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Bai J, Wang S, Pan H, Shi Z, Zhao M, Yue X, Yang K, Zhang X, Wang W, Liu C, Zhang T. Correlation analysis of dynamic changes of abdominal fat during rapid weight loss after bariatric surgery: A prospective magnetic resonance imaging study. Eur J Radiol 2024; 178:111630. [PMID: 39024662 DOI: 10.1016/j.ejrad.2024.111630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 06/20/2024] [Accepted: 07/14/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE The factors related to the changes in the liver and abdominal adipose tissue during the rapid weight loss after bariatric surgery remain uncertain. METHODS This study included 44 participants who had undergone sleeve gastrectomy. The study aimed to analyze changes and correlations of body weight (BW), laboratory tests, and magnetic resonance imaging (MRI) indicators of the liver and abdominal adipose tissue conducted before and after bariatric surgery at 1, 3, and 6 months. RESULTS Following a rapid weight loss within 6 months of surgery, there was a concurrent decrease in blood glucose, blood lipids, and fat content of the liver and abdomen and the changes showed a correlation. The change of BW (ΔBW) was positively correlated with the change of hepatic proton density fat fraction (ΔPDFF) in one and three months after surgery and was positively correlated with the change of abdominal visceral fat area (ΔAVFA) in six months after surgery, (P<0.05). In one month after surgery, ΔPDFF was positively correlated with the change of aspartate aminotransferase (ΔAST), change of alanine aminotransferase (ΔALT), and change of triglyceride glucose (ΔTYG) index (P<0.05). ΔPDFF was positively correlated with the change of hepatic native T1 values (P<0.001) and was moderately negatively correlated with the change of hepatic apparent diffusion coefficient (ΔADC) values in three months after surgery (P<0.05). CONCLUSION ΔBW can serve as an indirect indicator for evaluating changes in liver fat fraction at 1 and 3 months after bariatric surgery and indicative of changes in visceral fat 6 months after surgery. ΔPDFF was positively correlated with ΔAST, ΔALT and ΔTYG index in 1 months after surgery.
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Affiliation(s)
- Jinquan Bai
- Department of Radiology, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, YiYuan Street, NanGang District, Harbin 150001, Heilongjiang, China
| | - Shuting Wang
- Department of Radiology, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, YiYuan Street, NanGang District, Harbin 150001, Heilongjiang, China
| | - Hong Pan
- Department of Radiology, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, YiYuan Street, NanGang District, Harbin 150001, Heilongjiang, China
| | - Zhenzhou Shi
- Department of Radiology, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, YiYuan Street, NanGang District, Harbin 150001, Heilongjiang, China
| | - Min Zhao
- Pharmaceutical Diagnostics, GE Healthcare, No. 1, Tongji South Road, Daxing District, Beijing 100176, China
| | - Xiuzheng Yue
- Philips Healthcare, Tower No. 2, The World Profit Centre, No. 16, Tianze Road, Chaoyang District, Beijing 100600, China
| | - Kai Yang
- Department of Bariatric and Metabolic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, YiYuan Street, NanGang District, Harbin 150001, Heilongjiang, China
| | - Xia Zhang
- Department of Bariatric and Metabolic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, YiYuan Street, NanGang District, Harbin 150001, Heilongjiang, China
| | - Wei Wang
- The MRI Room, The First Affliated Hospital of Harbin Medical University, No. 23, YouZheng Street, NanGang District, Harbin 150001, Heilongjiang, China
| | - Chang Liu
- Department of Bariatric and Metabolic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, YiYuan Street, NanGang District, Harbin 150001, Heilongjiang, China.
| | - Tong Zhang
- Department of Radiology, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, YiYuan Street, NanGang District, Harbin 150001, Heilongjiang, China.
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Malandris K, Papandreou S, Vasilakou D, Kakotrichi P, Sarakapina A, Kalopitas G, Karagiannis T, Giouleme O, Bekiari E, Liakos A, Iatridi F, Paschos P, Sinakos E, Tsapas A. Efficacy of pharmacologic interventions on magnetic resonance imaging biomarkers in patients with nonalcoholic fatty liver disease: systematic review and network meta-analysis. J Gastroenterol Hepatol 2024; 39:1219-1229. [PMID: 38627972 DOI: 10.1111/jgh.16559] [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: 11/21/2023] [Revised: 03/14/2024] [Accepted: 03/25/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND AND AIM Several agents are under investigation for nonalcoholic fatty liver disease (NAFLD). We assessed the comparative efficacy of pharmacologic interventions for patients with NAFLD focusing on magnetic resonance imaging (MRI) biomarkers. METHODS We searched Medline, Embase, and CENTRAL. We included randomized controlled trials of more than 12 weeks of intervention that recruited patients with biopsy-confirmed or MRI-confirmed NAFLD and assessed the efficacy of interventions on liver fat content (LFC) and fibrosis by means of MRI. We performed random-effects frequentist network meta-analyses and assessed confidence in our estimates using the CINeMA (Confidence in Network Meta-Analysis) approach. RESULTS We included 47 trials (8583 patients). Versus placebo, thiazolidinediones were the most efficacious for the absolute change in LFC, followed by vitamin E, fibroblast growth factor (FGF) analogs, and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with mean differences ranging from -7.46% (95% confidence interval [-11.0, -3.9]) to -4.36% (-7.2, -1.5). No differences between drug classes were evident. Patients receiving GLP-1 RAs or glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs were more likely to achieve ≥30% relative reduction in LFC. Among agents, efruxifermin produced the largest reduction in LFC compared to placebo [-13.5% (-18.5, -8.5)], followed by pioglitazone, while being superior to most interventions. The effect of interventions on magnetic resonance elastography assessed fibrosis was small and insignificant. The confidence in our estimates was low to very low. CONCLUSIONS Several drug classes may reduce LFC in patients with NAFLD without a significant effect on fibrosis; nevertheless, trial duration was small, and confidence in the effect estimates was low.
