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Yoo SH, Park JY, Lee HS, Lee HW, Lee JI. Risk of dementia in the elderly with non-alcoholic fatty liver disease: A nested case-control study in the Republic of Korea. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:570-579. [PMID: 38920146 DOI: 10.47102/annals-acadmedsg.202379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Introduction Non-alcoholic fatty liver disease (NAFLD) is known to be associated with metabolic syndrome of which diabetes is an important component. Although diabetes is a known risk factor for dementia, studies on the association between NAFLD and dementia still produce conflicting results. This study aimed to determine whether NAFLD would be a risk factor for the development of dementia in an elderly population. Method This study included 107,369 subjects aged ≥60 years in the Korean National Health Insurance Service-Senior cohort, entered in 2009 and followed up until 2015. NAFLD was diagnosed by calculating fatty liver index (FLI). Subjects were screened for dementia at baseline using a Korean Dementia Screening Questionnaire, and dementia was diagnosed using ICD-10 codes. Controls were randomly selected at a ratio of 1:5 from individuals who were at risk of becoming the case subjects at the time of selection. Results From 107,369 subjects, 65,690 stroke- and dementia-free subjects without chronic hepatitis B or C or excessive alcohol drinking were selected for evaluation. Having NAFLD, determined by FLI, was associated with increased risk of dementia development (adjusted odds ratio [AOR] 1.493; 95% confidence interval [CI] 1.214-1.836). The increased risk of dementia in NAFLD subjects was independent of type 2 diabetes (AOR 1.421; 95% CI 1.013-1.994, in subjects with diabetes: AOR 1.540; 95% CI 1.179- 2.010, in subjects without diabetes). Conclusion In this population-based nested case-control study, having NAFLD increased the risk of dementia in elderly individuals, independent of accompanying diabetes.
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Affiliation(s)
- Sung Hwan Yoo
- Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Gangnam Severance Hospital, Yonsei University College of Medicine, Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Ju-Young Park
- Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Hyun Woong Lee
- Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Gangnam Severance Hospital, Yonsei University College of Medicine, Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Jung Il Lee
- Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Gangnam Severance Hospital, Yonsei University College of Medicine, Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
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Taharboucht S, Guermaz R, Brouri M, Bengherbia L, Chibane A. Ankle systolic pressure index in non-diabetic non-alcoholic fatty liver disease: A case-control study. JOURNAL DE MEDECINE VASCULAIRE 2023; 48:154-162. [PMID: 38035921 DOI: 10.1016/j.jdmv.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Several studies have shown that mortality in Non-alcoholic Fatty Liver Disease (NAFLD) or metabolic steatopathy is more related to cardiovascular diseases than to hepatic complications. Our work aimed to verify the relationship between this liver disease and the ankle-brachial pressure index (ABPI), which is a good screening tool for peripheral arterial disease (PAD) and a reliable marker of cardiovascular risk. PATIENTS AND METHODS A prospective sex- and age-matched case-control study was conducted in non-diabetic patients aged 30 to 70 years. All patients underwent a clinical and biological evaluation. Hepatic steatosis was diagnosed by ultrasound. All participants had their ankle-brachial pressure index measured using a Dopplex® Pocket Doppler in addition to arterial ultrasound of the supra-aortic trunk and a carotid-femoral pulse wave velocity (CfPWV) measurement. An ABPI<0.9 was considered pathological (suggestive of PAD). Statistical analyses were performed using SPSS 21.0 software (IBM). RESULTS In total, 213 NAFLD patients (100 men/113 women) with a mean age of 48.5±10.14 years were matched to 213 controls. Metabolic syndrome (MS) was more common in NAFLD than in controls, regardless of the International Diabetes Federation (IDF 2005) criteria used (P<0.001). Low ABPI (<0.90) was noted in 19 (8.9%) NAFLD patients vs. 5 (2.3%) in controls (P=0.003). The mean age of these patients was 48.8±8.6 years with a female predominance (20 patients). 62.5% reported dyslipidemia on questioning, 70.8% a metabolic syndrome according to the IDF and 12.5% (3/24) of them were active smokers. There were no records of mediacalcosis. PAD was significantly associated with NAFLD in univariate analysis (OR=4.0 CI 95% (1.4-11.1)). Factors independently associated with PAD in NAFLD patients were nocturnal systolic blood pressure, smoking, thigh circumference, and being a female. CONCLUSION The findings of our study show a significant association between NAFLD and low ABPI, likely reflecting the high vascular risk of this patient population.
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Affiliation(s)
| | | | | | | | - Ahcene Chibane
- Service de médecine interne, CHU de Douera, Alger, Algeria
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Fu D, Wu S, Jiang X, You T, Li Y, Xin J, Feng X, Wen J, Huang Y, Hu C. Caveolin-1 alleviates acetaminophen-induced vascular oxidative stress and inflammation in non-alcoholic fatty liver disease. Free Radic Biol Med 2023; 195:245-257. [PMID: 36596386 DOI: 10.1016/j.freeradbiomed.2022.12.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023]
Abstract
Acetaminophen (APAP) is one of the most widely used drugs in the world. The literature shows that excessive or long-term use of APAP can lead to increased cardiovascular dysfunction. An acute increase in angiotensin Ⅱ (Ang Ⅱ) caused by APAP use in fatty liver disease may increase the risk and severity of vascular injury. However, the underlying mechanism remains unclear. Caveolin-1 (CAV1) is a broad-spectrum kinase inhibitor that significantly determines endothelial function. This study aimed to observe the effects of APAP on the vasculature in non-alcoholic fatty liver disease (NAFLD) and to determine whether CAV1 could alleviate vascular oxidative stress and inflammation by targeting Ang Ⅱ or its downstream pathways. In this study, 7-week-old C57BL/6 male mice (18-20 g) were administered APAP by gavage after eight weeks of a high-fat diet. Any resulting vascular oxidative stress and inflammation were assessed. Levels of Ang Ⅱ, CAV1, and other related proteins were measured using ELISA and western blotting. In APAP-treated NAFLD mice, CAV1 expression was downregulated and Ang Ⅱ expression was upregulated compared to normal APAP-treated mice. In vitro, HUVECs were incubated with Ang Ⅱ (300 nM) for 48 h. Overexpression of CAV1 in HUVECs attenuated Ang Ⅱ-induced oxidative stress and inflammation and downregulated the expression of Protein kinase C (PKC) and p-P38/P38. After intervention with CAV1-siRNA, immunofluorescence results showed that the fluorescence intensity of PKC on mitochondria was further increased, and flow cytometry results showed that the mitochondrial membrane potential increased. PKC inhibitors alleviated Ang Ⅱ-induced endothelial injury. In conclusion, our findings confirmed that CAV1 exerts a protective effect against vascular injury by inhibiting oxidative stress and inflammation through the PKC/MAPK pathway. Therefore, restoration of CAV1 may have clinical benefits in reducing APAP-induced vascular damage in NAFLD patients.
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Affiliation(s)
- Dongdong Fu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China
| | - Shuai Wu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China
| | - Xiangfu Jiang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China
| | - Tingyu You
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China
| | - Yu Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China
| | - Jiao Xin
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China
| | - Xiaowen Feng
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China
| | - Jiagen Wen
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China
| | - Yan Huang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China
| | - Chengmu Hu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Institute for Liver Diseases of Anhui Medical University, School of Pharmacy, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Hefei, 230032, China.
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Ye S, Liu Y, Zhang T, Feng H, Liu Y, Ma L. Analysis of the correlation between non-alcoholic fatty liver disease and the risk of colorectal neoplasms. Front Pharmacol 2022; 13:1068432. [PMID: 36438843 PMCID: PMC9682006 DOI: 10.3389/fphar.2022.1068432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/28/2022] [Indexed: 09/19/2023] Open
Abstract
This study aims at assessing the potential association between non-alcoholic fatty liver disease (NAFLD) and colorectal neoplasms (CRN). PubMed, Cochrane Library, and Embase were searched for cohort studies. 14 cohort studies with a total population of 38,761,773 were included for meta-analysis after selection. The results showed that NAFLD is related to an increased risk of CRN (OR = 1.23; 95% CI: 1.14-1.32; I2 = 70.7%, p < 0.001). In the subgroup analysis, NAFLD were found to be the independent risk factor of colorectal adenoma (CRA) (OR = 1.29; 95% CI = 1.15-1.45; I2 = 66.4%) and colorectal cancer (CRC) (OR = 1.13; 95% CI = 1.12-1.15; I2 = 69.4%). There is no close correlation between smoking status of NAFLD patients and CRN. Interestingly, bioinformatics analysis revealed that there were overlap of dysregulated gene sets among NAFLD, CRC, and two recently identified regulated cell death types, ferroptosis and cuproptosis, respectively. Our meta- and bioinformatics analysis shows that NAFLD increases the risk of CRN. Ferroptosis and cuproptosis may be the critical links between NAFLD and CRN, respectively. These findings here support that NAFLD is necessary to be considered as an emerging risk factor for CRN.
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Affiliation(s)
- Shujun Ye
- Endoscopy Center, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Yang Liu
- Endoscopy Center, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Te Zhang
- Anesthesiology Department, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Huijin Feng
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, United States
| | - Yanqing Liu
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, United States
| | - Lianjun Ma
- Endoscopy Center, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
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Gumussoy M, Koc O, Karatas G, Ozercan M, Ellik Z, Duman S, Kiremitci S, Gokcan H, Elhan AH, Savas B, Idilman R. Factors associated with the development of extrahepatic malignancy in patients with nonalcoholic fatty liver disease: a single-center longitudinal study. Eur J Gastroenterol Hepatol 2022; 34:1172-1177. [PMID: 36170687 DOI: 10.1097/meg.0000000000002448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND AIMS The aim of the present study was to determine incident cases of extrahepatic malignancy in patients with nonalcoholic fatty liver disease (NAFLD) and to identify whether the factors are associated with cancer development. METHODS Between 15 January 2001 and 14 March 2021, a total of 1365 patients had been diagnosed with NAFLD were enrolled in the study. RESULTS The median follow-up period was 59.5 months. The mean age was 50.9 ± 10.9 years. The female gender was predominant (57%). During the follow-up period, 62 extrahepatic malignancies and 11 hepatocellular carcinomas were identified. Of all extrahepatic malignancies, 51 were solid organ malignancies and 11 were hematological malignancies. Female breast cancer was the most frequent (25.8%), followed by thyroid cancer (19.4%), lymphoma (12.9%), and lung cancer (9.7%). In univariate and multivariable analyses, after adjusting for age and sex, the presence of diabetes and high initial baseline gamma glutamyl transpeptidase (GGT) levels were significantly associated with the development of extrahepatic malignancies [hazard ratio (HR) = 1.82, 95% confidence interval (CI): 1.04-3.20, P = 0.036] and HR = 1.96, 95% CI: 1.14-3.38, P = 0.015, respectively). In 424 biopsy-proven NAFLD patients, the development of extrahepatic cancer was significantly associated with the severity of hepatic fibrosis (HR = 3.31, 95% CI: 1.36-8.07; P = 0.008). CONCLUSION Extrahepatic malignancies are frequently seen in patients with NAFLD. Diabetes mellitus, high baseline GGT levels, and significant hepatic fibrosis are associated with the development of extrahepatic cancer in patients with NAFLD.
