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Sun Y, Qi X, Wang X, Lin X, Zhou Y, Du Y, Liu A, Lv X, Zhou J, Li Z, Wu X, Zou Z, Dou S, Zhang M, Zhu J, Shang F, Li F, Hu Y, Li H, Li Y. Association between liver fat level and risk of hypertension: evidence from a Chinese health examination dataset. J Hypertens 2024; 42:1785-1794. [PMID: 38920061 PMCID: PMC11356678 DOI: 10.1097/hjh.0000000000003803] [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: 04/16/2024] [Accepted: 06/09/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Hypertension development is predominantly influenced by inflammation, excessive fat deposition, and metabolic irregularities. Among these factors, liver fat accumulation is a critical metabolic disorder. However, the quantification of liver fat levels and its associated risk for hypertension incidence remain ambiguous. This project is designed to explore the association between liver fat levels and the risk of hypertension in a healthy population. METHODS This cross-sectional study involved 4955 participants from the Health Management Center at Henan Provincial People's Hospital who were surveyed between February 2020 and February 2023. Participants were categorized into four groups based on liver fat quartiles. Subgroup analyses, restricted cubic spline regression models, and logistic regression were utilized to assess the association between liver fat levels and hypertension risk. The relationships between liver fat levels and inflammatory markers were examined using multiple linear regression models. Additionally, a mediation analysis was conducted to explore the role of inflammatory factors in the relationship between liver fat and hypertension risk. RESULTS Participants with hypertension exhibited greater liver fat levels than did those without hypertension. An increased risk of hypertension was associated with elevated liver fat levels, even after adjusting for other covariates [Q4 vs. Q1 in model II: odds ratio (OR = 1.28), 95% confidence interval (CI) = 1.04-1.59, P = 0.022; P for trend = 0.039]. A nonlinear relationship was observed between liver fat level and hypertension risk, with a notable increase in hypertension risk occurring at liver fat levels greater than 8.65%. Additionally, a positive correlation was found between inflammatory markers and liver fat levels. A mediation effect of 4.76% was noted, linking hypertension risk and liver fat levels through neutrophils. CONCLUSION Liver fat levels exceeding 8.65% significantly elevated the risk of hypertension. Inflammatory factors serve as crucial mediators of the relationship between liver fat and hypertension.
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Affiliation(s)
- Yongbing Sun
- Department of Medical Imaging, People's Hospital of Zhengzhou University
| | - Xin Qi
- Department of Medical Imaging, Henan Provincial People's Hospital, Xinxiang Medical College
| | - Xuan Wang
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University
| | - Xinbei Lin
- Department of Medical Imaging, People's Hospital of Zhengzhou University
| | - Yang Zhou
- Department of Medical Imaging, People's Hospital of Zhengzhou University
| | - Yawei Du
- Department of Medical Imaging, Henan Provincial People's Hospital, Henan University People's Hospital
| | - Ao Liu
- Department of Medical Imaging, People's Hospital of Zhengzhou University
| | - Xue Lv
- Henan Provincial People's Hospital
| | - Jing Zhou
- Henan Provincial Research Center of Clinical Medicine of Nephropathy
| | - Zhonglin Li
- Department of Medical Imaging, People's Hospital of Zhengzhou University
| | - Xiaoling Wu
- Department of Nuclear Medicine, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Zhi Zou
- Department of Medical Imaging, People's Hospital of Zhengzhou University
| | - Shewei Dou
- Department of Medical Imaging, People's Hospital of Zhengzhou University
| | - Michael Zhang
- Sevenoaks Health Management Center, Canada-Canada Institute of Health Engineering, University of Manitoba, Winnipeg, Canada
| | - Jiadong Zhu
- Department of Health Management, Henan Provincial People's Hospital, Chronic Health Management Laboratory
| | - Feifei Shang
- Department of Health Management, Henan Provincial People's Hospital, Chronic Health Management Laboratory
| | - Fengli Li
- Department of Bariatric Metabolic Surgery, Central Hospital of Zhengzhou University, Zhengzhou
| | - Yangxi Hu
- Department of Bariatric Metabolic Surgery, Central Hospital of Zhengzhou University, Zhengzhou
| | - Hao Li
- Fuwaihua Central Vascular Disease Hospital, Zhengzhou, Henan, China
| | - Yongli Li
- Department of Health Management, Henan Provincial People's Hospital, Chronic Health Management Laboratory
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Askani E, Rospleszcz S, Lorbeer R, Wintergerst C, Müller-Peltzer K, Kiefer LS, Kellner E, Reisert M, Rathmann W, Peters A, Schlett CL, Bamberg F, Storz C. Associations between adrenal gland volume and adipose tissue compartments - a whole body MRI study. Nutr Metab (Lond) 2024; 21:45. [PMID: 38982517 PMCID: PMC11234623 DOI: 10.1186/s12986-024-00823-x] [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: 02/29/2024] [Accepted: 06/28/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Obesity is associated with alterations in the hypothalamic-pituitary-adrenal (HPA) axis. Effects of glucocorticoids on adipose tissues appear to depend on the specific adipose depot, in which they take place. In this study, we aimed to investigate the role of MRI-based adrenal gland volume as an imaging marker in association with different adipose tissue compartments. METHODS The study cohort derives from the population-based research platform KORA (Cooperative Health Research in the Augsburg Region, Germany) MRI sub-study, a cross-sectional sub-study investigating the interactions between subclinical metabolic changes and cardiovascular disease in a study sample of 400 participants. Originally, eligible subjects underwent a whole-body MRI. MRI-based segmentations were performed manually and semi-automatically for adrenal gland volume, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), epi- and pericardial fat and renal sinus fat. Hepatic and pancreatic lipid content were measured as pancreatic proton density fraction (PDFF) and MR-spectroscopic hepatic fat fraction (HFF). Multivariable linear regression analyses were performed. RESULTS A number of 307 participants (56.2 ± 9.1 years, 60.3% male, 14.3% with type 2 diabetes (T2DM), 30.6% with obesity, 34.2% with hypertension) were included. In multivariable analyses, strong positive associations between adrenal gland volume and VAT, total adipose tissue (TAT) as well as HFF persisted after extensive step-wise adjustment for possible metabolic confounders (VAT: beta = 0.31, 95%-CI [0.71, 0.81], p < 0.001; TAT: beta = 0.14, 95%-CI [0.06, 0.23], p < 0.001; HFF: beta = 1.17, 95%-CI [1.04, 1.31], p = 0.009). In contrast, associations between adrenal gland volume and SAT were attenuated in multivariate analysis after adjusting for BMI. Associations between pancreatic PDFF, epi- and pericardial fat and renal sinus fat were mediated to a great extent by VAT (pancreatic PDFF: 72%, epicardial adipose tissue: 100%, pericardial adipose tissue: 100%, renal sinus fat: 81.5%). CONCLUSION Our results found MRI-based adrenal gland volume as a possible imaging biomarker of unfavorable adipose tissue distribution, irrespective of metabolic risk factors. Thus, adrenal gland volume may serve as a potential MRI-based biomarker of metabolic changes and contributes to an individual characterization of metabolic states and individual risk stratification. Future studies should elucidate in a longitudinal study design, if and how HPA axis activation may trigger unfavorable adipose tissue distribution and whether and to which extent this is involved in the pathogenesis of manifest metabolic syndrome.
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Affiliation(s)
- Esther Askani
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Susanne Rospleszcz
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
- Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilans-University Hospital, Munich, Germany
| | - Charlotte Wintergerst
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Müller-Peltzer
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lena S Kiefer
- Department of Diagnostic and Interventional Radiology, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Elias Kellner
- Medical Physics, Department of Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Marco Reisert
- Medical Physics, Department of Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Site Neuherberg, Neuherberg, Germany
| | - Annette Peters
- Department of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
- Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Partner Site Neuherberg, Neuherberg, Germany
- German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Corinna Storz
- Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, Freiburg, 79106, Germany.
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Singh S, Kumar A, Gupta S, Agrawal R. Curative role of natural PPARγ agonist in non-alcoholic fatty liver disease (NAFLD). Tissue Barriers 2024; 12:2289830. [PMID: 38050958 PMCID: PMC11262216 DOI: 10.1080/21688370.2023.2289830] [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: 09/04/2023] [Accepted: 11/15/2023] [Indexed: 12/07/2023] Open
Abstract
NAFLD is a condition that develops when the liver accumulates excess fat without alcohol consumption. This chronic liver ailment progresses along with insulin resistant and is typically not diagnosed until the patients have cirrhosis. Nuclear hormone receptor superfamily PPARs are essential for metabolism of fatty acids and glucose. In liver, lipid metabolism is regulated by nuclear receptors and PPARα, and PPARβ/δ encourages fatty acid β-oxidation. PPAR-γ, an energy-balanced receptor is a crucial regulator in NAFLD. The partial activation of PPAR-γ could lead to increased level of adiponectin and insulin sensitivity, thus improved NAFLD. Because of less side effects, natural compounds are emerged as potential therapeutic agents for NAFLD by PPARγ agonists. Although the results from preclinical studies are promising, further research is needed to determine the potential dosing and efficacy of mentioned compounds in human subjects. In this review, we summarize the effect of natural PPARγ agonist in the NAFLD.
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Affiliation(s)
- Swati Singh
- College of Pharmacy, JSS Academy of Technical Sciences, Noida, Uttar Pradesh, India
| | - Anit Kumar
- Department of Pharmacology, Divine College of Pharmacy, Bihar, India
| | - Suruchi Gupta
- School of Pharmacy, YBN University, Ranchi, Jharkhand, India
| | - Rohini Agrawal
- College of Pharmacy, JSS Academy of Technical Sciences, Noida, Uttar Pradesh, India
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Hu Y, Tang W, Liu Y, Zhang N, Zhu X, Tang D, Zhang Y, Xu H, Zhuoma D, Yang T, Yu Z, Xu C, Xiao X, Zhao X. Temporal relationship between hepatic steatosis and blood pressure elevation and the mediation effect in the development of cardiovascular disease. Hypertens Res 2024; 47:1811-1821. [PMID: 38760520 DOI: 10.1038/s41440-024-01708-5] [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: 02/15/2024] [Revised: 04/01/2024] [Accepted: 04/07/2024] [Indexed: 05/19/2024]
Abstract
The temporal relationship between non-alcoholic fatty liver disease (NAFLD) and hypertension remains highly controversial, with ongoing debates on whether NAFLD induces hypertension or vice versa. We employed cross-lagged panel models to investigate the temporal relationship between hepatic steatosis (assessed by Fatty Liver Index [FLI] in the main analysis, and by Proton Density Fat Fraction [PDFF] in the validation study) and blood pressure (systolic and diastolic blood pressure [SBP/ DBP]). Subsequently, we employed causal mediation models to explore the mediation effect in CVD development, including ischemic heart disease and stroke. The main analysis incorporated repeated measurement data of 5,047 participants from the China Multi-Ethnic Cohort (CMEC) and 5,685 participants from the UK Biobank (UKB). In both cohorts, the path coefficients from FLI to blood pressure were significant and greater than the path from blood pressure to FLI, with βFLI→SBP = 0.081, P < 0.001 versus βSBP→FLI = 0.020, P = 0.031; βFLI→DBP = 0.082, P < 0.001 versus βDBP→FLI = -0.006, P = 0.480 for CEMC, and βFLI→SBP = 0.057, P < 0.001 versus βSBP→FLI = -0.001, P = 0.727; βFLI→DBP = 0.061, P < 0.001, versus βDBP→FLI = -0.006, P = 0.263 for UKB. The validation study with 962 UKB participants using PDFF consistently supported these findings. In the mediation analyses encompassing 11,108 UKB participants, SBP and DBP mediated 12.2% and 5.2% of the hepatic steatosis-CVD association, respectively. The proportions were lower for ischemic heart disease (SBP: 6.1%, DBP: non-statistically significant -6.8%), and relatively stronger for stroke (SBP: 19.4%, DBP: 26.1%). In conclusion, hepatic steatosis more strongly contributes to elevated blood pressure than vice versa. Blood pressure elevation positively mediates the hepatic steatosis-CVD association, particularly in stroke compared to ischemic heart disease.
