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Blanc-Durand F, Camilleri GM, Bayle A, Aldea M, Vasseur D, Ouali K, Michels J, Pautier P, Nicotra C, Ngo-Camus M, Lacroix L, Rouleau E, Ponce-Aix S, Italiano A, Leary A. Clinical utility of comprehensive liquid molecular profiling in patients with advanced endometrial cancer. Cancer 2024. [PMID: 38824658 DOI: 10.1002/cncr.35381] [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: 01/26/2024] [Revised: 03/24/2024] [Accepted: 04/01/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Molecular characterization has significantly improved the management of advanced endometrial cancer (EC). It distinguishes four molecular subclasses associated with prognosis and personalized therapeutic strategies. This study assesses the clinical utility of cell-free DNA (cfDNA) profiling in EC to identify targetable alterations. METHODS Women with metastatic or recurrent EC were prospectively recruited within the framework of the STING trial (NCT04932525), during which cfDNA was analyzed. Genomic alterations were identified with the FoundationOne CDx assay. Each molecular report underwent review by a molecular tumor board. Alterations were categorized via the European Society of Medical Oncology Scale for Clinical Actionability of Molecular Targets (ESCAT). RESULTS A total of 61 patients were enrolled. The median age was 66.9 years, with 43% presenting frontline metastatic disease. All histologic subgroups were represented. Notably, 89% of patients yielded informative cfDNA analysis. Six tumors were classified with deficient mismatch repair/microsatellite instability (11%) and 37 as TP53 gene mutant (67%), and 12 had nonspecific molecular profiles (22%). Molecular classification based on liquid biopsy showed 87.5% accuracy in correlating with tissue results. Moreover, 65% of cases exhibited ≥1 actionable alteration, including 25% ESCAT I alterations and 13% ESCAT II alterations. Consequently, 16% of patients received a molecularly matched therapy, and presented with a 56% response rate and median progression-free survival of 7.7 months. CONCLUSIONS cfDNA sequencing in EC is a feasible approach that produces informative results in 89% of cases and accurately categorizes patients into the main molecular subclasses. It also reveals multiple actionable alterations, which offers the potential for personalized therapeutic strategies.
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Affiliation(s)
- Félix Blanc-Durand
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) U981, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - Arnaud Bayle
- Bureau Biostatistique et Épidémiologie, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
- INSERM, Université Paris-Saclay, CESP U1018 Oncostat, Labelisé Ligue Contre le Cancer, Villejuif, France
| | - Mihaela Aldea
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Damien Vasseur
- Cancer Genetics Unit, Department of Biology and Pathology, Institut Gustave Roussy, Villejuif, France
| | - Kaissa Ouali
- Drug Development Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Judith Michels
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Patricia Pautier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Claudio Nicotra
- Drug Development Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Maud Ngo-Camus
- Drug Development Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Ludovic Lacroix
- Cancer Genetics Unit, Department of Biology and Pathology, Institut Gustave Roussy, Villejuif, France
| | - Etienne Rouleau
- Cancer Genetics Unit, Department of Biology and Pathology, Institut Gustave Roussy, Villejuif, France
| | - Santiago Ponce-Aix
- Drug Development Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Antoine Italiano
- Drug Development Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alexandra Leary
