JHEP Reports, Journal Year: 2023, Volume and Issue: 5(5), P. 100694 - 100694
Published: Feb. 3, 2023
Per- and polyfluoroalkyl substances (PFAS) are widespread pollutants with demonstrated hepatotoxicity. Few studies have examined the association between PFAS fatty liver disease (FLD) risk in an adult population.
Language: Английский
Frontiers in Cellular and Infection Microbiology, Journal Year: 2022, Volume and Issue: 12
Published: Nov. 8, 2022
The incidence of nonalcoholic fatty liver disease (NAFLD) is increasing recently and has become one the most common clinical diseases. Since pathogenesis NAFLD not been completely elucidated, few effective therapeutic drugs are available. As “second genome” human body, gut microbiota plays an important role in digestion, absorption metabolism food drugs. Gut can act as driver to advance occurrence development NAFLD, accelerate its progression cirrhosis hepatocellular carcinoma. Growing evidence demonstrated that metabolites directly affect intestinal morphology immune response, resulting abnormal activation inflammation endotoxemia; dysbiosis also causes dysfunction gut-liver axis via alteration bile acid pathway. Because composition diversity disease-specific expression characteristics, holds strong promise novel biomarkers targets for NAFLD. Intervening microbiota, such antibiotic/probiotic treatment fecal transplantation, a strategy preventing treating In this article, we have reviewed emerging functions association bacterial components different stages discussed potential implications diagnosis therapy.
Language: Английский
Citations
102
Cardiovascular Diabetology, Journal Year: 2022, Volume and Issue: 21(1)
Published: Dec. 3, 2022
The newly proposed term "metabolic dysfunction-associated fatty liver disease" (MAFLD) is replacing the old "non-alcoholic (NAFLD) in many global regions, because it better reflects pathophysiology and cardiometabolic implications of this common disease. change terminology from NAFLD to MAFLD not simply a single-letter an acronym, since defined by set specific positive diagnostic criteria. In particular, definition specifically incorporates within classification recognized cardiovascular risk factors. Although convincing evidence supports significant association between both MAFLD, with increased CVD morbidity mortality, neither nor have received sufficient attention Cardiology community. fact, there paucity scientific guidelines focusing on burdensome disease professional societies. This Perspective article discusses rationale clinical relevance for Cardiologists definition.
Language: Английский
Citations
100
Gastroenterology, Journal Year: 2023, Volume and Issue: 165(4), P. 1080 - 1088
Published: Aug. 4, 2023
DescriptionThe purpose of this American Gastroenterological Association (AGA) Clinical Practice Update Expert Review is to provide clinicians with guidance on the use noninvasive tests (NITs) in evaluation and management patients nonalcoholic fatty liver disease (NAFLD). NAFLD affects nearly 30% global population a growing cause end-stage liver-related health care resource utilization. However, only minority all experience outcome. It therefore critically important for assess prognosis identify those increased risk progression negative clinical outcomes at time initial assessment. equally trajectory over time, particularly response currently available therapeutic approaches. The reference standard assessment monitoring histologic examination biopsy specimens. There are, however, many limitations biopsies their reading that have limited routine practice. utilization NITs facilitates stratification longitudinal NAFLD. This update provides best practice advice based review literature clinicians. Accordingly, combination evidence consensus-based expert opinion, without formal rating strength quality