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Affiliation(s)
- Konstantinos Malandris
- Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stylianos Papandreou
- Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Despoina Vasilakou
- Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiota Kakotrichi
- Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna Sarakapina
- First Medical Department, Papageorgiou Hospital, Thessaloniki, Greece
| | - Georgios Kalopitas
- First Medical Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Karagiannis
- Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Olga Giouleme
- Second Propaedeutic Medical Department, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Bekiari
- Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aris Liakos
- Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fotini Iatridi
- First Department of Nephrology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paschalis Paschos
- First Medical Department, Papageorgiou Hospital, Thessaloniki, Greece
| | - Emmanouil Sinakos
- Fourth Medical Department, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Tsapas
- Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Harris Manchester College, University of Oxford, Oxford, UK
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Zhu X, Zeng C, Yu B. White adipose tissue in metabolic associated fatty liver disease. Clin Res Hepatol Gastroenterol 2024; 48:102336. [PMID: 38604293 DOI: 10.1016/j.clinre.2024.102336] [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: 12/05/2023] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Metabolic associated fatty liver disease (MAFLD) is a prevalent chronic liver condition globally, currently lacking universally recognized therapeutic drugs, thereby increasing the risk of cirrhosis and hepatocellular carcinoma. Research has reported an association between white adipose tissue and MAFLD. SCOPE OF REVIEW White adipose tissue (WAT) is involved in lipid metabolism and can contribute to the progression of MAFLD by mediating insulin resistance, inflammation, exosomes, autophagy, and other processes. This review aims to elucidate the mechanisms through which WAT plays a role in the development of MAFLD. MAJOR CONCLUSIONS WAT participates in the occurrence and progression of MAFLD by mediating insulin resistance, inflammation, autophagy, and exosome secretion. Fibrosis and restricted expansion of adipose tissue can lead to the release of more free fatty acids (FFA), exacerbating the progression of MAFLD. WAT-secreted TNF-α and IL-1β, through the promotion of JNK/JKK/p38MAPK expression, interfere with insulin receptor serine and tyrosine phosphorylation, worsening insulin resistance. Adiponectin, by inhibiting the TLR-4-NF-κB pathway and suppressing M2 to M1 transformation, further inhibits the secretion of IL-6, IL-1β, and TNF-α, improving insulin resistance in MAFLD patients. Various gene expressions within WAT, such as MBPAT7, Nrf2, and Ube4A, can ameliorate insulin resistance in MAFLD patients. Autophagy-related gene Atg7 promotes the expression of fibrosis-related genes, worsening MAFLD. Non-pharmacological treatments, including diabetes-related medications and exercise, can improve MAFLD.
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Affiliation(s)
- Xiaoqin Zhu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, No. 99 Zhang Zhidong Road, Wuhan, Hubei, 430000, PR China
| | - Chuanfei Zeng
- Department of Gastroenterology, Renmin Hospital of Wuhan University, No. 99 Zhang Zhidong Road, Wuhan, Hubei, 430000, PR China
| | - Baoping Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, No. 99 Zhang Zhidong Road, Wuhan, Hubei, 430000, PR China.
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Zhang Q, Lu C, Lu F, Liao Y, Cai J, Gao J. Challenges and opportunities in obesity: the role of adipocytes during tissue fibrosis. Front Endocrinol (Lausanne) 2024; 15:1365156. [PMID: 38686209 PMCID: PMC11056552 DOI: 10.3389/fendo.2024.1365156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
Obesity is a chronic disease that affects the energy balance of the whole body. In addition to increasing fat mass, tissue fibrosis occurred in white adipose tissue in obese condition. Fibrosis is the over-activation of fibroblasts leading to excessive accumulation of extracellular matrix, which could be caused by various factors, including the status of adipocytes. The morphology of adipocytes responds rapidly and dynamically to nutrient fluctuations. Adaptive hypertrophy of normal adipocytes protects peripheral organs from damage from lipotoxicity. However, the biological behavior of hypertrophic adipocytes in chronic obesity is abnormally altered. Adipocytes lead to fibrotic remodeling of the extracellular matrix by inducing unresolved chronic inflammation, persistent hypoxia, and increasing myofibroblast numbers. Moreover, adipocyte-induced fibrosis not only restricts the flexible expansion and contraction of adipose tissue but also initiates the development of various diseases through cellular autonomic and paracrine effects. Regarding anti-fibrotic therapy, dysregulated intracellular signaling and epigenetic changes represent potential candidate targets. Thus, modulation of adipocytes may provide potential therapeutic avenues for reversing pathological fibrosis in adipose tissue and achieving the anti-obesity purpose.