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) U981, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Carneiro CRG, Ayres ABS, Gestic MA, Utrini MP, Chaim FDM, Callejas-Neto F, Chaim EA, Cazzo E. Association of Histopathological and Biochemical Aspects of NAFLD With the Severity of Liver Fibrosis in Individuals With Obesity: Cross-sectional Study. Obes Surg 2024; 34:1569-1574. [PMID: 38502518 DOI: 10.1007/s11695-024-07180-x] [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: 01/25/2024] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Given the importance of fibrosis in the progression of non-alcoholic fatty liver disease (NAFLD), identifying biochemical and histopathological aspects associated with its severity is important to determine the course of disease in high-risk populations. OBJECTIVES The study aims to investigate correlations between biochemical and histopathological variables associated with the occurrence and severity of NAFLD-related liver fibrosis in individuals with obesity. METHODS This is a cross-sectional study which enrolled 171 individuals who underwent bariatric surgery at a tertiary university hospital. Clinical, laboratory, and histopathological hepatic characteristics were analyzed. Univariate and multivariate analyses were carried out to identify factors associated with the outcomes studied (severity of fibrosis staging) through simple and multiple regression models. RESULTS Female were 87.7%, and the mean age was 38.4 ± 9.3 years. The most common histopathological abnormalities were macrovesicular steatosis (74.9%) and hepatocellular ballooning (40.4%). In the histopathological univariate analysis, liver fibrosis significantly correlated with severities of microvesicular steatosis (p = 0.003), lobular inflammation (p = 0.001), and NAS (p < 0.001). In the multivariate analysis, the degrees of microvesicular steatosis (p < 0.001) and NAS (p < 0.001) independently correlated with fibrosis severity. In the univariate biochemical analysis, fibrosis severity significantly correlated with levels of hemoglobin A1c (p = 0.004) and glucose (p = 0.01). In the multivariate analysis, glucose levels independently correlated with liver fibrosis degree (p = 0.007). CONCLUSION Significant and independent associations were observed between the intensities of microvesicular steatosis, NAS, and glucose levels and the severity degree of liver fibrosis in individuals with obesity.
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Affiliation(s)
- Carollyne Rodovalho Guerra Carneiro
- Dept. of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Arthur Balestra Silveira Ayres
- Dept. of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Martinho Antonio Gestic
- Dept. of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Murillo Pimentel Utrini
- Dept. of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Felipe David Mendonça Chaim
- Dept. of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Francisco Callejas-Neto
- Dept. of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Elinton Adami Chaim
- Dept. of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Everton Cazzo
- Dept. of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil.
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Liu K, Yang X, Zhang G, Xiang Z. Therapeutic Effect and Mechanism Prediction of Fuzi-Gancao Herb Couple on Non-alcoholic Fatty Liver Disease (NAFLD) based on Network Pharmacology and Molecular Docking. Comb Chem High Throughput Screen 2024; 27:773-785. [PMID: 37317908 DOI: 10.2174/1386207326666230614102412] [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: 03/27/2023] [Revised: 05/28/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Fuzi-Gancao herb couple is one of the most common herb couples involved in the TCM formula, which was used for the treatment of chronic diseases. The herb couple has a hepatoprotective effect. However, its main components and therapeutic mechanism are not yet clear. This study aims to elucidate the therapeutic effect and mechanism of the Fuzi-Gancao herb couple on NAFLD from animal experiments, network pharmacology, and molecular docking. METHODS 60 Male C57BL/6 mice (20 g ± 2 g) were randomly divided into six groups including the blank group (n=10) and NALFD group (n=50). The mice of the NALFD group were fed with a high-fat diet for 20 weeks to establish the NAFLD model and the NALFD mice were randomly divided into five groups including positive group (berberine), model group and F-G groups with three dosages (0.257, 0.514, 