Clinical utility of the MAFLD definition

Journal of Hepatology, Journal Year: 2020, Volume and Issue: 74(4), P. 989 - 991

Published: Dec. 24, 2020

Language: Английский

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FIB-4 First in the Diagnostic Algorithm of Metabolic-Dysfunction-Associated Fatty Liver Disease in the Era of the Global Metabodemic

Life, Journal Year: 2021, Volume and Issue: 11(2), P. 143 - 143

Published: Feb. 14, 2021

The prevalence of obesity or metabolic syndrome is increasing worldwide (globally metabodemic). Approximately 25% the adult general population suffering from nonalcoholic fatty liver disease (NAFLD), which has become a serious health problem. In 2020, global experts suggested that nomenclature NAFLD should be updated to metabolic-dysfunction-associated (MAFLD). Hepatic fibrosis most significant determinant all cause- and -related mortality in MAFLD. non-invasive test (NIT) urgently required evaluate hepatic fibrosis-4 (FIB-4) index first triaging tool for excluding advanced because its accuracy, simplicity, cheapness, especially physicians endocrinologists, although FIB-4 several drawbacks. Accumulating evidence vibration-controlled transient elastography (VCTE) enhanced (ELF) may useful as second step after by index. leading cause MAFLD cardiovascular (CVD), extrahepatic malignancy, liver-related diseases. often complicates chronic kidney (CKD), resulting increased simultaneous transplantation. could predictor not only incident hepatocellular carcinoma, but also prevalent CKD, CVD, malignancy. Although NITs milestones evaluating treatment efficacy have never been established, expected reflect histological longitudinal studies. We here review role management

Language: Английский

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Non-obese non-alcoholic fatty liver disease (NAFLD) in Asia: an international registry study

Metabolism, Journal Year: 2021, Volume and Issue: 126, P. 154911 - 154911

Published: Oct. 13, 2021

A significant proportion of the non-alcoholic fatty liver disease (NAFLD) population is non-obese. Prior studies reporting severity NAFLD amongst non-obese patients were heterogenous. Our study, using data from largest biopsy-proven international registry within Asia, aims to characterize demographic, metabolic and histological differences between obese patients.1812 across nine countries in Asia assessed 2006 2019 pooled into a curated clinical registry. Demographic, evaluated. The performance Fibrosis-4 index for fibrosis (FIB-4) score (NFS) identify advanced varying obesity subgroups was compared. random forest analysis performed novel predictors steatohepatitis patients.One-fifth (21.6%) Non-obese had lower proportions NASH (50.5% vs 56.5%, p = 0.033) (14.0% 18.7%, 0.033). Metabolic syndrome individuals associated with (OR 1.59, 95% CI 1.01-2.54, 0.047) 1.88, 0.99-3.54, 0.051). FIB-4 better than NFS (AUROC 81.5% 73.7%, < 0.001) when classifying F2-4 patients. Haemoglobin, GGT, waist circumference cholesterol are additional variables found on useful identifying disease.A substantial has or fibrosis. FIB-4, compared identifies disease. Serum cholesterol, haemoglobin circumference, which neither components nor important biomarkers

Language: Английский

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Non-Alcoholic Fatty Liver Disease and Risk of Macro- and Microvascular Complications in Patients with Type 2 Diabetes

Journal of Clinical Medicine, Journal Year: 2022, Volume and Issue: 11(4), P. 968 - 968

Published: Feb. 12, 2022

Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome. To date, NAFLD most frequent chronic seen day by in clinical practice across high-income countries, affecting nearly 25-30% adults general population and up to 70% patients with T2DM. Over last few decades, it clearly emerged that a "multisystemic disease" leading cause death among cardiovascular (CVD). Indeed, several observational studies some meta-analyses have documented NAFLD, especially its advanced forms, strongly associated fatal non-fatal events, as well specific cardiac complications, including sub-clinical myocardial alteration dysfunction, heart valve diseases arrhythmias. Importantly, various studies, these associations remained significant after adjustment for established risk factors other confounders. Additionally, also reported independently microvascular conditions, such kidney distal or autonomic neuropathy. Conversely, data regarding potential association between retinopathy are scarce often conflicting. This narrative review will describe current evidence about macro- manifestations CVD, We briefly discuss biological mechanisms underpinning forms CVD.

