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Wang TJ, Chen MY, Lin YC, Chiu WN, Huang TJ, Weng HH. High prevalence of fatty liver and its association with metabolic syndrome among rural adults with chronic hepatitis C: Implications for primary healthcare. BMC Public Health 2024; 24:532. [PMID: 38378519 PMCID: PMC10880326 DOI: 10.1186/s12889-024-17851-0] [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: 02/11/2023] [Accepted: 01/23/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Chronic hepatitis C (CHC) virus infection is a global health concern that is associated with significant liver-related morbidity and mortality. Owing to the inflammatory pathway, CHC can causefatty liver, liver cirrhosis, and liver cancer and is associated with cardiometabolic diseases, such as hypertension and diabetes. Fatty liver is associated with metabolic disorders, cardiovascular diseases, diabetes, and liver cancer. Hence, the early detection of fatty liver through noninvasive screening in adults with CHC is important in primary healthcare settings. This study aimed to explore the prevalence of fatty liver and its association with metabolic syndrome amongrural adults with CHC. METHODS This was a series of cohort studies related to the elimination of the CHC burden around the western coastal Yunlin County, Taiwan, between August 2018 and July 2021. A cross-sectional study was conducted after hepatitis C virus RNA confirmation in a hepatitis C- endemic area. A gastrointestinal physician or radiologist assessed fatty liver by ultrasonography. Fatty liver was classified into four grades: normal, mild, moderate, and severe. Three liver enzyme biomarkers were identified. According to the Taiwan national standard, metabolic syndrome was defined based on the presence of three or more of the five abnormal biomarkers, including increased waist circumference, elevated blood pressure, elevated fasting blood glucose level, elevated triglyceride level, and low high-density lipoprotein cholesterol level. RESULTS A total of 256 rural adults with CHC were enrolled. The mean age of the participants was 67.5 (standard deviation = 11.8) years, with a low educational level. High prevalence of fatty liver (79%), central obesity (54.3%), elevated blood pressure (55.5%),elevated fasting blood glucose (FBG) level (44.9%), and metabolic syndrome (37.9%) were observed.The results showed that adults with CHC with moderate to severe fatty liver were significantly associated with an increased risk of increased waist circumference (P < 0.001), increased blood pressure (P < 0.001), low high-density lipoprotein cholesterol level (P < 0.05), and elevated liver enzyme biomarker levels (all P < 0.05) after adjusting for age, sex, and educational level. Furthermore, adults with CHC with moderate to severe fatty liver were significantly associated with a greater risk of metabolic syndrome (odds ratio = 2.85, 95% confidence interval = 1.66 to 4.92). CONCLUSIONS The findings demonstrate a high prevalence of fatty liver in rural adults with CHC, which is significantly associated with obesity, metabolic syndrome, and elevated liver biomarker levels. Clinicians and primary healthcare providers must encourage patients with CHC to receive antiviral therapy combined with weight loss management and lifestyle modification, allowing general improvements in their liver and cardiometabolic health.
