脂肪肝真的可以逆转吗 Can You Reverse Fatty Liver

Question: Does weight loss reverse a fatty liver?

问：减肥可以逆转脂肪肝吗？

Answer: The short answer is yes.

答：简单的回答是：“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.

在美国，每五名成年人中就有一人患有非酒精性脂肪肝，这种疾病与肥胖的流行密切相关。目前尚没有治疗的药物，因此大多数临床医师建议患者注重改变生活方式，譬如通过节食和锻炼来减轻体重，以改善预后。脂肪肝如果不能得到控制，就会导致肝脏衰竭。

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.

美国肝病研究学会(American Association for the Study of Liver Diseases)在关于脂肪肝的指南中指出，患者需要减掉约3%到5%的体重才能减轻脂肪肝的程度。该学会还称，要想改善肝脏炎症等较为严重的症状，则需要减重更多——达体重的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.

长久以来，临床医生一直建议脂肪肝患者减肥，他们猜测这会对病情大有帮助。但直到最近才开始有研究证实减肥的效果有多强大，约翰斯·霍普金斯医学院(Johns Hopkins School of Medicine)的肝脏病学家、助理教授艾米·基姆(Amy Kim)博士说道。

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月发表在《胃肠病学》杂志(Gastroenterology)的一项研究中，科学家们招募了293名患者，并研究了他们在执行锻炼和节食方案一年后的变化。所有患者均患有晚期脂肪肝，肝脏伤痕累累，还存在炎症，这种情况称为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.

作者们报告，在体重至少减轻10%的患者中，“90%出现NASH缓解，45%出现肝纤维化逆转”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.”

“在临床中，我们总是说要患者减肥，”基姆博士说。“这项大型前瞻性试验证实了这一理论。”

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

她又补充道：“减肥越多，改善越大。”