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Affiliation(s)
- Yifan Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wenge Tang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Yujie Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ning Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xingren Zhu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Dan Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuan Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Hao Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Duoji Zhuoma
- High Altitude Health Science Research Center of Tibet University, Lhasa, China
| | - Tingting Yang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Zhimiao Yu
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Chuanzhi Xu
- School of Public Health, Kunming Medical University, Kunming, China
| | - Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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5
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Liu R, Li X, Liu Y, Du L, Zhu Y, Wu L, Hu B. A high-speed microscopy system based on deep learning to detect yeast-like fungi cells in blood. Bioanalysis 2024; 16:289-303. [PMID: 38334080 DOI: 10.4155/bio-2023-0193] [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: 02/10/2024] Open
Abstract
Background: Blood-invasive fungal infections can cause the death of patients, while diagnosis of fungal infections is challenging. Methods: A high-speed microscopy detection system was constructed that included a microfluidic system, a microscope connected to a high-speed camera and a deep learning analysis section. Results: For training data, the sensitivity and specificity of the convolutional neural network model were 93.5% (92.7-94.2%) and 99.5% (99.1-99.5%), respectively. For validating data, the sensitivity and specificity were 81.3% (80.0-82.5%) and 99.4% (99.2-99.6%), respectively. Cryptococcal cells were found in 22.07% of blood samples. Conclusion: This high-speed microscopy system can analyze fungal pathogens in blood samples rapidly with high sensitivity and specificity and can help dramatically accelerate the diagnosis of fungal infectious diseases.
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Affiliation(s)
- Ruiqi Liu
- Guangxi Key Laboratory of Special Biomedicine, School of Medicine, Guangxi University, Nanning, Guangxi, P.R. China
| | - Xiaojie Li
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
| | - Yingyi Liu
- Guangxi Key Laboratory of Special Biomedicine, School of Medicine, Guangxi University, Nanning, Guangxi, P.R. China
| | - Lijun Du
- Department of Clinical Laboratory, Huadu District People's Hospital of Guangzhou, Guangdong, China
| | - Yingzhu Zhu
- Guangzhou Waterrock Gene Technology, Guangdong, China
| | - Lichuan Wu
- Guangxi Key Laboratory of Special Biomedicine, School of Medicine, Guangxi University, Nanning, Guangxi, P.R. China
| | - Bo Hu
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
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Wu W, Zhang Z, Qi Y, Zhang H, Zhao Y, Li J. Association between dietary inflammation index and hypertension in participants with different degrees of liver steatosis. Ann Med 2023; 55:2195203. [PMID: 37036742 PMCID: PMC10088928 DOI: 10.1080/07853890.2023.2195203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND The prevalence of hypertension (HTN) is higher in patients with non-alcoholic fatty liver disease (NAFLD). Inflammation is the key link between HTN and NAFLD. Systemic inflammation can be dramatically increased by inflammatory diet intake. However, whether controlling the inflammatory diet intake in NAFLD patients could affect the occurrence of HTN still remains unknown. Our aim here is to evaluate the effect of the dietary inflammatory index (DII) on blood pressure in patients with different grades of hepatic steatosis. MATERIALS AND METHODS The data were collected from the National Health and Nutrition Examination Survey (NHANES) (2017-2018). DII was calculated based on the data of 24-h dietary recall interviews. The severity of liver steatosis was assessed by a controlled attenuation parameter. Multivariable logistic regression, multivariable linear regression and subgroup analyses were conducted to determine the association between DII and blood pressure in patients with different degrees of hepatic steatosis. RESULTS A total of 5449 participants were included in this analysis. In male participants with severe liver steatosis (S3), the highest DII tertile group was more likely to have higher systolic blood pressure (SBP) compared with the lowest tertile group (Tertile1: 128.31(125.31,131.31), Tertile3: 133.12(129.40,136.85), P for trend =0.03551). DII was positively correlated with SBP and the prevalence of HTN in males with hepatic steatosis grade S3 (≥ 67% steatosis) (SBP: P for trend = 0.011, HTN: P for trend = 0.039). Regarding the association of DII with SBP and HTN, the tests for interaction were significant for hepatic steatosis (SBP: interaction for p = 0.0015, HTN: interaction for p = 0.0202). CONCLUSIONS In the present study, we demonstrated that DII was a risk factor for increased SBP and the prevalence of HTN in males with severe hepatic steatosis S3, indicating that anti-inflammatory dietary management should be considered in these individuals to reduce the risk of developing HTN.
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Affiliation(s)
- Wenhao Wu
- Department of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University
| | - Zhuoya Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Shanxi Medical University
| | - Yan Qi
- Department of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University
| | - Hua Zhang
- Department of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University
| | - Yuan Zhao
- Department of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University
| | - Jin Li
- Department of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University
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Huang X, Zeng Y, Ma M, Xiang L, Liu Q, Xiao L, Feng R, Li W, Zhang X, Lin M, Hu Z, Zhao H, Du S, Ye W. Associations between body composition profile and hypertension in different fatty liver phenotypes. Front Endocrinol (Lausanne) 2023; 14:1247110. [PMID: 38089604 PMCID: PMC10714003 DOI: 10.3389/fendo.2023.1247110] [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: 06/25/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
Background It is currently unclear whether and how the association between body composition and hypertension varies based on the presence and severity of fatty liver disease (FLD). Methods FLD was diagnosed using ultrasonography among 6,358 participants. The association between body composition and hypertension was analyzed separately in the whole population, as well as in subgroups of non-FLD, mild FLD, and moderate/severe FLD populations, respectively. The mediation effect of FLD in their association was explored. Results Fat-related anthropometric measurements and lipid metabolism indicators were positively associated with hypertension in both the whole population and the non-FLD subgroup. The strength of this association was slightly reduced in the mild FLD subgroup. Notably, only waist-to-hip ratio and waist-to-height ratio showed significant associations with hypertension in the moderate/severe FLD subgroup. Furthermore, FLD accounted for 17.26% to 38.90% of the association between multiple body composition indicators and the risk of hypertension. Conclusions The association between body composition and hypertension becomes gradually weaker as FLD becomes more severe. FLD plays a significant mediating role in their association.
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Affiliation(s)
- Xiaoyin Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yuchen Zeng
- Department of Ultrasonography, The Affiliated Fuqing Hospital of Fujian Medical University, Fuqing, China
| | - Mingyang Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Liangguang Xiang
- Department of General Surgery, The Affiliated Fuqing Hospital of Fujian Medical University, Fuqing, China
| | - Qingdan Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Ling Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Ruimei Feng
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Wanxin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoling Zhang
- Department of Ultrasonography, The Affiliated Fuqing Hospital of Fujian Medical University, Fuqing, China
| | - Moufeng Lin
- Department of Public Health, The Fifth Hospital of Fuqing City, Fuqing, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Hongwei Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, United States
| | - Shanshan Du
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Weimin Ye
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Wachinger C, Wolf TN, Pölsterl S. Deep learning for the prediction of type 2 diabetes mellitus from neck-to-knee Dixon MRI in the UK biobank. Heliyon 2023; 9:e22239. [PMID: 38034698 PMCID: PMC10686850 DOI: 10.1016/j.heliyon.2023.e22239] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/07/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
Rationale and objectives We evaluate the automatic identification of type 2 diabetes from neck-to-knee, two-point Dixon MRI scans with 3D convolutional neural networks on a large, population-based dataset. To this end, we assess the best combination of MRI contrasts and stations for diabetes prediction, and the benefit of integrating risk factors. Materials and methods Subjects with type 2 diabetes mellitus have been identified in the prospective UK Biobank Imaging study, and a matched control sample has been created to avoid confounding bias. Five-fold cross-validation is used for the evaluation. All scans from the two-point Dixon neck-to-knee sequence have been standardized. A neural network that considers multi-channel MRI input was developed and integrates clinical information in tabular format. An ensemble strategy is used to combine multi-station MRI predictions. A subset with quantitative fat measurements is identified for comparison to prior approaches. Results MRI scans from 3406 subjects (mean age, 66.2 years ± 7.1 [standard deviation]; 1128 women) were analyzed with 1703 diabetics. A balanced accuracy of 78.7 %, AUC ROC of 0.872, and an average precision of 0.878 was obtained for the classification of diabetes. The ensemble over multiple Dixon MRI stations yields better performance than selecting the individually best station. Moreover, combining fat and water scans as multi-channel inputs to the networks improves upon just using single contrasts as input. Integrating clinical information about known risk factors of diabetes in the network boosts the performance across all stations and the ensemble. The neural network achieved superior results compared to the prediction based on quantitative MRI measurements. Conclusions The developed deep learning model accurately predicted type 2 diabetes from neck-to-knee two-point Dixon MRI scans.
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Affiliation(s)
- Christian Wachinger
- Department of Radiology, Technical University of Munich, Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, München, Germany
- Lab for Artificial Intelligence in Medical Imaging, Department of Medicine, LMU Klinikum, Germany
- Munich Center for Machine Learning (MCML), Germany
| | - Tom Nuno Wolf
- Department of Radiology, Technical University of Munich, Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, München, Germany
- Munich Center for Machine Learning (MCML), Germany
| | - Sebastian Pölsterl
- Lab for Artificial Intelligence in Medical Imaging, Department of Medicine, LMU Klinikum, Germany
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Zhang Z, Li L, Hu Z, Zhou L, Zhang Z, Xiong Y, Yao Y. The causal associations of non-alcoholic fatty liver disease with blood pressure and the mediating effects of cardiometabolic risk factors: A Mendelian randomization study. Nutr Metab Cardiovasc Dis 2023; 33:2151-2159. [PMID: 37580235 DOI: 10.1016/j.numecd.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/07/2023] [Accepted: 07/07/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND AND AIMS Non-alcoholic fatty liver disease (NAFLD) is prevalent in hypertensive people, but the causal effect remains unclear. We employed Mendelian randomization (MR) approach to assess the causality between NAFLD and different blood pressure (BP) parameters. METHOD AND RESULTS Instrumental variables for genetically predicted NAFLD, including chronically elevated serum alanine aminotransferase levels (cALT) and imaging and biopsy-confirmed NAFLD, were obtained from a genome-wide association study (N = 164,197). Multiple MR methods were implemented, including Inverse variance weighted, MR-Egger, Maximum likelihood, Weighted median, Simple median, Penalised weighted median, MR-RAPS, and cML-MA. Outliers were detected using MR-PRESSO, and pleiotropy was assessed using MR-Egger intercept and Phenoscanner. Heterogeneity was quantified using Cochran's Q and Rucker's Q' tests. Potential shared risk factors were analyzed to reveal the mediating effect. A higher genetic predisposition to cALT was causally associated with an increased risk of elevated BP levels, resulting in 0.65 mmHg (95% CI, 0.42-0.87), 0.38 mmHg (95% CI, 0.25-0.50) and 0.33 mmHg (95% CI, 0.22-0.44) higher for systolic BP, diastolic BP and pulse pressure, respectively. When more stringent criteria were used, imaging and biopsy-confirmed NAFLD showed a 1.12 mmHg (95% CI, 0.94-1.30) increase in SBP and a 0.55 mmHg (95% CI, 0.39-0.70) increase in DBP. Risk factor and mediation analyses suggested type 2 diabetes and fasting insulin levels might mediate the causal relationship between NAFLD and BP. CONCLUSION The two-sample MR analyses showed robust causal effects of genetically predicted NAFLD on 3 different BP indices. The shared genetic profile between NAFLD and BP may suggest important therapeutic targets and early interventions for cardiometabolic risk factors.