0.771 g/kg) (n=10). After 10 weeks of administration, the serum was collected for the analysis of ALT, AST, LDL-c, HDL-c, and TC, and liver tissues were collected for pathological analysis. The TCMAS database was used to collect the main components and targets of the Fuzi-Gancao herb couple. The GeneCards database was used to collect NAFLD-related targets, and the key targets were obtained by intersecting with herbal targets. The diseasecomponent- target relationship diagram was constructed by Cytoscape 3.9.1. The obtained key targets were imported into the String database to obtain the PPI network, and imported into the DAVID database for KEGG pathway analysis and GO analysis. Finally, the key targets and key gene proteins were imported into Discovery Studio 2019 for molecular docking verification. RESULTS In this study, H-E staining indicated the pathological changes of liver tissue in Fuzi- Gancao groups were significantly improved, and the levels of AST, ALT, TC, HDL-c, and LDL-c in serum of Fuzi-Gancao groups decreased in a dose-dependent manner, compared with the model group. 103 active components and 299 targets in the Fuzi-Gancao herb couple were confirmed in the TCMSP database and 2062 disease targets in NAFLD were obtained. 142 key targets and 167 signal pathways were screened, such as the AGE-RAGE signaling pathway in diabetic complications, HIF-1 signaling pathway, IL-17 signaling pathway, TNF signaling pathway, and so on. The main bioactive ingredients of Fuzi-Gancao herb couple in the treatment of NAFLD are quercetin, kaempferol, naringenin, inermine, (R)-norcoclaurine, isorhamnetin, ignavine, 2,7-Dideacetyl-2,7- dibenzoyl-taxayunnanine F, glycyrol mainly involving IL6, AKT1, TNF, TP53, IL1B, VEGFA and other core targets. Molecular docking analysis indicated that there is a good affinity between the key components and the key targets. CONCLUSION This study preliminarily explained the main components and mechanism of the Fuzi- Gancao herb couple in the treatment of NAFLD and provided an idea for subsequent research.
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Affiliation(s)
- Kejia Liu
- Graduate School, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Xu Yang
- Department of Rehabilitation Medicine, General Hospital of Northern Theater Command, Shenyang, China
| | - Guihong Zhang
- School of Pharmaceutical Science, Liaoning University, Shenyang, China
| | - Zheng Xiang
- School of Pharmaceutical Science, Liaoning University, Shenyang, China
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Altajar S, Wang N, Rosenthaler MP, Murabito JM, Long MT. NAFLD Associates with Sarcopenia Defined by Muscle Mass and Slow Walking Speed: A Cross-Sectional Analysis from the Framingham Heart Study. J Clin Med 2023; 12:7523. [PMID: 38137592 PMCID: PMC10743412 DOI: 10.3390/jcm12247523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
Sarcopenia is associated with NAFLD. It is unknown if the association is explained by shared risk factors. Our study sought to investigate the association between liver fat and sarcopenia in our cohort. Liver fat was measured on CT between 2008 and 2011. We excluded heavy alcohol use and missing covariates. Muscle mass in a subset (n = 485) was measured by 24 h urinary creatinine. Physical function was defined by h strength and walking speed. Sarcopenia was defined as low muscle mass and/or low physical function. We created multivariable-adjusted regression models to evaluate cross-sectional associations between liver fat and low muscle mass, grip strength, and walking speed. The prevalence of hepatic steatosis was 30% (n = 1073; 58.1% women; mean age 65.8 ± 8.6 years). There was a significant positive association between liver fat and muscle mass in linear regression models. The association was not significant after adjusting for BMI. The odds of sarcopenia increased by 28% for each SD in liver fat (OR 1.28; 95% CI 1.02, 1.60) and persisted after accounting for confounders in multivariable-adjusted models (OR 1.30, 95% CI 1.02, 1.67). Further studies are needed to determine if there is a causal relationship between liver fat and sarcopenia and whether treatment of sarcopenia improves liver fat.
