Episode Transcript
Announcer: 向大发娱乐的专家大发娱乐提供有关您今天面临的最大健康问题的深入信息, "The Specialists" with Dr. Tom Miller is on The Scope.
Interviewer: 脂肪肝影响着8000多万美国人, and many of them don't even know they have it. Dr. 汤姆·米勒，作为一名医生，为什么脂肪肝会引起你的关注?
Dr. Miller: Well, 脂肪肝正在成为西方工业化国家最常见的慢性肝病, and especially in the United States. And it used to be, 病毒性肝炎是肝脏疾病的一个原因，也是移植的主要原因, which it still is, 但很快肝移植的主要原因是肝功能衰竭是脂肪肝.
Interviewer: And not necessarily caused by alcohol. 我一直以为，酗酒的人容易得脂肪肝.
Dr. Miller: Well, they get liver disease. 这并不一定是你们想象中的脂肪肝, 它过去是，现在仍然是肝脏疾病的一个原因, 而是因为大发娱乐的生活方式以及30%的美国人患有肥胖症的事实, 脂肪肝是目前慢性肝病最常见的病因.
Interviewer: Yeah, 80 million Americans, that's quite a . . . that's almost an epidemic, isn't it? 比如，如果8000万美国人有任何其他类型的疾病，大发娱乐会吓坏的.
Dr. Miller: Right. I think the term might be just a little bit . . . 它的分类有一点误导，因为不是每个脂肪肝患者都会发展成肝功能衰竭. In fact, 这些人中有一小部分最终会肝功能衰竭, 但鉴于脂肪肝患者人数众多, 相当多的美国人最终会患上晚期肝病.
Interviewer: And what exactly is going on? So I think the name implies that there's some fat, maybe excess fat deposits in the liver, but why is that bad?
Dr. Miller: Fat is a cause, a driver of inflammation, and we don't exactly know why, but when people gain weight, 其中一些重量储存在中心，也储存在肝脏细胞之间. So if you look at a person's tissue from the liver, you will see if they have fatty liver, which is called non-alcoholic fatty liver. You'll see fat stores or globules in between the cells. For whatever reason, this causes inflammation, and inflammation predisposes to damage, fibrosis, 破坏肝脏中大发娱乐大发娱乐清除体内毒素的活跃细胞.
Interviewer: And you're talking about scarring.
Dr. Miller: I'm talking about scarring.
Interviewer: That's why I used those words, yeah.
Dr. Miller: Fibrosis leads to scarring.
Interviewer: Yeah.
Dr. Miller: Now, again, 大多数脂肪肝患者最终不会出现炎症, 大发娱乐并不完全理解为什么有些人有与脂肪肝相关的炎症问题，而有些人没有. 并不是每个患有肝脏炎症的人都会发展成肝硬化.
Interviewer: 但你肯定不想走这条路去发现那些东西.
Dr. Miller: No, definitely not, and it can be treated.
Interviewer: All right. So, when a patient comes into your office, 你能通过观察他们来判断他们是否患有严重的脂肪肝疾病从而导致移植或死亡吗?
Dr. Miller: I think the way that we think about it now, 我相信大发娱乐现在对它的看法是，如果你肥胖, that is you have a body mass index greater than 30, 你患非酒精性脂肪肝的几率很高. So, basically, 和大发娱乐之前在节目中讨论过的一样, right diet, right weight, right exercise is your best treatment to prevent it. 这是工业化国家的一个问题，他们有太多的食物和错误的食物种类.
Interviewer: Yeah. And once that scarring happens, there's no cure for it. It eventually will lead to liver failure.
Dr. Miller: Once you start down a path of scarring, 你患上晚期肝病并需要移植的几率非常高. 不仅如此，有了这些疤痕，你更容易得肝癌.
Interviewer: And if you start to lose some weight, I understand it doesn't take, necessarily, 通过大量的减肥来减少肝脏中脂肪细胞的数量如果疤痕没有发生的话，就会开始支持它.
Dr. Miller: Right. 我认为一个人想要达到正常的体重指数，也就是在18之间.5 and 25.
Interviewer: Okay.
Dr. Miller: And that's not easy. I mean, I tell you that that's the treatment, 但要让每个人都得到这种治疗是很困难的，因为大发娱乐没有有效的减肥药物, and basically it's a lifestyle adjustment, which is hard for people given the abundance of food.
Interviewer: 你可以做一些测试来确定是否有.
Dr. Miller: There are. 所以大发娱乐基本上开始研究那些大发娱乐认为可能患有脂肪肝的人的炎症问题通过观察血液测试中肝脏产生的酶. If these are elevated, there are a number of causes, but eventually, if you can rule out sort of the medical, the drug-associated causes and other causes, that is if they're not drinking, 你可以认为这可能与非酒精性脂肪肝有关. 如果你真的想知道肝脏的损伤，你必须做肝脏活检. 现在还有另一种测试是无创的，但肝脏活检仍然是金标准.
Interviewer: 大发娱乐还没有发现这个问题，但它通常没有症状.
Dr. Miller: 绝大多数非酒精性脂肪肝患者没有症状.
Interviewer: Yeah.
Dr. Miller: And, in fact, you're only symptomatic towards the end . . .
Interviewer: When it's kind of too late.
Dr. Miller: . . . 当你有纤维化和疤痕或者肝癌的时候. 所以，再一次，大发娱乐想看看肥胖和生活方式作为预防这种情况的反应.
Interviewer: 所以让身体质量指数回到一个合理的范围?
Dr. Miller: Well, 这和大发娱乐现在谈论的西方世界饮食中的所有东西是一样的, which is high blood pressure, heart disease, metabolic syndrome, type 2 diabetes. 他们都在一个篮子里，包括这种非酒精性脂肪肝. 同样，治疗方法唾手可得，但并不容易实现.
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