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Shao M, Lu Y, Xiang H, Wang J, Ji G, Wu T. Application of metabolomics in the diagnosis of non-alcoholic fatty liver disease and the treatment of traditional Chinese medicine. Front Pharmacol 2022; 13:971561. [PMID: 36091827 PMCID: PMC9453477 DOI: 10.3389/fphar.2022.971561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/25/2022] [Indexed: 12/01/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease around the world, and it often coexists with insulin resistance-related diseases including obesity, diabetes, hyperlipidemia, and hypertension, which seriously threatens human health. Better prevention and treatment strategies are required to improve the impact of NAFLD. Although needle biopsy is an effective tool for diagnosing NAFLD, this method is invasive and difficult to perform. Therefore, it is very important to develop more efficient approaches for the early diagnosis of NAFLD. Traditional Chinese medicine (TCM) can play a certain role in improving symptoms and protecting target organs, and its mechanism of action needs to be further studied. Metabolomics, the study of all metabolites that is thought to be most closely associated with the patients’ characters, can provide useful clinically biomarkers that can be applied to NAFLD and may open up new methods for diagnosis. Metabolomics technology is consistent with the overall concept of TCM, and it can also be used as a potential mechanism to explain the effects of TCM by measuring biomarkers by metabolomics. Based on PubMed/MEDLINE and other databases, this paper retrieved relevant literature NAFLD and TCM intervention in NAFLD using metabolomics technology in the past 5 years were searched, and the specific metabolites associated with the development of NAFLD and the potential mechanism of Chinese medicine on improving symptoms were summarized.
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Affiliation(s)
- Mingmei Shao
- Baoshan District Hospital of Intergrated Traditional Chinese and Western Medicine, Shanghai, China
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yifei Lu
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongjiao Xiang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Junmin Wang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guang Ji
- Baoshan District Hospital of Intergrated Traditional Chinese and Western Medicine, Shanghai, China
- Institute of Digestive Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tao Wu
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Guang Ji, , ; Tao Wu, ,
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Batool M, Ranjha MMAN, Roobab U, Manzoor MF, Farooq U, Nadeem HR, Nadeem M, Kanwal R, AbdElgawad H, Al Jaouni SK, Selim S, Ibrahim SA. Nutritional Value, Phytochemical Potential, and Therapeutic Benefits of Pumpkin ( Cucurbita sp.). PLANTS (BASEL, SWITZERLAND) 2022; 11:plants11111394. [PMID: 35684166 PMCID: PMC9182978 DOI: 10.3390/plants11111394] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 05/05/2023]
Abstract
Pumpkin is a well-known multifunctional ingredient in the diet, full of nutrients, and has opened new vistas for scientists during the past years. The fruit of pumpkin including the flesh, seed, and peel are a rich source of primary and secondary metabolites, including proteins, carbohydrates, monounsaturated fatty acids, polyunsaturated fatty acids, carotenoids, tocopherols, tryptophan, delta-7-sterols, and many other phytochemicals. This climber is traditionally used in many countries, such as Austria, Hungary, Mexico, Slovenia, China, Spain, and several Asian and African countries as a functional food and provides health promising properties. Other benefits of pumpkin, such as improving spermatogenesis, wound healing, antimicrobial, anti-inflammatory, antioxidative, anti-ulcerative properties, and treatment of benign prostatic hyperplasia have also been confirmed by researchers. For better drug delivery, nanoemulsions and niosomes made from pumpkin seeds have also been reported as a health promising tool, but further research is still required in this field. This review mainly focuses on compiling and summarizing the most relevant literature to highlight the nutritional value, phytochemical potential, and therapeutic benefits of pumpkin.
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Affiliation(s)
- Maria Batool
- University Institute of Diet and Nutritional Sciences, University of Lahore, Gujrat 50700, Pakistan;
| | | | - Ume Roobab
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China; (U.R.); (R.K.)
| | | | - Umar Farooq
- Department of Food Science and Technology, Muhammad Nawaz Shareef University of Agriculture, Multan 59300, Pakistan;
| | - Hafiz Rehan Nadeem
- Institute of Food Science and Nutrition, Bahauddin Zakariya University, Multan 59300, Pakistan;
| | - Muhammad Nadeem
- Institute of Food Science and Nutrition, University of Sargodha, Sargodha 40100, Pakistan; (M.M.A.N.R.); (M.N.)
| | - Rabia Kanwal
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China; (U.R.); (R.K.)
| | - Hamada AbdElgawad
- Integrated Molecular Plant Physiology Research, Department of Biology, University of Antwerp, 2020 Antwerpen, Belgium;
- Botany and Microbiology Department, Faculty of Science, Beni-Suef University, Beni-Suef 62511, Egypt
| | - Soad K. Al Jaouni
- Department of Hematology/Oncology, Yousef Abdulatif Jameel Scientific Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Samy Selim
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia
- Correspondence: (S.S.); (S.A.I.)
| | - Salam A. Ibrahim
- Food Microbiology and Biotechnology Laboratory, North Carolina Agricultural and Technical State University, Greensboro, NC 27411, USA
- Correspondence: (S.S.); (S.A.I.)
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Kim GA, Oh CH, Kim JW, Jeong SJ, Oh IH, Lee JS, Park KC, Shim JJ. Association between non-alcoholic fatty liver disease and the risk of dementia: A nationwide cohort study. Liver Int 2022; 42:1027-1036. [PMID: 35289469 DOI: 10.1111/liv.15244] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Little is known about the association between non-alcoholic fatty liver disease (NAFLD) and dementia. Given that hepatic steatosis is linked to abnormal fat metabolism, and fat dysregulation in the brain is related to dementia, we aimed to investigate whether NAFLD is associated with an increased risk of dementia. METHODS We conducted a nationwide cohort study involving 4 031 948 subjects aged 40-69 years who underwent ≥2 health check-ups provided by the National Health Insurance Service in Korea between January 2004 and December 2007. Based on the hepatic steatosis index (HSI), subjects were categorized into non-NAFLD (HSI <30 at all check-ups) and NAFLD (HSI >36 at one or more check-ups). Dementia defined by ICD-10 codes with prescription data was followed up until December 2017. Cox proportional hazards regression models analysed the dementia risk. RESULTS At baseline, 31.3% had NAFLD. During the median follow-up of 9.5 years, 138 424 in NAFLD group and 69 982 in non-NAFLD group developed dementia. NAFLD group was associated with a higher risk of dementia than non-NAFLD group on multivariable-adjusted analysis (hazard ratio [HR], 1.05; p < .001), competing risk analysis (HR, 1.08; p < .001) and propensity-score matched analysis (HR, 1.09; p < .001). The association between NAFLD and dementia risk was more prominent among females (HR, 1.16; p < .001). The association was stronger among non-obese NAFLD subjects (BMI <25 kg/m2 , HR, 1.09; p < .001) than obese NAFLD subjects. CONCLUSIONS This nationwide study found that NAFLD is associated with an increased risk of dementia. The association was prominent among females and non-obese NAFLD subjects.
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Affiliation(s)
- Gi-Ae Kim
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Chi Hyuk Oh
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Jung Wook Kim
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Su Jin Jeong
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Key-Chung Park
- Department of Neurology, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Jae-Jun Shim
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
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Kim HY. Biopsy-proven Non-alcoholic Fatty Liver Disease and Incident Cancer. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021. [DOI: 10.4166/kjg.2021.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Hee Yeon Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
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Wu MJ, Fang QL, Zou SY, Zhu Y, Lu W, Du X, Shi BM. Influencing factors for hepatic fat accumulation in patients with type 2 diabetes mellitus. World J Clin Cases 2021; 9:7717-7728. [PMID: 34621822 PMCID: PMC8462247 DOI: 10.12998/wjcc.v9.i26.7717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/23/2021] [Accepted: 07/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease has become the most common chronic liver disease worldwide, which originates from the accumulation of triglyceride (TG) in the liver. Patients with type 2 diabetes mellitus (T2DM) are considered to have a predisposition to hepatic steatosis. However, the influencing factors for hepatic fat accumulation in T2DM patients remain unclear.
AIM To investigate the influencing factors for hepatic fat accumulation in T2DM patients.
METHODS We enrolled 329 T2DM patients admitted to the Endocrinology Department of the First Affiliated Hospital of Soochow University, who underwent MR mDIXON-Quant examination to quantify the hepatic fat fraction (HFF). According to body mass index (BMI), the patients were divided into normal weight, overweight, and obese groups. The differences in general statistics, biochemical parameters, islet function, and HFF were compared among the three groups. The associations between HFF and other parameters and the influences of various parameters on the severity of hepatic fat accumulation were analyzed.
RESULTS The HFF of T2DM patients gradually increased in the normal weight, overweight, and obese groups (P < 0.05). Spearman correlation analysis showed that in T2DM patients, HFF was negatively correlated with age and high-density lipoprotein cholesterol (P < 0.05), whereas it was positively correlated with BMI, waist-hip ratio, fasting plasma glucose, alanine aminotransferase (ALT), aspartate aminotransferase, bilirubin, glutamyl transpeptidase, lactate dehydrogenase, albumin (ALB), uric acid (UA), total cholesterol, TG, low-density lipoprotein cholesterol (LDL-C), C-reactive protein, free triiodothyronine, fasting insulin, fasting C-peptide, and homeostasis model assessment of insulin resistance (P < 0.05). Multiple linear regression analysis showed significant positive influences of BMI, ALT, LDL-C, UA, and ALB on HFF in T2DM patients (P < 0.05). Binary logistic regression analysis showed that BMI, ALT, ALB, and LDL-C were independent risk factors for moderate to severe fatty liver in T2DM patients, and obesity increased the risk of being complicated with moderate to severe fatty liver by 4.03 times (P < 0.05).