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Affiliation(s)
- Sarah Altajar
- Division of Gastroenterology and Hepatology, University of Miami Health System, Miami, FL 33136, USA;
| | - Na Wang
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA 02118, USA;
| | - Max P. Rosenthaler
- Department of Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA;
| | - Joanne M. Murabito
- Department of Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA;
| | - Michelle T. Long
- Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA;
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Cucoranu DC, Pop M, Niculescu R, Kosovski IB, Toganel RO, Licu RA, Bacârea A. The Association of Nonalcoholic Fatty Liver Disease With Neutrophil-to-Lymphocyte Ratio and Neutrophil-Percentage-to-Albumin Ratio. Cureus 2023; 15:e41197. [PMID: 37525801 PMCID: PMC10387286 DOI: 10.7759/cureus.41197] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 08/02/2023] Open
Abstract
Background and objective Nonalcoholic fatty liver disease (NAFLD) is closely linked to metabolic syndrome, leading to consequences related to dyslipidemia, endothelial dysfunction, type 2 diabetes, and obesity. Due to a limited understanding of the factors contributing to the progression of NAFLD, predicting clinical outcomes in patients remains challenging. In light of this, this study aimed to evaluate the association between the occurrence of NAFLD and the neutrophil-percentage-to-albumin ratio (NPAR) as well as the neutrophil-to-lymphocyte ratio (NLR). Methods A total of 115 adult patients (mean age: 58 ± 12.5 years; 55.65% male) who underwent abdominal non-contrast-enhanced CT scans were included in the study. The analysis of CT scans was conducted to assess the attenuation values of liver parenchyma. Results There was a statistically significant difference in terms of gamma-glutamyl transpeptidase (GGT), triglyceride (TG), albumin, and NPAR between individuals with and without hepatic steatosis (GGT p<0.0001, TG p=0.0006, albumin p<0.0001, NPAR p=0.001). However, NLR values between the two groups did not show any statistical differences. NPAR (r=-0.27, p=0.0029) had a weak inverse correlation with liver attenuation value, which is expressed in Hounsfield units (HU). Conclusions Significant differences were observed in GGT, TG, albumin, and NPAR levels between individuals with and without hepatic steatosis. An inverse correlation between NPAR and liver attenuation values was also observed.
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Affiliation(s)
| | - Marian Pop
- Radiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, ROU
| | - Raluca Niculescu
- Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, ROU
| | - Irina-Bianca Kosovski
- Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, ROU
| | - Radu-Ovidiu Toganel
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, ROU
| | | | - Anca Bacârea
- Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, ROU
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Villamil FG, Barbero M, Massenzio NE, Giani SM, Kozima S, Cairo FM, Belloni RA, Mariani J, Gazari MR, Coisson PE, Gallardo SC, Cocco PA, Riboldi CM, Gallardo PE. Prevalence of non-alcoholic fatty liver disease and liver fibrosis in a general population cohort from Argentina. Ann Hepatol 2023; 28:101111. [PMID: 37100383 DOI: 10.1016/j.aohep.2023.101111] [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: 01/27/2023] [Revised: 04/02/2023] [Accepted: 04/18/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION AND OBJECTIVES South America is one of the regions with the highest rates of non-alcoholic fatty liver disease (NAFLD). This study aimed to assess the prevalence and severity of NAFLD in suburban Argentina. PATIENTS AND METHODS The study involved a general community cohort of 993 subjects evaluated sequentially with a comprehensive lifestyle questionnaire, laboratory testing, abdominal ultrasound (US) and transient elastography with XL probe. NAFLD was diagnosed according to standard criteria. RESULTS The prevalence of NAFLD by the US was 37.2% (326/875) overall, 50.3% in subjects with overweight/obesity, 58.6% with hypertriglyceridemia, 62.3% with diabetes/hyperglycemia and 72.1% with all three risk factors. Male gender (OR 1.42, 95% CI 1.03-1.47, p=0.029), age (50-59 years: OR 1.98, 95 CI 1.16-3.39, p=0.013 and ≥60 years: OR 1.86, 95% CI 1.13-3.09, p=0.015), BMI (25-29: OR 2.87, 95% CI 1.86-4.51, p<0.001 and ≥30: OR 9.57, 95% CI 6.14-15.20, p<0.001), diabetes/hyperglycemia (OR 1.65, 95% CI 1.05-2.61, p=0.029) and hypertriglyceridemia (OR 1.73, 95% CI 1.20-2.48, p=0.002) were independent predictors of NAFLD. Among patients with steatosis, 22.2 % (69/311) had ≥F2 fibrosis (overweight 25%, hypertriglyceridemia 32%, diabetes/hyperglycemia 34%). BMI (OR 5.22, 95% CI 2.64-11.74, p<0.001), diabetes/hyperglycemia (OR 2.12, 95% CI 1.05-4.29, p=0.04) and hypertriglyceridemia (OR 1.94, 95% CI 1.03-3.68, p=0.040) were independent predictors of liver fibrosis. CONCLUSIONS This general population study from Argentina showed a high prevalence of NAFLD. Significant liver fibrosis was present in 22% of subjects with NAFLD. This information adds to the existing knowledge of NAFLD epidemiology in Latin America.