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Affiliation(s)
- Qian Zhang
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chongxuan Lu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Feng Lu
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yunjun Liao
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Junrong Cai
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianhua Gao
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Gu X, Wang X, Wang S, Shen Y, Lu L. Composite Dietary Antioxidant Index is inversely associated with visceral adipose tissue area among U.S. adults: A cross-sectional study. Nutr Res 2024; 124:13-20. [PMID: 38359510 DOI: 10.1016/j.nutres.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/17/2024]
Abstract
Obesity is becoming a global health problem. Visceral adiposity is the main cause of metabolic and cardiovascular diseases. Dietary improvement is the key to controlling obesity. We hypothesized that a higher Composite Dietary Antioxidant Index (CDAI) was associated with a lower visceral adipose tissue (VAT) area. In this cross-sectional study, 10,389 adults were selected from the National Health and Nutrition Examination Survey 2011-2018. CDAI was calculated based on 6 micronutrients: zinc, selenium, total carotenoids, vitamin A, vitamin C, and vitamin E. VAT area was determined by the dual-energy X-ray absorptiometry scan. Linear regression models were constructed to evaluate the association between CDAI and VAT area. Subgroup analyses were also performed. The mean age of participants was 39.68 years, 5240 were male, and 3841 of those were non-Hispanic White. The inverse associations were observed in all models. In model 3, CDAI was inversely associated with VAT area as a continuous variable, β (95% confidence interval), -0.56 (-0.85 to -0.27). When compared with the first tertile, the third tertile of CDAI was also inversely associated with VAT area, β (95% confidence interval), -6.72 (-10.44 to -2.99). No interactions were found in the subgroup analyses. In conclusion, an inverse association between CDAI and VAT area was found among U.S. adults aged 20 to 59 years. These results suggest the possible benefit of an antioxidant diet in relieving visceral obesity. More prospective studies are needed to identify this dietary benefit.
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Affiliation(s)
- Xi Gu
- Department of Endocrinology, RuiJin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, China.
| | - Xun Wang
- Department of Endocrinology, RuiJin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, China
| | - Sujie Wang
- Department of Endocrinology, RuiJin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, China
| | - Ying Shen
- Department of Endocrinology, RuiJin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, China
| | - Leiqun Lu
- Department of Endocrinology, RuiJin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, China
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Liu L, Lin J, Yin M, Liu L, Gao J, Liu X, Zhu J, Wu A. Association of the fat mass index with hepatic steatosis and fibrosis: evidence from NHANES 2017-2018. Sci Rep 2024; 14:6943. [PMID: 38521854 PMCID: PMC10960854 DOI: 10.1038/s41598-024-57388-1] [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] [Received: 01/14/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
Limited population-based studies discuss the association between fat mass index (FMI) and the risk of liver diseases. This investigation utilized data from the National Health and Nutrition Examination Survey (NHANES) to examine the linkage between the FMI and liver conditions, specifically steatosis and fibrosis. The study leveraged data from NHANES's 2017-2018 cross-sectional study, employing an oversampling technique to deal with sample imbalance. Hepatic steatosis and fibrosis were identified by vibration-controlled transient elastography. Receiver operating curve was used to assess the relationship of anthropometric indicators, e.g., the FMI, body mass index (BMI), weight-adjusted-waist index (WWI), percentage of body fat (BF%), waist-to-hip ratio (WHR), and appendicular skeletal muscle index (ASMI), with hepatic steatosis and fibrosis. In this study, which included 2260 participants, multivariate logistic regression models, stratified analyses, restricted cubic spline (RCS), and sharp regression discontinuity analyses were utilized. The results indicated that the WHR and the FMI achieved the highest area under the curve for identifying hepatic steatosis and fibrosis, respectively (0.720 and 0.726). Notably, the FMI presented the highest adjusted odds ratio for both hepatic steatosis (6.40 [4.91-8.38], p = 2.34e-42) and fibrosis (6.06 [5.00, 7.37], p = 5.88e-74). Additionally, potential interaction effects were observed between the FMI and variables such as the family income-to-poverty ratio, smoking status, and hypertension, all of which correlated with the presence of liver fibrosis (p for interaction < 0.05). The RCS models further confirmed a significant positive correlation of the FMI with the controlled attenuation parameter and liver stiffness measurements. Overall, the findings underscore the strong link between the FMI and liver conditions, proposing the FMI as a potential straightforward marker for identifying liver diseases.
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Affiliation(s)
- Lihe Liu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
- Suzhou Clinical Center of Digestive Diseases, Suzhou, 215006, China
| | - Jiaxi Lin
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
- Suzhou Clinical Center of Digestive Diseases, Suzhou, 215006, China
| | - Minyue Yin
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Lu Liu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
- Suzhou Clinical Center of Digestive Diseases, Suzhou, 215006, China
| | - Jingwen Gao
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
- Suzhou Clinical Center of Digestive Diseases, Suzhou, 215006, China
| | - Xiaolin Liu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
- Suzhou Clinical Center of Digestive Diseases, Suzhou, 215006, China
| | - Jinzhou Zhu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
| | - Airong Wu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
- Suzhou Clinical Center of Digestive Diseases, Suzhou, 215006, China.