CONCLUSION The HFF of T2DM patients increases with BMI. Higher BMI, ALT, ALB, and LDL-C are independent risk factors for moderate to severe fatty liver in T2DM patients.
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Affiliation(s)
- Meng-Jiao Wu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Qiong-Lei Fang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Sheng-Yi Zou
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Yan Zhu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Wen Lu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Xuan Du
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Bi-Min Shi
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
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Aguiar AJFC, de Queiroz JLC, Santos PPA, Camillo CS, Serquiz AC, Costa IS, Oliveira GS, Gomes AFT, Matias LLR, Costa ROA, Passos TS, Morais AHA. Beneficial Effects of Tamarind Trypsin Inhibitor in Chitosan-Whey Protein Nanoparticles on Hepatic Injury Induced High Glycemic Index Diet: A Preclinical Study. Int J Mol Sci 2021; 22:9968. [PMID: 34576130 PMCID: PMC8470918 DOI: 10.3390/ijms22189968] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/17/2021] [Accepted: 08/17/2021] [Indexed: 12/12/2022] Open
Abstract
Several studies have sought new therapies for obesity and liver diseases. This study investigated the effect of the trypsin inhibitor isolated from tamarind seeds (TTI), nanoencapsulated in chitosan and whey protein isolate (ECW), on the liver health status of the Wistar rats fed with a high glycemic index (HGLI) diet. The nanoformulations without TTI (CW) and ECW were obtained by nanoprecipitation technique, physically and chemically characterized, and then administered to the animals. The adult male Wistar rats (n = 20) were allocated to four groups: HGLI diet + water; standard diet + water; HGLI diet + ECW (12.5 mg/kg); and HGLI diet + CW (10.0 mg/kg), 1 mL per gagave, for ten days. They were evaluated using biochemical and hematological parameters, Fibrosis-4 Index for Liver Fibrosis (FIB-4), AST to Platelet Ratio Index (APRI) scores, and liver morphology. Both nanoparticles presented spherical shape, smooth surface, and nanometric size [120.7 nm (ECW) and 136.4 nm (CW)]. In animals, ECW reduced (p < 0.05) blood glucose (17%), glutamic oxalacetic transaminase (39%), and alkaline phosphatase (24%). Besides, ECW reduced (p < 0.05) APRI and FIB-4 scores and presented a better aspect of hepatic morphology. ECW promoted benefits over a liver injury caused by the HGLI diet.
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Affiliation(s)
- Ana J. F. C. Aguiar
- Biochemistry and Molecular Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (A.J.F.C.A.); (J.L.C.d.Q.); (I.S.C.); (L.L.R.M.); (R.O.A.C.)
| | - Jaluza L. C. de Queiroz
- Biochemistry and Molecular Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (A.J.F.C.A.); (J.L.C.d.Q.); (I.S.C.); (L.L.R.M.); (R.O.A.C.)
| | - Pedro P. A. Santos
- Structural and Functional Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (P.P.A.S.); (C.S.C.)
| | - Christina S. Camillo
- Structural and Functional Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (P.P.A.S.); (C.S.C.)
| | - Alexandre C. Serquiz
- Nutrition Course, University Center of Rio Grande do Norte, Natal 59.014-545, RN, Brazil;
| | - Izael S. Costa
- Biochemistry and Molecular Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (A.J.F.C.A.); (J.L.C.d.Q.); (I.S.C.); (L.L.R.M.); (R.O.A.C.)
- Nutrition Course, Potiguar University, Natal 59.056-000, RN, Brazil
| | - Gerciane S. Oliveira
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (G.S.O.); (A.F.T.G.)
| | - Ana F. T. Gomes
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (G.S.O.); (A.F.T.G.)
| | - Lídia L. R. Matias
- Biochemistry and Molecular Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (A.J.F.C.A.); (J.L.C.d.Q.); (I.S.C.); (L.L.R.M.); (R.O.A.C.)
| | - Rafael O. A. Costa
- Biochemistry and Molecular Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (A.J.F.C.A.); (J.L.C.d.Q.); (I.S.C.); (L.L.R.M.); (R.O.A.C.)
| | - Thaís S. Passos
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil;
| | - Ana H. A. Morais
- Biochemistry and Molecular Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (A.J.F.C.A.); (J.L.C.d.Q.); (I.S.C.); (L.L.R.M.); (R.O.A.C.)
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil; (G.S.O.); (A.F.T.G.)
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal 59.078-970, RN, Brazil;
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12
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Xiu L, Jiang T, Yao XA, Wen Z. Correlation Between 25 Hydroxyvitamin D Levels and Nonalcoholic Fatty Liver Disease in Chinese Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. Int J Gen Med 2021; 14:3099-3107. [PMID: 34234538 PMCID: PMC8257066 DOI: 10.2147/ijgm.s319449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/15/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose We aimed to analyze the serum vitamin D level in Chinese patients with type 2 diabetes mellitus (T2DM) and discuss its correlation with nonalcoholic fatty liver disease (NAFLD). Patients and Methods A total of 300 patients with T2DM (92 patients without NAFLD and 208 patients with NAFLD) were enrolled, and 25-hydroxyvitamin D [25-(OH)D] levels were compared between the two groups. Second, the NAFLD fibrosis score (NFS) and fatty liver index (FLI) were used to group patients with T2DM complicated by NAFLD, and the differences in serum 25-(OH)D in patients with different degrees of liver fibrosis were compared. Third, multiple regression analysis was used to analyze the independent predictors of liver fibrosis in patients with T2DM complicated by NAFLD. Results The level of 25-(OH)D in patients with T2DM complicated by NAFLD was significantly lower than that in patients with T2DM alone. Based on the NFS and FLI, the 25-(OH)D level of the hepatic fibrosis subgroup was significantly lower than that of the subgroup without liver fibrosis. 25-(OH)D was found to be an independent predictor of liver fibrosis in patients with T2DM complicated by NAFLD. Conclusion The serum 25-(OH)D level in patients with T2DM complicated by NAFLD was significantly reduced, and the 25-(OH)D level showed a gradual downward trend with the degree of liver fibrosis. Low concentrations of 25-(OH)D may be indicative of the degree of liver fibrosis in diabetic patients.
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Affiliation(s)
- Lei Xiu
- Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Tao Jiang
- Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Xiao-Ai Yao
- Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Zhen Wen
- Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
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Taharboucht S, Guermaz R, Brouri M, Chibane A. Subclinical atherosclerosis and arterial stiffness in nonalcoholic fatty liver disease: A case-control study in Algerian population. JOURNAL DE MEDECINE VASCULAIRE 2021; 46:129-138. [PMID: 33990287 DOI: 10.1016/j.jdmv.2021.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 03/20/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Nonalcoholic fatty liver disease (NAFLD) was described for the first time in 1980, and became within a few years one of the most frequent causes of chronic liver disease. However, during the last decade, many studies suggested a strong relationship between NAFLD and cardiovascular diseases including carotid atherosclerosis evoking the hypothesis that NAFLD is a factor or a marker of cardiovascular risk. In Algeria, data on this subject are rare or inexistent. The objective of our work was to study the relationship between NAFLD and atherosclerosis in an Algerian population without diabetes. PATIENTS AND METHODS It is a case-control study with a strict matching by age and sex. Non-diabetic participants between 30 and 70 years of age were consecutively included in the department of internal medicine of the public hospital of El Biar. The diagnosis of NAFLD was made by ultrasound and hepatic elasticity was assessed by FibroScan®. We collected the data of the carotid ultrasound, the carotid-femoral pulse wave velocity (cfPWV), ankle-brachial pressure index and arterial pressure (consultation and ambulatory monitoring). Non parametric statistical methods (chi 2 McNemar for the percentages, t Friedman test for medium) were used and the association between variables was estimated by odds ratio (OR). These analyses were performed using SPSS 21.0 software (IBM). RESULTS 213 patients with NAFLD, with a mean age of 48.5 years±10.14 (100 men/113 women) were matched to 213 controls. The presence of carotid atherosclerotic plaque (CAP) was higher in NAFLD than in controls (31.92% (n=68) vs. 7.05% (n=15), P<0.001). In multivariate analysis, the CAP (OR 8.6, 95% CI [3.6-20.5], P<0.001), high Intima media thickness (OR 2.8, 95% CI [1.4-5.4], P=0.002), CRP≥6mg/l (OR 14.7, 95% CI [5.9-36.9], P=0.001), abdominal obesity (OR 3.8, 95% CI [1.4-9.7], P=0.05), high cfPWV (OR 4.4, 95% CI [2.4-8.1], P<0.001), elevated alanine aminotransferase(OR 4.0, 95% CI [1.6-9.8], P=0.002), overall obesity (OR 2.0, 95% CI [1.0-3.8], P=0.03), dyslipidemia (OR 2.0, 95% CI [1.0-3.8], P=0.02), and elevated GGT (OR 2.8, 95% [1.1-7.1] were independently associated to NAFLD. CONCLUSION Our study suggests that NAFLD is significantly associated with carotid atherosclerosis and arterial stiffness. These results may have implications in the management of patients with NAFLD in terms of cardiovascular prevention.