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Affiliation(s)
- Ta-Jen Wang
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Mei-Yen Chen
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
- Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Nursing, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Chih Lin
- Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Wen-Nan Chiu
- Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tung-Jung Huang
- Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Hsu-Huei Weng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Fateh HL, Rashid SA, Muhammad SS, Al-Jaf SH, Ali AM. Comparing effects of beetroot juice and Mediterranean diet on liver enzymes and sonographic appearance in patients with non-alcoholic fatty liver disease: a randomized control trials. Front Nutr 2023; 10:1181706. [PMID: 37662597 PMCID: PMC10469647 DOI: 10.3389/fnut.2023.1181706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background In both developed and developing countries, non-alcoholic fatty liver disease (NAFLD) has lately risen to the top of the list of chronic liver illnesses. Although there is no permanent cure, early management, diagnosis, and treatment might lessen its effects. The purpose of conducting the current study is to compare the effects of beetroot juice and the Mediterranean diet on the lipid profile, level of liver enzymes, and liver sonography in patients with NAFLD. Methods In this randomized controlled trial, 180 people with a mean age of (45.19 ± 14.94) years participated. Participants ranged in age from 19 to 73. The mean weight before intervention was (82.46 ± 5.97) kg, while the mean weight after intervention was roughly (77.88 ± 6.26) kg. The trial lasted for 12 weeks. The participants were split into four groups: control, a Mediterranean diet with beet juice (BJ + MeD), Mediterranean diet alone (MeD), and beetroot juice (BJ). The Mediterranean diet included fruits, vegetables, fish, poultry, and other lean meats (without skin), sources of omega-3 fatty acids, nuts, and legumes. Beetroot juice had 250 mg of beetroot. Data analysis was done using SPSS software (version 26.0). p < 0.05 is the statistical significance level. Results Following the intervention, Serum Bilirubin, alkaline phosphatase (ALP), alanine transaminase (ALT), serum cholesterol (CHOL), triglyceride (TG), and low-density lipoprotein (LDL) levels were significantly decreased in the BJ + MeD, BJ, and MeD groups (p = 0.001). Also, high-density lipoprotein (HDL) significantly increased in the BJ + MeD, BJ, and MeD groups (p = 0.001), while decreasing in the Control group (p = 0.001). Conclusion The research findings indicate a significant reduction in hepatic steatosis among the groups receiving beetroot juice (BJ) and beetroot juice combined with the Mediterranean diet (BJ + MeD). This suggests that beetroot juice holds potential as an effective treatment for non-alcoholic fatty liver disease (NAFLD) in adults. Furthermore, the combination of beetroot juice with the Mediterranean diet showed enhanced efficacy in addressing NAFLD.Clinical trial registration: ClinicalTrials.gov, identifier NCT05909631.
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Affiliation(s)
- Hawal Lateef Fateh
- Nursing Department, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
- Nursing Department, Kalar Technical College, Garmian Polytechnic University, Kalar, Iraq
| | | | - Sarmad S. Muhammad
- Medical Laboratory Technology Department, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
- Medical Laboratory Technology Department, Kalar Technical College, Garmian Polytechnic University, Kalar, Iraq
| | - Sabah H. Al-Jaf
- Department of Chemistry, College of Science, University of Garmian, Sulaimani, Iraq
| | - Ayad M. Ali
- Department of Chemistry, College of Science, University of Garmian, Sulaimani, Iraq
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Irfan R, Kumar S. Letter to the Editor: Association between birth weight, preterm birth, and nonalcoholic fatty liver disease in a community-based cohort. Hepatology 2023; 78:E8. [PMID: 36929826 DOI: 10.1097/hep.0000000000000368] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Rabia Irfan
- Federal Medical and Dental College, Rawalpindi, Pakistan
| | - Satesh Kumar
- Shaheed Mohtarma Benazir Bhutto Medical College, Liyari, Karachi, Pakistan
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Kim K, Chon N, Jeong HW, Lee Y. Improvement of Ultrasound Image Quality Using Non-Local Means Noise-Reduction Approach for Precise Quality Control and Accurate Diagnosis of Thyroid Nodules. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13743. [PMID: 36360621 PMCID: PMC9654012 DOI: 10.3390/ijerph192113743] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to improve the quality of ultrasound images by modeling an algorithm using a non-local means (NLM) noise-reduction approach to achieve precise quality control and accurate diagnosis of thyroid nodules. An ATS-539 multipurpose phantom was used to scan the dynamic range and gray-scale measurement regions, which are most closely related to the noise level. A convex-type 3.5-MHz frequency probe is used for scanning according to ATS regulations. In addition, ultrasound images of human thyroid nodules were obtained using a linear probe. An algorithm based on the NLM noise-reduction approach was modeled based on the intensity and relative distance of adjacent pixels in the image, and conventional filtering methods for image quality improvement were designed as a comparison group. When the NLM algorithm was applied to the image, the contrast-to-noise ratio and coefficient of variation values improved by 28.62% and 19.54 times, respectively, compared with those of the noisy images. In addition, the image improvement efficiency of the NLM algorithm was superior to that of conventional filtering methods. Finally, the applicability of the NLM algorithm to human thyroid images using a high-frequency linear probe was validated. We demonstrated the efficiency of the proposed algorithm in ultrasound images and the possibility of capturing improved images in the dynamic range and gray-scale region for quality control parameters.
