Ingaba nesibindi sakho sinamafutha? Masifunde nge-MASH (Metabolic Dysfunction-Associated Steatohepatitis)!

Ngaba wakha weva ngesifo apho amafutha aqokelelana esibindini? Ngamanye amaxesha, le meko inokuba mandundu ngaphandle kweempawu ezinkulu. Namhlanje, siza kuthetha ngesifo esinye esinjalo esinokuchaphazela isibindi sethu buthule. Oku kubizwa ngokuba yi-MASH (Metabolic Dysfunction-Associated Steatohepatitis).

Yintoni kanye kanye i-MASH (i-Metabolic Dysfunction-Associated Steatohepatitis)?

Ngamafutshane, i-MASH yimeko apho isibindi sakho sinamafutha amaninzi, nto leyo ebangela ukudumba , imeko efana nokwenzakala. Cinga ngale ndlela: xa unenxeba, indawo iba bomvu, idumbe, kwaye ishushu, kwaye kwenzeka into efanayo ngaphakathi kwesibindi. Igama lale meko yi-NASH (i-steatohepatitis engeyotywala).

Le meko, ebizwa ngokuba yi-MASH, yinxalenye yeqela elibanzi lezifo zesibindi ezibizwa ngokuba yi-MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). Oku kubangelwa kukuqokelelwa kwamafutha esibindini ngezizathu ezingezizo ezokusebenzisa utywala.

Eyona nto ibalulekileyo kukuba ukuba oku akuphathwanga kakuhle, ngokuhamba kwexesha kunokukhokelela kwiimeko ezifana ne-cirrhosis, ebangela ukuba isibindi sibe lukhuni kwaye sibe namanxeba, okanye nezifo eziyingozi ezifana nomhlaza wesibindi. Ngoko ke, kubaluleke kakhulu ukuqaphela oku.

Ziziphi izizathu eziqhelekileyo ze-MASH? Ngubani osengozini?

Eyona nto ibangela i-MASH kukuqokelelwa kwamafutha amaninzi esibindini, nto leyo eyonakalisa isibindi kwaye ibangele ukudumba. Le meko inokwenzeka xa kukho iingxaki ngemetabolism yeswekile namafutha emzimbeni wethu. Makhe sijonge izizathu eziphambili kunye nezinto ezibangela umngcipheko ezichaphazela oku:

• Ukutyeba kakhulu okanye ukutyeba kakhulu: Le yeyona nto iphambili.
• Uhlobo lwesibini lwesifo seswekile: Abantu abanesifo seswekile basengozini enkulu yokuba ne-MASH.
• I-cholesterol ephezulu: Amanqanaba aphezulu e-cholesterol embi egazini.
• Ii-triglycerides eziphezulu: Olu luhlobo lwamafutha egazini. Ukwanda kwezi zinto nako akulunganga.
• Uxinzelelo lwegazi oluphezulu: Silubiza ngokuba luxinzelelo.
• Ukumelana ne-insulin: Xa iiseli zomzimba zingasabeli kakuhle kwi-insulin. Le yimeko eyenzeka ngaphambi kwesifo seswekile.

Khumbula, ngamanye amaxesha nokuba unobunzima obuqhelekileyo, ukuba une-cholesterol ephezulu, uxinzelelo lwegazi oluphezulu, okanye iimeko ezifana nesifo seswekile, usenokuba semngciphekweni othile wokuba ne-MASH. Ngoko ke, ukuba unayo nayiphi na kwezi zinto zinobungozi, kububulumko ukubona ugqirha wakho kwaye uhlolwe i-MASH.

Zithini iimpawu ze-MASH? Uzibona njani?

Nantsi ingxaki: I-MASH idla ngokungabonisi zimpawu zicacileyo kwizigaba zokuqala.Esi sifo sikhula kancinci kwiminyaka emininzi. Ezinye iimpawu ziqala ukubonakala emva kokuba isibindi sonakele kakhulu. Xa iimpawu zibonakala, zingabandakanya:

• Ukudinwa: Ukudinwa nokuba ungenzanga nto.
• Ukungakhululeki okanye iintlungu esiswini sakho sasekunene: Kanye apho kukho isibindi.
• Ukunciphisa umzimba ngendlela engachazekiyo.
• Ubuthathaka bemisipha okanye ukulahleka kwemisipha.
• Isisu okanye imilenze evuvukileyo.
• Xa imeko imbi kakhulu, amehlo nolusu luba tyheli (i-jaundice): Oku yinto esithi ngamanye amaxesha yi-jaundice.