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Venkatesh SK, Idilman IS, Li J, Yin M. Shrinking fat, healing liver: unlocking the metabolic dysfunction associated steatohepatitis puzzle. Hepatobiliary Surg Nutr 2024; 13:132-135. [PMID: 38322227 PMCID: PMC10839737 DOI: 10.21037/hbsn-23-569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/06/2023] [Indexed: 02/08/2024]
Affiliation(s)
| | | | - Jiahui Li
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Meng Yin
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Lu F, Fan J, Li F, Liu L, Chen Z, Tian Z, Zuo L, Yu D. Abdominal adipose tissue and type 2 diabetic kidney disease: adipose radiology assessment, impact, and mechanisms. Abdom Radiol (NY) 2024; 49:560-574. [PMID: 37847262 DOI: 10.1007/s00261-023-04062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023]
Abstract
Diabetic kidney disease (DKD) is a significant healthcare burden worldwide that substantially increases the risk of kidney failure and cardiovascular events. To reduce the prevalence of DKD, extensive research is being conducted to determine the risk factors and consequently implement early interventions. Patients with type 2 diabetes mellitus (T2DM) are more likely to be obese. Abdominal adiposity is associated with a greater risk of kidney damage than general obesity. Abdominal adipose tissue can be divided into different fat depots according to the location and function, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), perirenal adipose tissue (PAT), and renal sinus adipose tissue (RSAT), which can be accurately measured by radiology techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI). Abdominal fat depots may affect the development of DKD through different mechanisms, and radiologic abdominal adipose characteristics may serve as imaging indicators of DKD risk. This review will first describe the CT/MRI-based assessment of abdominal adipose depots and subsequently describe the current studies on abdominal adipose tissue and DKD development, as well as the underlying mechanisms in patients of T2DM with DKD.
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Affiliation(s)
- Fei Lu
- School of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong, China
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Jinlei Fan
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Fangxuan Li
- Department of Ultrasound, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Lijing Liu
- Department of Imaging, Yantaishan Hospital, Yantai, 264001, Shandong, China
| | - Zhiyu Chen
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Ziyu Tian
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Liping Zuo
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Dexin Yu
- School of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong, China.
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China.
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Hassouneh R, Flynn S, Shen S, Tseng M, Bui AT, Pham J, Park D, Matherly S, Bruno D, Lee S, Kumaran V, Patel V, Muthiah M, Sharma A, Siddiqui MS. Impact of Liver Transplantation on Adipose Tissue Compartments and Its Association With Metabolic Sequela. Transplantation 2024; 108:235-241. [PMID: 37439776 DOI: 10.1097/tp.0000000000004704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
BACKGROUND Loss of skeletal muscle can be accompanied by an increase in adipose tissue leading to sarcopenic obesity. There are limited data on how liver transplantation (LT) might impact adipose tissue compartments, particularly among patients with metabolically active disease, such as nonalcoholic steatohepatitis (NASH) and subsequent metabolic sequela. METHODS Skeletal muscle, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were measured using cross-sectional imaging performed in 190 patients pre-LT, 6 mo post-LT and 12 mo post-LT. Changes in adipose tissue and their impact on metabolic diseases were determined in patients transplanted for NASH versus non-NASH. RESULTS Skeletal muscle, VAT, and SAT were similar in patients with NASH and non-NASH pre-LT despite a higher burden of metabolic diseases in patients with NASH. Following LT, no significant differences between skeletal muscle and SAT were observed in the entire cohort and among patients with NASH (versus non-NASH). LT recipients with the highest muscle mass pre-LT were at the greatest risk for muscle loss post-LT. A time-dependent increase in VAT was noted post-LT, which was more robust among patients with a history of NASH cirrhosis. In adjusted multivariate analysis, NASH versus non-NASH was a strong predictor of post-LT increase in VAT (β-coefficient 3.00, P = 0.04). Pre-LT VAT was an independent predictor of post-LT serum triglycerides (β-coefficient 5.49 ± 2.78, P = 0.05) and low-density lipoprotein cholesterol (β-coefficient 1.80 ± 0.75, P = 0.02). A trend between pre-LT VAT and diabetes was noted but did not reach statistical significance. CONCLUSIONS VAT but not SAT increases rapidly after LT, especially among patients transplanted for NASH cirrhosis and predicts future metabolic burden.
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Affiliation(s)
- Ramzi Hassouneh
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
- Department of Gastroenterology, Indiana University, Indianapolis, IN
| | - Sean Flynn
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Steve Shen
- Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Michael Tseng
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Anh Tuan Bui
- Department of Statistical Sciences and Operations Research, Virginia Commonwealth University, Richmond, VA
| | - Jay Pham
- Department of Radiology, Virginia Commonwealth University, Richmond, VA
| | - Dan Park
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Scott Matherly
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA
| | - David Bruno
- Division of Transplant Surgery, Virginia Commonwealth University, Richmond, VA
| | - Seung Lee
- Division of Transplant Surgery, Virginia Commonwealth University, Richmond, VA
| | - Vinay Kumaran
- Division of Transplant Surgery, Virginia Commonwealth University, Richmond, VA
| | - Vaishali Patel
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA
| | - Mark Muthiah
- Department of Gastroenterology and Heptology, National University Hospital, Singapore
| | - Amit Sharma
- Division of Transplant Surgery, Virginia Commonwealth University, Richmond, VA
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA
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Marti-Aguado D, Arnouk J, Liang JX, Lara-Romero C, Behari J, Furlan A, Jimenez-Pastor A, Ten-Esteve A, Alfaro-Cervello C, Bauza M, Gallen-Peris A, Gimeno-Torres M, Merino-Murgui V, Perez-Girbes A, Benlloch S, Pérez-Rojas J, Puglia V, Ferrández-Izquierdo A, Aguilera V, Giesteira B, França M, Monton C, Escudero-García D, Alberich-Bayarri Á, Serra MA, Bataller R, Romero-Gomez M, Marti-Bonmati L. Development and validation of an image biomarker to identify metabolic dysfunction associated steatohepatitis: MR-MASH score. Liver Int 2024; 44:202-213. [PMID: 37904633 DOI: 10.1111/liv.15766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/11/2023] [Accepted: 10/08/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND AND AIMS Diagnosis of metabolic dysfunction-associated steatohepatitis (MASH) requires histology. In this study, a magnetic resonance imaging (MRI) score was developed and validated to identify MASH in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Secondarily, a screening strategy for MASH diagnosis was investigated. METHODS This prospective multicentre study included 317 patients with biopsy-proven MASLD and contemporaneous MRI. The discovery cohort (Spain, Portugal) included 194 patients. NAFLD activity score (NAS) and fibrosis were assessed with the NASH-CRN histologic system. MASH was defined by the presence of steatosis, lobular inflammation, and ballooning, with NAS ≥4 with or without fibrosis. An MRI-based composite biomarker of Proton Density Fat Fraction and waist circumference (MR-MASH score) was developed. Findings were afterwards validated in an independent cohort (United States, Spain) with different MRI protocols. RESULTS In the derivation cohort, 51% (n = 99) had MASH. The MR-MASH score identified MASH with an AUC = .88 (95% CI .83-.93) and strongly correlated with NAS (r = .69). The MRI score lower cut-off corresponded to 88% sensitivity with 86% NPV, while the upper cut-off corresponded to 92% specificity with 87% PPV. MR-MASH was validated with an AUC = .86 (95% CI .77-.92), 91% sensitivity (lower cut-off) and 87% specificity (upper cut-off). A two-step screening strategy with sequential MR-MASH examination performed in patients with indeterminate-high FIB-4 or transient elastography showed an 83-84% PPV to identify MASH. The AUC of MR-MASH was significantly higher than that of the FAST score (p < .001). CONCLUSIONS The MR-MASH score has clinical utility in the identification and management of patients with MASH at risk of progression.