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Affiliation(s)
- Federico Guillermo Villamil
- Hospital Británico de Buenos Aires, Unidad de Trasplante Hepático. Perdriel 74, Ciudad Autónoma de Buenos Aires (C1280AEB), Argentina; Hospital el Cruce, Unidad de Hepatología y Trasplante Hepático, Diagnóstico por Imágenes y Cardiología. Avenida Calchaquí 5401, Florencio Varela (B1888AAE), Provincia de Buenos Aires, Argentina; Fundación para la Docencia e Investigación de las Enfermedades del Hígado. Uruguay 3241, Victoria (B1644HGA), Provincia de Buenos Aires, Argentina.
| | - Manuel Barbero
- Hospital el Cruce, Unidad de Hepatología y Trasplante Hepático, Diagnóstico por Imágenes y Cardiología. Avenida Calchaquí 5401, Florencio Varela (B1888AAE), Provincia de Buenos Aires, Argentina
| | - Nancy Elena Massenzio
- Hospital Británico de Buenos Aires, Unidad de Trasplante Hepático. Perdriel 74, Ciudad Autónoma de Buenos Aires (C1280AEB), Argentina; Hospital el Cruce, Unidad de Hepatología y Trasplante Hepático, Diagnóstico por Imágenes y Cardiología. Avenida Calchaquí 5401, Florencio Varela (B1888AAE), Provincia de Buenos Aires, Argentina; Fundación para la Docencia e Investigación de las Enfermedades del Hígado. Uruguay 3241, Victoria (B1644HGA), Provincia de Buenos Aires, Argentina; Unidad Sanitaria "Martín Espinel Bavio", 25 de Mayo y Maipú, General O'Brien (B6646), Provincia de Buenos Aires, Argentina; Hospital General de Agudos Dr. Cosme Argerich, Departamento de Diagnóstico y Tratamiento. Pi y Margall 750, Ciudad Autónoma de Buenos Aires (C1155AAD), Argentina; Hospital HIGA San Martin de la Plata, Unidad de Hepatología. Avenida 1 y 70, La Plata (B1900), Provincia de Buenos Aires, Argentina; Fundación Sayani. Calilegua 960, San Salvador de Jujuy (4514), Argentina
| | - Sandra Mónica Giani
- Fundación para la Docencia e Investigación de las Enfermedades del Hígado. Uruguay 3241, Victoria (B1644HGA), Provincia de Buenos Aires, Argentina
| | - Shigeru Kozima
- Hospital General de Agudos Dr. Cosme Argerich, Departamento de Diagnóstico y Tratamiento. Pi y Margall 750, Ciudad Autónoma de Buenos Aires (C1155AAD), Argentina
| | - Fernando Mario Cairo
- Hospital Británico de Buenos Aires, Unidad de Trasplante Hepático. Perdriel 74, Ciudad Autónoma de Buenos Aires (C1280AEB), Argentina; Hospital el Cruce, Unidad de Hepatología y Trasplante Hepático, Diagnóstico por Imágenes y Cardiología. Avenida Calchaquí 5401, Florencio Varela (B1888AAE), Provincia de Buenos Aires, Argentina; Fundación para la Docencia e Investigación de las Enfermedades del Hígado. Uruguay 3241, Victoria (B1644HGA), Provincia de Buenos Aires, Argentina; Unidad Sanitaria "Martín Espinel Bavio", 25 de Mayo y Maipú, General O'Brien (B6646), Provincia de Buenos Aires, Argentina; Hospital General de Agudos Dr. Cosme Argerich, Departamento de Diagnóstico y Tratamiento. Pi y Margall 750, Ciudad Autónoma de Buenos Aires (C1155AAD), Argentina; Hospital HIGA San Martin de la Plata, Unidad de Hepatología. Avenida 1 y 70, La Plata (B1900), Provincia de Buenos Aires, Argentina; Fundación Sayani. Calilegua 960, San Salvador de Jujuy (4514), Argentina
| | - Rodrigo Agustín Belloni
- Hospital HIGA San Martin de la Plata, Unidad de Hepatología. Avenida 1 y 70, La Plata (B1900), Provincia de Buenos Aires, Argentina
| | - Javier Mariani
- Hospital el Cruce, Unidad de Hepatología y Trasplante Hepático, Diagnóstico por Imágenes y Cardiología. Avenida Calchaquí 5401, Florencio Varela (B1888AAE), Provincia de Buenos Aires, Argentina