Ekubeni kungekho zimpawu kwisigaba sokuqala, kubaluleke kakhulu ukuba uhlolwe rhoqo, ingakumbi ukuba unezinto ezinokubangela umngcipheko ezifana nokutyeba kakhulu, isifo seswekile, okanye i-cholesterol ephezulu. Kulapho unokuyibona khona le meko kwangethuba.

Ziziphi ezinye iingxaki ezinokwenzeka ngenxa ye-MASH?

Ukuba i-MASH ayinyangwa kakuhle, inokukhokelela kwiingxaki ezinzulu, ngamanye amaxesha ezisongela ubomi. Nazi ezi zinto:

• I-fibrosis yesibindi: Oku kukuqhekeka kwesibindi. Ekuhambeni kwexesha, oku kuqhekeka kwezilonda, nto leyo ekhokelela kwi-cirrhosis.
• I-Cirrhosis: Le yimeko apho isibindi siba namanxeba amaninzi kwaye ukusebenza kwaso kuyaphazamiseka. Le yimeko ehlala ihleli, nto leyo ethetha ukuba kunzima ukuyibuyisela umva.
• Ukungasebenzi kakuhle kwesibindi: Isibindi siyayeka ukusebenza kakuhle. Oku kungenzeka ngequbuliso. Ukuba oku kuyenzeka, ungadinga uncedo lwezonyango ngokukhawuleza okanye ukufakelwa isibindi.
• I-Hepatocellular carcinoma: I-MASH inyusa umngcipheko wokufumana olu hlobo luqhelekileyo lomhlaza wesibindi.
• Isifo sentliziyo: Abantu abane-MASH basengozini enkulu yokufumana izifo ezinxulumene nentliziyo ezifana nokuhlaselwa yintliziyo kunye nesifo sohlangothi.

Khawucinge nje, konke kuqala ngamafutha amancinci esibindini. Yiyo loo nto sithi, musa ukuyityeshela neyona nto incinci.

Oogqirha bayixilonga njani isifo se-MASH?

Ngenxa yokuba i-MASH ayibangeli zimpawu ekuqaleni, kukho amanyathelo aliqela ekufuneka uwathathe ukuze uyixilonge. Ugqirha uya kuqala enze uvavanyo lomzimba. Emva koko baya kukubuza ngezinye iimeko zempilo ezinokunyusa umngcipheko wakho wokuba ne-MASH (umz. isifo seswekile, i-cholesterol). Ukongeza, banokwenza ezi vavanyo zilandelayo:

Uvavanyo lwegazi

Ugqirha wakho uza kuyalela uvavanyo lwegazi ukujonga umonakalo wesibindi okanye ukudumba. Oku kungabandakanya:

• I-CBC (Ubalo olupheleleyo lwegazi): Ubalo olupheleleyo lweeseli zegazi.
• I-BMP (Iphaneli yeMetabolic eSisiseko): Uvavanyo lwenkqubo ye-metabolic esisiseko.
• Iphaneli yeLipid: Jonga amanqanaba amafutha afana ne-cholesterol kunye ne-triglycerides.
• IHemoglobin A1C: Uvavanyo lokuvavanya ulawulo lwesifo seswekile.

Uvavanyo lokufota

Olu vavanyo lungathatha imifanekiso (imifanekiso) yangaphakathi kwesibindi sakho. Ugqirha wakho uza kujonga le mifanekiso ukujonga naluphi na utshintsho kwisibindi sakho olunxulumene nesimo se-MASH. Uvavanyo olufana nolu lunokwenziwa:

• Iskeni ye-CT (iskeni ye-CT - iskeni ye-Computed Tomography)
• Iskeni ye-ultrasound
• I-FibroScan®: Olu luhlobo olukhethekileyo lwe-ultrasound olulinganisa ukuqina kwesibindi. Oku kunokunika umbono we-fibrosis yesibindi.
• I-magnetic resonance elastography kunye ne-proton density fat fraction (MRE-PDFF): Oku kunokulinganisa ngokuchanekileyo ubungakanani bamafutha esibindini.

i-biopsy yesibindi

Ngamanye amaxesha, ugqirha wakho unokufuna ukuthatha isampuli encinci yezicubu esibindini sakho ebizwa ngokuba yi-liver biopsy. Ingcali yezonyango iya kuhlola isampuli phantsi kwemakroskopu ukujonga amafutha, ukudumba, kunye namanxeba esibindini. I-liver biopsy yeyona ndlela ilungileyo yokuxilonga ngokuchanekileyo i-MASH.