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Affiliation(s)
- Zhuxin Zhang
- Fuwai Hospital, National Center for Cardiovascular Diseases, National Key Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Le Li
- Fuwai Hospital, National Center for Cardiovascular Diseases, National Key Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhao Hu
- Fuwai Hospital, National Center for Cardiovascular Diseases, National Key Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Likun Zhou
- Fuwai Hospital, National Center for Cardiovascular Diseases, National Key Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhenhao Zhang
- Fuwai Hospital, National Center for Cardiovascular Diseases, National Key Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yulong Xiong
- Fuwai Hospital, National Center for Cardiovascular Diseases, National Key Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Yao
- Fuwai Hospital, National Center for Cardiovascular Diseases, National Key Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Pan J, Hu Y, Pang N, Yang L. Association between Dietary Niacin Intake and Nonalcoholic Fatty Liver Disease: NHANES 2003-2018. Nutrients 2023; 15:4128. [PMID: 37836412 PMCID: PMC10574350 DOI: 10.3390/nu15194128] [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: 09/04/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Evidence regarding the association between dietary niacin intake and nonalcoholic fatty liver disease (NAFLD) is limited. The objective of this study was to examine the association of dietary niacin intake with NAFLD. Subjects aged 20 years and older who participated in the National Health and Nutrition Examination Survey (NHANES) 2003-2018 were included in this study. Dietary niacin intake was assessed by two 24-h dietary recalls. NAFLD was defined using the United States fatty liver index (US-FLI). Weighted logistic regression models and restricted cubic splines were used to examine the association between dietary niacin and NAFLD. Of the 12,355 participants in this study, 4378 had NAFLD. There is no evident nonlinear relationship between dietary niacin intake and the presence of NAFLD in the restricted cubic spline regression (poverall < 0.001; pnon-linearity = 0.068). The multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD were 0.84 (0.68-1.03), 0.80 (0.65-0.97), and 0.69 (0.55-0.85), respectively, when comparing the second, third, and fourth quartiles of niacin intake levels to the lowest quartile (ptrend = 0.001). Stratified analysis revealed that the effect of niacin intake on NAFLD varied in the group with or without hypertension (pinteraction = 0.033). In conclusion, our results indicate that higher dietary niacin intake may be associated with a lower likelihood of NAFLD.
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Affiliation(s)
- Jie Pan
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.P.)
| | - Yuhua Hu
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Nengzhi Pang
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.P.)
| | - Lili Yang
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.P.)
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11
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Cottier KE, Bhalerao D, Lewis C, Gaffney J, Heyward SA. Micropatterned primary hepatocyte co-culture (HEPATOPAC) for fatty liver disease modeling and drug screening. Sci Rep 2023; 13:15837. [PMID: 37739978 PMCID: PMC10517001 DOI: 10.1038/s41598-023-42785-9] [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: 12/12/2022] [Accepted: 09/14/2023] [Indexed: 09/24/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, progressive disorder and growing public health concern. To address this issue considerable research has been undertaken in pursuit of new NAFLD therapeutics. Development of effective, high-throughput in vitro models is an important aspect of drug discovery. Here, a micropatterned hepatocyte co-culture (MPCC) was used to model liver steatosis. The MPCC model (HEPATOPACTM) is comprised of hepatocytes and 3T3-J2 mouse stromal cells plated onto a patterned standard 96-well or 24-well plate, allowing the cultures to be handled and imaged in a standardized multi-well format. These studies employed high content imaging (HCI) analysis to assess lipid content in cultures. HCI analysis of lipid accumulation allows large numbers of samples to be imaged and analyzed in a relatively short period of time compared to manual acquisition and analysis methods. Treatment of MPCC with free fatty acids (FFA), high glucose and fructose (HGF), or a combination of both induces hepatic steatosis. MPCC treatment with ACC1/ACC2 inhibitors, as either a preventative or reversal agent, showed efficacy against FFA induced hepatic steatosis. Drug induced steatosis was also evaluated. Treatment with valproic acid showed steatosis induction in a lean background, which was significantly potentiated in a fatty liver background. Additionally, these media treatments changed expression of fatty liver related genes. Treatment of MPCC with FFA, HGF, or a combination reversibly altered expression of genes involved in fatty acid metabolism, insulin signaling, and lipid transport. Together, these data demonstrate that MPCC is an easy to use, long-term functional in vitro model of NAFLD having utility for compound screening, drug toxicity evaluation, and assessment of gene regulation.
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12
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Golubeva JA, Sheptulina AF, Elkina AY, Liusina EO, Kiselev AR, Drapkina OM. Which Comes First, Nonalcoholic Fatty Liver Disease or Arterial Hypertension? Biomedicines 2023; 11:2465. [PMID: 37760906 PMCID: PMC10525922 DOI: 10.3390/biomedicines11092465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/28/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) and arterial hypertension (AH) are widespread noncommunicable diseases in the global population. Since hypertension and NAFLD are diseases associated with metabolic syndrome, they are often comorbid. In fact, many contemporary published studies confirm the association of these diseases with each other, regardless of whether other metabolic factors, such as obesity, dyslipidemia, and type 2 diabetes mellites, are present. This narrative review considers the features of the association between NAFLD and AH, as well as possible pathophysiological mechanisms.
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Affiliation(s)
- Julia A. Golubeva
- Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - Anna F. Sheptulina
- Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
- Department of Therapy and Preventive Medicine, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
| | - Anastasia Yu. Elkina
- Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
- Department of Intermediate Level Therapy, Saratov State Medical University, 410012 Saratov, Russia
| | - Ekaterina O. Liusina
- Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - Anton R. Kiselev
- Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - Oxana M. Drapkina
- Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
- Department of Therapy and Preventive Medicine, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
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13
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Wang G, Shen X, Wang Y, Lu H, He H, Wang X. Analysis of risk factors related to nonalcoholic fatty liver disease: a retrospective study based on 31,718 adult Chinese individuals. Front Med (Lausanne) 2023; 10:1168499. [PMID: 37457561 PMCID: PMC10339707 DOI: 10.3389/fmed.2023.1168499] [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: 02/22/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Nonalcoholic fatty liver disease (NAFLD) is becoming increasingly prevalent worldwide. This study guides the prevention and diagnosis of NAFLD by analyzing its risk factors and the diagnostic value of each index for NAFLD. Method We collected the clinical information of adults individuals who underwent physical examination in the Physical Examination Center of Qingpu Branch of Zhongshan Hospital, Fudan University, from January 2016 to January 2020, including gender, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). We performed logistic regression analysis and ROC diagnostic analysis. Results The results showed that age, BMI, SBP, ALT, AST, FBG, TBIL, TG, and LDL were risk factors for NAFLD in adults, and HDL was a protective factor (all p-values were less than 0.05). Among them, age, BMI, ALT, TG, and HDL had a predictive value for the occurrence of NAFLD in the adults (AUC = 0.708, 0.836, 0.767, 0.780, and 0.732, respectively). The combination of age, BMI, ALT, TG, and HDL had a diagnostic value for the occurrence of NAFLD (AUC = 0.881). Conclusion Healthy people should pay attention to their BMI levels, manage blood pressure, blood glucose, and lipid levels, and pay attention to changes in ALT and AST index levels to prevent NAFLD. Age, BMI, ALT, TG, and HDL indexes are helpful factors in the diagnosis of NAFLD.
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Affiliation(s)
- Ganggang Wang
- Department of Hepatobiliary Surgery, Pudong Hospital, Fudan University, Shanghai, China
- Department of General Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaowei Shen
- Department of General Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yicun Wang
- Department of General Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huanhua Lu
- Department of General Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hua He
- Department of General Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaoliang Wang
- Department of Hepatobiliary Surgery, Pudong Hospital, Fudan University, Shanghai, China
- Department of General Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China
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14
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Tomasi M, Cherubini A, Pelusi S, Margarita S, Bianco C, Malvestiti F, Miano L, Romeo S, Prati D, Valenti L. Circulating Interlukin-32 and Altered Blood Pressure Control in Individuals with Metabolic Dysfunction. Int J Mol Sci 2023; 24:ijms24087465. [PMID: 37108628 PMCID: PMC10138906 DOI: 10.3390/ijms24087465] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Fatty liver disease is most frequently related to metabolic dysfunction (MAFLD) and associated comorbidities, heightening the risk of cardiovascular disease, and is associated with higher hepatic production of IL32, a cytokine linked with lipotoxicity and endothelial activation. The aim of this study was to examine the relationship between circulating IL32 concentration and blood pressure control in individuals with metabolic dysfunction at high risk of MAFLD. IL32 plasma levels were measured by ELISA in 948 individuals with metabolic dysfunction enrolled in the Liver-Bible-2021 cohort. Higher circulating IL32 levels were independently associated with systolic blood pressure (estimate +0.008 log10 per 1 mmHg increase, 95% c.i. 0.002-0.015; p = 0.016), and inversely correlated with antihypertensive medications (estimate -0.189, 95% c.i. -0.291--0.088, p = 0.0002). Through multivariable analysis, IL32 levels predicted both systolic blood pressure (estimate 0.746, 95% c.i 0.173-1.318; p = 0.010) and impaired blood pressure control (OR 1.22, 95% c.i. 1.09-1.38; p = 0.0009) independently of demographic and metabolic confounders and of treatment. This study reveals that circulating IL32 levels are associated with impaired blood pressure control in individuals at risk of cardiovascular disease.
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Affiliation(s)
- Melissa Tomasi
- Precision Medicine Lab-Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alessandro Cherubini
- Precision Medicine Lab-Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Serena Pelusi
- Precision Medicine Lab-Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sara Margarita
- Precision Medicine Lab-Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Cristiana Bianco
- Precision Medicine Lab-Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Francesco Malvestiti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Lorenzo Miano
- Precision Medicine Lab-Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Stefano Romeo
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Wallenberg Laboratory, University of Gothenburg, 413 45 Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy
| | - Daniele Prati
- Precision Medicine Lab-Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Luca Valenti
- Precision Medicine Lab-Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
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Luo Y, Wang C, Zhang T, He X, Hao J, Shen A, Zhao H, Chen S, Ren L. Factors Associated with Liver Fibrosis in Chinese Patients with Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease. Int J Gen Med 2023; 16:293-302. [PMID: 36718143 PMCID: PMC9884006 DOI: 10.2147/ijgm.s395948] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/08/2023] [Indexed: 01/25/2023] Open
Abstract
Purpose Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are frequently co-occurring diseases. Liver fibrosis (LF), with increasing incidence, has a prognostic value for NAFLD mortality. Our study aimed to investigate the relevant factors for FL in T2DM individuals with NAFLD. Patients and Methods A total of 565 T2DM patients with NAFLD from Hebei General Hospital participated in the study. Patients underwent an abdominal ultrasound, a questionnaire and laboratory tests. The fibrosis-4 index (FIB-4) was used to evaluate LF, with FIB ≥1.3 indicating LF and FIB ≥2.67 indicating F3-4 fibrosis. Results Compared with NLF group, LF group had higher levels of systolic blood pressure (SBP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transpeptidase (GGT). The glomerular filtration rate (GFR), low-density lipoprotein cholesterol (LDL), glycated hemoglobin (HbA1c), and platelets (PLT) in LF patients were lower than those without LF. Patients with LF were older than those without LF. ALT, AST, and GGT in patients with severe LF were higher than those with mild LF, while platelet was lower. Age, SBP, duration of diabetes, ALT, AST, and GGT were positively correlated with FIB-4, while eGFR, TC, LDL, and HbA1c were negatively correlated with FIB-4. Logistic regression showed that age, SBP, ALT, GGT, LDL, and PLT were independently associated with LF. Conclusion For T2DM patients combined with NAFLD, older age, higher SBP, higher ALT, higher GGT, lower LDL, and lower PLT were relevant factors for LF.