| | - Mercedes Rodriguez Gazari
- Hospital Británico de Buenos Aires, Unidad de Trasplante Hepático. Perdriel 74, Ciudad Autónoma de Buenos Aires (C1280AEB), Argentina
| | - Paola Evangelina Coisson
- Hospital Británico de Buenos Aires, Unidad de Trasplante Hepático. Perdriel 74, Ciudad Autónoma de Buenos Aires (C1280AEB), Argentina; Hospital el Cruce, Unidad de Hepatología y Trasplante Hepático, Diagnóstico por Imágenes y Cardiología. Avenida Calchaquí 5401, Florencio Varela (B1888AAE), Provincia de Buenos Aires, Argentina
| | | | - Paula Andrea Cocco
- Hospital Británico de Buenos Aires, Unidad de Trasplante Hepático. Perdriel 74, Ciudad Autónoma de Buenos Aires (C1280AEB), Argentina; Hospital el Cruce, Unidad de Hepatología y Trasplante Hepático, Diagnóstico por Imágenes y Cardiología. Avenida Calchaquí 5401, Florencio Varela (B1888AAE), Provincia de Buenos Aires, Argentina; Fundación para la Docencia e Investigación de las Enfermedades del Hígado. Uruguay 3241, Victoria (B1644HGA), Provincia de Buenos Aires, Argentina; Unidad Sanitaria "Martín Espinel Bavio", 25 de Mayo y Maipú, General O'Brien (B6646), Provincia de Buenos Aires, Argentina; Hospital General de Agudos Dr. Cosme Argerich, Departamento de Diagnóstico y Tratamiento. Pi y Margall 750, Ciudad Autónoma de Buenos Aires (C1155AAD), Argentina; Hospital HIGA San Martin de la Plata, Unidad de Hepatología. Avenida 1 y 70, La Plata (B1900), Provincia de Buenos Aires, Argentina; Fundación Sayani. Calilegua 960, San Salvador de Jujuy (4514), Argentina
| | - Claudia Mabel Riboldi
- Hospital el Cruce, Unidad de Hepatología y Trasplante Hepático, Diagnóstico por Imágenes y Cardiología. Avenida Calchaquí 5401, Florencio Varela (B1888AAE), Provincia de Buenos Aires, Argentina
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Liu CF, Chien LW. Predictive Role of Neutrophil-Percentage-to-Albumin Ratio (NPAR) in Nonalcoholic Fatty Liver Disease and Advanced Liver Fibrosis in Nondiabetic US Adults: Evidence from NHANES 2017-2018. Nutrients 2023; 15:nu15081892. [PMID: 37111111 PMCID: PMC10141547 DOI: 10.3390/nu15081892] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/31/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is highly prevalent globally and includes chronic liver diseases ranging from simple steatosis to nonalcoholic steatohepatitis (NASH). The neutrophil-to-albumin ratio (NPAR) is a cost-effective, readily available biomarker of inflammation used to assess cancer and cardiovascular disease prognosis, and it may be of predictive value in NAFLD. This study was to evaluate the associations between the NPAR, the neutrophil-to-lymphocyte ratio (NLR), and the presence of NAFLD or advanced liver fibrosis, and to assess the predictive value of the NPAR in NAFLD in a nationally representative database. This population-based, cross-sectional, retrospective study analyzed the secondary data of adults with NAFLD or advanced liver fibrosis extracted from the National Health and Nutrition Examination Survey (NHANES) database 2017-2018. NHANES participants with complete information of vibration-controlled transient elastography (VCTE) and controlled attenuation parameter (CAP) were enrolled. A logistic regression analysis was used to determine the associations between the variables in the participants with and without NAFLD or advanced liver fibrosis. The mean values of the lymphocyte counts, neutrophil counts, NPAR, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), total