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Affiliation(s)
- S Taharboucht
- Internal medecine department, CHU de Douera, University of Blida 1, Algiers, Algeria.
| | - R Guermaz
- Internal medecine department, EPH EL BIAR, University of Algiers, Algiers, Algeria
| | - M Brouri
- Internal medecine department, EPH EL BIAR, University of Algiers, Algiers, Algeria
| | - A Chibane
- Internal medecine department, CHU de Douera, University of Blida 1, Algiers, Algeria
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Non-Alcoholic Fatty Liver Disease Is Associated with Kidney Glomerular Hyperfiltration in Adults with Metabolic Syndrome. J Clin Med 2021; 10:jcm10081717. [PMID: 33923418 PMCID: PMC8073467 DOI: 10.3390/jcm10081717] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is a risk factor for the development of chronic kidney disease (CKD), which is early marked by kidney glomerular hyperfiltration. However, the association of NAFLD with kidney glomerular hyperfiltration has not been tested so far in adults with metabolic syndrome (MetS). Aims: To assess the relationship between NAFLD and kidney glomerular hyperfiltration in adults with MetS. Methods: The study included 154 participants aged 40–60 years with MetS and NAFLD diagnosed by ultrasound. NAFLD was confirmed by MRI in 109 subjects. Participants underwent anthropometric measurements, and biochemistry testing. Estimated GFR (eGFR) was calculated using the CKD-Epidemiology Collaboration (CKD-EPI) formula; hyperfiltration was defined as eGFR ≥ 120 mL/min. Results: Participants with MRI-proven NAFLD showed a worse metabolic profile and higher levels of eGFR than those with no NAFLD. Presence of NAFLD and increased weight were independently associated with an increased probability of presenting hyperfiltration. Conclusions: The present study shows an association between kidney glomerular hyperfiltration and NAFLD in adults with MetS. Establishing an association between NAFLD and kidney glomerular hyperfiltration would help to earlier identify those patients at increased risk of CKD, who would benefit from an early intervention.
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15
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Liu H, Zha X, Ding C, Hu L, Li M, Yu Y, Zhou W, Wang T, Zhu L, Bao H, Cheng X. AST/ALT Ratio and Peripheral Artery Disease in a Chinese Hypertensive Population: A Cross-Sectional Study. Angiology 2021; 72:916-922. [PMID: 33779311 DOI: 10.1177/00033197211004410] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous studies reported that the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT) was a risk factor in cardiovascular disease. Peripheral artery disease (PAD) is an important risk factor for cardiovascular death. However, only a few studies investigated the correlations between the AST/ALT ratio and PAD. We analyzed data from 10 900 patients with hypertension from the Chinese Hypertension Registry Study; 350 patients had PAD (prevalence 3.2%). After adjusting for potential confounders, the AST/ALT ratio was independently and positively associated with risk of PAD (OR: 1.31, 95% CI, 1.13-1.59), and a significant increased risk of PAD for the third AST/ALT ratio tertile (T3) compared with the first tertile (T1; OR: 1.49, 95% CI, 1.09-2.04, P trend = .005) was found. Moreover, when we combined T1 and T2 into one group and used it as a reference group, the risk of PAD increased with the increase in AST/ALT; the risk ratio was 1.52 (95% CI, 1.20-1.95). A higher AST/ALT ratio (≥1.65) was associated with PAD risk in Chinese adults with hypertension. Our results suggest that the AST/ALT ratio may help identify patients at high risk of vascular end points and might be a convenient, economical, and effective tool for evaluating the risk of atherosclerosis.
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Affiliation(s)
- Hui Liu
- Department of Cardiovascular Medicine, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Xiaoyuan Zha
- Rancheng Community Health Service Center, Wuyuan, Jiangxi, People's Republic of China
| | - Congcong Ding
- Department of Cardiovascular Medicine, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Lihua Hu
- Department of Cardiovascular Medicine, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Minghui Li
- Department of Cardiovascular Medicine, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Yu Yu
- Department of Cardiovascular Medicine, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Tao Wang
- Center for Prevention and Treatment of Cardiovascular Diseases, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Lingjuan Zhu
- Center for Prevention and Treatment of Cardiovascular Diseases, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Huihui Bao
- Center for Prevention and Treatment of Cardiovascular Diseases, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Xiaoshu Cheng
- Center for Prevention and Treatment of Cardiovascular Diseases, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
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16
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Lonardo A. Renaming NAFLD to MAFLD: Could the LDE System Assist in This Transition? J Clin Med 2021; 10:492. [PMID: 33572544 PMCID: PMC7866816 DOI: 10.3390/jcm10030492] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/13/2022] Open
Abstract
Our understanding of fatty liver syndromes and their relationship with the metabolic syndrome has improved over recent decades and, paralleling this, we are now at the dawn of the NAFLD (nonalcoholic fatty liver disease) to MAFLD (metabolic-associated fatty liver disease) transition. The pitfalls of NAFLD diagnosis, together with disappointing results in therapeutic trials, and the inconsistencies and risks inherent in a "negative" definition (such as "nonalcoholic") as opposed to a "positive" one (i.e., "metabolic") are predicted to facilitate the proposed renaming of NAFLD to MAFLD. However, a premature change of terminology would not necessarily address major unmet needs in this area, and may even become counterproductive. As an aid to selecting more homogeneous cohorts of patients, I propose the LDE (Liver, Determinants, Extra-hepatic) classification system which, in principle, may help to assess the natural course of disease as well as the efficacy of novel drugs in patients with NAFLD/MAFLD.
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Affiliation(s)
- Amedeo Lonardo
- Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Modena, 4110 Modena, Italy
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17
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Sun Y, Tan Z, Jiang Z, Li M, Wang W, Huang Y, Sun J. Comparative efficacy and safety of traditional Chinese patent medicine for NAFLD in childhood or adolescence: A protocol for a Bayesian network meta analysis. Medicine (Baltimore) 2021; 100:e24277. [PMID: 33546051 PMCID: PMC7837984 DOI: 10.1097/md.0000000000024277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease is a common reason for chronic liver disease in children and adults. The increasing incidence of the disease has become one of the most critical public health problems in the 21st century, closely related to genetic and environmental factors. So far, apart from changing lifestyle and diet, modern medicine still lacks effective treatment measures. Chinese patent medicine has the advantages of apparent curative effect, overall regulation and fewer side effects. However, there is a lack of research on the simultaneous comparison of various Chinese patent medicines. Therefore, we used a reticular meta-analysis to indirectly compare the efficacy and safety of different oral Chinese patent medicines through standard reference. METHOD We will conduct a comprehensive and systematic search of Chinese and English databases from the beginning to December 2020. All randomized controlled trials (RCTs) of oral Chinese patent medicine for NAFLD in children will be searched. The 2 researchers then independently filter the retrieved literature, extract the data according to the data extraction table and assess the risk of bias. We will perform a pair of meta-analyses and a Bayesian network meta-analysis. STATA and Win BUGS software will be used for data analysis. RESULTS This study will thoroughly compare and analyze the differences in the efficacy of all kinds of TCPM in NAFLD treatment in childhood or adolescence. CONCLUSION This study will provide reference and evidence support for clinical drug selection optimization. ETHICS AND DISSEMINATION This study does not require ethical approval. INPLASY REGISTRATION NUMBER 2020120068.
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Affiliation(s)
- Yuli Sun
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Zhaofeng Tan
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Zhenyuan Jiang
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Min Li
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Weiqin Wang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Yaoyao Huang
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Jianguang Sun
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
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Wu L, Li J, Feng J, Ji J, Yu Q, Li Y, Zheng Y, Dai W, Wu J, Guo C. Crosstalk between PPARs and gut microbiota in NAFLD. Biomed Pharmacother 2021; 136:111255. [PMID: 33485064 DOI: 10.1016/j.biopha.2021.111255] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/03/2021] [Accepted: 01/03/2021] [Indexed: 02/08/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has become the most common liver disorder in both China and worldwide. It ranges from simple steatosis and progresses over time to nonalcoholic steatohepatitis (NASH), advanced liver fibrosis, cirrhosis, or hepatocellular carcinoma(HCC). Furthermore, NAFLD and its complications impose a huge health burden to society. The microbiota is widely connected and plays an active role in human physiology and pathology, and it is a hidden 'organ' in determining the state of the host, in terms of homeostasis, or disease. Peroxisome proliferator-activated receptors (PPARs) are members of the nuclear receptorsuperfamily and can regulate multiple pathways involved in metabolism, and serve as effective targets forthe treatment of many types of metabolic syndromes, including NAFLD. The purpose of this review is to integrate related articles on gut microbiota, PPARs and NAFLD, and present a balanced overview on how the microbiota can possibly influence the development of NAFLD through PPARs.
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Affiliation(s)
- Liwei Wu
- Department of Gastroenterology, Putuo People's Hospital, Tongji University School of Medicine, Shanghai, 200060, China; Department of Gastroenterology, Shanghai Tenth People'sHospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Jingjing Li
- Department of Gastroenterology, Putuo People's Hospital, Tongji University School of Medicine, Shanghai, 200060, China; Department of Gastroenterology, Shanghai Tenth People'sHospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Jiao Feng
- Department of Gastroenterology, Shanghai Tenth People'sHospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Jie Ji
- Department of Gastroenterology, Shanghai Tenth People'sHospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Qiang Yu
- Department of Gastroenterology, Shanghai Tenth People'sHospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Yan Li
- Department of Gastroenterology, Shanghai Tenth People'sHospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Yuanyuan Zheng
- Department of Gastroenterology, Shanghai Tenth People'sHospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Weiqi Dai
- Department of Gastroenterology, Putuo People's Hospital, Tongji University School of Medicine, Shanghai, 200060, China; Department of Gastroenterology, Shanghai Tenth People'sHospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Jianye Wu
- Department of Gastroenterology, Putuo People's Hospital, Tongji University School of Medicine, Shanghai, 200060, China.
| | - Chuanyong Guo
- Department of Gastroenterology, Shanghai Tenth People'sHospital, Tongji University School of Medicine, Shanghai, 200072, China.
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Singeap AM, Stanciu C, Huiban L, Muzica CM, Cuciureanu T, Girleanu I, Chiriac S, Zenovia S, Nastasa R, Sfarti C, Cojocariu C, Trifan A. Association between Nonalcoholic Fatty Liver Disease and Endocrinopathies: Clinical Implications. Can J Gastroenterol Hepatol 2021; 2021:6678142. [PMID: 33505943 PMCID: PMC7814954 DOI: 10.1155/2021/6678142] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/31/2020] [Indexed: 02/08/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has a rising prevalence worldwide. Its potential for evolution towards liver cirrhosis and hepatocellular carcinoma, as well as associations with extrahepatic manifestations, represents a double burden for patients and physicians alike. Recently, there has been increasing evidence of the association between NAFLD and a number of endocrinopathies, such as hypothyroidism, polycystic ovarian syndrome (PCOS), hypopituitarism, growth hormone deficiency (GHD), hypogonadism, and hypercortisolism. Definite correlations are supported by clear evidence so far, but further studies are needed in order to completely clarify the pathogenic mechanisms and, especially, to identify therapeutic implications. In this review, we present the main relationships between NAFLD and endocrinopathies, emphasizing the reciprocal causality, evolutive interconnections, and current clinical scenarios of presentations of which the clinicians should be aware.
