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."
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裘德·奧本醫生是一位肝臟病專家，上周他帶給一位60歲的病人一個壞消息——他又一次患上了肝硬化。這已經是這位病人第二次得這種疾病了。
四年前他為這位患者進行了肝移植手術，那是這位患者首次因肥胖患肝硬化。“不幸的是，我的這位病人繼續暴飲暴食并保持肥胖狀態，”在英國皇家自由醫院和圣托馬斯醫院工作的肝臟病專家奧本說道。“因此，他再一次感染肝硬化疾病。不幸的是，我只能告訴他這一次他可能不會再得到另一個肝臟了。”
這并不是個例，肥胖引發的肝硬化正威脅著整個英國。奧本解釋說，人們都知道肥胖癥者的高血壓和糖尿病發病率高，并因此導致新陳代謝紊亂。但是，人們從來不會把肝硬化和肥胖聯系起來，而事實是，肥胖會導致肝硬化。
奧本最近發起了一項名為“肥胖行動”的慈善活動，旨在抑制肝硬化疾病的傳播。他說，十年前在他的診所里，因為肥胖導致的肝硬化患者寥寥無幾，現在情況卻愈演愈烈，因為在病人肝臟的不可逆疤痕會導致其狀況惡化。過去在英國，酗酒和肝炎是肝硬化的主要病因，如今，肥胖已經取代酗酒和肝炎，一躍成為英國肝臟疾病多發的主要原因。
肝病患者平均壽命為59歲，而心肺疾病、中風以及肺部疾病患者平均壽命在82歲到84歲之間。肝病已成為英國第五大殺手。和十年前相比，35歲至55歲年齡段的肝硬化患者數量翻了5番。奧本預測隨著肥胖者數量的增加，情況只會愈演愈烈。
“現在肥胖者約占英國總人口的三分之一，最近政府預計，到2050年這項數據將上升到50%。但說實話，我個人認為肥胖率上漲到50%根本不需要那么長的時間，并且到時候肝硬化患者驟增也勢在必然。”
肥胖程度的增加不僅會導致肝硬化。食道癌、胰臟癌、結腸癌患者也會增加，且預計將一直上漲。
“坦白的說，我們國家的肥胖水平已經可以與美國相較。2001年我到美國工作，來診所的大量肥胖患者讓我目瞪口呆。幾年后當我回到英國，發現我們國家的肥胖者數量就要趕上美國時，我又一次被嚇呆了。”
科學家表示肥胖的原因有很多，高熱量的食物的攝入以及運動量的減少都與此相關。另外，奧本的研究表明，通常肥胖的媽媽也會對孩子產生影響。
“這是又一個令人擔心的因素，”他說。“醫學治療對肥胖也束手無策。” |
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