肥胖引发肝硬化“浪潮”

Doctor Jude Oben had grim news for a patient last week. The liver expert told the 60-year-old man that he had cirrhosis – for the second time in his life.

Only four years ago Oben's patient had required a liver transplant after his first bout of cirrhosis, a condition he had contracted because he was obese. "Unfortunately my patient continued to overeat and remained obese," said Oben, a hepatologist based at the Royal Free and St Thomas' hospitals in London. "As a result, he contracted cirrhosis again. Sadly, I had to tell him that this time it was very unlikely he would be given another liver."

Oben's patient is one of a "tidal wave" of cases of cirrhosis, triggered by obesity, that threatens to sweep through hospitals across the UK. "People might be aware that there are metabolic disorders such as diabetes and high blood pressure associated with obesity, but very few know about the connection with cirrhosis. However, there is a very clear link. Obesity can trigger cirrhosis."

Oben, who recently launched the charity Obesity Action Campaign to help in the battle against the spread of the condition, said that 10 years ago he saw only an occasional case of obesity-related cirrhosis in his clinic. Today he has dozens of cases of the illness, which occurs when irreversible scarring causes a person's liver to deteriorate. In the past, excess alcohol consumption and hepatitis infections have been the main causes of cirrhosis in Britain. Now a third cause – obesity – has triggered a major increase in cases of liver disease in the UK.

The average age of death from liver disease is 59, compared with 82-84 for heart and lung disease and strokes, for example. It is the fifth largest cause of death in the UK, and in the past 10 years there has been a fivefold increase in cirrhosis for those aged between 35 and 55. Oben predicts that these figures are only going to get worse as obesity levels rise.

"About a third of the UK population is now obese, while one government estimate recently suggested that this figure will rise to 50% by 2050," said Oben. "Frankly, I think we will have reached that level long before then, and when we do that we will find that cirrhosis case numbers have increased steeply."

Nor will cirrhosis cases be the only ones to follow in the wake of Britain's increasing obesity levels. Cancers of the oesophagus, liver, pancreas and colon are linked to obesity; cases of these are increasing and are expected to continue to rise.

"Frankly, we are reaching US levels of obesity," said Oben. "I went to work in the US in 2001 and was stunned by the numbers of obese people that came into clinics. When I came back to Britain a few years later, I discovered – to my horror – that we are catching up."

As to the causes of this expected tidal wave of obesity-linked illness, scientists point to the increasing abundance of calorie-dense foods and a decrease in numbers of people taking regular exercise. In addition, Oben's own research has indicated that obese mothers may pass on a propensity for their offspring to become obese.

"It is another worrying factor," he said. "Obesity is a very difficult condition to treat medically."

查看译文

裘德·奥本医生是一位肝脏病专家，上周他带给一位60岁的病人一个坏消息——他又一次患上了肝硬化。这已经是这位病人第二次得这种疾病了。

四年前他为这位患者进行了肝移植手术，那是这位患者首次因肥胖患肝硬化。“不幸的是，我的这位病人继续暴饮暴食并保持肥胖状态，”在英国皇家自由医院和圣托马斯医院工作的肝脏病专家奥本说道。“因此，他再一次感染肝硬化疾病。不幸的是，我只能告诉他这一次他可能不会再得到另一个肝脏了。”

这并不是个例，肥胖引发的肝硬化正威胁着整个英国。奥本解释说，人们都知道肥胖症者的高血压和糖尿病发病率高，并因此导致新陈代谢紊乱。但是，人们从来不会把肝硬化和肥胖联系起来，而事实是，肥胖会导致肝硬化。

奥本最近发起了一项名为“肥胖行动”的慈善活动，旨在抑制肝硬化疾病的传播。他说，十年前在他的诊所里，因为肥胖导致的肝硬化患者寥寥无几，现在情况却愈演愈烈，因为在病人肝脏的不可逆疤痕会导致其状况恶化。过去在英国，酗酒和肝炎是肝硬化的主要病因，如今，肥胖已经取代酗酒和肝炎，一跃成为英国肝脏疾病多发的主要原因。

肝病患者平均寿命为59岁，而心肺疾病、中风以及肺部疾病患者平均寿命在82岁到84岁之间。肝病已成为英国第五大杀手。和十年前相比，35岁至55岁年龄段的肝硬化患者数量翻了5番。奥本预测随着肥胖者数量的增加，情况只会愈演愈烈。

“现在肥胖者约占英国总人口的三分之一，最近政府预计，到2050年这项数据将上升到50%。但说实话，我个人认为肥胖率上涨到50%根本不需要那么长的时间，并且到时候肝硬化患者骤增也势在必然。”

肥胖程度的增加不仅会导致肝硬化。食道癌、胰脏癌、结肠癌患者也会增加，且预计将一直上涨。

“坦白的说，我们国家的肥胖水平已经可以与美国相较。2001年我到美国工作，来诊所的大量肥胖患者让我目瞪口呆。几年后当我回到英国，发现我们国家的肥胖者数量就要赶上美国时，我又一次被吓呆了。”

科学家表示肥胖的原因有很多，高热量的食物的摄入以及运动量的减少都与此相关。另外，奥本的研究表明，通常肥胖的妈妈也会对孩子产生影响。

“这是又一个令人担心的因素，”他说。“医学治疗对肥胖也束手无策。”