EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)

Journal of Hepatology, Год журнала: 2024, Номер 81(3), С. 492 - 542

Опубликована: Июнь 7, 2024

Язык: Английский

---

EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Obesity Facts, Год журнала: 2024, Номер 17(4), С. 374 - 444

Опубликована: Янв. 1, 2024

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty (NAFLD), is defined as (SLD) in the presence of one or more cardiometabolic risk factor(s) and absence harmful alcohol intake. The spectrum MASLD includes steatosis, metabolic steatohepatitis (MASH, NASH), fibrosis, cirrhosis MASH-related hepatocellular carcinoma (HCC). This joint EASL-EASD-EASO guideline provides an update on definitions, prevention, screening, diagnosis treatment for MASLD. Case-finding strategies with using non-invasive tests, should be applied individuals factors, abnormal enzymes, and/or radiological signs hepatic particularly type 2 diabetes (T2D) obesity additional factor(s). A stepwise approach blood-based scores (such FIB-4) and, sequentially, imaging techniques transient elastography) suitable to rule-out/in advanced which predictive liver-related outcomes. In adults MASLD, lifestyle modification - including weight loss, dietary changes, physical exercise discouraging consumption well optimal management comorbidities use incretin-based therapies (e.g. semaglutide, tirzepatide) T2D obesity, if indicated advised. Bariatric surgery also option obesity. If locally approved dependent label, non-cirrhotic MASH significant fibrosis (stage ≥2) considered a MASH-targeted resmetirom, demonstrated histological effectiveness acceptable safety tolerability profile. No pharmacotherapy can currently recommended cirrhotic stage. Management adaptations drugs, nutritional counselling, surveillance portal hypertension HCC, transplantation decompensated cirrhosis.

Язык: Английский

---

Synergistic Osteogenic and Antiapoptotic Framework Nucleic Acid Complexes Prevent Diabetic Osteoporosis

Advanced Functional Materials, Год журнала: 2024, Номер 34(28)

Опубликована: Март 12, 2024

Abstract Diabetes mellitus (DM) is characterized by elevated blood glucose and advanced glycation end product (AGEs) levels. Increased AGEs in bone tissue inhibit osteogenic differentiation marrow mesenchymal stem cells (BMSCs), leading to loss osteoporosis diabetic patients. Enhancing the capacity of BMSCs presence abundant can improve health prevent DM The flavonoid, Quercetin, has anti‐inflammatory, antibacterial, antitumor properties; however, it insoluble water thus not easily absorbed body. Nanodrug delivery systems such as tetrahedral framework nucleic acids (tFNAs) exhibit excellent biocompatibility, efficient cell uptake, drug piggybacking. In present study, tFNAs with quercetin complexed form a novel nanodrug (tFNAs/Que) that combined features both components. tFNAs/Que promote an vitro AGEs‐rich environment, maintain mass, mice vivo. mechanism against may be related JNK signaling pathway. conclusion, shown dual regulatory role promoting inhibiting apoptosis. Such feature promising for prevention treatment osteoporosis.

Язык: Английский

---

Therapeutic targeting of obesity-induced neuroinflammation and neurodegeneration

Frontiers in Endocrinology, Год журнала: 2025, Номер 15

Опубликована: Янв. 17, 2025

Obesity is a major modifiable risk factor leading to neuroinflammation and neurodegeneration. Excessive fat storage in obesity promotes the progressive infiltration of immune cells into adipose tissue, resulting release pro-inflammatory factors such as cytokines adipokines. These inflammatory mediators circulate through bloodstream, propagating inflammation both periphery central nervous system. Gut dysbiosis, which results leaky intestinal barrier, exacerbates plays significant role linking pathogenesis neurodegeneration gut-brain/gut-brain-liver axis. Inflammatory states within brain can lead insulin resistance, mitochondrial dysfunction, autolysosomal increased oxidative stress. disruptions impair normal neuronal function subsequently cognitive decline motor deficits, similar pathologies observed neurodegenerative diseases, including Alzheimer's disease, multiple sclerosis, Parkinson's disease. Understanding underlying disease mechanisms crucial for developing therapeutic strategies address defects these metabolic pathways. In this review, we summarize provide insights different strategies, methods alter gut lifestyle changes, dietary supplementation, well pharmacological agents derived from natural sources, that target obesity-induced

Язык: Английский

---

Inflammation and resolution in obesity

Nature Reviews Endocrinology, Год журнала: 2024, Номер unknown

Опубликована: Окт. 24, 2024

Язык: Английский

---

Role of lifestyle and glucagon‐like peptide‐1 receptor agonists for weight loss in obesity, type 2 diabetes and steatotic liver diseases

Alimentary Pharmacology & Therapeutics, Год журнала: 2024, Номер 59(S1)