evidence, was used develop these statements.MethodsThis commissioned approved by AGA Institute Updates Committee Governing Board timely topic high importance membership underwent internal peer external through procedures Gastroenterology. These statements were drawn from published opinion. Because systematic reviews not performed, do carry ratings or presented considerations.Best Advice StatementsBest 1NITs can be diagnostic NAFLD.Best 2A Fibrosis 4 Index score <1.3 associated strong predictive value advanced hepatic fibrosis may useful exclusion 3A 2 more combining serum biomarkers and/or imaging-based preferred staging whose >1.3.Best 4Use accordance manufacturer's specifications (eg, ascites pacemakers) minimize discordant results adverse events.Best 5NITs should interpreted context consideration pertinent data physical examination, biochemical, radiographic, endoscopic) optimize positive identification fibrosis.Best 6Liver considered NIT are indeterminate discordant; conflict other clinical, laboratory, radiologic findings; when alternative etiologies suspected.Best 7Serial using regression inform (ie, lifestyle modification intervention).Best 8Patients suggestive (F3) cirrhosis (F4) surveillance complications hepatocellular carcinoma screening variceal per Baveno criteria). Patients (F4), monitored serial stiffness measurement; vibration controlled transient elastography; magnetic resonance elastography, given its correlation clinically significant portal hypertension decompensation. statements. considerations. Best Statements A >1.3. Use events. fibrosis. Liver suspected. Serial intervention). Nonalcoholic (NAFLD) an emerging public crisis. approximately worldwide population.1Younossi Z.M. Golabi P. Paik J.M. et al.The epidemiology steatohepatitis (NASH): review.Hepatology. 2023; 77: 1335-1347Crossref PubMed Scopus (230) Google Scholar As metabolic representing manifestation systemic disorder, morbidity mortality, as well substantial utilization.2Allen A.M. Lazarus J.V. Younossi Healthcare socioeconomic costs NAFLD: framework navigate uncertainties.J Hepatol. 79: 209-217Abstract Full Text PDF (20) Scholar,3Younossi Non-alcoholic - perspective.J 2019; 70: 531-544Abstract (1252) traditional approach defining severity has been perform grading necroinflammation fibrosis—2 key features severity. Disease activity refers biological processes leading injury inflammation, whereas stage amount scarring thus proximity cirrhosis. strongest predictor future greatest prognostic information. Natural history studies found fibrosis, specifically cirrhosis, serves meaningful surrogate outcomes, such (HCC), decompensation hemorrhage, ascites, encephalopathy), transplantation, death.3Younossi Scholar,4Angulo Kleiner D.E. Dam-Larsen S. al.Liver but no features, long-term disease.Gastroenterology. 2015; 149: 389-397.e10Abstract (2012) biopsies, invasive; variable sampling5Ratziu V. Charlotte F. Heurtier A. al.Sampling variability 2005; 128: 1898-1906Abstract (1630) Scholar; subject intra- interobserver variability; and, rarely, severe fatal procedural complications. impractical biopsy-based prevalent chronic Noninvasive emerged validated tools address problem early Guidance limited. We reviewed (AF) predict guide responses therapies. subcategorized into serum-based biomarkers. Multiple models biochemical measurements proposed detect focus will readily available, point-of-care, cost-effective testing strategies stratify AF. designed (BPA) several issues pertaining NITs. developed BPA 8 issues. journal represent current studied populations. undertaken upon confirmation diagnosis NAFLD, competing diagnoses, presenting signs symptoms good Furthermore, final patient must take unique having discussed "pros cons" Among (NASH) progression. Most experts believe development NASH fibrosis). Within gastroenterology practice, implemented knowledge presence patient's access engagement system, ability follow recommendations, effective extrahepatic also improve AF, defined 3 (bridging fibrosis) (cirrhosis) biopsy.6Sanyal A.J. Van Natta M.L. Clark J. al.Prospective study adults disease.N Engl J Med. 2021; 385: 1559-1569Crossref (347) synchronized across liver, stages 3–4 continuum Initial applied viral hepatitis,7Sterling R.K. Lissen E. Clumeck N. al.Development simple index HIV/HCV coinfection.Hepatology. 