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Affiliation(s)
- Yu Luo
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Cuiyu Wang
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School, Hebei North University, Zhangjiakou, People’s Republic of China
| | - Tian Zhang
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School, North China University of Science and Technology, Tangshan, People’s Republic of China
| | - Xiaoyu He
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School, Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Jianan Hao
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School, Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Andong Shen
- Graduate School, North China University of Science and Technology, Tangshan, People’s Republic of China
- Gastroenterology Department, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Hang Zhao
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Shuchun Chen
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Luping Ren
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, People’s Republic of China
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Oura K, Morishita A, Tani J, Masaki T. Antitumor Effects and Mechanisms of Metabolic Syndrome Medications on Hepatocellular Carcinoma. J Hepatocell Carcinoma 2022; 9:1279-1298. [PMID: 36545268 PMCID: PMC9760577 DOI: 10.2147/jhc.s392051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022] Open
Abstract
Liver cancer has a high incidence and mortality rate worldwide, with hepatocellular carcinoma (HCC) being the most common histological type. With the decrease in the number of newly infected patients and the spread of antiviral therapy, hepatitis virus-negative chronic liver diseases including steatohepatitis are increasingly accounting for a large proportion of HCC, and an important clinical characteristic is the high prevalence of metabolic syndrome including hypertension, type 2 diabetes (T2D), dyslipidemia, and obesity. Since patients with steatohepatitis are less likely to undergo surveillance for early detection of HCC, they may be diagnosed at an advanced stage and have worse prognosis. Therefore, treatment strategies for patients with HCC caused by steatohepatitis, especially in advanced stages, become increasingly important. Further, hypertension, T2D, and dyslipidemia may occur as side effects during systemic treatment, and there will be increasing opportunities to prescribe metabolic syndrome medications, not only for originally comorbid diseases, but also for adverse events during HCC treatment. Interestingly, epidemiological studies have shown that patients taking some metabolic syndrome medications are less likely to develop various types of cancers, including HCC. Basic studies have also shown that these drugs have direct antitumor effects on HCC. In particular, angiotensin II receptor blockers (a drug group for treating hypertension), biguanides (a drug group for treating T2D), and statins (a drug group for treating dyslipidemia) have shown to elucidate antitumor effects against HCC. In this review, we focus on the antitumor effects of metabolic syndrome medications on HCC and their mechanisms based on recent literature. New therapeutic agents are also increasingly being reported. Analysis of the antitumor effects of metabolic syndrome medications on HCC and their mechanisms will be doubly beneficial for HCC patients with metabolic syndrome, and the use of these medications may be a potential strategy against HCC.
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Affiliation(s)
- Kyoko Oura
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan,Correspondence: Kyoko Oura, Department of Gastroenterology and Neurology, Kagawa University, 1750-1 Ikenobe, Miki, Kida, Kagawa, Japan, Tel +81-87-891-2156, Fax +81-87-891-2158, Email
| | - Asahiro Morishita
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Joji Tani
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Tsutomu Masaki
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Fresneda S, Abbate M, Busquets-Cortés C, López-González A, Fuster-Parra P, Bennasar-Veny M, Yáñez AM. Sex and age differences in the association of fatty liver index-defined non-alcoholic fatty liver disease with cardiometabolic risk factors: a cross-sectional study. Biol Sex Differ 2022; 13:64. [PMID: 36333736 PMCID: PMC9636717 DOI: 10.1186/s13293-022-00475-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Despite the extensive scientific evidence accumulating on the epidemiological risk factors for non-alcoholic fatty liver disease (NAFLD), evidence exploring sex- and age-related differences remains insufficient. The present cross-sectional study aims to investigate possible sex differences in the prevalence of FLI-defined NAFLD as well as in its association with common risk factors across different age groups, in a large sample of Spanish working adults. Methods This cross-sectional study included data from 33,216 Spanish adult workers (18–65 years) randomly selected during voluntary routine occupational medical examinations. Sociodemographic characteristics (age and social class), anthropometric (height, weight, and waist circumference) and clinical parameters (blood pressure and serum parameters) were collected. NAFLD was determined by the validated fatty liver index (FLI) with a cut-off value of ≥ 60. The presence of metabolic syndrome (MetS) was assessed according to the diagnostic criteria of the International Diabetes Federation. Cardiovascular risk was determined using the REGICOR-Framingham equation. The association between FLI-defined NAFLD and risk factors by sex and age was evaluated by multivariate logistic regression. Results The prevalence of FLI-defined NAFLD (FLI ≥ 60) was 19.1% overall, 27.9% (95% CI 23.3–28.5%) for men and 6.8% (95% CI 6.4–7.3%) for women and increasing across age intervals. As compared to women, men presented worse cardiometabolic and anthropometric profiles. The multivariate analysis model showed that hepatic steatosis assessed by FLI was strongly associated with age, HDL-cholesterol, social class, prediabetes, diabetes, prehypertension, hypertension, and smoking status for both men and women. The association between diabetes and hypertension with FLI-defined NAFLD was stronger in women than in men at both univariate and multivariate analyses. Conclusions Men presented a higher prevalence of NAFLD than women across all age intervals, as well as a worse cardiometabolic profile and a higher cardiovascular risk. Nevertheless, the association between FLI-defined NAFLD and diabetes or hypertension was significantly stronger in women than in men, possibly indicating that the presence of a dysmetabolic state might affect women more than men with regard to liver outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s13293-022-00475-7. There is a lack of evidence exploring sex- and age-related differences on the epidemiological risk factors for non-alcoholic fatty liver disease. In our sample, hepatic steatosis assessed by FLI is more prevalent in men than women and is associated with age, lower social class and a dysmetabolic state characterized by prediabetes or diabetes, prehypertension or hypertension and low HDL-cholesterol. Importantly, we observed that although FLI-defined NAFLD is strongly associated with cardiometabolic imbalances in both sexes, its association with diabetes and hypertension is stronger in women than in men, regardless of age. We also observed that such association in women is evident even at stages preceding diabetes and hypertension and at younger ages.
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Affiliation(s)
- Sergio Fresneda
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain
| | - Manuela Abbate
- Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Escuela Universitaria ADEMA, C/ Gremi de Passamaners, 11, 07009 Palma, Illes Balears Spain
| | - Carla Busquets-Cortés
- Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Escuela Universitaria ADEMA, C/ Gremi de Passamaners, 11, 07009 Palma, Illes Balears Spain
| | - Arturo López-González
- Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Escuela Universitaria ADEMA, C/ Gremi de Passamaners, 11, 07009 Palma, Illes Balears Spain ,Prevention of Occupational Risk in Health Services, Balearic Islands Health Service, C/ Reina Esclaramunda, 9, 07003 Palma, Illes Balears Spain
| | - Pilar Fuster-Parra
- Department of Mathematics and Computer Science, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,grid.413448.e0000 0000 9314 1427CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Aina M. Yáñez
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain
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Auth PA, da Silva GR, Amaral EC, Bortoli VF, Manzano MI, de Souza LM, Lovato ECW, Ribeiro-Paes JT, Gasparotto Junior A, Lívero FADR. Croton urucurana Baill. Ameliorates Metabolic Associated Fatty Liver Disease in Rats. Front Pharmacol 2022; 13:886122. [PMID: 35668935 PMCID: PMC9164250 DOI: 10.3389/fphar.2022.886122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/26/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Metabolic associated fatty liver disease (MAFLD) affects a quarter of the worldwide population, but no drug therapies have yet been developed. Croton urucurana Baill. (Euphorbiaceae) is a medicinal species, that is, widely distributed in Brazil. It is used in popular medicine to treat gastrointestinal, cardiovascular, and endocrine system diseases. However, its hepatoprotective and lipid-lowering effects have not yet been scientifically investigated. Aim of the study: The present study investigated the effects of an extract of C. urucurana in a rat model of MAFLD that was associated with multiple risk factors, including hypertension, smoking, and dyslipidemia. Material and Methods: The phytochemical composition of C. urucurana was evaluated by liquid chromatography-mass spectrometry. Spontaneously hypertensive rats received a 0.5% cholesterol-enriched diet and were exposed to cigarette smoke (9 cigarettes/day for 10 weeks). During the last 5 weeks, the animals were orally treated with vehicle (negative control [C-] group), C. urucurana extract (30, 100, and 300 mg/kg), or simvastatin + enalapril (two standard reference drugs that are commonly used to treat dyslipidemia and hypertension, respectively). One group of rats that were not exposed to these risk factors was also evaluated (basal group). Blood was collected for the analysis of cholesterol, triglyceride, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels. The liver and feces were collected for lipid quantification. The liver was also processed for antioxidant and histopathological analysis. Results: The main constituents of the C. urucurana extract were flavonoids, glycosides, and alkaloids. The model successfully induced MAFLD, reflected by increases in AST and ALT levels, and induced oxidative stress in the C- group. Treatment with the C. urucurana extract (300 mg/kg) and simvastatin + enalapril decreased plasma and hepatic lipid levels. In contrast to simvastatin + enalapril treatment, C. urucurana reduced AST and ALT levels. Massive lesions were observed in the liver in the C- group, which were reversed by treatment with the C. urucurana extract (300 mg/kg). Conclusion:C. urucurana extract exerted promising hepatoprotective and lipid-lowering effects in a preclinical rat model of MAFLD.
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Affiliation(s)
- Pablo Alvarez Auth
- Laboratory of Preclinical Research of Natural Products, Post-Graduate Program in Animal Science with Emphasis on Bioactive Products, Paranaense University, Umuarama, Brazil
| | - Gustavo Ratti da Silva
- Laboratory of Preclinical Research of Natural Products, Post-Graduate Program in Animal Science with Emphasis on Bioactive Products, Paranaense University, Umuarama, Brazil
| | - Eduarda Carolina Amaral
- Laboratory of Preclinical Research of Natural Products, Post-Graduate Program in Medicinal Plants and Phytotherapeutics in Basic Attention, Paranaense University, Umuarama, Brazil
| | - Victor Fajardo Bortoli
- Laboratory of Preclinical Research of Natural Products, Post-Graduate Program in Medicinal Plants and Phytotherapeutics in Basic Attention, Paranaense University, Umuarama, Brazil
| | | | - Lauro Mera de Souza
- Institute of Research Pelé Pequeno Príncipe, Pequeno Príncipe Faculty, Curitiba, Brazil
| | - Evellyn Claudia Wietzikoski Lovato
- Laboratory of Neurosciences, Post-Graduate Program in Medicinal Plants and Phytotherapeutics in Basic Attention, Paranaense University, Umuarama, Brazil
| | | | - Arquimedes Gasparotto Junior
- Laboratory of Cardiovascular Pharmacology, Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Brazil
| | - Francislaine Aparecida Dos Reis Lívero
- Laboratory of Preclinical Research of Natural Products, Post-Graduate Program in Medicinal Plants and Phytotherapeutics in Basic Attention, Post-Graduate in Animal Science with Emphasis on Bioactive Products, Paranaense University, Umuarama, Brazil
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A Molecular Insight into the Role of Antioxidants in Nonalcoholic Fatty Liver Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9233650. [PMID: 35602098 PMCID: PMC9117022 DOI: 10.1155/2022/9233650] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) defines fat accumulation in the liver, and it is commonly associated with metabolic syndromes like diabetes and obesity. Progressive NAFLD leads to nonalcoholic steatohepatitis (NASH) and ultimately causes cirrhosis and hepatocellular carcinoma, and NASH is currently a frequent cause of liver transplantation. Oxidative stress is often contributed to the progression of NAFLD, and hence, antioxidants such as silymarin, silybin, or silibinin, pentoxifylline, resveratrol, and vitamins A, C, and E are used in clinical trials against NAFLD. Silymarin induces the peroxisome proliferator-activated receptor α (PPARα), a fatty acid sensor, which promotes the transcription of genes that are required for the enzymes involved in lipid oxidation in hepatocytes. Silybin inhibits sterol regulatory element-binding protein 1 and carbohydrate response element-binding protein to downregulate the expression of genes responsible for de novo lipogenesis by activating AMP-activated protein kinase phosphorylation. Pentoxifylline inhibits TNF-α expression and endoplasmic reticulum stress-mediated inflammatory nuclear factor kappa B (NF-κB) activation. Thus, it prevents NAFLD to NASH progression. Resveratrol inhibits methylation at Nrf-2 promoters and NF-κB activity via SIRT1 activation in NAFLD conditions. However, clinically, resveratrol has not shown promising beneficial effects. Vitamin C is beneficial in NAFLD patients. Vitamin E is not effectively regressing hepatic fibrosis. Hence, its combination with antifibrotic agents is used as an adjuvant to produce a synergistic antifibrotic effect. However, to date, none of these antioxidants have been used as a definite therapeutic agent in NAFLD patients. Further, these antioxidants should be studied in NAFLD patients with larger populations and multiple endpoints in the future.