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Affiliation(s)
- Kyuseok Kim
- Department of Integrative Medicine, Major in Digital Healthcare, Yonsei University College of Medicine, Unju-ro, Gangman-gu, Seoul 06229, Korea
| | - Nuri Chon
- Woori Yonsei Internal Medicine, 370, Anyang-ro, Manan-gu, Anyang-si 13991, Korea
| | - Hyun-Woo Jeong
- Department of Biomedical Engineering, Eulji University, 553, Sanseong-daero, Sujeong-gu, Seongnam-si 13135, Korea
| | - Youngjin Lee
- Department of Radiological Science, College of Health Science, Gachon University, 191, Hambakmoe-ro, Yeonsu-gu, Incheon 21936, Korea
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Ha J, Oh YR, Kang E, Nam HK, Rhie YJ, Lee KH. Single Point Insulin Sensitivity Estimator for predicting type 2 diabetes mellitus in obese adolescents. Ann Pediatr Endocrinol Metab 2022; 27:201-206. [PMID: 35073668 PMCID: PMC9537672 DOI: 10.6065/apem.2142178.089] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/15/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The prevalence of adolescents with type 2 diabetes mellitus (T2DM) has rapidly increased in Korea over the past few decades with the increase in the number of obese adolescents. The single point insulin sensitivity estimator (SPISE) was recently introduced as a surrogate marker for insulin sensitivity to predict T2DM in adults. We aimed to determine risk factors for T2DM in obese adolescents, including SPISE. METHODS This retrospective study included 104 adolescents diagnosed with T2DM at Korea University Hospital between January 2010 and December 2020. We compared clinical and biochemical parameters and the SPISE of normoglycemic overweight and obese individuals with those of prediabetic and diabetic adolescents to determine risk factors for T2DM. Receiver operating characteristic analysis was performed with the Youden index to determine the cutoff point of SPISE. RESULTS Frequency of fatty liver and family history of T2DM were significantly higher and SPISE level was significantly lower in patients with T2DM than in normoglycemic overweight/obese and prediabetic adolescents (p<0.01). A family history of T2DM, fatty liver, and SPISE value below the cutoff point (4.49) were identified as significant risk factors for T2DM in multiple logistic regression analysis after controlling for age, sex, and body mass index standard deviation score (p<0.01). CONCLUSION Family history of T2DM, fatty liver, and low SPISE (<4.49) are risk factors that can independently affect the occurrence of T2DM in obese adolescents. Among these risk factors, SPISE is a promising marker for predicting adolescent T2DM; careful monitoring of these individuals is needed to prevent progression to T2DM.