2006; 43: 1317-1325Crossref (3120) subsequently diseases, NAFLD.8McPherson Stewart S.F. Henderson al.Simple non-invasive scoring systems reliably exclude non-alcoholic disease.Gut. 2010; 59: 1265-1269Crossref (660) Several [FIB-4] score, [NAFLD-FS], aspartate aminotransferase platelet ratio [APRI]; FIB-4 most validated. calculated algorithm age, alanine aminotransferase, count7Sterling outperforms calculations low probability High values all-cause population-based studies.9Unalp-Arida Ruhl C.E. scores mortality United States population.Hepatology. 2017; 66: 84-95Crossref (145) Although does outperform proprietary FibroTest/FibroSure [eviCore Healthcare], FIBROSpect [Prometheus Laboratories], Hepamet Score, Pro-C3 [ADAPT], FibroMeter [ARUP Hepascore), recommended first-line practitioners simplicity cost.10Kanwal Shubrook J.H. Adams L.A. al.Clinical pathway 161: 1657-1669Abstract (186) Scholar, 11Cusi K. Isaacs Barb D. al.American Endocrinology Guideline Diagnosis Management Fatty Primary Care Settings: Co-Sponsored Study Diseases (AASLD).Endocr Pract. 2022; 28: 528-562Abstract (247) 12Rinella M.E. Neuschwander-Tetri B.A. Siddiqui M.S. al.AASLD disease.Hepatology. 1797-1835Crossref (238) Enhanced (ELF; Siemens Healthineers USA) test, blood test consisting elements involved matrix turnover, NIS2+™ (property GENFIT; Loos, France), optimization NIS4® France) technology, blood-based detection "at-risk" F2 higher, respectively. An ELF ≥9.8 identifies events.13Miele L. De Michele T. Marrone G. al.Enhanced reliable tool assessing setting.Int Biol Markers. 32: e397-e402Crossref (26) Scholar,14Guha I.N. Parkes Roderick al.Noninvasive markers disease: validating European Panel exploring markers.Hepatology. 2008; 47: 455-460Crossref (621) Such options secondary assessments elastography available. Imaging-based biomarkers, (VCTE), shear wave (SWE), (MRE), frequently Ultrasound-based 3-dimensional (Velacur) iron-corrected T1 imaging, although less frequently, technologies. Currently, there minimum cutoff established accuracy AF Using histology standard, meta-analysis 10 evaluated performance imaging NAFLD.15Xiao Zhu Xiao X. al.Comparison laboratory tests, ultrasound, meta-analysis.Hepatology. 1486-1501Crossref (569) absence 1.24–1.45 range 2759 demonstrated mean sensitivity 77.8% (range, 63.0%–90.0%), specificity 71.2% 55.5%–88.0%), (PPV) 40.3% 24.0%–50.6%), (NPV) 92.7% 88.0%–98.0%). threshold otherwise adapted being ideal NAFLD-FS –1.455 3057 had 72.9% 22.7%–96.0%), 73.8% 42.9%–100%), PPV 50.4% 24.0%–100%), NPV 91.8% 81.3%–98.1%).15Xiao APRI 1.00 1101 43.2% 27.0%–67.0%), 86.1% 81.0%–89.0%), 33.5% 26.0%–40.0%), 89.8% 84.0%–95.0%). FIB-4, NAFLD-FS, APRI), Performance improved NPV. 1.92–2.48 439 76.4% 72.7%–80.0%), 82.4% 76.0%–88.7%), 39.0% 37.5%–40.4%), 96.2% 95.5%–96.9%). –0.014 197 80%, 80.8%, 42.8%, 95.7%. For 0.54–2.00 790 patients, 56.2% 20.5%–77.3%), 83.6% 56.3%–100%), 37.8% 16.7%–100%), 91.7% 83.0%–96.7%). Despite some profile consistent concordance reassurance stratification16Morling J.R. Fallowfield J.A. Guha al.Using people type diabetes mellitus: Edinburgh study.J 2014; 60: 384-391Abstract (58) (Table 1).Table 1Noninvasive Tests Accuracy Advanced (F3–4) DiseaseNoninvasive testRecommended rule fibrosisAF biopsy, AUROC (95% CI)Serum score>2.670.83 (0.79–0.86) NAFLD-FS>0.6760.75 (0.71–0.79) APRI>0.840.76 (0.74–0.79) ELF>9.80.81 (0.77–0.85)Imaging VCTE, kPa>12.00.93 (0.89–0.96) SWE, kPa>8.00.89 (0.80–0.98) MRE, kPa>3.60.93 (0.90–0.96)AUROC, area under receiver operating curve. Open table new tab AUROC, Evaluation VCTE M-probe within same 1540 9 7.6–8 kPa 88.9% 65.0%–100.0%), 77.2% 65.9%–90.2%), 43.4% 27.0%–52.0%), 95.5% 86.0%–100%). XL-probe 5.7–9.3 579 75.3% 57.0%–91.0%), 74.0% 54.0%–90.0%), 58.7% 45.0%–71.0%), 88.7% 84.0%–93.0%). In similarly improved; 10.3–11.3 1362 87.7% 78.0%–100%), 86.3% 82.0%–90.0%), 46.8% 33.0%–75.0%), 98.0% 94.0%–100%). XL-probe, broader 7.2–16 654 87.8% (71.0%–100%), 82.0% (70.0%–91.0%), 39.8% 31.0%–53.0%), 97.8% 95.0%–100%). SWE MRE excellent cutoffs 3.02–10.6 among 429 89.9% 88.2%–91.5%), 90.0%–94.0%), 88.2% 83.3%–93.1%), 93.4% 92.6%–94.2%). 3.36 181 100%, 85.6%, 55.2%, 100%. 3.62–4.8 628 85.7% 74.5%–92.2%), 90.8% 86.9%–93.3%), 71.0% 67.9%–74.5%), 81.0%–98.1%). measurement (LSM) 4.15–6.7 384 86.6% 80.0%–90.9%), 91.4%–94.5%), 53.4% 44.4%–58.8%), 98.8% 98.1%–99.2%).15Xiao NAFLD,10Kanwal it if uncertainty exists, need concomitant cross-sectional techniques unavailable. goal algorithms establish confidence. Indeterminate require additional testing. NITs, reported curve, sensitivity, specificity. utility dependent prevalence target population. populations, endocrinology clinics, practices likely differ Shah al17Shah A.G. Lydecker Murray disease.Clin Gastroenterol 2009; 7: 1104-1112Abstract (999) compared 7 national database predominantly Caucasian subjects histologically confirmed Statistically differences between groups included female gender nondiabetic status earlier (F1–2) vs cohorts. <1.30 74% 71%, More importantly, 90% When predictively 96% 10% dropped 73% 50% prevalence. comparison follows, remember than functions prevalence, hence, specialty clinics general distinction. One notable limitation proportion populations.18Sun W. Cui H. Li index, BARD prediction adult study.Hepatol Res. 2016; 46: 862-870Crossref (160) this, 30%, reasonable choose augment individuals AF.f influenced age performs poorly younger 35 years older 65 years. alone, poor adults.19Mosca Della Volpe Alisi al.Non-invasive adolescents disease.Front Pediatr. 10885576Crossref (5) Scholar,20van Kleef Sonneveld M.J. de Man R.A. al.Poor elderly implications EASL guideline.J 76: 245-246Abstract (9) Given heterogeneity diverse overreliance 1 reduce identifying both primary specialist contexts. second biomarker, ELF, considered.12Rinella referral Kingdom determination comprehensive revealed benefit sequential testing.21Srivastava Gailer R. Tanwar disease.J 71: 371-378Abstract (271) Of 1452 years, 1022 (71.3%) F
Language: Английский
Citations
98
The Lancet. Gastroenterology & hepatology, Journal Year: 2023, Volume and Issue: 8(12), P. 1080 - 1093
Published: Oct. 3, 2023
Language: Английский
Citations
93
Journal of Hepatology, Journal Year: 2023, Volume and Issue: 79(6), P. 1524 - 1541
Published: Sept. 18, 2023
While the links between metabolic dysfunction associated steatotic liver disease (MASLD) and obesity, insulin resistance are widely appreciated, there a host of complex interactions other endocrine axes. it can be difficult to definitively distinguish direct causal relationships those attributable increased adipocyte mass, is substantial evidence indirect specific dysregulation severity MASLD. Strong effects exists for low levels growth hormone, sex hormones, thyroid hormone with development disease. The impact steroid e.g. cortisol dehydropepiandrosterone, adipokines much more divergent. Thoughtful assessment, based on individual risk factors findings, also management non-insulin axes should performed in evaluation Multiple therapeutic pharmaceutical targets have emerged that leverage various reduce fibroinflammatory cascade steatohepatitis (MASH).