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Affiliation(s)
- Ana-Maria Singeap
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Carol Stanciu
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Laura Huiban
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Cristina Maria Muzica
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Tudor Cuciureanu
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Irina Girleanu
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Stefan Chiriac
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Sebastian Zenovia
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Robert Nastasa
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Catalin Sfarti
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Camelia Cojocariu
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Anca Trifan
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- 2Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
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20
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Li X, Wang H. Multiple organs involved in the pathogenesis of non-alcoholic fatty liver disease. Cell Biosci 2020; 10:140. [PMID: 33372630 PMCID: PMC7720519 DOI: 10.1186/s13578-020-00507-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/27/2020] [Indexed: 02/08/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) represents the leading cause of chronic liver disease worldwide and the anticipated health burden is huge. There are limited therapeutic approaches for NAFLD now. It’s imperative to get a better understanding of the disease pathogenesis if new treatments are to be discovered. As the hepatic manifestation of metabolic syndrome, this disease involves complex interactions between different organs and regulatory pathways. It’s increasingly clear that brain, gut and adipose tissue all contribute to NAFLD pathogenesis and development, in view of their roles in energy homeostasis. In the present review, we try to summarize currently available data regarding NAFLD pathogenesis and to lay a particular emphasis on the inter-organ crosstalk evidence.
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Affiliation(s)
- Xiaoyan Li
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Hua Wang
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China. .,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, 230032, China.
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21
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Zhao H, Yang A, Mao L, Quan Y, Cui J, Sun Y. Association Between Dietary Fiber Intake and Non-alcoholic Fatty Liver Disease in Adults. Front Nutr 2020; 7:593735. [PMID: 33330594 PMCID: PMC7710900 DOI: 10.3389/fnut.2020.593735] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/28/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Evidence on the association of non-alcoholic fatty liver disease (NAFLD), a public health concern, with dietary fiber intake is inconsistent. Objective: To investigate the relationship between dietary fiber intake from different sources and NAFLD risk in US adults. Methods: Data were collected from the 2007–2014 National Health and Nutrition Examination Survey. NAFLD was defined as a United States Fatty Liver Index ≥30, and dietary fiber intake was assessed through two 24-h dietary recall interviews. Logistic regression and restricted cubic spline models were used to explore the relationship of dietary intakes of total, cereal, fruit, and vegetable fiber with NAFLD risk. Results: A total of 6,613 participants, aged more than 20 years, were included in this study. After adjusting for multiple confounding factors, the odds ratios and 95% confidence intervals of NAFLD for the highest quartile vs. lowest quartile intakes of total, cereal, fruit, and vegetable fiber were 0.12 (0.08–0.16), 0.25 (0.19–0.33), 0.41 (0.33–0.52), and 0.42 (0.32–0.56), respectively. In stratified analyses by sex and age, statistically significant negative associations of dietary intakes of total, cereal, fruit, and vegetable fiber with NAFLD risk were observed in all participants. Dose-response analysis indicated a non-linear correlation between NAFLD risk and dietary intake of total fiber, whereas the relationship was linear for cereal, fruit, and vegetable fiber intakes. Conclusion: Total, cereal, fruit, and vegetable fiber intakes exhibit negative correlations with NAFLD risk in the general adult population in the United States.
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Affiliation(s)
- Huimin Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, China
| | - Aihua Yang
- Dept. of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lina Mao
- Qingdao Fuwai Cardiovascular Hospital, Qingdao, China
| | - Yaning Quan
- Qingdao Fuwai Cardiovascular Hospital, Qingdao, China
| | - Jiajia Cui
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, China
| | - Yongye Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, China
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22
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Ismaiel A, Leucuta DC, Popa SL, Fagoonee S, Pellicano R, Abenavoli L, Dumitrascu DL. Non-invasive biomarkers in predicting non-alcoholic steatohepatitis and assessing liver fibrosis: systematic review and meta-analysis. Panminerva Med 2020; 63:508-518. [PMID: 33165307 DOI: 10.23736/s0031-0808.20.04171-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Non-alcoholic steatohepatitis (NASH) is characterized by hepatic steatosis with inflammation, ballooned hepatocytes, and possible fibrosis, which may progress to liver cirrhosis. Although liver biopsy, remains the diagnostic gold standard of NASH, several noninvasive biomarkers have been studied, to avoid the need for this invasive procedure. We performed a systematic review with meta-analysis to evaluate the accuracy of several noninvasive biomarkers in predicting NASH and assessing liver fibrosis in NASH patients. EVIDENCE ACQUISITION An electronic search on PubMed and EMBASE was systematically performed. The principal summary outcome was the area under the curve (AUC), assessing the accuracy of NashTest, BARD (body mass index, AST/ALT ratio, diabetes) score, NAFLD fibrosis score (NFS), APRI (aspartate aminotransferase-to-platelet ratio index), and fibrosis-4 (FIB-4) index in predicting NASH and assessing liver fibrosis. EVIDENCE SYNTHESIS Thirteen studies involving 6,557 adult patients were included in the qualitative assessment of this review, out of which, six studies were included in the quantitative assessment. Prediction of NASH was evaluated better using NFS (AUC of 0.687) and FIB-4 (AUC of 0.729). Fibrosis stages 0 vs. 1-4 was diagnosed better using NFS (AUC of 0.718) and FIB-4 (AUC of 0.723). Advanced fibrosis was assessed better by BARD (AUC of 0.673), APRI (AUC of 0.762), NFS (AUC of 0.787) and FIB-4 (AUC of 0.821). CONCLUSIONS FIB-4 predicted NASH and quantified liver fibrosis, stages 0 vs. 1-4 more precisely compared to NFS, APRI, and BARD. However, considering that methodological quality of the assessed studies is limited, the results should be considered with caution.
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Affiliation(s)
- Abdulrahman Ismaiel
- Second Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniel-Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania -
| | - Stefan-Lucian Popa
- Second Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sharmila Fagoonee
- Institute for Biostructure and Bioimaging, National Research Council, Molecular Biotechnology Center, Turin, Italy
| | | | - Ludovico Abenavoli
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Dan L Dumitrascu
- Second Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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23
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Hu Y, Xu J, Chen Q, Liu M, Wang S, Yu H, Zhang Y, Wang T. Regulation effects of total flavonoids in Morus alba L. on hepatic cholesterol disorders in orotic acid induced NAFLD rats. BMC Complement Med Ther 2020; 20:257. [PMID: 32807146 PMCID: PMC7433163 DOI: 10.1186/s12906-020-03052-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Mulberry leaves are the dried leaves of Morus alba L., flavonoids from mulberry leaves (MLF) has showed regulatory effect on abnormal lipid metabolism, but the regulatory mechanism of MLF on cholesterol metabolism is still missing. This study was designed to investigate the effect of MLF and its active metabolite quercetin on regulating cholesterol disorders. METHODS The mechanism of MLF on alleviating liver injury and regulating cholesterol was examined in dyslipidemic SD rats. The regulatory mechanism of quercetin for cholesterol disorders have also been detected through lipid laden HepG2 cell model. RESULTS Our results showed that MLF significantly inhibited lipid accumulation and alleviate hepatic injury in NAFLD rat model. The hepatic expression level of SREBP2, HMGCR and miR-33a were significantly down-regulated, while CYP7A1 was induced by MLF treatment. In vitro, Quercetin significantly decreased lipid accumulation in HepG2 cells. Mechanistically, quercetin could inhibit the mRNA and protein expression level of SREBP2 and HMGCR with or without LDL treatment. In addition, quercetin could also reduce the LXRβ while induced SR-BI mRNA expression. CONCLUSION Our findings indicate that MLF and quercetin could reduce the excessive cholesterol accumulation in vivo and in vitro. These cholesterol-regulating phenomenon might attribute to its effect on down-regulating the expression of lipid-related markers such as SREBP2 and HMGCR, which may exert a protective role in the NAFLD treatment.
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Affiliation(s)
- Yucheng Hu
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Jingqi Xu
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Qian Chen
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Mengyang Liu
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Sijian Wang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Haiyang Yu
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Yi Zhang
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Tao Wang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
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Zhang X, Zhou X, Han X, Fu Z, Wang L, Li Y, Ji L. The Morbidity and Comorbidity of Nonalcoholic Fatty Liver Disease and Different Glucose Intolerance Strata in a Community-Based Chinese Population. Metab Syndr Relat Disord 2020; 18:284-290. [PMID: 32460629 PMCID: PMC7407000 DOI: 10.1089/met.2019.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To investigate the morbidity and comorbidity of nonalcoholic fatty liver disease (NAFLD) and different glucose intolerance strata in a community-based population and to explore the association between glucose tolerance levels and NAFLD. Methods: A community-based cohort established for Pinggu Metabolic Disease Study in a suburb of Beijing, China, was established from September 2013 to July 2014 using a random sampling method. Participants were eligible if they were born in Pinggu and had been living there for at least 5 years within the age range of 26-76 years. A 75 grams oral glucose tolerance test was used to determine the strata of glucose tolerance. Unenhanced abdominal computed tomography scan was performed to identify NAFLD. Results: A total of 3122 subjects were included in this analysis. The prevalence of NAFLD was 22.68% (27.58% vs. 19.97% among men and women). The prevalence of type 2 diabetes (T2D) was 18.03% (20.83% vs. 16.22% among men and women). Up to 7.21% of residents had both T2D and NAFLD. 39.96% of diabetic patients and 28.77% of prediabetic patients combined with NAFLD. Compared with adults with normal glucose tolerance, the incidence of NAFLD in T2D patients was more than three times higher after adjusting for sex, age, body mass index (BMI), sedentary time, and dietary habit [odds ratio (OR) = 3.58, confidence interval (95% CI) 2.80-4.58, P < 0.001]. NAFLD was also more common in individuals with prediabetes, especially patients with impaired glucose tolerance (IGT) (OR = 2.27, 1.75-2.95) or impaired fasting glucose+IGT (OR = 2.78, 1.92-4.03). Conclusions: The morbidity and comorbidity of NAFLD and glucose intolerance are high in the Pinggu population in northern China, highlighting the importance of early prevention and treatment of these two diseases at the same time.