cholesterol, triglycerides, and HbA1c were significantly higher in the participants with NAFLD than in those without NAFLD or advanced liver fibrosis. The mean blood albumin levels of the subjects without NAFLD or advancing fibrosis were considerably greater than those of the individuals with these conditions. The mean values of the NLR, NPAR, AST, ALT, triglycerides, lymphocyte count, neutrophil count, and HbA1c were significantly higher in patients with advanced fibrosis than in those without advanced fibrosis. A multivariate analysis showed that per unit increases in both the NLR and NPAR were significantly associated with an increased risk of developing NAFLD, while neither the NLR nor NPAR was significantly associated with higher odds of advanced fibrosis. In conclusion, the novel biomarker NPAR demonstrates a good association with NAFLD, along with participants' clinical characteristics, in a nationwide population. The NPAR may serve as a biomarker for NAFLD and help clinicians refine the diagnosis and treatment of chronic liver disease.
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Affiliation(s)
- Chi-Feng Liu
- School of Nursing, National Taipei University of Nursing and Health Science, Taipei 112, Taiwan
| | - Li-Wei Chien
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 112, Taiwan
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei 112, Taiwan
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Guo Z, Zhang T, Yun Z, Jin Q, Cao X, Kong D, Yao Y, Li X, Zhang J, Ye Y. Assessing the causal relationships between human blood metabolites and the risk of NAFLD: A comprehensive mendelian randomization study. Front Genet 2023; 14:1108086. [PMID: 37056283 PMCID: PMC10086196 DOI: 10.3389/fgene.2023.1108086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/08/2023] [Indexed: 03/30/2023] Open
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is a liver disease associated with obesity, insulin resistance, type 2 diabetes mellitus (T2DM), and metabolic syndrome. The risk factors for NAFLD have not been identified. Metabolic dysfunction has been found to be an important factor in the pathogenesis and progression of NAFLD. However, the causal impact of blood metabolites on NAFLD is unclear.Methods: We performed a two-sample Mendelian randomization (MR) study. A genome-wide association study (GWAS) with 7824 participants provided data on 486 human blood metabolites. Outcome information was obtained from a large-scale GWAS meta-analysis of NAFLD, which contained 8,434 cases and 770,180 controls of Europeans. The inverse variance weighted (IVW) model was chosen as the primary two-sample MR analysis approach, followed by sensitivity analyses such as the heterogeneity test, horizontal pleiotropy test, and leave-one-out analysis. In addition, we performed replication, meta-analysis, and metabolic pathway analysis. We further conducted colocalization analysis to deeply reflect the causality.Results: After rigorous genetic variant selection, IVW, sensitivity analysis, replication, and meta-analysis, two known metabolites were identified as being associated with the development of NAFLD [biliverdin: OR = 1.45; 95% CI 1.20-1.75; p = 0.0001; myristoleate: OR = 0.57; 95% CI 0.39-0.83; p = 0.0030].Conclusion: By combining genomics with metabolomics, our findings provide a new perspective on the underlying mechanisms of NAFLD and have important implications for the screening and prevention of NAFLD.
