko yeMASLD ingaguqulwa?

Ewe, inokwenziwa! Kodwa kuxhomekeke kwimeko yakho. Ngokubanzi, ukuba awunayo i-MASH-related cirrhosis, unyango lunokuguqula i-MASLD.

Kubalulekile ukuqaphela esi sifo kwangethuba . Oku kunokunceda ukulawula umonakalo wesibindi ngaphambi kokuba ube mkhulu kakhulu. Ukunciphisa umzimba nokwenza utshintsho kwindlela ophila ngayo kunokunceda ukubuyisela umonakalo wesibindi obangelwe yi-MASLD. Nangona kunjalo, oku kuxhomekeke kwimpilo yakho iyonke. Ngoko ke, buza ugqirha wakho ukuba ukunciphisa umzimba kungayiguqula na imeko yakho.

Ngaba i-MASLD ingathintelwa?

Le meko idla ngokuchaphazela abantu abatyebe kakhulu nabanesifo seswekile sohlobo lwesibini. Kusenokungabi lula ukuthintela ngokupheleleyo ezi meko ukuba zingabikho. Nangona kunjalo, ukubonwa kwangethuba kunye notshintsho kwindlela yokuphila kunokunceda ukuthintela okanye ukulawula uphuhliso lwe-MASLD.

Ukuba utyebile kakhulu okanye unesifo seswekile sohlobo lwesibini, ugqirha wakho unokucebisa ukuba uhlolwe igazi kwaye uskeni ukuze kuhlolwe iimpawu zale meko. Ukuba ufunyenwe kwangethuba, ungenza utshintsho kwindlela ophila ngayo ukuze unciphise umngcipheko wakho.

Ungaphila ixesha elingakanani ne-MASLD?

Uphando lubonisa ukuba ukuba ne-MASLD kunokuchaphazela ubomi bakho. Umzekelo, olunye uphando lufumanise ukuba abantu abane-MASLD banokuphila iminyaka eyi-2.8 ngaphantsi kunoko bangenaso esi sifo.

Nangona kunjalo, zininzi izinto ezichaphazela ukuba uza kuhlala ixesha elingakanani ne-MASLD. Imeko yakho isenokungafani neyezinye. Ke ngoko, ugqirha wakho ngoyena mthombo ulungileyo wolwazi malunga noko unokukulindela.

Ndingazinyamekela njani?

Ukuba une-MASLD, eyona ndlela ilungileyo yokuzinyamekela kukusebenza noogqirha bakho ukulawula iimeko ezibangele i-MASLD, ezinje ngokutyeba kakhulu, ukutyeba kakhulu, kunye nesifo seswekile sohlobo lwesibini. Ukunciphisa umzimba nokuhlala usebenza kunokunceda ukunciphisa, kwaye mhlawumbi ukubuyisela umva, umonakalo wesibindi.Nazi ezinye iingcebiso:

• Lumka ngempilo yakho iyonke. I-MASLD yonyusa umngcipheko wakho wokuba nesifo seswekile, isifo sentliziyo, kunye nezinye iintlobo zomhlaza. Ngoko ke, buza ugqirha wakho wosapho malunga novavanyo onokulwenza ukunciphisa umngcipheko wakho.
• Yakha imikhwa elungileyo kwisibindi sakho. Yeka ukutshaya nokusela utywala. Ukutshaya notywala kubeka uxinzelelo olungaphezulu kwisibindi sakho. Buza ugqirha wakho malunga nokugonyelwa i-hepatitis A kunye ne-hepatitis B.
• Musa ukuyeka, qhubeka uzama.

Ukunciphisa umzimba kuthatha ixesha. Usenokungaboni mahluko mkhulu kwangoko, kodwa uya kubona iziphumo kancinci kancinci. Kwakhona, ukuzilolonga rhoqo kukuzibophelela. Ukuba uziva udiniwe okanye ukruqukile ngeli xesha lohambo, thetha nogqirha wakho ngalo mba.

Ndifanele ndimbone nini ugqirha?

Ukuba ubona naluphi na utshintsho emzimbeni wakho, njengokuziva udiniwe ngaphezu kwesiqhelo okanye ukuba nentlungu kwicala eliphezulu lasekunene lesisu sakho, qiniseka ukuba ubona ugqirha wakho . Olu tshintsho lunokubonisa imeko enzima ye-MASH, imeko yesifo sesibindi esinamafutha esinokudlulela kwiimeko ezinzulu ngakumbi ezifana ne-cirrhosis kunye nomhlaza wesibindi.

Ngaba ukusetyenziswa kotywala kubangela i-MASLD?

Hayi, ukusela utywala akubangelwa ngqo yi-MASLD. Njengoko besitshilo ngaphambili, oku kwakubizwa ngokuba sisifo sesibindi esinamafutha esinganxilisiyo (i-NAFLD). Oku kuthetha ukuba le meko inokukhula nokuba awuseli utywala obuninzi.

Kodwa, eyona nto ibalulekileyo kukuba ukuba umntu one-MASLD usela iziselo ezinxilisayo, usemngciphekweni omkhulu wokuba ne-cirrhosis kunomntu oqhelekileyo. Yiyo loo nto oogqirha bedla ngokucebisa abantu abane-MASLD ukuba baphephe ngokupheleleyo iziselo ezinxilisayo.

Okokugqibela, izinto ekufuneka uzikhumbule

Ukuba uvavanyo lwegazi ngexesha lonyaka wakho lomzimba lubonisa ukuba unengxaki ngesibindi sakho, kunokwenziwa olunye uvavanyo ukuqinisekisa ukuba une-MASLD. Esi sifo sesibindi singakhokelela kwiingxaki ezinzulu ngakumbi ukuba asilawulwa kakuhle.

Kodwa iindaba ezimnandi zezokuba utshintsho kwindlela yokuphila, njengokunciphisa umzimba nokuba ngumntu osebenzayo, lunokunceda ekuthinteleni i-MASLD ukuba ingabi mbi. Zinokubuyisela umonakalo kwisibindi sakho. Kodwa ukunciphisa umzimba nokuba ngumntu osebenzayo asinto onokuyenza ngobusuku obunye. Kuthatha ixesha nokuzinikela. Kwezinye iintsuku, unokuziva ngathi uyadinwa zezi zinto. Iqela lakho lezempilo liyayiqonda imingeni yokuzama izinto ezibonakala zingasebenzi kwangoko. Ngoko ke, ungaze ungathandabuzi ukucela uncedo nenkxaso. Isibindi sakho sixabisekile kuwe, kwaye kuxhomekeke kuwe ukuba usinyamekele!

Amafutha esibindi , isibindi esinamafutha, isifo seswekile, ukutyeba kakhulu, isifo sokuqina kwesibindi, impilo yesibindi