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Affiliation(s)
- David Marti-Aguado
- Digestive Disease Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
- Biomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain
| | - Joud Arnouk
- Division of Gastroenterology, Hepatology and Nutrition, Center for Liver Diseases, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jia-Xu Liang
- Digestive Diseases Department, CIBERehd, Virgen del Rocio University Hospital, Seville, Spain
- Institute of Biomedicine of Seville (HUVR/CSIC/US), Department of Medicine, University of Seville, Seville, Spain
| | - Carmen Lara-Romero
- Digestive Diseases Department, CIBERehd, Virgen del Rocio University Hospital, Seville, Spain
- Institute of Biomedicine of Seville (HUVR/CSIC/US), Department of Medicine, University of Seville, Seville, Spain
| | - Jaideep Behari
- Division of Gastroenterology, Hepatology and Nutrition, Center for Liver Diseases, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Alessandro Furlan
- Division of Abdominal Imaging, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Ana Jimenez-Pastor
- Biomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain
- Quantitative Imaging Biomarkers in Medicine, QUIBIM SL, Valencia, Spain
| | - Amadeo Ten-Esteve
- Biomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain
| | - Clara Alfaro-Cervello
- Pathology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
- Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Mónica Bauza
- Pathology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Ana Gallen-Peris
- Digestive Disease Department, Hospital Arnau de Vilanova, Valencia, Spain
| | - Marta Gimeno-Torres
- Digestive Disease Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Víctor Merino-Murgui
- Digestive Disease Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Alexandre Perez-Girbes
- Biomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain
- Radiology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Salvador Benlloch
- Digestive Disease Department, Hospital Arnau de Vilanova, Valencia, Spain
- CIBERehd, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - Judith Pérez-Rojas
- Pathology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Víctor Puglia
- Pathology Department, Hospital Arnau de Vilanova, Valencia, Spain
| | - Antonio Ferrández-Izquierdo
- Pathology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
- Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Victoria Aguilera
- CIBERehd, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- Hepatology and Liver Transplantation Unit, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Bruno Giesteira
- Radiology Department, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Porto, Portugal
| | - Manuela França
- Radiology Department, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Porto, Portugal
| | - Cristina Monton
- Digestive Disease Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Desamparados Escudero-García
- Digestive Disease Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
- Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Ángel Alberich-Bayarri
- Biomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain
- Quantitative Imaging Biomarkers in Medicine, QUIBIM SL, Valencia, Spain
| | - Miguel A Serra
- Digestive Disease Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
- Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Ramon Bataller
- Division of Gastroenterology, Hepatology and Nutrition, Center for Liver Diseases, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Manuel Romero-Gomez
- Digestive Diseases Department, CIBERehd, Virgen del Rocio University Hospital, Seville, Spain
- Institute of Biomedicine of Seville (HUVR/CSIC/US), Department of Medicine, University of Seville, Seville, Spain
- University of Seville, Seville, Spain
| | - Luis Marti-Bonmati
- Biomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain
- Radiology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
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11
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Gu S, Qiao Y, Liu S, Yang S, Cong S, Wang S, Yu D, Wang W, Chai X. Frontiers and hotspots of adipose tissue and NAFLD: a bibliometric analysis from 2002 to 2022. Front Physiol 2023; 14:1278952. [PMID: 38187139 PMCID: PMC10768199 DOI: 10.3389/fphys.2023.1278952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Background: The annual incidence of non-alcoholic fatty liver disease (NAFLD) continues to rise steadily. In recent years, adipose tissue (AT) has gained recognition as a pivotal contributor to the pathogenesis of NAFLD. Employing bibliometric analysis, we examined literature concerning AT and NAFLD. Methods: Relevant literature on AT in NAFLD from 1980 to 2022 was extracted from the Web of Science Core Collection. These records were visualized using CiteSpace and VOSviewer regarding publications, countries/regions, institutions, authors, journals, references, and keywords. Results: Since 2002, a total of 3,330 papers have been included, exhibiting an annual surge in publications. Notably, the quality of publications is superior in the USA and Europe. Kenneth Cusi stands out as the author with the highest number of publications and H-index. Hepatology is the journal boasting the highest citation and H-index. The University of California System holds the highest centrality among institutions. References specifically delve into physiological processes associated with AT in NAFLD. Currently, lipid metabolism and inflammation constitute the principal research mechanisms in the AT-based regulation of NAFLD, with pertinent keywords including microRNA, T cell, hypoxia, sarcopenia, hepatokine, gut microbiota, and autophagy. The Mediterranean diet is among the most widely recommended dietary approaches for potential NAFLD treatment. Conclusion: This paper represents the inaugural bibliometric study on the effects of AT on NAFLD, offering valuable insights and directions for future research.