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Affiliation(s)
- Xiuying Zhang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Centre, Beijing, China
| | - Xianghai Zhou
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Centre, Beijing, China
| | - Xueyao Han
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Centre, Beijing, China
| | - Zuodi Fu
- Department of Endocrinology and Metabolism, Pinggu Hospital, Capital Medical University, Beijing, China
| | - Lianying Wang
- Department of Endocrinology and Metabolism, Pinggu Hospital, Capital Medical University, Beijing, China
| | - Yufeng Li
- Department of Endocrinology and Metabolism, Pinggu Hospital, Capital Medical University, Beijing, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Centre, Beijing, China
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25
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Goldshtein I, Chodick G, Kochba I, Gal N, Webb M, Shibolet O. Identification and Characterization of Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2020; 18:1887-1889. [PMID: 31404663 DOI: 10.1016/j.cgh.2019.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 08/04/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is characterized by substantial diagnostic and evaluation gaps with no systematic screening. Even recognized cases are undercoded because of the perceived benign nature of disease and current absence of approved pharmacologic treatment. NAFLD is often detected incidentally, particularly in the asymptomatic early phase. We doubled NAFLD detection via natural language processing of 1 million imaging reports combined with laboratory data from an unselected population. We describe NAFLD comorbidities and health care utilization as compared with age, sex, and body mass index matched control subjects.
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Affiliation(s)
- Inbal Goldshtein
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
| | - Gabriel Chodick
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Kochba
- Gilead Sciences, Europe, Middle East and Africa Medical Affairs, Hod-Hasharon, Israel
| | - Nitsan Gal
- Gilead Sciences, Europe, Middle East and Africa Medical Affairs, Hod-Hasharon, Israel
| | - Muriel Webb
- Radiology Institute, Maccabi Healthcare Services, Tel Aviv, Israel; Department of Gastroenterology and Hepatology, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel
| | - Oren Shibolet
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Gastroenterology and Hepatology, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel
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26
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Liu SS, Ma XF, Zhao J, Du SX, Zhang J, Dong MZ, Xin YN. Association between nonalcoholic fatty liver disease and extrahepatic cancers: a systematic review and meta-analysis. Lipids Health Dis 2020; 19:118. [PMID: 32475354 PMCID: PMC7262754 DOI: 10.1186/s12944-020-01288-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/15/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND NAFLD is tightly associated with various diseases such as diabetes, cardiovascular disease, kidney disease, and cancer. Previous studies had investigated the association between NAFLD and various extrahepatic cancers, but the available data to date is not conclusive. The aim of this study was to investigate the association between NAFLD and various extrahepatic cancers comprehensively. METHODS Searches were conducted of various electronic databases (PubMed, EMBASE, Medline, and the Cochrane Library) to identify observational studies published between 1996 and January 2020 which investigated the association between NAFLD and extrahepatic cancers. The pooled OR/HR/IRR of the association between NAFLD and various extrahepatic cancers were analyzed. RESULTS A total of 26 studies were included to investigate the association between NAFLD and various extrahepatic cancers. As the results shown, the pooled OR values of the risk of colorectal cancer and adenomas in patients with NAFLD were 1.72 (95%CI: 1.40-2.11) and 1.37 (95%CI: 1.29-1.46), respectively. The pooled OR values of the risk of intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma in patients with NAFLD were 2.46 (95%CI: 1.77-3.44) and 2.24 (95%CI: 1.58-3.17), respectively. The pooled OR value of the risk of breast cancer in patients with NAFLD was 1.69 (95%CI: 1.44-1.99). In addition, NAFLD was also tightly associatied with the risk of gastric cancer, pancreatic cancer, prostate cancer, and esophageal cancer. CONCLUSIONS NAFLD could significantly increase the development risk of colorectal adenomas and cancer, intrahepatic and extrahepatic cholangiocarcinoma, breast, gastric, pancreatic, prostate, and esophageal cancer. NAFLD could be considered as one of the influencing factors during the clinical diagnosis and treatment for the extrahepatic cancers.
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Affiliation(s)
- Shou-Sheng Liu
- Central Laboratories, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266071, China
- Digestive Disease Key Laboratory of Qingdao, Qingdao, 266071, China
| | - Xue-Feng Ma
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266011, China
| | - Jie Zhao
- Departments of Nephrology, Zibo Central Hospital, Zibo, 255020, China
| | - Shui-Xian Du
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266011, China
| | - Jie Zhang
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266011, China
| | - Meng-Zhen Dong
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266011, China
| | - Yong-Ning Xin
- Digestive Disease Key Laboratory of Qingdao, Qingdao, 266071, China.
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266011, China.
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Yan Y, Liu C, Zhao S, Wang X, Wang J, Zhang H, Wang Y, Zhao G. Probiotic Bifidobacterium lactis V9 attenuates hepatic steatosis and inflammation in rats with non-alcoholic fatty liver disease. AMB Express 2020; 10:101. [PMID: 32472368 PMCID: PMC7260323 DOI: 10.1186/s13568-020-01038-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/23/2020] [Indexed: 02/08/2023] Open
Abstract
Both steatosis and inflammation are key pathological events in the progression of non-alcoholic fatty liver disease (NAFLD). Probiotics are beneficial for the prevention and treatment of NAFLD. Bifidobacterium animalis subsp. lactis V9 (V9) is a newly isolated strain with favorable probiotic properties. The study aims to evaluate the effects and mechanisms of V9 on the hepatic steatosis and inflammatory responses in a rat model of NAFLD induced by high-fat diets (HFD). Our results showed that administration of V9 significantly attenuated the HFD-induced increases in alanine transaminase (ALT) and aspartate aminotransferase (AST) levels, resulting in alleviated hepatic steatosis. V9 supplementation reduced the accumulation of hepatic triglyceride and free fatty acid,while increasing the levels of glycogen. Serum levels of glucose were also decreased in HFD rats administrated with V9. Meanwhile, the transcription of SREBP-1c and FAS was reduced, and the hepatic expression of phosphorylated-AMPK and PPAR-α was restored after V9 administration. V9 suppressed the production of inflammatory cytokines (e.g. IL-6, IL-1β, and TNF-α) in HFD-fed rats. The anti-inflammatory effects of V9 was found to be associated with the inhibition of hepatic expression of TLR4, TLR9, NLRP3, and ASC mRNA. Furthermore, the activation of ERK, JNK, AKT and NF-κB were suppressed by V9 treatment. These results indicate that Bifidobacterium lactis V9 improves NAFLD by regulating de novo lipid synthesis and suppressing inflammation through AMPK and TLR-NF-κB pathways, respectively.
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Abstract
Patients with a current diagnosis of breast cancer are enjoying dramatic cure rates and survivorship secondary to an increase in awareness, earlier detection, and more effective therapies. Although strategies such as Breast Cancer Awareness Month in October focus on early detection, lifestyle changes are seldom discussed other than dietary concerns and physical activity. Lifestyle modifications centered on diet and exercise have been demonstrated to affect overall disease-free survival in breast cancer. Since the early 2000s, the role of the human gut microbiota and its relation to breast cancer has become a major area of interest in the scientific and medical community. We live and survive owing to the symbiotic relationship with the microorganisms within us: the human microbiota. Scientific advances have identified a subset of the gut microbiota: the estrobolome, those bacteria that have the genetic capability to metabolize estrogen, which plays a key role in most breast cancers. Recent research provides evidence that the gut microbiome plays a substantial role in estrogen regulation. Gut microbiota diversity appears to be an essential component of overall health, including breast health. Future research attention should include a more extensive focus on the role of the human gut microbiota in breast cancer.
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Affiliation(s)
- Balazs I Bodai
- The Breast Cancer Survivorship Institute, Kaiser Permanente, Sacramento, CA
| | - Therese E Nakata
- The Breast Cancer Survivorship Institute, Kaiser Permanente, Sacramento, CA
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Kwak MS, Yim JY, Yi A, Chung GE, Yang JI, Kim D, Kim JS, Noh DY. Nonalcoholic fatty liver disease is associated with breast cancer in nonobese women. Dig Liver Dis 2019; 51:1030-1035. [PMID: 30686716 DOI: 10.1016/j.dld.2018.12.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/20/2018] [Accepted: 12/24/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Growing evidence supports that nonalcoholic fatty liver disease (NAFLD) is associated with extrahepatic cancers. Nonalcoholic fatty liver disease (NAFLD) and breast cancer share similar risk factors, including obesity. AIM The aim of this case-control study was to investigate the association between NAFLD and breast cancer. METHODS Subjects who received health screening, including mammography and breast and hepatic ultrasonography simultaneously, were included. Subjects diagnosed with breast cancer were matched with controls. Conditional logistic regression analyses were performed. RESULTS Among 270 breast cancer patients and 270 controls, 81 cancer patients (30.0%) and 54 controls (20.0%) had NAFLD (P = 0.008). NAFLD was significantly associated with breast cancer in multivariate analysis (P = 0.046). When the interaction between obesity (BMI < 25 kg/m2 vs. ≥25 kg/m2) and NAFLD in breast cancer patients was examined, a significant effect modification between obesity and NAFLD in breast cancer was noted (P = 0.021). The subgroup analysis showed that NAFLD was significantly associated with breast cancer in the nonobese subgroup (odds ratio 3.04, 95% confidence interval 1.37-4.32, P = 0.002) but not in the obese group (P = 0.163). CONCLUSIONS NAFLD was significantly associated with breast cancer independent of traditional risk factors, and this association existed in the nonobese subgroup but not in the obese subgroup.