Опубликована: Май 30, 2024

Summary Background The current obesity pandemic has given rise to associated comorbidities and complications, including type 2 diabetes metabolic dysfunction‐associated steatotic liver disease (MASLD). During the last decade, certain glucagon‐like peptide 1 receptor agonists (GLP‐1RA), originally developed as antihyperglycemic drugs, also demonstrated efficacy for weight loss. Aims To review shared pathophysiologic features of common diseases compare therapeutic strategies reduce body related complications. Methods We performed an extensive literature research describe effects lifestyle modification, first‐generation anti‐obesity GLP‐1RA on loss in humans with obesity, MASLD. Results Until recently, treatment been limited which offer moderate degree sustainability few approved drugs are either short term use or forms obesity. Some significantly decrease caloric intake weight. Liraglutide semaglutide have therefore treating people They lead a reduction hepatic fat content inflammation biopsy‐confirmed Possible limitations comprise adverse effects, adherence persistence. Conclusion Certain superior modification inducing markedly changed portfolio additional beneficial disease.

Язык: Английский

---

Diabetes as a risk factor for MASH progression

Diabetes Research and Clinical Practice, Год журнала: 2024, Номер 217, С. 111846 - 111846

Опубликована: Сен. 6, 2024

Язык: Английский

---

Insulin resistance impairs biologic agent response in moderate-to-severe plaque psoriasis: insights from a prospective cohort study in China

British Journal of Dermatology, Год журнала: 2024, Номер 191(4), С. 616 - 623

Опубликована: Апрель 18, 2024

Abstract Background Psoriasis and insulin resistance (IR) are closely related, but it remains unclear whether IR affects the treatment of patients with psoriasis. Objective To investigate impairs response to biologic agents in moderate-to-severe plaque Methods This project was based on a prospective cohort study design. Data were collected from Shanghai Effectiveness Evaluation CoHort (SPEECH), which is exploring strategies for psoriasis China. assessed using triglyceride glucose–body mass index (TyG-BMI). severity Area Severity Index (PASI) Physician Global Assessment (PGA). Multiple logistic regression used explore differences between high low levels IR. Subgroup sensitivity analyses performed examine robustness results. Results A total 290 included analysis. Based median TyG-BMI, divided into two groups: The group exhibited higher prevalence diabetes, BMI, fasting blood glucose than group. Further analysis efficacy revealed that had lower PASI 75 [≥ 75% improvement (PASI)], 90 (≥ 90% PASI) PGA 0/1 (‘clear’ or ‘almost clear’) rates after 12 weeks treatment. In group, 81.9% achieved 75, 58.3% 75.7% 0/1. However, proportion responses at each endpoint significantly compared reduced rate more significant indicated by odd ratios. Subsequent subgroup produced consistent Conclusion associated effectiveness biologics

Язык: Английский

---

New Insights into Mitochondria in Health and Diseases

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(18), С. 9975 - 9975

Опубликована: Сен. 16, 2024

Mitochondria are a unique type of semi-autonomous organelle within the cell that carry out essential functions crucial for cell's survival and well-being. They location where eukaryotic cells energy metabolism. Aside from producing majority ATP through oxidative phosphorylation, which provides cellular functions, mitochondria also participate in other metabolic processes cell, such as electron transport chain, citric acid cycle, β-oxidation fatty acids. Furthermore, regulate production elimination ROS, synthesis nucleotides amino acids, balance calcium ions, process death. Therefore, it is widely accepted mitochondrial dysfunction factor causes or contributes to development advancement various diseases. These include common systemic diseases, aging, diabetes, Parkinson's disease, cancer, well rare disorders, like Kearns-Sayre syndrome, Leigh myopathy. This overview outlines mechanisms by involved numerous illnesses physiological activities. Additionally, new discoveries regarding involvement both disorders maintenance good health.

Язык: Английский

---

A novel RFE-GRU model for diabetes classification using PIMA Indian dataset

Scientific Reports, Год журнала: 2025, Номер 15(1)

Опубликована: Янв. 6, 2025

Abstract Diabetes is a long-term condition characterized by elevated blood sugar levels. It can lead to variety of complex disorders such as stroke, renal failure, and heart attack. requires the most machine learning help diagnose diabetes illness at an early stage, it cannot be treated adds significant complications our health-care system. The PIMA Indian dataset (PIDD) was used for classification in several studies, includes 768 instances 9 features; eight features are predictors, one feature target. Firstly, we performed preprocessing stage that mean imputation data normalization. Afterwards, trained extracted using various types Machine Learning (ML); Random Forest (RF), Logistic Regression (LR), K-Nearest neighbor (KNN), Naïve Bayes (NB), Histogram Gradient Boost (HGB), Gated Recurrent Unit (GRU) models. To achieve PIDD, new model called Recursive Feature Elimination-GRU (RFE-GRU) proposed this paper. RFE vital selecting training important predicting target variable. While GRU handles challenge vanishing inflating gradient results from RFE. Several predictive evaluation metrics, including precision, recall, F1-score, accuracy, Area Under Curve (AUC) achieved 90.50%, 90.70%, 0.9278, respectively, verify validate execution RFE-GRU model. comparative showed better than other

Язык: Английский

---