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Affiliation(s)
- Jaewook Ha
- Department of Pediatrics, Veterans Health Service, Seoul, Korea
| | - Ye-Rim Oh
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Eungu Kang
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Hyo-Kyoung Nam
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
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Doustmohammadian A, Nezhadisalami A, Safarnezhad Tameshke F, Motamed N, Maadi M, Farahmand M, Sohrabi M, Clark CCT, Ajdarkosh H, Faraji AH, Nikkhah M, Sobhrakhshankhah E, Ebrahimi R, Zamani F. A randomized triple-blind controlled clinical trial evaluation of sitagliptin in the treatment of patients with non-alcoholic fatty liver diseases without diabetes. Front Med (Lausanne) 2022; 9:937554. [PMID: 35966875 PMCID: PMC9365981 DOI: 10.3389/fmed.2022.937554] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
The current study aimed to evaluate the efficacy of sitagliptin vs. placebo in treating non-alcoholic fatty liver disease (NAFLD). In a triple-blind randomized clinical trial, we assigned 120 eligible subjects with NAFLD to receive daily dosing of 50 mg sitagliptin (n = 60) or the placebo (n = 60) for 56 weeks and lifestyle modification in both groups. Laboratory and anthropometric outcomes were measured, and liver stiffness was assessed using a fibroscan. The primary outcome measures were changes from baseline in fibrosis scores and liver transferases. Out of 120 patients randomized into sitagliptin and placebo groups, 76 patients completed the trial, of whom 44 were in the sitagliptin and 32 in the placebo groups. Patients receiving sitagliptin showed a significant decrease in the fibrosis scores (P = 0.001). The reductions in the alanine aminotransferase (AST) (P = 0.036) and aspartate AST (P < 0.001) levels were also statistically significant. The effect of sitagliptin in reducing fibrosis scores was significantly greater in normal-weight and overweight individuals than in obese individuals (p = 0.036, and p = 0.018, respectively), whereas the effects of sitagliptin on AST levels were greater among overweight/obese patients (p = 0.028, and p = 0.016, respectively). Sitagliptin reduced fibrosis scores and liver enzymes in NAFLD patients after 56 weeks of therapy. The changes in fibrosis scores were more prominent in patients with normal weight and overweight than obese patients, whereas the effects on AST levels were greater among overweight/obese patients. Other randomized trials with larger sample sizes and longer treatment durations may be required before precise results can be reached.Clinical Trial Registration[https://www.irct.ir/trial/46140], identifier [IRCT20140430017505N2].
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Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Nezhadisalami
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Nima Motamed
- Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mansooreh Maadi
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Farahmand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoudreza Sohrabi
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Hossein Ajdarkosh
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Faraji
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Nikkhah
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Sobhrakhshankhah
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Ebrahimi
- Department of Radiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
- *Correspondence: Farhad Zamani,
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Faraji S, Hosseini Azar MRM, Alizadeh M. Brewed chicory leaf consumption has unexpected side effects along beneficial effects on liver enzymes in non-alcoholic fatty liver disease patients. J Herb Med 2022. [DOI: 10.1016/j.hermed.2022.100572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Guan L, Zhang X, Tian H, Jin X, Fan H, Wang N, Sun J, Li D, Li J, Wang X, Zeng Z, Li Y. Prevalence and risk factors of metabolic-associated fatty liver disease during 2014-2018 from three cities of Liaoning Province: an epidemiological survey. BMJ Open 2022; 12:e047588. [PMID: 35177440 PMCID: PMC8860048 DOI: 10.1136/bmjopen-2020-047588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To investigate the incidence and characteristics of metabolic-associated fatty liver disease (MAFLD) in individuals undergoing physical examination in Liaoning Province (China). DESIGN Retrospective study. SETTING Single centre. PARTICIPANTS Adults who underwent routine health examination at Xikang Medical Center in Liaoning Province (Shenyang, Dandong and Dalian cities) between January 2014 and December 2018. RESULTS Among the 204 394 included subjects, 71 756 were diagnosed with MAFLD, accounting for 35.28%. The total prevalence of MAFLD in Shenyang, Dandong and Dalian cities over the past 5 years was 35.8%, 40.41% and 31.7%, respectively. Men had a prevalence of 46.12%, which was higher than in women (21.80%). The percentage of MAFLD in body mass index (BMI) <23 kg/m2 and ≥23 kg/m2 was 6.49% and 53.23%, respectively. In all subjects, BMI, systolic blood pressure, diastolic blood pressure (DBP), fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine transaminase, aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT), blood urea nitrogen, serum creatinine (SCr), serum uric acid (SUA), haematocrit (HCT), mean corpuscular volume (MCV) and urine protein were independently associated with MAFLD (all p<0.001). In lean subjects, DBP, FBG, TG, TC, LDL-C, HDL-C, AST, ALP, GGT, SCr, SUA, HCT and MCV were independently associated with MAFLD (all p<0.001). CONCLUSION The prevalence of MAFLD in Liaoning Province was found to be associated with sex, cities with different economic statuses, BMI and multiple metabolic indicators.