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Affiliation(s)
- Min-Sun Kwak
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
| | - Jeong Yoon Yim
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
| | - Ann Yi
- Department of Radiology, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
| | - Goh-Eun Chung
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
| | - Jong In Yang
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
| | - Joo Sung Kim
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
| | - Dong-Young Noh
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
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30
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Zhao L, Wang Q, Zhu X, Wang Y, Wan Y, Li H, Ma F, Ma C, Yang X, Zhu Y. Liver-protecting effects of extracts from Glossy privet fruit and Ecliptae herba formula in mice through suppression of Kupffer cells activation. FOOD AGR IMMUNOL 2019. [DOI: 10.1080/09540105.2019.1571565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Lijun Zhao
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- National Engineering Research Center for Nanomedicine, Wuhan, People’s Republic of China
| | - Qi Wang
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- National Engineering Research Center for Nanomedicine, Wuhan, People’s Republic of China
| | - Xiaoqiang Zhu
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- National Engineering Research Center for Nanomedicine, Wuhan, People’s Republic of China
| | - Yuanyuan Wang
- Joint Laboratory for the Research of Pharmaceutics, Huazhong University of Science and Technology and Infinitus, Wuhan, People’s Republic of China
| | - Yun Wan
- National Engineering Research Center for Nanomedicine, Wuhan, People’s Republic of China
| | - Hailong Li
- Joint Laboratory for the Research of Pharmaceutics, Huazhong University of Science and Technology and Infinitus, Wuhan, People’s Republic of China
| | - Fangli Ma
- Joint Laboratory for the Research of Pharmaceutics, Huazhong University of Science and Technology and Infinitus, Wuhan, People’s Republic of China
| | - Chungwah Ma
- Joint Laboratory for the Research of Pharmaceutics, Huazhong University of Science and Technology and Infinitus, Wuhan, People’s Republic of China
| | - Xiangliang Yang
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- National Engineering Research Center for Nanomedicine, Wuhan, People’s Republic of China
| | - Yanhong Zhu
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- National Engineering Research Center for Nanomedicine, Wuhan, People’s Republic of China
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31
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Zhu P, Lu H, Jing Y, Zhou H, Ding Y, Wang J, Guo D, Guo Z, Dong C. Interaction Between AGTR1 and PPARγ Gene Polymorphisms on the Risk of Nonalcoholic Fatty Liver Disease. Genet Test Mol Biomarkers 2019; 23:166-175. [PMID: 30793973 DOI: 10.1089/gtmb.2018.0203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
AIMS Nonalcoholic fatty liver disease (NAFLD) is an important public health issue worldwide. Several recent studies have reported that peroxisome proliferator-activated receptor-γ (PPARγ) and angiotensin II type 1 receptor (AGTR1) variants are associated with NAFLD occurrence, but the results have been inconsistent. The aim of this study was to analyze the interactions between PPARγ and AGTR1 polymorphisms and their associations with NAFLD in Chinese adults. METHODS Seven single nucleotide polymorphisms (SNPs) of the PPARγ gene and 5 SNPs of the AGTR1 gene were selected and genotyped in 1591 unrelated Chinese adults. The SNPAssoc package of R was used to examine the relationships between the selected SNPs and NAFLD. RESULTS After adjusting the covariance, the results from the overdominant model showed that participants carrying the T/C genotype of rs2638360 in AGTR1 have a decreased risk of NAFLD compared with those with T/T-C/C genotypes (odds ratio: 0.70, 95% confidence interval: 0.49-1.00). However, our results showed that none of the selected PPARγ variants were significantly associated with the risk of NAFLD after applying a false discovery rate correction. Among the 12 selected SNPs from PPARγ and AGTR1, model-based multifactor dimensionality reduction (MB-MDR) analyses for gene-gene interactions revealed that all the models were significantly associated with the increased risk of NAFLD (p < 0.05) except the 2-, 10-, 11-, and 12-locus models. Further, among the 10 SNPs negatively associated with NAFLD, the four-locus model (rs13431696 and rs3856806 in PPARγ, and rs5182, rs1492100 in ATGR1) and the five-locus model (rs9817428, rs1175543, rs13433696, and rs2920502 in PPARγ, and rs1492100 in ATGR1) were closely related with NAFLD susceptibility (p = 0.019 and p = 0.048, respectively). CONCLUSION Our present study suggests that interactions among multiple AGTR1 and PPARγ polymorphisms are associated with the risk of NAFLD in the Chinese population.
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Affiliation(s)
- Peifu Zhu
- 1 Zhangjiagang First People's Hospital, Suzhou, China
| | | | - Yang Jing
- 3 Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, China
| | - Hui Zhou
- 4 Suzhou Industrial Park Centers for Disease Control and Prevention, Suzhou, China
| | - Yi Ding
- 4 Suzhou Industrial Park Centers for Disease Control and Prevention, Suzhou, China
| | - Jie Wang
- 3 Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, China
| | - Daoxia Guo
- 3 Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, China
| | - Zhirong Guo
- 3 Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, China
| | - Chen Dong
- 3 Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, China
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Nam GE, Hwang SY, Chung HS, Choi JH, Lee HJ, Kim NH, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi KM. Implication of Nonalcoholic Fatty Liver Disease, Metabolic Syndrome, and Subclinical Inflammation on Mild Renal Insufficiency. Int J Endocrinol 2018; 2018:1835486. [PMID: 29808087 PMCID: PMC5902012 DOI: 10.1155/2018/1835486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/22/2018] [Accepted: 03/13/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Limited information exists about the impact of nonalcoholic fatty liver disease (NAFLD) on mild renal insufficiency. We compared the relative influence of NAFLD, metabolic syndrome (MetS), and subclinical inflammation, alone or in combination, on mild renal insufficiency. METHODS This study included 1174 Korean adults. NAFLD was diagnosed using ultrasonography. Mild renal insufficiency was defined as an estimated glomerular filtration rate (eGFR) ≥ 60 and <90 mL/min/1.73 m2. RESULTS In partial correlation analysis, several components of MetS and liver aminotransferase levels, but not high-sensitivity C-reactive protein (hsCRP), were associated with eGFR. Multivariate logistic regression analysis demonstrated the independent association of NAFLD (P = 0.034) and MetS (P = 0.018) with mild renal insufficiency, but not elevated hsCRP (P = 0.885). Furthermore, NAFLD without the MetS group (odds ratio (95% confidence interval) = 1.56 (1.05-2.34)) or MetS without the NAFLD group (1.82 (1.11-3.00)) was associated with mild renal insufficiency after adjusting for confounding variables. However, individuals with high hsCRP showed no relationship with mild renal insufficiency, irrespective of the existence of NAFLD. CONCLUSIONS This study demonstrated that NAFLD and MetS are independently associated with mild renal insufficiency, whereas subclinical inflammation did not affect the risk for mild renal insufficiency in Korean adults.
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Affiliation(s)
- Ga Eun Nam
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
- Department of Family Medicine, Sahmyook Medical Center, 80 Mangu-ro, Dongdaemun-gu, Seoul 02500, Republic of Korea
| | - Soon Young Hwang
- Department of Biostatistics, College of Medicine, Korea University, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
| | - Ju Hee Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
| | - Hyun Jung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
| | - Ji-A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, 80 Guro-dong, Guro-gu, Seoul 152-050, Republic of Korea
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Jiang B, Gu T, Zhou K, Zheng Y, Guo Y, Lu Y. Fatty Liver as a Potential Surrogate for Waist Circumference in the Diagnosis of Metabolic Syndrome: A Population-Based Study among Chinese Adults. Int J Endocrinol 2018; 2018:7903982. [PMID: 29849623 PMCID: PMC5914088 DOI: 10.1155/2018/7903982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/18/2017] [Accepted: 01/21/2018] [Indexed: 01/11/2023] Open
Abstract
Increased waist circumference (WC) is an essential component of metabolic syndrome (MetS). Asians have been found to have more intra-abdominal adipose tissue than Caucasians, in spite of having smaller WC. The purpose of this study was to explore whether NAFLD could be used as a surrogate for MetS diagnosis in the normal WC population. A total of 9694 Chinese residents were selected from SPECT-China, a population-based survey of Chinese adults aged ≥ 18 years in East China. Insulin resistance was calculated by the homeostatic model assessment for insulin resistance (HOMA-IR). MetS z-score was used to evaluate the degree of total metabolic disorder. Logistic regression models were used to obtain the associations between different categories and metabolic syndrome (MetS) components. The prevalence of NAFLD was 27.6%, in which 35.2% were without abnormal WC. Subjects with only NAFLD had similarly severe insulin resistance and OR for clustering of MetS components compared with those with only abnormal WC. A considerable number of NAFLD cases, although had severe metabolic disorder, would not be detected by the current MetS definition. NAFLD could be used as a potential surrogate marker for the diagnosis of MetS in normal WC population.
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Affiliation(s)
- Boren Jiang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Gu
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Zhou
- Department of Gastroenterology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanjun Zheng
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyu Guo
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingli Lu
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kim GA, Lee HC, Choe J, Kim MJ, Lee MJ, Chang HS, Bae IY, Kim HK, An J, Shim JH, Kim KM, Lim YS. Association between non-alcoholic fatty liver disease and cancer incidence rate. J Hepatol 2017; 68:S0168-8278(17)32294-8. [PMID: 29150142 DOI: 10.1016/j.jhep.2017.09.012] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 08/11/2017] [Accepted: 09/11/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Little is known about the association between non-alcoholic fatty liver disease (NAFLD) and cancer development. This study investigated the cancer incidence rates in NAFLD and analysed the association between NAFLD and cancer development. METHODS This historical cohort study included subjects who were followed up for >1 year after having a heath checkup at a tertiary hospital in Korea from September 1, 2004 to December 31, 2005. NAFLD was diagnosed by ultrasonographic detection of hepatic steatosis in the absence of other known liver disease, including alcoholic or viral hepatitis. Cox proportional hazards regression model was conducted to assess the association between NAFLD and cancer development. RESULTS Of 25,947 subjects, 8,721 (33.6%) had NAFLD. During the total follow-up of 164,671 person-years (median 7.5 years), the cancer incidence rate of the NAFLD group was higher than that of the non-NAFLD group (782.9 vs. 592.8 per 100,000 person-years; hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.17-1.49; p <0.001). When demographic and metabolic factors were adjusted for, NAFLD showed a strong association with three cancers: hepatocellular carcinoma ([HCC]; HR 16.73; 95% CI 2.09-133.85; p = 0.008), colorectal cancer in males (HR 2.01; 95% CI 1.10-3.68; p = 0.02), and breast cancer in females (HR 1.92; 95% CI 1.15-3.20; p = 0.01). A high NAFLD fibrosis score (NFS) and a high fibrosis-4 (FIB-4) score were associated with the development of all cancers and HCC. CONCLUSION NAFLD was associated with the development of HCC, colorectal cancer in males, and breast cancer in females. A high NFS and a high FIB-4 score showed a strong association with the development of all cancers and HCC. LAY SUMMARY Non-alcoholic fatty liver disease (NAFLD) is associated with developing hepatocellular carcinoma (HCC). There have been limited data on the association between NAFLD and extrahepatic cancers. This study demonstrated that patients with NAFLD showed a higher association with the development of HCC, colorectal cancer in males, and breast cancer in females. A high NAFLD fibrosis score and a high fibrosis-4 score showed a strong association with the development of all cancers and HCC.