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Affiliation(s)
- Shuxiao Gu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yanfang Qiao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Susu Liu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Shuangjie Yang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Shibo Cong
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Sili Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Deshuai Yu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wei Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xinlou Chai
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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12
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Kang PS, Neeland IJ. Body Fat Distribution, Diabetes Mellitus, and Cardiovascular Disease: an Update. Curr Cardiol Rep 2023; 25:1555-1564. [PMID: 37792133 DOI: 10.1007/s11886-023-01969-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE OF REVIEW Specific measures of body fat distribution may have particular value in the development and treatment of cardiometabolic conditions, such as cardiovascular disease (CVD) and diabetes mellitus (DM). Here, we review the pathophysiology, epidemiology, and recent advances in the identification and management of body fat distribution as it relates to DM and CVD risk. RECENT FINDINGS Accumulation of visceral and ectopic fat is a major contributor to CVD and DM risk above and beyond the body mass index (BMI), yet implementation of fat distribution assessment into clinical practice remains a challenge. Newer imaging-based methods offer improved sensitivity and specificity for measuring specific fat depots. Lifestyle, pharmacological, and surgical interventions allow a multidisciplinary approach to reduce visceral and ectopic fat. A focus on implementation of body fat distribution measurements into clinical practice should be a priority over the next 5 to 10 years, and clinical assessment of fat distribution can be considered to refine risk evaluation and to develop improved and effective preventive and therapeutic strategies for high-risk obesity.
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Affiliation(s)
- Puneet S Kang
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Ian J Neeland
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
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13
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Tilg H, Byrne CD, Targher G. NASH drug treatment development: challenges and lessons. Lancet Gastroenterol Hepatol 2023; 8:943-954. [PMID: 37597527 DOI: 10.1016/s2468-1253(23)00159-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 08/21/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide. Although NAFLD is tightly linked to obesity and type 2 diabetes, this liver disease also affects individuals who do not have obesity. NAFLD increases the risk of developing cardiovascular disease, chronic kidney disease, and certain extrahepatic cancers. There is currently no licensed pharmacotherapy for NAFLD, despite numerous clinical trials in the past two decades. Currently, the reason so few drugs have been successful in the treatment of NAFLD in a trial setting is not fully understood. As cardiovascular disease is the predominant cause of mortality in people with NAFLD, future pharmacotherapies for NAFLD must consider associated cardiometabolic risk factors. The successful use of glucose-lowering drugs in the treatment of type 2 diabetes in patients with NAFLD indicates that this strategy is important, and worth developing further. Greater public awareness of NAFLD is needed because collaboration between all stakeholders is vital to enable a holistic approach to successful treatment.
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Affiliation(s)
- Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria.
| | - Christopher D Byrne
- National Institute for Health and Care Research, Southampton Biomedical Research Centre, University Hospital Southampton and University of Southampton, Southampton, UK
| | - Giovanni Targher
- Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Verona, Verona, Italy; IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
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14
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Xu Q, Feng M, Ren Y, Liu X, Gao H, Li Z, Su X, Wang Q, Wang Y. From NAFLD to HCC: Advances in noninvasive diagnosis. Biomed Pharmacother 2023; 165:115028. [PMID: 37331252 DOI: 10.1016/j.biopha.2023.115028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 06/20/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) has gradually become one of the major liver health problems in the world. The dynamic course of the disease goes through steatosis, inflammation, fibrosis, and carcinoma. Before progressing to carcinoma, timely and effective intervention will make the condition better, which highlights the importance of early diagnosis. With the further study of the biological mechanism in the pathogenesis and progression of NAFLD, some potential biomarkers have been discovered, and the possibility of their clinical application is gradually being discussed. At the same time, the progress of imaging technology and the emergence of new materials and methods also provide more possibilities for the diagnosis of NAFLD. This article reviews the diagnostic markers and advanced diagnostic methods of NAFLD in recent years.
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Affiliation(s)
- Qinchen Xu
- Department of Clinical Laboratory, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, China
| | - Maoxiao Feng
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong Province, China
| | - Yidan Ren
- Department of Clinical Laboratory, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, China
| | - Xiaoyan Liu
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong Province, China
| | - Huiru Gao
- Department of Clinical Laboratory, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, China
| | - Zigan Li
- Department of Clinical Laboratory, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, China
| | - Xin Su
- Department of Clinical Laboratory, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, China
| | - Qin Wang
- Department of Anesthesiology, Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan 250012, China.
| | - Yunshan Wang
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong Province, China.