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Affiliation(s)
- Lin Guan
- Gastroenterology Department, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xinhe Zhang
- Gastroenterology Department, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Haoyu Tian
- The 3rd Clinical Department, China Medical University, Shenyang, Liaoning, China
| | - Xing Jin
- Gastroenterology Department, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Hang Fan
- Data Operation and Management Department, Neusoft Corporation, Shenyang, China
| | - Ningning Wang
- Gastroenterology Department, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jing Sun
- Gastroenterology Department, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Dan Li
- Gastroenterology Department, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jia Li
- Data Operation and Management Department, Neusoft Corporation, Shenyang, China
| | - Xue Wang
- Gastroenterology Department, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zilu Zeng
- Gastroenterology Department, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yiling Li
- Gastroenterology Department, The First Hospital of China Medical University, Shenyang, Liaoning, China
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Sohrabi M, Ajdarkosh H, Gholami A, Amirkalali B, Mansorian MR, Aten S, Sohrabi M, Nasiri-Toosi M, Zamani F, Keyvani H. Association between Melatonin Value and Interleukins1B, -18, and -33 Levels in Patients with Different Stages of Non-Alcoholic Fatty Liver Disease. Middle East J Dig Dis 2022; 14:110-117. [PMID: 36619722 PMCID: PMC9489333 DOI: 10.34172/mejdd.2022.263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 10/20/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND: Interaction between immune modulators and inflammatory factors is considered as one of the main underlying pathologies of non-alcoholic fatty liver disease (NAFLD). Hence we aimed to assess the association between these cytokines and melatonin. METHODS: We enrolled adult patients diagnosed with fatty liver by ultrasonography in a crosssectional study. All of them underwent Fibroscan evaluation. The subjects who met the inclusion and exclusion criteria for NAFLD were involved. A normal group who did not have NAFLD, viral or non-viral hepatitis, and without a history of pancreatobiliary surgery, bariatric surgery, and intake of any medication that influence the liver was also selected. The participants were categorized into the three following groups: 1) fibrosis>9.1 kPa and steatosis>290 dbm, 2) fibrosis: 6-9.0 kPa and steatosis 240-290 dbm, and 3) normal group with fibrosis<6.0 kPa and steatosis<240 dbm. Laboratory assessment and a questionnaire including demographic, anthropometric, laboratories, and clinical data were completed for each of them. RESULTS: Totally 97 subjects were enrolled in the present study. The mean age of the subjects was 42.2±11.3 years. 60% of them (59 patients) were female. Serum levels of melatonin, interleukin (IL)-1B, IL-18, and IL-33 increased according to the advancing of NAFLD state. Based on multiple linear regression model, melatonin was significantly associated with IL-1B (β=2.8, P<0.001,95% CI=1.41-4.19), IL-18 (β=0.018, P=0.0005, 95% CI=0.006-0.03), and IL-33 (β=0.31, P=0.045, 95% CI=0.008-0.62) after adjustment for other variables. CONCLUSION: Melatonin level has a strong association with these cytokines. This linkage probably influences on the development and progression of NAFLD. Therefore it can be hypothesized that the therapeutic approach that affects this process may have a significant impact.