Ukongeza, ugqirha wakho unokwenza nezinye iimvavanyo ukuze abone ukuba iimpawu zakho zibangelwa sisifo sesibindi esithile.

Ziziphi iindlela zonyango ze-MASH?

Unyango lwe-MASH lugxile ekuphuculeni impilo yemetabolism yomzimba wakho kunye nokuthintela umonakalo ongakumbi kwisibindi sakho. Isicwangciso sakho sonyango singabandakanya:

Utshintsho kwindlela yokuphila

Ukuze ulawule i-MASH, kubalulekile ukuba utye ukutya okunempilo, usebenze, kwaye wehlise umzimba. Ugqirha wakho unokucebisa utshintsho kwindlela ophila ngayo olufana nolu:

• Yitya ukutya okunempilo: Isicwangciso esihle sokutya esinceda ukulawula i-MASH kukutya kweMeditera okanye ukutya okune-carb ephantsi . Ngamafutshane, yitya imifuno emininzi, iziqhamo, iimbotyi, iinkozo ezipheleleyo ezine-fibrous, iiproteni ezisemgangathweni ophezulu (intlanzi, inkukhu), kunye namafutha asempilweni (i-avokhado, ioyile yomnquma, amantongomane). Kufuneka unciphise iilekese, ukutya okunamafutha, kunye nokutya okukhawulezayo kangangoko unako.
• Ukuba ngumntu okhutheleyo: ubuncinane kanye ngevekiZama ukwenza umthambo we-aerobic ophakathi kangangemizuzu eli-150 ukuya kwengama-300. Imizekelo ibandakanya ukuhamba ngokukhawuleza, ukubaleka, ukukhwela ibhayisekile, kunye nokudada.
• Luphephe ngokupheleleyo utywala: Nokuba isiselo esincinci sotywala sinokubangela uxinzelelo kwisibindi sakho, ngoko ke kubalulekile ukuba ungabuseli ngokupheleleyo utywala.

Amayeza

Ugqirha wakho angakunika amayeza athile ukunceda ekunciphiseni iimpawu, ezifana nokuqhekeka, okubangelwa yi-MASH. Umzekelo:

• I-Resmetiron (Rezdiffra®): Eli yeza linokunceda ukunciphisa okanye ukubuyisela umva amanxeba esibindi abangelwa yi-MASH. Liyeza kuphela elivunyiweyo yi-U.S. Food and Drug Administration (FDA) ukunyanga i-MASH kwizigaba 2 kunye ne-3 ze-fibrosis.
• Ii-agonists ze-GLP-1: La mayeza anceda ekunciphiseni ukudumba kunye namafutha esibindini. Imizekelo ibandakanya i-liraglutide (Victoza®, Saxenda®), i-semaglutide (Ozempic®, Wegovy®), kunye ne-tirzepatide (Mounjaro®, Zepbound®). Ezi zikwasetyenziswa rhoqo ukunyanga isifo seswekile.

Ukongeza, ugqirha wakho unokukunika amanye amayeza okanye izongezo. Umzekelo, amayeza esifo seswekile abizwa ngokuba yi-pioglitazone (Actoplus Met XR®) okanye isongezo esifana ne-vitamin E angacetyiswa.

Abaphandi okwangoku benza uvavanyo lweklinikhi lokufumana amayeza amatsha e-MASH. Ungathetha nogqirha wakho malunga nokuba uyakufanelekela na ukuthatha inxaxheba kolu vavanyo.