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Affiliation(s)
- Gi-Ae Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han Chu Lee
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Jaewon Choe
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Min-Ju Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Jung Lee
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye-Sook Chang
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - In Young Bae
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hong-Kyu Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jihyun An
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ju Hyun Shim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kang Mo Kim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Suk Lim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Hartleb M, Barański K, Zejda J, Chudek J, Więcek A. Non-alcoholic fatty liver and advanced fibrosis in the elderly: Results from a community-based Polish survey. Liver Int 2017; 37:1706-1714. [PMID: 28489307 DOI: 10.1111/liv.13471] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 04/28/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Development of non-alcoholic fatty liver (NAFL) is dependent on metabolic factors occurring at an increased frequency with advancing age. Until now, few studies have explored the prevalence of NAFL in aged populations. Our study aimed to determine the prevalence of NAFL and advanced fibrosis in the elderly population participating in a national survey of a community-based elderly cohort. METHODS A total of 3003 participants (mean age 79.6 years, 46.8% male) were enrolled in the study, after applying the following exclusion criteria: individuals younger than 65 years old (n=829) and those with positive serological biomarkers of HBV or HCV infection (n=391), chronic alcohol ingestion (n=727) or incomplete data records (n=745). Based on the fatty liver index (FLI), the participants were classified into three categories: FLI<30 (no NAFL), 30≤FLI<60 (borderline) and FLI≥60 (NAFL). According to the non-alcoholic fatty liver disease (NAFLD) fibrosis score (NFS), the participants were divided into three advanced fibrosis risk categories: NFS<-1.455 (low risk), -1.455≤NFS≤0.676 (intermediate risk) and NFS>0.676 (high risk). RESULTS The prevalence of NAFL in the general population was 37.2%; the prevalence reached 51.4% in participants 65-70 years of age and decreased with advancing age (P<.0001). The prevalence of advanced fibrosis was 7.79% (14.8% in the NAFL population) and increased with advancing age (P<.005). CONCLUSIONS The prevalence of NAFL and metabolically driven advanced fibrosis are relatively common in the elderly population, and these hepatic conditions run in adverse directions with advancing age.
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Affiliation(s)
- Marek Hartleb
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Kamil Barański
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Zejda
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jerzy Chudek
- Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantology and Internal Diseases, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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Ebert T, Linder N, Schaudinn A, Busse H, Berger J, Lichtinghagen R, Keim V, Wiegand J, Karlas T. Association of fetuin B with markers of liver fibrosis in nonalcoholic fatty liver disease. Endocrine 2017; 58:246-252. [PMID: 28914407 DOI: 10.1007/s12020-017-1417-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 08/30/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The liver-derived plasma protein fetuin B is associated with nonalcoholic fatty liver disease (NAFLD) and impaired glucose homeostasis in mice. However, its association with non-invasive ultrasound- and magnetic resonance (MR)-based markers of liver fibrosis and steatosis, the enhanced liver fibrosis (ELF) score, liver biopsy, as well as rs738409 in PNPLA3, has not been elucidated in NAFLD, so far. DESIGN AND METHODS The association of circulating fetuin B and transient elastography (TE), controlled attenuation parameter (CAP), 1H-MR-spectroscopy, the ELF score, liver biopsy, as well as risk alleles in rs738409 in PNPLA3, was studied in 101 NAFLD patients as compared to 15 healthy controls. RESULTS Serum fetuin B levels did not differ between NAFLD patients and controls (p = 0.863). Fetuin B was independently and negatively associated with transient elastography liver stiffness measurement (LSM) (p = 0.002), but not with the steatosis markers CAP or 1H-MR-spectroscopy. Fetuin B serum concentrations were significantly lower in individuals with LSM > 7.0 kPa as compared to patients with LSM < 7.0 kPa (p = 0.024). Furthermore, the ELF score and histologically proven fibrosis were independent and negative predictors of circulating fetuin B. Moreover, serum fetuin B significantly depended on number of rs738409 risk alleles (p = 0.026). CONCLUSIONS Fetuin B is independently and negatively associated with non-invasive markers of liver fibrosis and PNPLA3 status in NAFLD patients but does not show a correlation with the hepatic lipid content. Future studies need to elucidate the pathophysiological significance of fetuin B in NAFLD and its potential value as predictor for disease severity.
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Affiliation(s)
- Thomas Ebert
- Department of Endocrinology and Nephrology, University of Leipzig, 04103, Leipzig, Germany.
- Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany.
| | - Nicolas Linder
- Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Alexander Schaudinn
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Harald Busse
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Joachim Berger
- Division of Gastroenterology and Rheumatology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Ralf Lichtinghagen
- Institute of Clinical Chemistry, Hannover Medical School, 30625, Hannover, Germany
| | - Volker Keim
- Division of Gastroenterology and Rheumatology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Johannes Wiegand
- Division of Gastroenterology and Rheumatology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Thomas Karlas
- Division of Gastroenterology and Rheumatology, University Hospital Leipzig, 04103, Leipzig, Germany
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Ding YH, Ma Y, Qian LY, Xu Q, Wang LH, Huang DS, Zou H. Linking atrial fibrillation with non-alcoholic fatty liver disease: potential common therapeutic targets. Oncotarget 2017; 8:60673-60683. [PMID: 28948002 PMCID: PMC5601170 DOI: 10.18632/oncotarget.19522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 07/13/2017] [Indexed: 01/18/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF) are common chronic non-infectious diseases with rising incidences. NAFLD is an independent risk factor for the onset of AF, after adjusting potentially related factors. The pathogenesis of these diseases share several mechanisms including reduced adiponectin level, insulin resistance, and renin angiotensin aldosterone system (RAAS) activation, in addition to activation of common disease pathways that promote inflammation, oxidative stress, and fibrosis. Furthermore, statins and RAAS blockers exert therapeutic effects concurrently on NAFLD and AF. The common pathogenesis of NAFLD and AF may serve as a potential therapeutic target in the future.
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Affiliation(s)
- Ya-Hui Ding
- Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.,People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Yuan Ma
- Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.,People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Lin-Yan Qian
- Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.,People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Qiang Xu
- Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.,People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Li-Hong Wang
- Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.,People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Dong-Sheng Huang
- Department of Hepatobiliary Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.,People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Hai Zou
- Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.,People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
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Laou E, Milionis H, Petrou A, Arnaoutoglou E, Glantzounis G, Bairaktari E, Mavridis D, Mikhailidis DP, Papadopoulos G, Tzimas P. The impact of metabolic syndrome and its components on perioperative outcomes after elective laparotomy - A prospective observational study. Am J Surg 2017; 214:831-837. [PMID: 28330739 DOI: 10.1016/j.amjsurg.2017.02.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 02/01/2017] [Accepted: 02/25/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) represents a constellation of risk factors, including central obesity, elevated fasting blood glucose, high blood pressure and atherogenic dyslipidemia. This prospective observational study aimed to assess the impact of MetS on perioperative outcomes of patients undergoing elective abdominal surgery with laparotomy. METHODS We included 105 consecutive non-diabetic patients undergoing elective abdominal surgery with laparotomy. Patients were divided into two groups based on MetS diagnosis. Perioperative adverse events were recorded according to the definitions of the European Perioperative Clinical Outcome guidelines. RESULTS The prevalence of MetS was 57.1%. The presence of MetS was associated with a 2.64 higher odds (95% CI 1.18-5.95, P = 0.019) for respiratory events and a 3.42 higher odds (95% CI 1.05-11.13, P = 0.041) for superficial surgical site infections. Furthermore, regarding MetS patients, all individual components of MetS were associated with worse outcomes in an independent manner. CONCLUSIONS MetS as an entity along with its individual components are associated with an increased risk of perioperative events in patients undergoing elective abdominal surgery with laparotomy.
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Affiliation(s)
- Eleni Laou
- Department of Anesthesia and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
| | - Haralampos Milionis
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
| | - Anastasios Petrou
- Department of Anesthesia and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
| | - Eleni Arnaoutoglou
- Department of Anesthesia and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
| | - Georgios Glantzounis
- Department of Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
| | - Eleni Bairaktari
- Laboratory of Clinical Chemistry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
| | - Dimitrios Mavridis
- Department of Hygiene and Epidemiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), Pond Street, London NW3 2QG, UK.
| | - Georgios Papadopoulos
- Department of Anesthesia and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
| | - Petros Tzimas
- Department of Anesthesia and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina University Campus, Stavros Niarchos Ave., Ioannina 45110, Greece.
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Associations between Serum Uric Acid and the Remission of Non-Alcoholic Fatty Liver Disease in Chinese Males. PLoS One 2016; 11:e0166072. [PMID: 27835657 PMCID: PMC5106003 DOI: 10.1371/journal.pone.0166072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/21/2016] [Indexed: 12/31/2022] Open
Abstract
Epidemiological studies suggest that higher serum uric acid (sUA) level is significantly associated with nonalcoholic fatty liver disease (NAFLD) development. However, little information is available on the relationships between sUA and NAFLD remission. In the present study, 841 NAFLD males (30-75 years) were recruited from a Chinese prospective cohort study (PMMJS) and followed up for five years. The baseline sUA levels of participants were categorized into four quartiles: 191 μmol/L≤ sUA ≤ 347 μmol/L, 347 μmol/L < sUA ≤ 392 μmol/L, 392 μmol/L < sUA ≤ 441 μmol/L and 441 μmol/L<SUA≤676 μmol/L. As the results show, participants with elevated sUA levels at baseline were significantly associated with the decreased rate of NAFLD remission at the end of study (p<0.0001). After adjustment, RR (95%CI) for remitted NAFLD comparing Q1 to Q3 vs Q4 of sUA were 2.95 (1.49-5.83), 2.40 (1.22-4.73) and 1.39 (0.67-2.86), respectively. Furthermore, the sensitivity analysis showed these significant associations were not affected even after exclusion of participants who had hypertension, diabetes mellitus, MetS and hyperlipidemia. Additionally, the presence of the lowest quartile of sUA levels was still significantly associated with remitted NAFLD when the study population was stratified according to the smoking, and the median values of age, ALT, AST, serum creatinine, HDL-C and LDL-C. Therefore, our present study extended the previous findings and suggested that modulation of sUA levels may attenuate the progression of NAFLD.
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