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15
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Hadefi A, Arvanitakis M, Trépo E, Zelber‐Sagi S. Dietary strategies in non-alcoholic fatty liver disease patients: From evidence to daily clinical practice, a systematic review. United European Gastroenterol J 2023; 11:663-689. [PMID: 37491835 PMCID: PMC10493364 DOI: 10.1002/ueg2.12443] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/12/2023] [Indexed: 07/27/2023] Open
Abstract
Lifestyle modification comprising calorie restriction (CR) and increased physical activity enabling weight loss is the first-line of treatment for non-alcoholic fatty liver disease (NAFLD). However, CR alone is not optimal and evidence suggests that dietary pattern and composition are also critical in NAFLD management. Accordingly, high consumption of red and processed meat, saturated fat, added sugar, and sweetened beverages are associated with an increased risk of developing NAFLD and hepatocellular carcinoma, while other foods and compounds such as fish, olive oil, and polyphenols are, in contrast, beneficial for metabolic disorders. Therefore, several dietary interventions have been studied in order to determine which strategy would be the most beneficial for NAFLD. The evidence regarding the effectiveness of different dietary interventions such as low carbohydrate/low-fat diet, time-restricted eating diet, CR, and the well-studied Mediterranean diet is summarized.
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Affiliation(s)
- Alia Hadefi
- Department of Gastroenterology, Hepatopancreatology, and Digestive OncologyCUB Hôpital ErasmeUniversité Libre de BruxellesHôpital Universitaire de Bruxelles (HUB)BrusselsBelgium
- Laboratory of Experimental GastroenterologyUniversité Libre de BruxellesBrusselsBelgium
| | - Marianna Arvanitakis
- Department of Gastroenterology, Hepatopancreatology, and Digestive OncologyCUB Hôpital ErasmeUniversité Libre de BruxellesHôpital Universitaire de Bruxelles (HUB)BrusselsBelgium
| | - Eric Trépo
- Department of Gastroenterology, Hepatopancreatology, and Digestive OncologyCUB Hôpital ErasmeUniversité Libre de BruxellesHôpital Universitaire de Bruxelles (HUB)BrusselsBelgium
- Laboratory of Experimental GastroenterologyUniversité Libre de BruxellesBrusselsBelgium
| | - Shira Zelber‐Sagi
- Faculty of Social Welfare and Health SciencesSchool of Public HealthUniversity of HaifaHaifaIsrael
- Department of GastroenterologyTel‐Aviv Medical CentreTel‐AvivIsrael
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16
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Ding L, Teng R, Zhu Y, Liu F, Wu L, Qin L, Wu X, Liu T. Electroacupuncture treatment ameliorates metabolic disorders in obese ZDF rats by regulating liver energy metabolism and gut microbiota. Front Endocrinol (Lausanne) 2023; 14:1207574. [PMID: 37441502 PMCID: PMC10335763 DOI: 10.3389/fendo.2023.1207574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Metabolic disorders represent a major therapeutic challenge to public health worldwide due to their dramatically increasing prevalence. Acupuncture is widely used as adjuvant therapy for multiple metabolic diseases. However, detailed biological interpretation of the acupuncture stimulations is still limited. The gut and the liver are intrinsically connected and related to metabolic function. Microbial metabolites might affect the gut-liver axis through multiple mechanisms. Liver metabolomics and 16S rRNA sequencing were used to explore the specific mechanism of electroacupuncture in treating ZDF rats in this study. Electroacupuncture effectively improved glycolipid metabolism disorders of the ZDF rats. Histopathology confirmed that electroacupuncture improved diffuse hepatic steatosis and hepatocyte vacuolation, and promoted glycogen accumulation in the liver. The treatment significantly improved microbial diversity and richness and upregulated beneficial bacteria that maintain intestinal epithelial homeostasis and decreased bacteria with detrimental metabolic features on host metabolism. Liver metabolomics showed that the main effects of electroacupuncture include reducing the carbon flow and intermediate products in the TCA cycle, regulating the metabolism of various amino acids, and inhibiting hepatic glucose output and de novo lipogenesis. The gut-liver axis correlation analysis showed a strong correlation between the liver metabolites and the gut microbiota, especially allantoin and Adlercreutzia. Electroacupuncture treatment can improve abnormal energy metabolism by reducing oxidative stress, ectopic fat deposition, and altering metabolic fluxes. Our results will help us to further understand the specific mechanism of electroacupuncture in the treatment of metabolic diseases.
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Affiliation(s)
- Lei Ding
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Rufeng Teng
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yifei Zhu
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Fengming Liu
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lili Wu
- Key Laboratory of Health Cultivation of the Ministry of Education, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lingling Qin
- Department of Science and Technology, Beijing University of Chinese Medicine, Beijing, China
| | - Xi Wu
- Department of Education, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tonghua Liu
- Key Laboratory of Health Cultivation of the Ministry of Education, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Palmas F, Ciudin A, Guerra R, Eiroa D, Espinet C, Roson N, Burgos R, Simó R. Comparison of computed tomography and dual-energy X-ray absorptiometry in the evaluation of body composition in patients with obesity. Front Endocrinol (Lausanne) 2023; 14:1161116. [PMID: 37455915 PMCID: PMC10345841 DOI: 10.3389/fendo.2023.1161116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/17/2023] [Indexed: 07/18/2023] Open
Abstract
Objective a) To evaluate the accuracy of the pre-existing equations (based on cm2 provided by CT images), to estimate in kilograms (Kg) the body composition (BC) in patients with obesity (PwO), by comparison with Dual-energy X-ray absorptiometry (DXA). b) To evaluate the accuracy of a new approach (based on both cm2 and Hounsfield Unit parameters provided by CT images), using an automatic software and artificial intelligence to estimate the BC in PwO, by comparison with DXA. Methods Single-centre cross-sectional study including consecutive PwO, matched by gender with subjects with normal BMI. All the subjects underwent BC assessment by Dual-energy X-ray absorptiometry (DXA) and skeletal-CT at L3 vertebrae. CT images were processed using FocusedON-BC software. Three different models were tested. Model 1 and 2, based on the already existing equations, estimate the BC in Kg based on the tissue area (cm2) in the CT images. Model 3, developed in this study, includes as additional variables, the tissue percentage and its average Hounsfield unit. Results 70 subjects (46 PwO and 24 with normal BMI) were recruited. Significant correlations for BC were obtained between the three models and DXA. Model 3 showed the strongest correlation with DXA (r= 0.926, CI95% [0.835-0.968], p<0.001) as well as the best agreement based on Bland - Altman plots. Conclusion This is the first study showing that the BC assessment based on skeletal CT images analyzed by automatic software coupled with artificial intelligence, is accurate in PwO, by comparison with DXA. Furthermore, we propose a new equation that estimates both the tissue quantity and quality, that showed higher accuracy compared with those currently used, both in PwO and subjects with normal BMI.
