Outcomes of Various Classes of Oral Antidiabetic Drugs on Nonalcoholic Fatty Liver Disease

JAMA Internal Medicine, Journal Year: 2024, Volume and Issue: 184(4), P. 375 - 375

Published: Feb. 12, 2024

Importance Several oral antidiabetic drug (OAD) classes can potentially improve patient outcomes in nonalcoholic fatty liver disease (NAFLD) to varying degrees, but clinical data on which class is favored are lacking. Objective To investigate OAD associated with the best NAFLD and type 2 diabetes (T2D). Design, Setting, Participants This retrospective nonrandomized interventional cohort study used National Health Information Database, provided population-level for Korea. involved patients T2D concomitant NAFLD. Exposures Receiving either sodium-glucose cotransporter (SGLT2) inhibitors, thiazolidinediones, dipeptidyl peptidase-4 (DPP-4) or sulfonylureas, each combined metformin 80% more of 90 consecutive days. Main Outcomes Measures The main were regression assessed by index composite liver-related outcome (defined as hospitalization, mortality, transplant, hepatocellular carcinoma) using Fine-Gray model regarding competing risks. Results In total, 80 178 (mean [SD] age, 58.5 [11.9] years; 43 007 [53.6%] male) followed up 219 941 person-years, 4102 experiencing regression. When compared SGLT2 inhibitors (adjusted subdistribution hazard ratio [ASHR], 1.99 [95% CI, 1.75-2.27]), thiazolidinediones (ASHR, 1.70 1.41-2.05]), DPP-4 1.45 1.31-1.59]) a higher likelihood when 1.40 1.12-1.75]) 1.30-1.62]). Only 0.37 0.17-0.82]), not significantly lower incidence rates adverse sulfonylureas. Conclusions Relevance results this suggest that physicians may lean towards prescribing preferred individuals T2D, considering their potential benefits incidences outcomes. observational should prompt future research determine whether practices might merit reexamination.

Language: Английский

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Steatotic liver disease predicts cardiovascular disease and advanced liver fibrosis: A community-dwelling cohort study with 20-year follow-up

Metabolism, Journal Year: 2024, Volume and Issue: unknown, P. 155800 - 155800

Published: Jan. 1, 2024

Language: Английский

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Management of Metabolic-Associated Fatty Liver Disease/Metabolic Dysfunction-Associated Steatotic Liver Disease: From Medication Therapy to Nutritional Interventions

Nutrients, Journal Year: 2024, Volume and Issue: 16(14), P. 2220 - 2220

Published: July 11, 2024

Non-alcoholic fatty liver disease (NAFLD) is a common long-lasting that affects millions of people around the world. It best identified with hepatic fat build-up ultimately leads to inflammation and damage. The classification nomenclature NAFLD have long been controversial topic, until 2020 when group international experts recommended substituting MAFLD (metabolic dysfunction-associated FLD). was then terminologically complemented in 2023 by altering it MASLD, i.e., metabolic steatotic (MASLD). Both MASLD terminologies comprise element disorder, as they offer diagnostic benchmarks are embedded risk factors underlie disease. (as multisystemic disease) provides comprehensive definition includes larger population patients who at morbidity mortality, well adverse cardiovascular diabetes outcomes. highlights risks lean or normal weight individuals, factor has not accentuated discussed previous guidelines. Novel antihyperglycemic agents, anti-hyperlipidemic drugs, lifestyle modifications, nutritional interventions, exercise therapies extensively studied MASLD. Nutrition plays vital role managing both conditions, where centralizing on diet rich whole vegetables, fruits, foods, healthy fats, proteins, specific nutrients (e.g., omega-3 acids fibers) can improve insulin resistance reduce inflammation. Thus, essential understand nutrition these conditions work develop an individualized plan for optimal health. This review discusses prevention strategies NAFLD/MAFLD/MASLD management, particular attention correction.

Language: Английский

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Associations between estimated glucose disposal rate and arterial stiffness and mortality among US adults with non-alcoholic fatty liver disease

Frontiers in Endocrinology, Journal Year: 2024, Volume and Issue: 15

Published: May 8, 2024

Background The estimated glucose disposal rate (eGDR), an effective indicator of insulin resistance, has been related to acute coronary syndrome, ischemic stroke and heart failure. This study aims explore the relationship between eGDR arterial stiffness, all-cause mortality cardiovascular in patients with non-alcoholic fatty liver disease (NAFLD). Methods Participants NAFLD were chosen from National Health Nutrition Examination Survey (NHANES) 1999 2018. main outcomes are stiffness (represented by pulse wave velocity, ePWV), mortality. Multiple cox regression models, restricted cubic spline, sensitivity analysis subgroup carried out investigate correlation resistance indicators stiffness. Furthermore, receiver operating characteristic curves used compare predictive value triglyceride-glucose (TyG) index homeostasis model assessment (HOMA-IR) for Results In this study, a total 4,861 participants included analysis. After adjusting confounding factors multivariate weighted model, was inversely associated (Q4 vs. Q1, HR =0.65 (0.48-0.89, P=0.01) =0.35 (0.19-0.65, P<0.001). Compared TyG HOMA-IR, shows excellent (0.588 0.550 0.513, P < 0.001) (0.625 0.553 0.537, 0.001). addition, we found significant negative (β=-0.13(-0.14–0.11, P< However, HOMA-IR showed no Conclusions Low (an resistance) levels increased risk United States.