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Ciardullo S, Grassi G, Mancia G, Perseghin G. Nonalcoholic fatty liver disease and risk of incident hypertension: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2022; 34:365-371. [PMID: 34678858 PMCID: PMC8876398 DOI: 10.1097/meg.0000000000002299] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/02/2021] [Indexed: 12/12/2022]
Abstract
Several studies reported an association between nonalcoholic fatty liver disease (NAFLD) and the risk of incident hypertension. The objective of this systematic review and meta-analysis was to obtain a precise and reliable estimate of the nature and magnitude of this association. We systematically searched Ovid-MEDLINE up to March 2021 for observational studies in which NAFLD was diagnosed in adults using blood-based panels, imaging techniques or liver biopsy and with a follow-up ≥1 year. Measures of association from individual studies were meta-analyzed using random-effects models. Of the 1108 titles initially scrutinized, we included 11 cohort studies with data on 390 348 participants (52% male) and a mean follow-up of 5.7 years. In the overall analysis, NAFLD was associated with a moderately increased risk of incident hypertension (hazard ratio 1.66; 95% confidence interval (CI), 1.38-2.01; test for overall effect z = 5.266; P < 0.001). There was significant heterogeneity among the studies (P < 0.001). Sensitivity analyses showed that estimates were not affected by geographical location, duration of follow-up and adjustment for baseline blood pressure values. On the other hand, the magnitude of the association was lower in studies that adjusted for baseline adiposity compared with those that did not, explaining part of the observed heterogeneity. No significant publication bias was detected by funnel plot analysis and Egger's and Begg's tests. This large meta-analysis indicates that NAFLD is associated with a ~1.6-fold increased risk of developing hypertension. Further studies are needed to investigate the role of NAFLD severity in terms of inflammation and fibrosis on incident hypertension.
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Affiliation(s)
- Stefano Ciardullo
- Department of Medicine and Rehabilitation, Policlinico di Monza Hospital, Monza
- Department of Medicine and Surgery, School of Medicine and Surgery
| | - Guido Grassi
- Department of Medicine and Surgery, Clinica medica, University of Milano Bicocca, Milan, Italy
| | - Giuseppe Mancia
- Department of Medicine and Rehabilitation, Policlinico di Monza Hospital, Monza
- Department of Medicine and Surgery, School of Medicine and Surgery
| | - Gianluca Perseghin
- Department of Medicine and Rehabilitation, Policlinico di Monza Hospital, Monza
- Department of Medicine and Surgery, School of Medicine and Surgery
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21
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Kuchay MS, Misra A. Role of diabetologists in the management of nonalcoholic fatty liver disease: Primary prevention and screening/management of fibrosis and cirrhosis. Diabetes Metab Syndr 2022; 16:102446. [PMID: 35259705 DOI: 10.1016/j.dsx.2022.102446] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Nonalcoholic fatty liver disease (NAFLD) is a common condition, especially among individuals with type 2 diabetes (T2D). Presence of T2D increases the risk of progression of simple steatosis to more severe liver conditions, such as nonalcoholic steatohepatitis (NASH) and fibrosis (NASH-fibrosis). Since majority of patients with T2D are managed by diabetologists (including physicians and endocrinologists), their roles in the management of coexisting NAFLD are not well defined, partly due to lack of unambiguous guidelines. METHODS A literature search was performed with Medline (PubMed), Scopus and Google Scholar electronic databases till January 2022, using relevant keywords (nonalcoholic fatty liver disease and diabetologist; screening of NASH; management of NASH) to extract relevant studies describing prevention and screening of NAFLD/NASH, especially in people with T2D. RESULTS Diabetologists have two main roles for the management of patients with T2D and coexisting NAFLD. The most important role is to prevent the development of NASH-fibrosis in patients with simple steatosis (primary prevention). This can be achieved by reinforcing the importance of lifestyle measures, and by early use of glucose-lowering agents with beneficial effects on the liver. The second important role of diabetologists is to screen all patients with T2D for liver fibrosis and compensated cirrhosis, and provide appropriate referral for timely management of complications (secondary prevention). CONCLUSION Diabetologists can play a central role in mitigating the epidemic of NAFLD in individuals with T2D. However, diabetologists need to be aware about their roles in NASH-fibrosis prevention and screening. Furthermore, longitudinal studies should explore the role of newer glucose-lowering drugs in the primary prevention of NASH-fibrosis in individuals with coexisting T2D and simple steatosis.
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Affiliation(s)
- Mohammad Shafi Kuchay
- Division of Endocrinology and Diabetes, Medanta The Medicity Hospital, Gurugram, 122001, Haryana, India.
| | - Anoop Misra
- Fortis CDOC Hospital for Diabetes and Allied Sciences, New Delhi, India; National Diabetes Obesity and Cholesterol Foundation (NDOC) and Diabetes Foundation, India.
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22
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Tao Z, Li Y, Cheng B, Zhou T, Gao Y. Influence of Nonalcoholic Fatty Liver Disease on the Occurrence and Severity of Chronic Kidney Disease. J Clin Transl Hepatol 2022; 10:164-173. [PMID: 35233386 PMCID: PMC8845149 DOI: 10.14218/jcth.2021.00171] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/10/2021] [Accepted: 08/25/2021] [Indexed: 12/04/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is reported to affect 20-30% of adults and is accompanied by various metabolic comorbidities, where the economic and clinical burden of NAFLD is attributed to the progression of liver disease as well as the presence of extrahepatic diseases. Chronic kidney disease (CKD), which has a high incidence rate, high morbidity and mortality rates, and high medical costs, has been linked to NAFLD. CKD is associated with some metabolism-related risk factors that overlap with metabolic comorbidities of NAFLD. Therefore, to investigate the potential factors that influence CKD occurrence, the association between NAFLD and CKD should be clarified. Some studies have confirmed that NAFLD influences the occurrence and severity of CKD, whereas some studies have indicated that there is no correlation. In this review, the results of a few studies have been discussed, the potential risk factors for CKD in NAFLD are explored, and the respective biological mechanisms are elaborated to help clinicians identify CKD in patients much earlier than it is diagnosed now and thus help in reducing the incidence of liver and kidney transplants.
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Affiliation(s)
| | | | | | | | - Yanjing Gao
- Correspondence to: Yanjing Gao, Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong 250012, China. ORCID: https://orcid.org/0000-0001-8153-3754. Tel: +86-18560086087, E-mail:
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von Krüchten R, Rospleszcz S, Lorbeer R, Hasic D, Peters A, Bamberg F, Schulz H, Karrasch S, Schlett CL. Whole-Body MRI-Derived Adipose Tissue Characterization and Relationship to Pulmonary Function Impairment. Tomography 2022; 8:560-569. [PMID: 35314623 PMCID: PMC8938839 DOI: 10.3390/tomography8020046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 01/10/2023] Open
Abstract
Background: Specification of adipose tissues by whole-body magnetic resonance imaging (MRI) was performed and related to pulmonary function parameters in a population-based cohort. Methods: 203 study participants underwent whole-body MRI and pulmonary function tests as part of the KORA (Cooperative Health Research in the Augsburg Region) MRI study. Both visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were derived from the T1-Dixon sequence, and hepatic adipose tissue from the proton density fat fraction (PDFFhepatic). Associations between adipose tissue parameters and spirometric indices such as forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and Tiffeneau-index (FEV1/FVC) were examined using multivariate linear regression analysis excluding cofounding effects of other clinical parameters. Results: VAT (β = −0.13, p = 0.03) and SAT (β = −0.26, p < 0.001), but not PDFFhepatic were inversely associated with FEV1, while VAT (β = −0.27, p < 0.001), SAT (β = −0.41, p < 0.001), and PDFFhepatic (β = −0.17, p = 0.002) were inversely associated with FVC. PDFFhepatic was directly associated with the Tiffeneau index (β = 2.46, p < 0.001). Conclusions: In the adjusted linear regression model, VAT was inversely associated with all measured spirometric parameters, while PDFFhepatic revealed the strongest association with the Tiffeneau index. Non-invasive adipose tissue quantification measurements might serve as novel biomarkers for respiratory impairment.
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Affiliation(s)
- Ricarda von Krüchten
- Department of Diagnostic and Interventional Radiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (R.v.K.); (D.H.); (F.B.)
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; (S.R.); (A.P.); (H.S.)
- Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-University, 81377 Munich, Germany;
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilians-University Hospital, 80336 Munich, Germany;
| | - Dunja Hasic
- Department of Diagnostic and Interventional Radiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (R.v.K.); (D.H.); (F.B.)
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; (S.R.); (A.P.); (H.S.)
- Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-University, 81377 Munich, Germany;
- German Center for Diabetes Research, München-Neuherberg, 85764 Neuherberg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (R.v.K.); (D.H.); (F.B.)
| | - Holger Schulz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; (S.R.); (A.P.); (H.S.)
| | - Stefan Karrasch
- Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-University, 81377 Munich, Germany;
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, 80336 Munich, Germany
- Comprehensive Pneumology Center Munich, Member of the German Center for Lung Research, Munich-Neuherberg, 85764 Neuherberg, Germany
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (R.v.K.); (D.H.); (F.B.)
- Correspondence: ; Tel.: +49-761-270-38190
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Maevskaya M, Kotovskaya Y, Ivashkin V, Tkacheva O, Troshina E, Shestakova M, Breder V, Geyvandova N, Doschitsin V, Dudinskaya E, Ershova E, Kodzoeva K, Komshilova K, Korochanskaya N, Mayorov A, Mishina E, Nadinskaya M, Nikitin I, Pogosova N, Tarzimanova A, Shamkhalova M. The National Consensus statement on the management of adult patients with non-alcoholic fatty liver disease and main comorbidities. TERAPEVT ARKH 2022; 94:216-253. [DOI: 10.26442/00403660.2022.02.201363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Indexed: 12/15/2022]
Abstract
The National Consensus was prepared with the participation of the National Medical Association for the Study of the Multimorbidity, Russian Scientific Liver Society, Russian Association of Endocrinologists, Russian Association of Gerontologists and Geriatricians, National Society for Preventive Cardiology, Professional Foundation for the Promotion of Medicine Fund PROFMEDFORUM.
The aim of the multidisciplinary consensus is a detailed analysis of the course of non-alcoholic fatty liver disease (NAFLD) and the main associated conditions. The definition of NAFLD is given, its prevalence is described, methods for diagnosing its components such as steatosis, inflammation and fibrosis are described.
The association of NAFLD with a number of cardio-metabolic diseases (arterial hypertension, atherosclerosis, thrombotic complications, type 2 diabetes mellitus (T2DM), obesity, dyslipidemia, etc.), chronic kidney disease (CKD) and the risk of developing hepatocellular cancer (HCC) were analyzed. The review of non-drug methods of treatment of NAFLD and modern opportunities of pharmacotherapy are presented.
The possibilities of new molecules in the treatment of NAFLD are considered: agonists of nuclear receptors, antagonists of pro-inflammatory molecules, etc. The positive properties and disadvantages of currently used drugs (vitamin E, thiazolidinediones, etc.) are described. Special attention is paid to the multi-target ursodeoxycholic acid (UDCA) molecule in the complex treatment of NAFLD as a multifactorial disease. Its anti-inflammatory, anti-oxidant and cytoprotective properties, the ability to reduce steatosis an independent risk factor for the development of cardiovascular pathology, reduce inflammation and hepatic fibrosis through the modulation of autophagy are considered.
The ability of UDCA to influence glucose and lipid homeostasis and to have an anticarcinogenic effect has been demonstrated. The Consensus statement has advanced provisions for practitioners to optimize the diagnosis and treatment of NAFLD and related common pathogenetic links of cardio-metabolic diseases.