Language: Английский
Citations
86
The Lancet. Gastroenterology & hepatology, Journal Year: 2023, Volume and Issue: 8(7), P. 660 - 670
Published: April 13, 2023
Language: Английский
Citations
84
Hepatology Communications, Journal Year: 2023, Volume and Issue: 7(10)
Published: Oct. 1, 2023
Background: The latest meta-analyses suggest NAFLD is increasing globally. Its limitations may preclude accurate estimates. We evaluated the global burden and its’ trends in prevalence liver–related mortality (LRM) by sex, age, region, country over past 3 decades using data from Global Burden of Disease (GBD) 2019 study. Methods: Crude age-standardized NAFLD-LRM rates were obtained for all-age individuals with 204 countries/territories between 1990 2019. Joinpoint trend analysis assessed time trends. Weighted average annual percent change (APC) period 1990–2019 2010–2019 reported. Results: All-age (children adults) crude increased:10.5% (561 million)–16.0% (1,236 million); an APC increase: + 1.47% (95% CI, 1.44%, 1.50%). Among adults (+20 y), increased (1990: 17.6%, 2019:23.4%; APC: 1.00%, 95% CI: 0.97%, 1.02%). In groups, rate (per 100,000) 1.75%, 2019: 2.18%; 0.77% 0.70%, 0.84%). By analysis, 2010 to 2019, worsening LRM observed among 202 167 countries, respectively. there 1.24 billion prevalent cases 168,969 associated deaths; Asia regions accounted 57.2% 46.2% NAFLD-LRM. highest was Middle East North Africa (LRM 26.5%); Central Latin America (5.90 per 100,000). Conclusions: globally groups—over 80% countries experienced increase These have important policy implications affected health.
Language: Английский
Citations
82
Metabolism, Journal Year: 2024, Volume and Issue: 154, P. 155835 - 155835
Published: March 19, 2024
Language: Английский
Citations
79
Diabetes & Metabolism Journal, Journal Year: 2023, Volume and Issue: 47(5), P. 575 - 594
Published: Sept. 26, 2023
In May 2023, the Committee of Clinical Practice Guidelines Korean Diabetes Association published revised clinical practice guidelines for adults with diabetes and prediabetes. We incorporated latest research findings through a comprehensive systematic literature review applied them in manner suitable population. These are designed all healthcare providers nationwide, including physicians, experts, certified educators who manage patients or individuals at risk developing diabetes. Based on recent changes international results epidemiological study, recommended age screening has been lowered. collaboration relevant medical societies, recently managing hypertension dyslipidemia have into this guideline. An abridgment containing practical information patient education management clinic was separately.
Language: Английский
Citations
76
Diabetes Care, Journal Year: 2023, Volume and Issue: 47(Supplement_1), P. S52 - S76
Published: Dec. 11, 2023
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide components diabetes care, general treatment goals guidelines, tools evaluate quality care. Members ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating Standards annually, or more frequently as warranted. For a detailed description standards, statements, reports, well evidence-grading system full list Committee members, please refer Introduction Methodology. Readers who wish comment on invited do so at professional.diabetes.org/SOC.
Language: Английский
Citations
75