The Lancet. Gastroenterology & hepatology,
Journal Year:
2023,
Volume and Issue:
8(9), P. 829 - 836
Published: July 4, 2023
Summary
Background
Data
are
scarce
regarding
the
development
of
hepatic
decompensation
in
patients
with
non-alcoholic
fatty
liver
disease
(NAFLD)
and
without
type
2
diabetes.
We
aimed
to
assess
risk
people
NAFLD
Methods
did
a
meta-analysis
individual
participant-level
data
from
six
cohorts
USA,
Japan,
Turkey.
Included
participants
had
magnetic
resonance
elastography
between
Feb
27,
2007,
June
4,
2021.
Eligible
studies
included
those
fibrosis
characterisation
by
elastography,
longitudinal
assessment
for
death,
adult
(aged
≥18
years)
NAFLD,
whom
were
available
presence
diabetes
at
baseline.
The
primary
outcome
was
decompensation,
defined
as
ascites,
encephalopathy,
or
variceal
bleeding.
secondary
hepatocellular
carcinoma.
used
competing
regression
using
Fine
Gray
subdistribution
hazard
ratio
(sHR)
compare
likelihood
Death
event.
Findings
2016
(736
diabetes;
1280
diabetes)
this
analysis.
1074
(53%)
female
mean
age
57·8
years
(SD
14·2)
BMI
31·3
kg/m2
7·4).
Among
1737
(602
1135
data,
105
developed
over
median
follow-up
time
2·8
(IQR
1·4–5·5).
Participants
significantly
higher
1
year
(3·37%
[95%
CI
2·10–5·11]
vs
1·07%
[0·57–1·86]),
3
(7·49%
[5·36–10·08]
2·92%
[1·92–4·25]),
5
(13·85%
[10·43–17·75]
3·95%
[2·67–5·60])
than
(p<0·0001).
After
adjustment
multiple
confounders
(age,
BMI,
race),
(sHR
2·15
1·39–3·34];
p=0·0006)
glycated
haemoglobin
(1·31
1·10–1·55];
p=0·0019)
independent
predictors
decompensation.
association
remained
consistent
after
baseline
stiffness
determined
elastography.
Over
2·9
1·4–5·7),
22
1802
analysed
(18
639
four
1163
incident
carcinoma
(1·34%
0·64–2·54]
0·09%
[0·01–0·50],
(2·44%
[1·36–4·05]
0·21%
[0·04–0·73]),
(3·68%
[2·18–5·77]
0·44%
[0·11–1·33])
Type
an
predictor
5·34
[1·67–17·09];
p=0·0048).
Interpretation
is
associated
Funding
National
Institute
Diabetes
Digestive
Kidney
Diseases.
Gut,
Journal Year:
2023,
Volume and Issue:
unknown, P. gutjnl - 331003
Published: Oct. 31, 2023
Objective
We
explored
clinical
implications
of
the
new
definition
metabolic
dysfunction-associated
steatotic
liver
disease
(MASLD)
by
assessing
its
prevalence
and
associated
cardiovascular
(CVD)
risk.
Design
From
nationwide
health
screening
data,
we
identified
9
775
066
adults
aged
20–79
who
underwent
examination
in
2009.
Participants
were
categorised
into
four
mutually
exclusive
groups:
(1)
MASLD;
(2)
MASLD
with
increased
alcohol
intake
(MetALD);
(3)
other
combined
aetiology
(the
three
collectively
referred
to
as
MASLD/related
(SLD));
(4)
no
SLD.
SLD
was
determined
fatty
index
≥30.
The
primary
outcome
CVD
event,
defined
a
composite
myocardial
infarction,
ischaemic
stroke,
heart
failure
or
death.
Results
MASLD,
MetALD
27.5%,
4.4%
1.5%,
respectively.
A
total
8
808
494
participants
without
prior
followed
up
for
median
12.3
years,
during
which
272
863
events
occurred.
cumulative
incidence
multivariable-adjusted
risk
higher
than
those
(HR
1.38
(95%
CI
1.37
1.39)).
Multivariable-adjusted
HR
CI)
1.39
(1.38
1.40)
1.28
(1.26
1.30)
1.30
1.34)
compared
absence
any
these
conditions.
also
non-alcoholic
respective
condition.
Conclusion
Over
one-third
Korean
have
bear
high
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).
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.
The Lancet. Gastroenterology & hepatology,
Journal Year:
2023,
Volume and Issue:
8(9), P. 829 - 836
Published: July 4, 2023
Summary
Background
Data
are
scarce
regarding
the
development
of
hepatic
decompensation
in
patients
with
non-alcoholic
fatty
liver
disease
(NAFLD)
and
without
type
2
diabetes.
We
aimed
to
assess
risk
people
NAFLD
Methods
did
a
meta-analysis
individual
participant-level
data
from
six
cohorts
USA,
Japan,
Turkey.
Included
participants
had
magnetic
resonance
elastography
between
Feb
27,
2007,
June
4,
2021.
Eligible
studies
included
those
fibrosis
characterisation
by
elastography,
longitudinal
assessment
for
death,
adult
(aged
≥18
years)
NAFLD,
whom
were
available
presence
diabetes
at
baseline.
The
primary
outcome
was
decompensation,
defined
as
ascites,
encephalopathy,
or
variceal
bleeding.
secondary
hepatocellular
carcinoma.
used
competing
regression
using
Fine
Gray
subdistribution
hazard
ratio
(sHR)
compare
likelihood
Death
event.
Findings
2016
(736
diabetes;
1280
diabetes)
this
analysis.
1074
(53%)
female
mean
age
57·8
years
(SD
14·2)
BMI
31·3
kg/m2
7·4).
Among
1737
(602
1135
data,
105
developed
over
median
follow-up
time
2·8
(IQR
1·4–5·5).
Participants
significantly
higher
1
year
(3·37%
[95%
CI
2·10–5·11]
vs
1·07%
[0·57–1·86]),
3
(7·49%
[5·36–10·08]
2·92%
[1·92–4·25]),
5
(13·85%
[10·43–17·75]
3·95%
[2·67–5·60])
than
(p<0·0001).
After
adjustment
multiple
confounders
(age,
BMI,
race),
(sHR
2·15
1·39–3·34];
p=0·0006)
glycated
haemoglobin
(1·31
1·10–1·55];
p=0·0019)
independent
predictors
decompensation.
association
remained
consistent
after
baseline
stiffness
determined
elastography.
Over
2·9
1·4–5·7),
22
1802
analysed
(18
639
four
1163
incident
carcinoma
(1·34%
0·64–2·54]
0·09%
[0·01–0·50],
(2·44%
[1·36–4·05]
0·21%
[0·04–0·73]),
(3·68%
[2·18–5·77]
0·44%
[0·11–1·33])
Type
an
predictor
5·34
[1·67–17·09];
p=0·0048).
Interpretation
is
associated
Funding
National
Institute
Diabetes
Digestive
Kidney
Diseases.