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Song Q, Liu S, Ling QH, Gao QN, Yang RX, Chen SH, Wu S, Chen ML, Cai J. Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community-Based Cohort Study. Front Endocrinol (Lausanne) 2022; 13:942647. [PMID: 36093080 PMCID: PMC9453754 DOI: 10.3389/fendo.2022.942647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND It is unclear whether more severe non-alcoholic fatty liver disease (NAFLD) combined with prehypertension or hypertension is associated with a higher risk of cardiovascular events (CVEs). To evaluate the relationship between the severity of NAFLD and CVEs among patients with prehypertension or hypertension. METHODS In this prospective community-based Kailuan cohort, participants without cardiovascular disease and alcohol abuse, or other liver diseases were enrolled. NAFLD was diagnosed by abdominal ultrasonography. Prehypertension was defined as systolic blood pressure (BP) of 120-139 mmHg or diastolic BP of 80-89 mmHg. Participants with NAFLD were divided into mild, moderate, and severe subgroups. Follow-up for CVEs including myocardial infarction, hemorrhagic stroke, and ischemic stroke. The Cox proportional hazards model was used to estimate hazard ratios and 95% CIs of CVEs according to the severity of NAFLD and hypertensive statutes. The C-statistic was used to evaluate the efficiency of models. RESULTS A total of 71926 participants (mean [SD] age, 51.83 [12.72] years, 53794 [74.79%] men, and 18132 [25.21%] women) were enrolled in this study, 6,045 CVEs occurred during a median of 13.02 (0.65) years of follow-up. Compared with participants without NAFLD, the hazard ratios of CVEs for patients with mild, moderate, and severe NAFLD were 1.143 (95% CI 1.071-1.221, P < 0.001), 1.218 (95% CI 1.071-1.221, P < 0.001), and 1.367 (95% CI 1.172-1.595, P < 0.001), respectively. Moreover, participants with prehypertension plus moderate/severe NAFLD and those with hypertension plus moderate/severe NAFLD had 1.558-fold (95% CI 1.293-1.877, P < 0.001) and 2.357-fold (95% CI 2.063-2.691, P < 0.001) higher risks of CVEs, respectively, compared with those with normal BP and no NAFLD. Adding a combination of NAFLD and BP status to the crude Cox model increased the C-statistic by 0.0130 (0.0115-0.0158, P < 0.001). CONCLUSIONS Our findings indicated that the increased cardiovascular risk with elevated BP is largely driven by the coexistence of moderate/severe NAFLD, suggesting that the severity of NAFLD may help further stratify patients with prehypertension and hypertension.
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Affiliation(s)
- Qi–Rui Song
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuo–Lin Liu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Qian-Hui Ling
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qian-Nan Gao
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui-Xue Yang
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuo-Hua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shou–Ling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
- *Correspondence: Shou–Ling Wu, ; Mu-Lei Chen, ; Jun Cai,
| | - Mu-Lei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- *Correspondence: Shou–Ling Wu, ; Mu-Lei Chen, ; Jun Cai,
| | - Jun Cai
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Shou–Ling Wu, ; Mu-Lei Chen, ; Jun Cai,
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Kountouras J, Papaefthymiou A, Polyzos SA, Deretzi G, Vardaka E, Soteriades ES, Tzitiridou-Chatzopoulou M, Gkolfakis P, Karafyllidou K, Doulberis M. Impact of Helicobacter pylori-Related Metabolic Syndrome Parameters on Arterial Hypertension. Microorganisms 2021; 9:microorganisms9112351. [PMID: 34835476 PMCID: PMC8618184 DOI: 10.3390/microorganisms9112351] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/28/2021] [Accepted: 11/10/2021] [Indexed: 12/12/2022] Open
Abstract
Arterial hypertension is a risk factor for several pathologies, mainly including cardio-cerebrovascular diseases, which rank as leading causes of morbidity and mortality worldwide. Arterial hypertension also constitutes a fundamental component of the metabolic syndrome. Helicobacter pylori infection is one of the most common types of chronic infection globally and displays a plethora of both gastric and extragastric effects. Among other entities, Helicobacter pylori has been implicated in the pathogenesis of the metabolic syndrome. Within this review, we illustrate the current state-of-the-art evidence, which may link several components of the Helicobacter pylori-related metabolic syndrome, including non-alcoholic fatty liver disease and arterial hypertension. In particular, current knowledge of how Helicobacter pylori exerts its virulence through dietary, inflammatory and metabolic pathways will be discussed. Although there is still no causative link between these entities, the emerging evidence from both basic and clinical research supports the proposal that several components of the Helicobacter pylori infection-related metabolic syndrome present an important risk factor in the development of arterial hypertension. The triad of Helicobacter pylori infection, the metabolic syndrome, and hypertension represents a crucial worldwide health problem on a pandemic scale with high morbidity and mortality, like COVID-19, thereby requiring awareness and appropriate management on a global scale.
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Affiliation(s)
- Jannis Kountouras
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.P.); (M.T.-C.); (M.D.)
- Correspondence:
| | - Apostolis Papaefthymiou
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.P.); (M.T.-C.); (M.D.)
- Department of Gastroenterology, University Hospital of Larisa, 41110 Larisa, Greece
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Stergios A. Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Georgia Deretzi
- Multiple Sclerosis Unit, Department of Neurology, Papageorgiou General Hospital, 56403 Thessaloniki, Greece;
| | - Elisabeth Vardaka
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia 2252, Cyprus;
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Maria Tzitiridou-Chatzopoulou
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.P.); (M.T.-C.); (M.D.)
- School of Healthcare Sciences, Midwifery Department, University of West Macedonia, Koila, 50100 Kozani, Greece
| | - Paraskevas Gkolfakis
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, 1070 Brussels, Belgium;
- Department of Medical Oncology, Institut Jules Bordet, 1000 Brussels, Belgium
| | - Kyriaki Karafyllidou
- Department of Pediatrics, University Children’s Hospital of Zurich, 8032 Zurich, Switzerland;
| | - Michael Doulberis
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.P.); (M.T.-C.); (M.D.)
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, 5001 Aarau, Switzerland
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MRI-Derived Radiomics Features of Hepatic Fat Predict Metabolic States in Individuals without Cardiovascular Disease. Acad Radiol 2021; 28 Suppl 1:S1-S10. [PMID: 32800693 DOI: 10.1016/j.acra.2020.06.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 12/21/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate radiomics features of hepatic fat as potential biomarkers of type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) in individuals without overt cardiovascular disease, and benchmarking against hepatic proton density fat fraction (PDFF) and the body mass index (BMI). MATERIALS AND METHODS This study collected liver radiomics features of 310 individuals that were part of a case-controlled imaging substudy embedded in a prospective cohort. Individuals had known T2DM (n = 39; 12.6 %) and MetS (n = 107; 34.5 %) status, and were divided into stratified training (n = 232; 75 %) and validation (n = 78; 25 %) sets. Six hundred eighty-four MRI radiomics features were extracted for each liver volume of interest (VOI) on T1-weighted dual-echo Dixon relative fat water content (rfwc) maps. Test-retest and inter-rater variance was simulated by additionally extracting radiomics features using noise augmented rfwc maps and deformed volume of interests. One hundred and seventy-one features with test-retest reliability (ICC(1,1)) and inter-rater agreement (ICC(3,k)) of ≥0.85 on the training set were considered stable. To construct predictive random forest (RF) models, stable features were filtered using univariate RF analysis followed by sequential forward aggregation. The predictive performance was evaluated on the independent validation set with area under the curve of the receiver operating characteristic (AUROC) and balanced accuracy (AccuracyB). RESULTS On the validation set, the radiomics RF models predicted T2DM with AUROC of 0.835 and AccuracyB of 0.822 and MetS with AUROC of 0.838 and AccuracyB of 0.787, outperforming the RF models trained on the benchmark parameters PDFF and BMI. CONCLUSION Hepatic radiomics features may serve as potential imaging biomarkers for T2DM and MetS.
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28
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Cai X, Rospleszcz S, Mensel B, Schminke U, Kühn JP, Aghdassi AA, Storz C, Lorbeer R, Schlett CL, Rathmann W, Roden M, Hohenester S, Bülow R, Bamberg F, Peters A, Thorand B, Völzke H, Nano J. Association between hepatic fat and subclinical vascular disease burden in the general population. BMJ Open Gastroenterol 2021; 8:bmjgast-2021-000709. [PMID: 34593525 PMCID: PMC8487174 DOI: 10.1136/bmjgast-2021-000709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/27/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE It is still controversial if increased hepatic fat independently contributes to cardiovascular risk. We aimed to assess the association between hepatic fat quantified by MRI and various subclinical vascular disease parameters. DESIGN We included two cross-sectional investigations embedded in two independent population-based studies (Study of Health in Pomerania (SHIP): n=1341; Cooperative Health Research in the Region of Augsburg (KORA): n=386). The participants underwent a whole-body MRI examination. Hepatic fat content was quantified by proton-density fat fraction (PDFF). Aortic diameters in both studies and carotid plaque-related parameters in KORA were measured with MRI. In SHIP, carotid intima-media thickness (cIMT) and plaque were assessed by ultrasound. We used (ordered) logistic or linear regression to assess associations between hepatic fat and subclinical vascular disease. RESULTS The prevalence of fatty liver disease (FLD) (PDFF >5.6%) was 35% in SHIP and 43% in KORA. In SHIP, hepatic fat was positively associated with ascending (β, 95% CI 0.06 (0.04 to 0.08)), descending (0.05 (0.04 to 0.07)) and infrarenal (0.02 (0.01 to 0.03)) aortic diameters, as well as with higher odds of plaque presence (OR, 95% CI 1.22 (1.05 to 1.42)) and greater cIMT (β, 95% CI 0.01 (0.004 to 0.02)) in the age-adjusted and sex-adjusted model. However, further adjustment for additional cardiometabolic risk factors, particularly body mass index, attenuated these associations. In KORA, no significant associations were found. CONCLUSIONS The relation between hepatic fat and subclinical vascular disease was not independent of overall adiposity. Given the close relation of FLD with cardiometabolic risk factors, people with FLD should still be prioritised for cardiovascular disease screening.
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Affiliation(s)
- Xinting Cai
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Pettenkofer School of Public Health, Ludwig-Maximilians-Universitat Munchen, Munich, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.,Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology-IBE, Ludwig-Maximilians-Universitat Munchen, Munich, Germany.,German Center for Cardiovascular Disease Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Birger Mensel
- Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Jens-Peter Kühn
- Institute and Policlinic for Diagnostic and Interventional Radiology, University Hospital Carl-Gustav-Carus, Dresden University of Technology, Dresden, Germany
| | | | - Corinna Storz
- Department of Neuroradiology, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Roberto Lorbeer
- Department of Radiology, University Hospital, LMU Munich, Munich, Bayern, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Freiburg, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Partner site Düsseldorf, German Center for Diabetes Research, Neuherberg, Germany
| | - Michael Roden
- Partner site Düsseldorf, German Center for Diabetes Research, Neuherberg, Germany.,Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Institute for Clinical Diabetology, German Diabetes Center, German Diabetes Center Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Simon Hohenester
- Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Freiburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Cardiovascular Disease Research (DZHK), partner site Munich Heart Alliance, Munich, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Ludwig Maximilians University Munich, Munich, Germany.,Partner site Munich-Neuherberg, German Center for Diabetes Research, Neuherberg, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.,Partner site Munich-Neuherberg, German Center for Diabetes Research, Neuherberg, Germany
| | - Henry Völzke
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany.,Partner site Greifswald, German Center for Cardiovascular Disease Research, Greifswald, Germany
| | - Jana Nano
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany .,Partner site Munich-Neuherberg, German Center for Diabetes Research, Neuherberg, Germany
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Ma C, Yan K, Wang Z, Zhang Q, Gao L, Xu T, Sai J, Cheng F, Du Y. The association between hypertension and nonalcoholic fatty liver disease (NAFLD): literature evidence and systems biology analysis. Bioengineered 2021; 12:2187-2202. [PMID: 34096467 PMCID: PMC8806441 DOI: 10.1080/21655979.2021.1933302] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has become a major public health issue as its progression increases risks of multisystem morbidity and mortality. Recent evidence indicates a more complex relationship between hypertension and NAFLD than previously thought. In this study, a comprehensive literature search was used to gather information supporting the comorbidity phenomenon of hypertension and NAFLD. Then, systems biology approach was applied to identify the potential genes and mechanisms simultaneously associated with hypertension and NAFLD. With the help of protein-protein interaction network-based algorithm, we found that the distance between hypertension and NAFLD was much less than random ones. Sixty-four shared genes of hypertension and NAFLD modules were identified as core genes. Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analysis indicated that some inflammatory, metabolic and endocrine signals were related to the potential biological functions of core genes. More importantly, drugs used to treat cardiovascular diseases, hypertension, hyperlipidemia, inflammatory diseases and depression could be potential therapeutics against hypertension-NAFLD co-occurrence. After analyzing public OMICs data, ALDH1A1 was identified as a potential therapeutic target, without being affected by reverse causality. These findings give a clue for the potential mechanisms of comorbidity of hypertension and NAFLD and highlight the multiple target-therapeutic strategy of NAFLD for future clinical research.
