脂肪肝真的可以逆轉嗎 Can You Reverse Fatty Liver

Question: Does weight loss reverse a fatty liver?

問：減肥可以逆轉脂肪肝嗎？

Answer: The short answer is yes.

答：簡單的回答是：“是的”。

Nonalcoholic fatty liver disease, which affects about one in five adults in the United States, is tightly linked to the obesity epidemic. There are no drugs to treat the disease, so most clinicians recommend that patients focus on lifestyle changes that produce weight loss, like diet and exercise, to improve their prognoses. Unchecked, fatty liver disease can lead to liver failure.

在美國，每五名成年人中就有一人患有非酒精性脂肪肝，這種疾病與肥胖的流行密切相關。目前尚沒有治療的藥物，因此大多數臨牀醫師建議患者注重改變生活方式，譬如通過節食和鍛鍊來減輕體重，以改善預後。脂肪肝如果不能得到控制，就會導致肝臟衰竭。

In its guidelines on fatty liver disease, the American Association for the Study of Liver Diseases notes that patients need to lose about 3 percent to 5 percent of their body weight to see reductions in liver fat. But the association says more weight loss — up to 10 percent — is needed to improve more severe symptoms like inflammation in the liver.

美國肝病研究學會(American Association for the Study of Liver Diseases)在關於脂肪肝的指南中指出，患者需要減掉約3%到5%的體重才能減輕脂肪肝的程度。該學會還稱，要想改善肝臟炎症等較爲嚴重的症狀，則需要減重更多——達體重的10%左右。

Clinicians have long recommended weight loss to fatty liver patients on the assumption that it could be very helpful. But only recently have studies begun to demonstrate just how powerful losing weight can be, said Dr. Amy Kim, a hepatologist and assistant professor at Johns Hopkins School of Medicine.

長久以來，臨牀醫生一直建議脂肪肝患者減肥，他們猜測這會對病情大有幫助。但直到最近纔開始有研究證實減肥的效果有多強大，約翰斯·霍普金斯醫學院(Johns Hopkins School of Medicine)的肝臟病學家、助理教授艾米·基姆(Amy Kim)博士說道。

In a study published in the journal Gastroenterology in August, scientists recruited 293 patients and looked at what happened when they followed exercise and diet programs for a year. The patients all had an advanced form of fatty liver disease in which the liver becomes scarred and inflamed, known as nonalcoholic steatohepatitis, or NASH.

8月發表在《胃腸病學》雜誌(Gastroenterology)的一項研究中，科學家們招募了293名患者，並研究了他們在執行鍛鍊和節食方案一年後的變化。所有患者均患有晚期脂肪肝，肝臟傷痕累累，還存在炎症，這種情況稱爲非酒精性脂肪性肝炎(nonalcoholic steatohepatitis, NASH)。

Among those who lost 10 percent or more of their body weight, “90 percent had resolution of NASH, and 45 percent had regression of fibrosis,” or scarring, the authors reported.

作者們報告，在體重至少減輕10%的患者中，“90%出現NASH緩解，45%出現肝纖維化逆轉”或瘢痕形成。

“In clinic, we always say weight loss,” Dr. Kim said. “But this was a large prospective trial that confirmed that.”

“在臨牀中，我們總是說要患者減肥，”基姆博士說。“這項大型前瞻性試驗證實了這一理論。”

“The more weight loss there is, the better the improvement,” she added.

她又補充道：“減肥越多，改善越大。”