Language: Английский

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Prevalence of steatotic liver disease, advanced fibrosis and cirrhosis among community-dwelling overweight and obese individuals in the USA

Gut, Journal Year: 2024, Volume and Issue: 73(12), P. 2045 - 2053

Published: Aug. 7, 2024

There are limited prospective data among overweight and obese individuals on the prevalence of advanced fibrosis, cirrhosis using MRI-based methods in USA. The aim this study was to fill that gap knowledge by prospectively determining steatotic liver disease (SLD) its subcategories, fibrosis residing

Language: Английский

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Prevalence of Steatotic Liver Disease Based on a New Nomenclature in the Japanese Population: A Health Checkup-Based Cross-Sectional Study

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(4), P. 1158 - 1158

Published: Feb. 19, 2024

This cross-sectional study examined the prevalence and characteristics of steatotic liver disease (SLD) based on a recently introduced nomenclature in Japanese health checkup population. SLD was evaluated using ultrasonography, participants were categorized into metabolic dysfunction-associated (MASLD), dysfunction alcohol associated (MetALD), alcohol-associated/related (ALD), cryptogenic groups. The subclasses assessed, subgroup analyses conducted for non-obese (body mass index [BMI] ≤ 25 kg/m2) lean (BMI 23 populations. Among 694 participants, with median age 47 years comprising 54% males, MASLD, MetALD, ALD, 26%, 2%, 1%, respectively. A remarkable difference observed according to age, sex, BMI. Subgroup revealed heterogeneous demographic, clinical, biochemical parameters between categories. Individuals MetALD had higher gamma-glutamyl transferase levels, lower platelet counts, fibrosis-4 than did those MASLD. Furthermore, MASLD 13% 6%, provides preliminary information new

Language: Английский

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Prognosis of biopsy-confirmed metabolic dysfunction- associated steatotic liver disease: A sub-analysis of the CLIONE study

Clinical and Molecular Hepatology, Journal Year: 2024, Volume and Issue: 30(2), P. 225 - 234

Published: Jan. 24, 2024

Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative concept to nonalcoholic fatty (NAFLD). We aimed investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study.

Language: Английский

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Systemic metabolic abnormalities: Key drivers of complications and mortality in MASLD

Journal of Hepatology, Journal Year: 2024, Volume and Issue: 80(6), P. e246 - e248

Published: Feb. 2, 2024

Language: Английский

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Evolutionary changes in metabolic dysfunction-associated steatotic liver disease and risk of hepatocellular carcinoma: A nationwide cohort study

Clinical and Molecular Hepatology, Journal Year: 2024, Volume and Issue: 30(3), P. 487 - 499

Published: May 7, 2024

Background/Aims: To determine the association between evolutionary changes in metabolic dysfunction-associated steatotic liver disease (MASLD) status and risk of hepatocellular carcinoma (HCC) a nationwide population-based cohort.Methods: Information on study participants was derived from Korea National Health Insurance Service database. The population consisted 5,080,410 who underwent two consecutive biennial health screenings 2009 2012. All were followed up until HCC, death, or 31 December 2020. MASLD status, as assessed by fatty index cardiometabolic factors, including persistent non-MASLD, resolved MASLD, incident with HCC evaluated using multivariable-adjusted Cox proportional hazards regression.Results: Among 39,910,331 person-years follow-up, 4,801 developed HCC. incidence resolved, incident, approximately 2.2-, 2.3-, 4.7-fold higher, respectively, than that those non-MASLD among Korean adult population. When stratifying according to change (adjusted hazard ratio [aHR], 2.94; 95% confidence interval [CI], 2.68–3.21; P<0.001), (aHR, 1.85; CI, 1.63–2.10; 1.33; 1.18–1.50; P<0.001) had an increased compared non-MASLD.Conclusions: associated differential independent factors concomitant medications, providing additional information stratification patients MASLD.

Language: Английский

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Liver cancer risk across metabolic dysfunction-associated steatotic liver disease and/or alcohol: a nationwide study

The American Journal of Gastroenterology, Journal Year: 2024, Volume and Issue: unknown

Published: June 27, 2024

INTRODUCTION: New terminologies of metabolic dysfunction-associated steatotic liver disease (MASLD) have been developed. We assessed hepatocellular carcinoma (HCC) risk across MASLD and/or alcohol intake. METHODS: included participants aged 40–79 years receiving a national health checkup from 2009 to 2010 in the Republic Korea, classified as follows: non-MASLD, MASLD, with increased intake (MetALD; weekly 210–420 g for male and 140–350 female individuals), alcohol-associated (ALD; excessive ≥420 or ≥350 individuals). The primary outcome was HCC incidence. estimated using multivariable Cox proportional hazard models. RESULTS: Among 6,412,209 participants, proportions MetALD, ALD cases were 59.5%, 32.4%, 4.8%, 3.4%, respectively. During follow-up (median 13.3 years), 27,118 had newly developed HCC. Compared (adjusted ratio [aHR] 1.66, 95% confidence interval [CI] 1.62–1.71) MetALD (aHR 2.17, CI 2.08–2.27) 2.34, 2.24–2.45) stepwise manner. Furthermore, older non-cirrhosis subgroups more vulnerable detrimental effects intake, concerning risk. older, female, cirrhosis subgroups, poses similar risks ALD. DISCUSSION: manner, compared non-MASLD. For an effective prevention HCC, comprehensive approach should be required modify both dysfunction habit.

Language: Английский

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