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Affiliation(s)
- Chongyang Ma
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Kai Yan
- Department of Traditional Chinese Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Zisong Wang
- Department of Traditional Chinese Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Qiuyun Zhang
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Lianyin Gao
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Tian Xu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jiayang Sai
- Department of Oncology, The Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Fafeng Cheng
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yuqiong Du
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
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30
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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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Chiriac S, Stanciu C, Girleanu I, Cojocariu C, Sfarti C, Singeap AM, Cuciureanu T, Huiban L, Muzica CM, Zenovia S, Nastasa R, Trifan A. Nonalcoholic Fatty Liver Disease and Cardiovascular Diseases: The Heart of the Matter. Can J Gastroenterol Hepatol 2021; 2021:6696857. [PMID: 33505944 PMCID: PMC7815392 DOI: 10.1155/2021/6696857] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/16/2020] [Accepted: 12/21/2020] [Indexed: 02/08/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has emerged as the most frequent cause of liver disease worldwide, comprising a plethora of conditions, ranging from steatosis to end-stage liver disease. Cardiovascular disease (CVD) has been associated with NAFLD and CVD-related events represent the main cause of death in patients with NAFLD, surpassing liver-related mortality. This association is not surprising as NAFLD has been considered a part of the metabolic syndrome and has been related to numerous CVD risk factors, namely, insulin resistance, abdominal obesity, dyslipidemia, hyperuricemia, chronic kidney disease, and type 2 diabetes. Moreover, both NAFLD and CVD present similar pathophysiological mechanisms, such as increased visceral adiposity, altered lipid metabolism, increased oxidative stress, and systemic inflammation that could explain their association. Whether NAFLD increases the risk for CVD or these diagnostic entities represent distinct manifestations of the metabolic syndrome has not yet been clarified. This review focuses on the relation between NAFLD and the spectrum of CVD, considering the pathophysiological mechanisms, risk factors, current evidence, and future directions.
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Affiliation(s)
- 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
| | - Carol Stanciu
- 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
| | - 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
| | - 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
| | - 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
| | - Tudor Cuciureanu
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Laura Huiban
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Cristina Maria Muzica
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Sebastian Zenovia
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Robert Nastasa
- 1Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, 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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32
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Storz C, Rospleszcz S, Askani E, Rothenbacher T, Linseisen J, Messmann H, De Cecco CN, Machann J, Kiefer LS, Elser S, Rathmann W, Peters A, Schlett CL, Bamberg F. Magnetic Resonance Imaging of Diverticular Disease and its Association with Adipose Tissue Compartments and Constitutional Risk Factors in Subjects from a Western General Population. ROFO-FORTSCHR RONTG 2020; 193:33-41. [PMID: 32785905 DOI: 10.1055/a-1212-5669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine the association of asymptomatic diverticular disease as assessed by magnetic resonance imaging (MRI) with adipose tissue compartments, hepatic steatosis and constitutional risk factors within a cohort drawn from a Western general population. MATERIALS AND METHODS Asymptomatic subjects enrolled in a prospective case-control study underwent a 3 Tesla MRI scan, including an isotropic VIBE-Dixon sequence of the entire trunk. The presence and extent of diverticular disease were categorized according to the number of diverticula in each colonic segment in a blinded fashion. The amount of visceral, subcutaneous, and total adipose tissue (VAT, SAT, and TAT) was quantified by MRI. Additionally, the degree of hepatic steatosis, indicated as hepatic proton density fat fraction (hepatic PDFF) was determined using a multi-echo T1w sequence. Constitutional cardiometabolic risk factors were obtained and univariate and multivariate associations were calculated. RESULTS A total of 371 subjects were included in the analysis (58.2 % male, 56.2 ± 9.2 years). Based on MRI, 154 participants (41.5 %) had diverticular disease with 62 cases (17 %) being advanced diverticular disease. Subjects with advanced diverticular disease had a significantly higher body mass index (BMI) (BMI: 29.9 ± 5.1 vs. 27.5 ± 4.6, p < 0.001; respectively). Furthermore, all adipose tissue compartments were increased in subjects with advanced diverticular disease (e. g. VAT: 6.0 ± 2.8 vs. 4.2 ± 2.6 and SAT: 9.2 ± 3.6 vs. 7.8 ± 3.6, all p < 0.001, respectively). Similarly, subjects with advanced diverticular disease had significantly higher hepatic PDFF (4.9 [2.7, 11.4] vs. 6.1 [5.5, 14.6], p = 0.002). CONCLUSION Advanced diverticular disease is associated with an increased volume of adipose tissue compartments and BMI, which may suggest a metabolic role in disease development. KEY POINTS · Diverticular disease is associated with constitutional risk factors such as BMI.. · Excess of adipose tissue compartments and hepatic steatosis are associated with the prevalence of diverticular disease.. · Our results suggest a shared pathological pathway of cardiometabolic alterations and the prevalence of diverticular disease.. · MRI is feasible for the assessment of adipose tissue compartments, hepatic steatosis, and diverticular disease and allows identification of patients who are at risk but in an asymptomatic disease state.. CITATION FORMAT · Storz C, Rospleszcz S, Askani E et al. Magnetic Resonance Imaging of Diverticular Disease and its Association with Adipose Tissue Compartments and Constitutional Risk Factors in Subjects from a Western General Population. Fortschr Röntgenstr 2021; 193: 33 - 41.
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Affiliation(s)
- Corinna Storz
- Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Centre Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - Esther Askani
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Theresa Rothenbacher
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Jakob Linseisen
- Chair of Epidemiology, Ludwig-Maximilians University of Munich, UNIKA-T Augsburg, Augsburg, Germany.,IRG Clinical Epidemiology, Helmholtz Centre Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - Helmut Messmann
- Department of Internal Medicine III, Klinikum Augsburg, Augsburg, Germany
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA, USA
| | - Jürgen Machann
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tuebingen, Germany.,German Center for Diabetes Research (DZD), Tuebingen, Germany
| | - Lena Sophie Kiefer
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Elser
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Wolfgang Rathmann
- Department of Biometry and Epidemiology, German Diabetes Center, Duesseldorf, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Centre Munich, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Cardiovascular Disease Research (DZHK e. V.), Munich, Germany.,Institute for Cardiovascular Prevention, Ludwig-Maximilians-University-Hospital, Munich, Germany.,Chair of Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany
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33
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Ciardullo S, Monti T, Sala I, Grassi G, Mancia G, Perseghin G. Nonalcoholic Fatty Liver Disease and Advanced Fibrosis in US Adults Across Blood Pressure Categories. Hypertension 2020; 76:562-568. [PMID: 32594797 DOI: 10.1161/hypertensionaha.120.15220] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is common in patients with hypertension but controversy exists as to whether screening for this condition should be performed. Here, we evaluate the prevalence of NAFLD and advanced fibrosis in US adults across blood pressure categories and estimate the number of patients who require referral to hepatologists. In this cross-sectional analysis of 11 489 adults from the 2005 to 2016 National Health and Nutrition Examination Survey, participants were segregated as having optimal, normal, high normal, and elevated blood pressure according to the 2018 European Society of Cardiology/Hypertension guidelines. NAFLD was defined using the US fatty liver index, whereas fibrosis was assessed using the NAFLD fibrosis score, fibrosis-4, and Hepamet Fibrosis Score. NAFLD prevalence increased progressively from optimal (16.5%) to normal (34.5%), high normal (39.9%), and elevated blood pressure (50.2%, P<0.001). Patients with hypertension also showed a higher prevalence of advanced fibrosis (3%-9%, based on the specific biomarker used). When the screening flowchart from the European Association for the Study of the Liver, Diabetes, and Obesity guidelines was applied to patients with hypertension, 26.7% needed referral to hepatologists. Risk of referral was higher in Hispanic patients and those with diabetes mellitus, heart failure, and an altered urinary albumin excretion. NAFLD is highly prevalent in US adults with hypertension and a quarter of them would need to be referred to hepatologists because of a high risk of advanced fibrosis. While future studies on cost-effectiveness are needed, screening for NAFLD in these patients could be beneficial.
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Affiliation(s)
- Stefano Ciardullo
- From the Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy (S.C., G.M., G.P.).,School of Medicine and Surgery (S.C., G.M., G.P.), University of Milano Bicocca, Milan, Italy
| | - Tommaso Monti
- Department of Statistics and Quantitative Methods (T.M., I.S.), University of Milano Bicocca, Milan, Italy
| | - Isabella Sala
- Department of Statistics and Quantitative Methods (T.M., I.S.), University of Milano Bicocca, Milan, Italy
| | - Guido Grassi
- Clinica medica (G.G.), University of Milano Bicocca, Milan, Italy
| | - Giuseppe Mancia
- From the Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy (S.C., G.M., G.P.).,School of Medicine and Surgery (S.C., G.M., G.P.), University of Milano Bicocca, Milan, Italy
| | - Gianluca Perseghin
- From the Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy (S.C., G.M., G.P.).,School of Medicine and Surgery (S.C., G.M., G.P.), University of Milano Bicocca, Milan, Italy
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34
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Abstract
Hypertension, a multifactorial disorder resulting from the interplay between genetic predisposition and environmental risk factors, affects ≈30% of adults. Emerging evidence has shown that nonalcoholic fatty liver disease (NAFLD), as an underestimated metabolic abnormality, is strongly associated with an increased risk of incident prehypertension and hypertension. However, the role of NAFLD in the development of hypertension is still obscure and is highly overlooked by the general public. Herein, we highlight the epidemiological evidence and putative mechanisms focusing on the emerging roles of NAFLD in hypertension, with the purpose of reinforcing the notion that NAFLD may serve as an independent risk factor and an important driving force in the development and progression of hypertension. Finally, we also briefly summarize the current potential treatments for NAFLD that might also be beneficial approaches against hypertension.
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Affiliation(s)
- Yan-Ci Zhao
- From the Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, P.R. China (Y.-C.Z., G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
- Institute of Model Animal of Wuhan University, P.R. China (Y.-C.Z.,G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
| | - Guo-Jun Zhao
- From the Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, P.R. China (Y.-C.Z., G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
- Institute of Model Animal of Wuhan University, P.R. China (Y.-C.Z.,G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
| | - Ze Chen
- From the Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, P.R. China (Y.-C.Z., G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
- Institute of Model Animal of Wuhan University, P.R. China (Y.-C.Z.,G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
| | - Zhi-Gang She
- From the Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, P.R. China (Y.-C.Z., G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
- Institute of Model Animal of Wuhan University, P.R. China (Y.-C.Z.,G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
- Basic Medical School (Z.-G.S., H.L.), Wuhan University, P.R. China
- Medical Research Institute, School of Medicine (Z.-G.S.), Wuhan University, P.R. China
| | - Jingjing Cai
- From the Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, P.R. China (Y.-C.Z., G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, P.R. China (J.C.)