Language: Английский

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PNPLA3I148M gene variant and chronic kidney disease in type 2 diabetic patients with NAFLD: Clinical and experimental findings

Liver International, Journal Year: 2020, Volume and Issue: 40(5), P. 1130 - 1141

Published: March 3, 2020

Emerging evidence suggests an association between patatin-like phospholipase domain-containing protein-3 (PNPLA3) rs738409 (I148M protein variant) and risk of chronic kidney disease (CKD), but the mechanisms underpinning this are poorly understood.We studied 157 patients with type 2 diabetes (T2DM) who underwent ultrasonography vibration-controlled transient elastography for diagnosing nonalcoholic fatty liver (NAFLD). CKD was defined as estimated glomerular filtration rate (e-GFR) <60 mL/min/1.73 m2 and/or abnormal albuminuria. We surveyed PNPLA3 mRNA expression in human tissues, using a positive control, also measured levels cell lines represented liver.In all, 112 had NAFLD 43 CKD. Patients homozygous I148M variant (n = 11) lower e-GFR (60.6 ± 11.7 vs 77.8 15.9 83.5 16.5 , P .0001) higher prevalence (63.6% 24.2% 25.0%, .028), compared to those I/M 66) I/I 80) genotype. The homozygosity (P < (adjusted-odds ratio 6.65; 95% CI 1.65-26.8, .008) independent severity (as detected by stiffness ≥7kPa) other factors. greatest renal cortex, podocytes showed high levels, comparable that hepatocytes hepatic stellate cells respectively.The associated CKD, independently common factors were particularly podocytes.

Language: Английский

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Hepatocyte apoptosis fragment product cytokeratin-18 M30 level and non-alcoholic steatohepatitis risk diagnosis: an international registry study

Chinese Medical Journal, Journal Year: 2023, Volume and Issue: unknown

Published: Feb. 27, 2023

Abstract Background: Liver biopsy for the diagnosis of non-alcoholic steatohepatitis (NASH) is limited by its inherent invasiveness and possible sampling errors. Some studies have shown that cytokeratin-18 (CK-18) concentrations may be useful in diagnosing NASH, but results across been inconsistent. We aimed to identify utility CK-18 M30 as an alternative liver non-invasive identification NASH. Methods: Individual data were collected from 14 registry centers on patients with biopsy-proven fatty disease (NAFLD), all patients, circulating levels measured. Individuals a NAFLD activity score (NAS) ≥5 including ≥1 each steatosis, ballooning, lobular inflammation diagnosed having definite NASH; individuals NAS ≤2 no fibrosis (NAFL). Results: A total 2571 participants screened, 1008 (153 NAFL 855 NASH) finally enrolled. Median higher NASH than those (mean difference 177 U/L; standardized mean [SMD]: 0.87 [0.69–1.04]). There was interaction between serum alanine aminotransferase, body mass index (BMI), hypertension ( P < 0.001, = 0.026 0.049, respectively). positively associated histological most centers. The area under receiver operating characteristics (AUROC) 0.750 (95% confidence intervals: 0.714–0.787), at Youden's maximum 275.7 U/L. Both sensitivity (55% [52%–59%]) positive predictive value (59%) not ideal. Conclusions: This large multicenter study shows measurement isolation non-invasively

Language: Английский

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Adverse effect of PNPLA3 p.I148M genetic variant on kidney function in middle‐aged individuals with metabolic dysfunction

Alimentary Pharmacology & Therapeutics, Journal Year: 2023, Volume and Issue: 57(10), P. 1093 - 1102