Utyando lokunciphisa umzimba (utyando lweBariatric)

Ukuba utyebe kakhulu kwaye unesifo sesibindi esinzima, utyando lokunciphisa umzimba (utyando lwe-bariatric) lolunye ukhetho lonyango. Utyando lwesisu (ukususwa kwenxalenye yesisu) okanye utyando lwesisu olusebenzisa i-gastric bypass (ukunciphisa isisu) lunokubonelela ngezi zibonelelo zilandelayo:

• Inceda ekunciphiseni ubunzima bomzimba.
• Umonakalo kwisibindi obangelwa yi-MASH ungancitshiswa ngandlela thile, mhlawumbi ubuye uguqulwe.
• Inciphisa kakhulu umngcipheko wokuba nesifo sesibindi, umhlaza wesibindi, kunye nesidingo sokufakelwa isibindi.

Ngaba i-MASH inganyangeka ngokupheleleyo?

I-MASH ayinyangeki rhoqo. Nangona kunjalo, ukuba isifo sifunyenwe kwangethuba kwaye unyango luqalwe kwangethuba, ngamanye amaxesha sinokuguqulwa okanye sithintelwe ukuba singabi mandundu. Oku kuthetha ukuba kukho ithuba elihle lokuba umonakalo ongakumbi kwisibindi unokuthintelwa.

Umntu one-MASH angaphila ixesha elingakanani?

Ubungakanani bexesha ophila ngalo buxhomekeke ekubeni isibindi sakho singakanani umonakalo owenziwe yi-MASH. Ukuba esi sifo sifunyenwe kwaye sinyangwa kwangethuba, uninzi lwabantu lunokuphila ubomi obuqhelekileyo.Nangona kunjalo, njengoko isifo sisiya kwinqanaba eliphezulu, umngcipheko wokufa kwangethuba ngenxa yeengxaki ezifana nokusilela kwesibindi kunye nomhlaza wesibindi uyanda. Nangona kunjalo, unyango lunokucothisa ukuqhubela phambili kwesi sifo kwaye luphucule umgangatho wobomi. Ukuqala unyango kwangethuba yeyona ndlela ilungileyo yokufumana iziphumo ezilungileyo.

Ndifanele ndimbone nini ugqirha?

Ukuba uziva udiniwe ngalo lonke ixesha, unentlungu okanye ukungakhululeki kwinxalenye ephezulu ngasekunene yesisu sakho, okanye uneempawu ezifana nokwehla kobunzima ngendlela engachazekiyo, kubalulekile ukubona ugqirha. Ezi zinokuba ziimpawu zokuba kukho into engalunganga ngesibindi sakho. Ugqirha wakho uza kwenza uvavanyo ukuze abone ukuba yi-MASH okanye esinye isifo sesibindi.

Khumbula, ezinye iimeko zempilo, ezinje ngokutyeba kakhulu kunye nesifo seswekile sohlobo lwesibini, ziyandisa umngcipheko wakho wokuba ne-MASH. Ukuba unayo nayiphi na kwezi meko, ugqirha wakho uya kujonga rhoqo ukusebenza kwesibindi sakho.

Okokugqibela, ezona zinto zibalulekileyo ekufuneka uzikhumbule

Xa ufunyaniswa une-MASH (i-metabolic dysfunction-associated steatohepatitis), ungaziva wothukile kwaye uloyiko olukhulu. Ukuba uneemeko ezifana nokutyeba kakhulu, uxinzelelo lwegazi oluphezulu, okanye i-cholesterol ephezulu, ungazibuza, "Ngaba ndim obangela oku?"

Kodwa khumbula into enye. Akukho nanye kwezi meko, kuquka ne-MASH, eyimpazamo yakho. Iqela lakho lezonyango ligxila kwixesha langoku, kungekhona kwixesha elidlulileyo. Baza kukuchazela amanyathelo onokuwathatha ukulawula i-MASH. Kwaye baya kuba nawe kuyo yonke inyathelo. Ngoko ke ungoyiki.

Eyona nto ibalulekileyo kukwazi iimpawu, ukufumana uvavanyo olufanelekileyo lwezonyango ukuba kukho izinto ezinobungozi, nokulandela iingcebiso zonyango. Emva koko singasindisa isibindi sethu kolu tshaba luthuleyo.

` MASH, isibindi esinamafutha, isifo sokuqina kwesibindi, umhlaza wesibindi, isifo seswekile, ukutyeba kakhulu, i-cholesterol