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Affiliation(s)
- Masoudreza Sohrabi
- Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Ajdarkosh
- Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran,Department of Epidemiology & Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Bahreh Amirkalali
- Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Reza Mansorian
- Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
| | - Sima Aten
- Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
| | - Melika Sohrabi
- Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Nasiri-Toosi
- Liver transplantation Research Center. Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Keyvani
- Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran,Corresponding Author: Hossein Keyvani, MD Gastrointestinal and Liver Disease Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran Telefax:+98 21 82141633
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Sohrabi M, Gholami A, Amir Kalali B, Khoonsari M, Sahraei R, Nasiri Toosi M, Zamani F, Keyvani H. Are Serum Levels of Nuclear Factor Kappa B and Forkhead Box Protein P3 in Patients with Non-Alcoholic Fatty Liver Disease Related to Severity of Fibrosis? Middle East J Dig Dis 2021; 13:356-362. [PMID: 36606010 PMCID: PMC9489454 DOI: 10.34172/mejdd.2021.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/02/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Inflammation has a significant impact on the development and progression of fatty liver diseases.In this study, we aimed to investigate the relation between serum levels of nuclear factor kappa B (NFkB) and Forkhead box protein P3 (FOXP3)with fibrosis severity among patients with non-alcoholic fatty liver disease(NAFLD). METHODS In a prospective study, the patients suspicios of havingfatty liver were enrolled. The exclusion criteria lack of viral hepatitis, autoimmune hepatitis, Wilson's or other known liver diseases,history of liver or biliary surgery,bariatric surgery, and medications that influence liver metabolism. The participantsunderwent liver fibroscan. According to liver fibrosis, the patients weredivided into two groups; 1)fibrosis less than 7.2 KP,2)advanced NAFLD, fibrosis ≥7.3 KP. A10 cc fasting blood sample was taken from each patient for laboratory assessments.The variables between the two groups were compared using Chi-square or Fisher's exact test.The independence of cytokines was assessed by a logistic regression test. RESULTS Totally 90 patients were enrolled.The mean age was 42.21 ± 11 years. Of them, 50 and 47 participants were allocated to groups 1 and 2, respectively. In the univariate analysis, we revealed asignificant difference between age, body mass index (BMI), fasting blood glucose, liver enzymes, total cholesterol, andtriglyceride levels. Also, there was a significant difference betweenthe levels of NFKB and FOXP3 in group one compared with group two of the participants,as FOXP3(9.17 ± 10.0 vs. 18.63 ± 12.9; p < 0.001) and NFKB (1.70 ± 1.70; p < 0.01). After excluding the confounding factors, we observed a significant association between fibrosis level and cytokine levels in logistic regression. CONCLUSION Serum levels of NFKB and FOXP3 increased by advancing liver fibrosis in patients with NAFLD.This is an independent association. The identification of intermediary regulatory factors would be necessary.
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Affiliation(s)
- Masoudreza Sohrabi
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences,Tehran, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
,Department of Epidemiology & Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Bahareh Amir Kalali
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences,Tehran, Iran
| | - Mahmoodreza Khoonsari
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences,Tehran, Iran
| | - Roghieh Sahraei
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences,Tehran, Iran
| | - Mohsen Nasiri Toosi
- Liver transplantation Research Center. Imam Khomeini Hospital, Tehran University of Medical Sciences.Tehran iran
| | - Farhad Zamani
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences,Tehran, Iran
| | - Hossein Keyvani
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences,Tehran, Iran
,Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran
,Corresponding Author: Hossein Keyvani, PhD Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran. Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel : + 98 21 88941831 Fax : + 98 21 88941831
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Hsiao CC, Teng PH, Wu YJ, Shen YW, Mar GY, Wu FZ. Severe, but not mild to moderate, non-alcoholic fatty liver disease associated with increased risk of subclinical coronary atherosclerosis. BMC Cardiovasc Disord 2021; 21:244. [PMID: 34011282 PMCID: PMC8132380 DOI: 10.1186/s12872-021-02060-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/12/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is associated with high risk of cardiovascular disease. The prevalence is increasing to 45-65% in the general population with routine health check-up, and most subjects have the mild degree NAFLD in recent years. Moreover, there are no studies on the association between NAFLD severity and coronary atherosclerosis in the real-world setting by ultrasonography. METHODS The aim of this study was to determine the relationship between the severity of NAFLD and subclinical coronary atherosclerosis. Overall, 817 subjects meet criteria for NAFLD were enrolled in the retrospective cohort study (155 subjects were excluded). The severity of NAFLD was divided into the normal, mild, moderate and severe degree based on the finding of abdominal ultrasonography. The assessment of coronary atherosclerosis was based on CAC scan/coronary CT angiography finding in terms of CAC score ≧ 100, CAC score ≧ 400, CAD-RADS ≧ 3 and presence of vulnerable plaque(s). RESULTS A significant linear trend was observed between the severity of NAFLD and subclinical coronary atherosclerosis. Compared with the reference group (including normal, mild, and moderate NAFLD), severe degree NAFLD was the independently associated risk of subclinical coronary atherosclerosis in term of CAC score ≧ 100, CAC score ≧ 400, CAD-RADS ≧ 3 and presence of vulnerable plaque(s) based on binary logistic regression after adjustment for FRS score and body fat percentage. CONCLUSIONS Severe degree, but not mild to moderate, was associated with high risk of subclinical coronary atherosclerosis, independently of FRS score and body-fat percentage.