Published: March 22, 2023

Summary Background The PNPLA3 p.I148M variant is the main genetic determinant of nonalcoholic fatty liver disease, and silencing being evaluated to treat this condition. Data suggest that predisposes kidney damage, but relative contribution function, compared overall susceptibility, not defined. Aims We aimed assess effect on estimated glomerular filtration rate (eGFR) in individuals with metabolic dysfunction. Methods included 1144 middle‐aged from Liver‐Bible‐2022 cohort. Glomerular was using Chronic Kidney Disease Epidemiology Collaboration equation. eGFR CKD‐EPI levels tested under additive models adjusted for clinical predictors, ethnicity a polygenic risk score chronic disease (PRS‐CKD). In subset 144 individuals, we examined over median follow‐up 17 months. Results associated lower (−1.24 mL/min/1.73 m 2 per allele, 95% CI: −2.32 −0.17; p = 0.023), independent age, sex, height, waist circumference, systolic blood pressure, LDL‐cholesterol, transaminases, fasting insulin, albuminuria, lipid‐lowering drugs, PRS‐CKD score. prospective evaluation, independently faster decline (ΔeGFR −3.57 −6.94 −0.21; 0.037). Conclusions found detrimental impact This association established factors, predisposition CKD. may protect against damage progression carriers.

Language: Английский

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PNPLA3 gene and kidney disease

Exploration of Medicine, Journal Year: 2020, Volume and Issue: 1(1), P. 42 - 50

Published: Feb. 29, 2020

Chronic kidney disease (CKD) is a regularly seen in clinical practice. At present, CKD described as change of structure and/or function and it classified relation to cause, values glomerular filtration rate albuminuria category. Seeing that closely linked the development end-stage renal other comorbidities, determination additional independent predictors for clinically necessary. there evidence associating non-alcoholic fatty liver (NAFLD) with CKD, thereby suggesting NAFLD patients may require intensive surveillance reduce their risk CKD. In 2008, genome-wide association studies documented an between variant rs738409 (C > G p.I148M) patatin-like phospholipase domain containing 3 (PNPLA3) gene (mainly implicated lipid regulation) entire spectrum (i.e., steatosis, steatohepatitis, fibrosis, hepatocellular carcinoma). last years, accumulating epidemiological suggests existence relationship PNPLA3 indicating also contribute injury. This particular scientific interest, such explain, at least part, disease. this narrative review, we will discuss regarding putative biological mechanisms underpinning relationship, possible future perspective.

Language: Английский

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Non-alcoholic fatty liver and chronic kidney disease: Retrospect, introspect, and prospect

World Journal of Gastroenterology, Journal Year: 2021, Volume and Issue: 27(17), P. 1864 - 1882

Published: April 28, 2021

With the growing prevalence of obesity and diabetes in United States across world, a rise overall incidence non-alcoholic fatty liver disease (NAFLD) is expected. The risk factors for NAFLD are also associated with development chronic kidney (CKD). We review epidemiology, factors, genetics, implications gut dysbiosis, specific pathogenic mechanisms linking to CKD. Mechanisms such as ectopic lipid accumulation, cellular signaling abnormalities, interplay between fructose consumption uric acid accumulation have led emergence potential therapeutic this patient population. Transplant evaluation setting both CKD reviewed. Potential strategies surveillance management include monitoring comorbidities, use non-invasive fibrosis scoring systems, measurement laboratory markers. Lastly, we discuss patients CKD, from preventative measures experimental interventions.

Language: Английский

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Non-alcoholic fatty liver disease is associated with increased risk of chronic kidney disease

Therapeutic Advances in Chronic Disease, Journal Year: 2021, Volume and Issue: 12

Published: Jan. 1, 2021

Whether non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of incident chronic kidney (CKD) independent established cardio-renal factors remains controversial. We aimed to provide a quantitative estimate the association and strength between NAFLD CKD after adjustment for multiple factors.We searched electronic databases (PubMed, Embase, Google Scholar) studies published from database inception until 30 November 2020. Analysis included cohort that reported multivariable-adjusted ratios [including odds ratios, relative risks (RRs), or hazard ratios] 95% confidence intervals (CIs) compared individuals without NAFLD.A total 11 were comprising 1,198,242 participants (46.3% women) analysis. The median follow-up duration was 3.7 years, 31,922 cases CKD. Compared NAFLD, unadjusted models showed higher (RR 1.54, CI 1.38-1.71). After adjusting factors, still significantly in patients 1.39, 1.27-1.52). adjusted absolute increase 5.1 (95% 3.5-6.8) per 1000 person-years.NAFLD factors.

Language: Английский

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