- Institute of Model Animal of Wuhan University, P.R. China (Y.-C.Z.,G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
| | - Hongliang Li
- From the Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, P.R. China (Y.-C.Z., G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
- Institute of Model Animal of Wuhan University, P.R. China (Y.-C.Z.,G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
- Basic Medical School (Z.-G.S., H.L.), Wuhan University, P.R. China
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Association of serum uric acid with visceral, subcutaneous and hepatic fat quantified by magnetic resonance imaging. Sci Rep 2020; 10:442. [PMID: 31949261 PMCID: PMC6965096 DOI: 10.1038/s41598-020-57459-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/28/2019] [Indexed: 12/20/2022] Open
Abstract
Elevated serum uric acid (SUA) is associated with a variety of medical conditions, such as hypertension, diabetes and obesity. Analyses investigating uric acid and obesity were primarily conducted using anthropometric measures like BMI and waist circumference. However, different adipose tissue depots might be differentially affected in uric acid metabolism. We analyzed the relation of SUA with visceral, subcutaneous and hepatic fat as quantified by Magnetic Resonance Imaging in N = 371 individuals from a cross-sectional sample of a population-based cohort. Associations of SUA and fat depots were calculated by regressions adjusted for potential confounders. We found that SUA was correlated with all fat measures (e.g. Pearson’s r between SUA and hepatic fat: 0.50, 95%-CI: 0.42, 0.57). Associations with visceral and hepatic fat, but not with subcutaneous fat, remained evident after adjustment for anthropometric measures (e.g. visceral fat: β = 0.51 l, 95%-CI: 0.30 l, 0.72 l). In conclusion, these results show how different adipose tissue compartments are affected by SUA to varying degrees, thus emphasizing the different physiological roles of these adipose tissues in uric acid metabolism.
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Association of longitudinal risk profile trajectory clusters with adipose tissue depots measured by magnetic resonance imaging. Sci Rep 2019; 9:16972. [PMID: 31740739 PMCID: PMC6861315 DOI: 10.1038/s41598-019-53546-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/31/2019] [Indexed: 12/20/2022] Open
Abstract
The objective of the study was to identify associations of longitudinal trajectories of traditional cardiometabolic risk factors with abdominal and ectopic adipose tissue depots measured by magnetic resonance imaging (MRI). We measured total abdominal, visceral, and subcutaneous adipose tissue in liter and intrahepatic, intrapancreatic and renal sinus fat as fat fractions by MRI in 325 individuals free of cardiovascular disease at Exam 3 of a population-based cohort. We related these MRI measurements at Exam 3 to longitudinal risk profile trajectory clusters, based on risk factor measurements from Exam 3, Exam 2 (seven years prior to MRI) and Exam 1 (14 years prior to MRI). Based on the levels and longitudinal trajectories of several risk factors (blood pressure, lipid profile, anthropometric measurements, HbA1c), we identified three different trajectory clusters. These clusters displayed a graded association with all adipose tissue traits after adjustment for potential confounders (e.g. visceral adipose tissue: βClusterII = 1.30 l, 95%-CI:[0.84 l;1.75 l], βClusterIII = 3.32 l[2.74 l;3.90 l]; intrahepatic: EstimateClusterII = 1.54[1.27,1.86], EstimateClusterIII = 2.48[1.93,3.16]. Associations remained statistically significant after additional adjustment for the risk factor levels at Exam 1 or Exam 3, respectively. Trajectory clusters provided additional information in explaining variation in the different fat compartments beyond risk factor profiles obtained at individual exams. In conclusion, sustained high risk factor levels and unfavorable trajectories are associated with high levels of adipose tissue; however, the association with cardiometabolic risk factors varies substantially between different ectopic adipose tissues. Trajectory clusters, covering longitudinal risk profiles, provide additional information beyond single-point risk profiles. This emphasizes the need to incorporate longitudinal information in cardiometabolic risk estimation.
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Correlation of MRI-derived adipose tissue measurements and anthropometric markers with prevalent hypertension in the community. J Hypertens 2019; 36:1555-1562. [PMID: 29601409 DOI: 10.1097/hjh.0000000000001741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To compare the correlations of MRI-derived adipose tissue measurements and anthropometric markers, respectively, with prevalent hypertension in a community-based sample, free of clinical cardiovascular disease. METHODS MRI-derived adipose tissue measurements were obtained in 345 participants (143 women; age 39-73 years) of the KORA FF4 survey from Southern Germany using a 3-Tesla machine and included total adipose tissue (TAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SCAT), hepatic fat fraction (HFF), pancreatic fat fraction (PFF) as well as pericardial adipose tissue (PAT). In addition, the anthropometric markers body mass index, waist circumference, hip circumference, waist-hip ratio (WHR) and waist-height ratio (WHtR) as well as blood pressure measurements were obtained. RESULTS The prevalence of hypertension was 33.6% (women: 28%, men: 38%). VAT and PAT had the highest area under the curve (AUC) values for identifying individuals with prevalent hypertension (AUC: 0.75; 0.73, respectively), whereas WHtR and waist circumference were best performing anthropometric markers (AUC: 0.72; 0.70, respectively). A 1SD increment of TAT was associated with the highest odd for hypertension in the age-adjusted and sex-adjusted model (OR = 2.20, 95% CI 1.67-2.91, P < 0.001) and in the fully adjusted model (OR = 1.97, 95% CI 1.45-2.66, P < 0.001). TAT was the only MRI-derived adipose tissue measurement that was associated with hypertension independently of the best performing anthropometric marker waist circumference in the fully adjusted model (OR = 1.93, 95% CI 1.00-3.72, P = 0.049). CONCLUSION MRI-derived adipose tissue measurements perform similarly in identifying prevalent hypertension compared with anthropometric markers. Especially, TAT, VAT and PAT as well as WHtR and waist circumference were highly correlated with prevalent hypertension.
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Hepatic fat is superior to BMI, visceral and pancreatic fat as a potential risk biomarker for neurodegenerative disease. Eur Radiol 2019; 29:6662-6670. [PMID: 31187217 DOI: 10.1007/s00330-019-06276-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/06/2019] [Accepted: 05/16/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Prior studies relating body mass index (BMI) to brain volumes suggest an overall inverse association. However, BMI might not be an ideal marker, as it disregards different fat compartments, which carry different metabolic risks. Therefore, we analyzed MR-based fat depots and their association with gray matter (GM) volumes of brain structures, which show volumetric changes in neurodegenerative diseases. METHODS Warp-based automated brain segmentation of 3D FLAIR sequences was obtained in a population-based study cohort. Associations of temporal lobe, cingulate gyrus, and hippocampus GM volume with BMI and MR-based quantification of visceral adipose tissue (VAT), as well as hepatic and pancreatic proton density fat fraction (PDFFhepatic and PDFFpanc, respectively), were assessed by linear regression. RESULTS In a sample of 152 women (age 56.2 ± 9.0 years) and 199 men (age 56.1 ± 9.1 years), we observed a significant inverse association of PDFFhepatic and cingulate gyrus volume (p < 0.05) as well as of PDFFhepatic and hippocampus volume (p < 0.05), when adjusting for age and sex. This inverse association was further enhanced for cingulate gyrus volume after additionally adjusting for hypertension, smoking, BMI, LDL, and total cholesterol (p < 0.01) and also alcohol (p < 0.01). No significant association was observed between PDFFhepatic and temporal lobe and between temporal lobe, cingulate gyrus, or hippocampus volume and BMI, VAT, and PDFFpanc. CONCLUSIONS We observed a significant inverse, independent association of cingulate gyrus and hippocampus GM volume with hepatic fat, but not with other obesity measures. Increased hepatic fat could therefore serve as a marker of high-risk fat distribution. KEY POINTS • Obesity is associated with neurodegenerative processes. • In a population-based study cohort, hepatic fat was superior to BMI and visceral and pancreatic fat as a risk biomarker for decreased brain volume of cingulate gyrus and hippocampus. • Increased hepatic fat could serve as a marker of high-risk fat distribution.
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Abstract
Nonalcoholic fatty liver disease (NAFLD) is an increasingly dominant cause of liver disease worldwide. The progressive subtype, nonalcoholic steatohepatitis, is a leading indication for liver transplantation and a noteworthy cause of hepatocellular carcinoma. The overall prevalence of NAFLD is on the rise, and even more concerning data modeling predicts that an increasing percentage of those with NAFLD will develop advanced disease. This increased volume of patients with advanced liver disease will impose a significant health care burden in terms of resources and cost. Thus, the identification of patients with established fibrosis or at high risk of developing advanced liver disease is critical to effectively intervene and prevent overall and liver-related morbidity and mortality. Herein, we provide a framework to consider for the identification of patients with NAFLD at high risk of nonalcoholic steatohepatitis with advanced fibrosis and provide a critical assessment of currently accessible diagnostic and treatment modalities.
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Mechanisms of NAFLD development and therapeutic strategies. Nat Med 2018; 24:908-922. [PMID: 29967350 DOI: 10.1038/s41591-018-0104-9] [Citation(s) in RCA: 2401] [Impact Index Per Article: 400.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/30/2018] [Indexed: 02/07/2023]
Abstract
There has been a rise in the prevalence of nonalcoholic fatty liver disease (NAFLD), paralleling a worldwide increase in diabetes and metabolic syndrome. NAFLD, a continuum of liver abnormalities from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), has a variable course but can lead to cirrhosis and liver cancer. Here we review the pathogenic and clinical features of NAFLD, its major comorbidities, clinical progression and risk of complications and in vitro and animal models of NAFLD enabling refinement of therapeutic targets that can accelerate drug development. We also discuss evolving principles of clinical trial design to evaluate drug efficacy and the emerging targets for drug development that involve either single agents or combination therapies intended to arrest or reverse disease progression.
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Hypertension and hepatic triglycerides content: a two (multi)-faceted clinical challenge? J Hypertens 2018; 35:715-717. [PMID: 28248900 DOI: 10.1097/hjh.0000000000001290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Lonardo A, Nascimbeni F, Mantovani A, Targher G. Hypertension, diabetes, atherosclerosis and NASH: Cause or consequence? J Hepatol 2018; 68:335-352. [PMID: 29122390 DOI: 10.1016/j.jhep.2017.09.021] [Citation(s) in RCA: 466] [Impact Index Per Article: 77.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/13/2017] [Accepted: 09/23/2017] [Indexed: 02/06/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) has become one of the most common forms of chronic liver disease worldwide and its prevalence is expected to continue rising. NAFLD has traditionally been considered a consequence of metabolic syndrome (MetS). However, the link between NAFLD and MetS components, especially type 2 diabetes mellitus (T2DM), hypertension (HTN), and cardiovascular disease (CVD) is more complex than previously thought. Indeed, the adverse effects of NAFLD extend far beyond the liver, with a large body of clinical evidence now suggesting that NAFLD may precede and/or promote the development of T2DM, HTN and atherosclerosis/CVD. The risk of developing these cardiometabolic diseases parallels the underlying severity of NAFLD. Accumulating evidence suggests that the presence and severity of NAFLD is associated with an increased risk of incident T2DM and HTN. Moreover, long-term prospective studies indicate that the presence and severity of NAFLD independently predicts fatal and nonfatal CVD events. In this review, we critically discuss the rapidly expanding body of clinical evidence that supports the existence of a bi-directional relationship between NAFLD and various components of MetS, particularly T2DM and HTN, as well as the current knowledge regarding a strong association between NAFLD and CVD morbidity and mortality. Finally, we discuss the most updated putative biological mechanisms through which NAFLD may contribute to the development of HTN, T2DM and CVD.
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Affiliation(s)
- Amedeo Lonardo
- Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, Azienda Ospedaliero-Universitaria, Ospedale Civile di Baggiovara, Modena, Italy
| | - Fabio Nascimbeni
- Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, Azienda Ospedaliero-Universitaria, Ospedale Civile di Baggiovara, Modena, Italy
| | - Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
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