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Affiliation(s)
- Chia-Chi Hsiao
- Section of Thoracic and Circulation Imaging, Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.,Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Pai-Hsueh Teng
- Section of Thoracic and Circulation Imaging, Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.,Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Yun-Ju Wu
- Section of Thoracic and Circulation Imaging, Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan
| | - Yi-Wen Shen
- Section of Thoracic and Circulation Imaging, Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan
| | - Guang-Yuan Mar
- Physical Examination Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Fu-Zong Wu
- Section of Thoracic and Circulation Imaging, Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan. .,Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan. .,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
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Choi Y, Lee CH, Kim IH, Park EH, Park S, Yoo WH. Methotrexate use does not increase the prevalence of hepatic steatosis: a real-world retrospective nested case-control study. Clin Rheumatol 2020; 40:2037-2045. [PMID: 33078254 DOI: 10.1007/s10067-020-05456-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We aimed to determine whether methotrexate (MTX) treatment in patients with rheumatoid arthritis (RA) leads to the development of non-alcoholic fatty liver (NAFL). METHOD Data were derived from records of all patients with RA who underwent abdominal ultrasonography at the Jeonbuk National University Hospital. Patients with ultrasound-proven NAFL were identified, and those without NAFL were matched by age and sex using the propensity score matching method at 1:3 ratio. We also analyzed the Health Insurance Review and Assessment Service-National Patient Samples, a nationwide cohort database, to determine the association between MTX use and NAFL in a large number of patients (n = 24,653). RESULTS In the hospital cohort, 92 patients with NAFL did not show significant differences in the cumulative MTX dose when compared with the no-NAFL group (n = 276) (1908.5 ± 1757.5 vs. 1948.6 ± 2118.8 mg, p = 0.911). The prevalence of NAFL was not significantly different across strata of cumulative MTX dose. Multiple logistic analyses identified hypertriglyceridemia (OR, 4.88 [95% CI, 1.13-20.93]) and higher body mass index (OR, 1.22 [95% CI, 1.05-1.41]) as being associated with an increased risk of NAFL. In the nationwide cohort, the MTX exposure rate between the NAFL and no-NAFL groups was not significantly different. CONCLUSIONS Collectively, no significant association between NAFL development and administration of MTX was detected in this study. Our results suggest that it is more efficient to adjust for individualized risk factors for NAFL prevention rather than discontinuation of MTX in patients with RA. Key Points • NAFLD has been highlighted with increasing prevalence worldwide and possible progression to end-stage liver disease. • Cumulative dose or exposure history of MTX does not show a significant association with NAFLD prevalence. • Modifying well-established risk factors is more efficient in NAFLD prevention rather than discontinuation of MTX.
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Affiliation(s)
- Yunjung Choi
- Division of Rheumatology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, South Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Chang Hun Lee
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.,Division of Gastroenterology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, South Korea
| | - In Hee Kim
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.,Division of Gastroenterology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, South Korea
| | - Eun Hae Park
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.,Department of Radiology, Jeonbuk National University Hospital, Jeonju, South Korea
| | - SoJeong Park
- Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, South Korea
| | - Wan-Hee Yoo
- Division of Rheumatology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, South Korea. .,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
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