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Affiliation(s)
- Fiorella Palmas
- Endocrinology and Nutrition Department, Hospital Universitari Vall D´Hebron, Barcelona, Spain
| | - Andreea Ciudin
- Endocrinology and Nutrition Department, Hospital Universitari Vall D´Hebron, Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall d’Hebron Institut De Recerca (VHIR), Barcelona, Spain
- Department of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain
- Centro De Investigación Biomédica En Red De Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto De Salud Carlos III (ISCIII), Madrid, Spain
| | | | - Daniel Eiroa
- Department of Radiology, Institut De Diagnòstic Per La Imatge (IDI), Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Carina Espinet
- Nuclear Medicine Deparment, Vall Hebron Hospital, Barcelona, Spain
| | - Nuria Roson
- Department of Radiology, Institut De Diagnòstic Per La Imatge (IDI), Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Rosa Burgos
- Endocrinology and Nutrition Department, Hospital Universitari Vall D´Hebron, Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall d’Hebron Institut De Recerca (VHIR), Barcelona, Spain
- Department of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain
| | - Rafael Simó
- Endocrinology and Nutrition Department, Hospital Universitari Vall D´Hebron, Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall d’Hebron Institut De Recerca (VHIR), Barcelona, Spain
- Department of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain
- Centro De Investigación Biomédica En Red De Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto De Salud Carlos III (ISCIII), Madrid, Spain
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18
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Shen Y, Wu Y, Fu M, Zhu K, Wang J. Association between weight-adjusted-waist index with hepatic steatosis and liver fibrosis: a nationally representative cross-sectional study from NHANES 2017 to 2020. Front Endocrinol (Lausanne) 2023; 14:1159055. [PMID: 37274346 PMCID: PMC10235694 DOI: 10.3389/fendo.2023.1159055] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/05/2023] [Indexed: 06/06/2023] Open
Abstract
Background The negative effects of obesity on hepatic steatosis and fibrosis have received considerable attention in recent years. The weight-adjusted-waist index (WWI) reflects weight-independent centripetal obesity. Herein, we provide the first investigation of a link between WWI, hepatic steatosis, and liver fibrosis. Methods We used data from the National Health and Nutrition Examination Survey 2017-2020 to conduct a cross-sectional study. The linear relationship between WWI, controlled attenuation parameters, and liver stiffness measurements (LSM) was investigated using multivariate linear regression models. The nonlinear relationship was described using fitted smoothed curves and threshold effect analyses. Subgroup analyses were performed based on gender, age, body mass index, diabetes, hypertension, drinking, and smoking. Results This population-based study included 7,594 people, 50.74% of whom were men and 49.26% of whom were women. Multivariate linear regression analysis revealed a significant positive relationship between WWI and hepatic steatosis [CAP, β=7.60, 95% confidence interval (CI) (4.42, 10.78), P<0.0001]. This positive association was stronger when excessive alcohol intake was present compared to when it was absent (P for interaction = 0.031), and when hypertension was present compared to when it was not (P for interaction = 0.014). The linear relationship between WWI and liver fibrosis was not statistically significant on multiple regression analysis [LSM, β=0.03, 95% CI (-0.26, 0.32), P=0.84]. However, a U-shaped association was seen between WWI and LSM, with a negative correlation when WWI< 10.92 and a positive correlation when WWI > 10.92. Conclusion We report a strong association between WWI and hepatic steatosis, and suggest that it may potentially be used as a simple anthropometric index to predict hepatic steatosis.
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Affiliation(s)
- Yun Shen
- Department of Pathology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
- Department of Pathology, Changzhi Medical College the First Clinical College, Changzhi, Shanxi, China
| | - Yahui Wu
- Department of Pathology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
- Department of Pathology, Changzhi Medical College the First Clinical College, Changzhi, Shanxi, China
| | - Minghan Fu
- Department of Pathology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
- Department of Pathology, Changzhi Medical College the First Clinical College, Changzhi, Shanxi, China
| | - Kai Zhu
- Department of Pathology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
- Department of Pathology, Changzhi Medical College the First Clinical College, Changzhi, Shanxi, China
| | - Jinsheng Wang
- Department of Pathology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
- Department of Pathology, Changzhi Medical College the First Clinical College, Changzhi, Shanxi, China
- Key Laboratory of Esophageal Cancer Basic Research and Clinical Transformation, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
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