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Affiliation(s)
- Ziwei Guo
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Tingyu Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Zhangjun Yun
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Qian Jin
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Cao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Deming Kong
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Yuhao Yao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoke Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute of Liver Diseases, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Xiaoke Li, ; Jiaxin Zhang, ; Yong’An Ye,
| | - Jiaxin Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute of Liver Diseases, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Xiaoke Li, ; Jiaxin Zhang, ; Yong’An Ye,
| | - Yong’An Ye
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute of Liver Diseases, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Xiaoke Li, ; Jiaxin Zhang, ; Yong’An Ye,
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Bilska-Markowska M, Kaźmierczak M. Horner-Wadsworth-Emmons reaction as an excellent tool in the synthesis of fluoro-containing biologically important compounds. Org Biomol Chem 2023; 21:1095-1120. [PMID: 36632995 DOI: 10.1039/d2ob01969h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Selective introduction of a double bond motif into a multifunctional organic compound is always a big challenge. The Horner-Wadsworth-Emmons reaction is one of the most reliable, simple, and stereoselective olefination methods, widely used in organic chemistry. To the best of our knowledge, no review article on the application of HWE reaction in the synthesis of fluoroorganic compounds with direct biological interest has been published in recent years. The importance of the HWE reaction should be emphasised due to its simplicity and stereoselectivity. Under mild conditions and in one step, valuable compounds can be obtained. The HWE reaction is primarily a great tool in the synthesis of fluoroolefins that are, among others, peptide bond mimetics. Therefore, it can serve as an indispensable approach to access peptide bioisosteres and, consequently, analogues of numerous enzyme inhibitors. The protocol may be utilized to obtain florinated vinylphosphonate, vinylsulfone or sulfonate derivatives, which exhibit biological activity. In this review article, we would like to summarize the HWE reaction output of the last 12 years (since 2010).
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Affiliation(s)
- Monika Bilska-Markowska
- Faculty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland.
| | - Marcin Kaźmierczak
- Faculty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland. .,Centre for Advanced Technologies, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 10, 61-614 Poznań, Poland
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10
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Xia Z, Hu M, Zheng L, Zheng E, Deng M, Wu J, Sheng X. Assessing whether serum ceruloplasmin promotes non-alcoholic steatohepatitis via regulating iron metabolism. J Med Biochem 2023; 42:113-121. [PMID: 36819130 PMCID: PMC9921090 DOI: 10.5937/jomb0-37597] [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: 05/26/2022] [Accepted: 06/06/2022] [Indexed: 11/02/2022] Open
Abstract
Background Non-alcoholic steatohepatitis (NASH) is a progressive form of non-alcoholic fatty liver disease (NAFLD). The diagnostic gold standard for detecting NASH still relies upon an invasive pathological biopsy. There is, therefore, a need to identify non-invasive diagnostic markers. Oxidative stress mediates fatty liver progression to NASH. Imbalanced iron metabolism produces many reactive oxygen species (ROS). Ceruloplasmin is associated with oxidase and iron metabolism-related activities. The current study aimed to determine whether there was a correlation between ceruloplasmin levels and NASH and whether such a relationship may be associated with altered iron metabolism in NASH patients. Methods A total of 135 NAFLD patients were enrolled in this study. A pathological biopsy confirmed that 60 of those patients had NAFLD activity scores (NAS) 5, while the remaining 75 had NAS<5. Results Receiver operating characteristic (ROC) curves confirmed that serum ceruloplasmin and ferritin levels were predictors of NAS 5 and NAS<5, with area under the curve (AUC) values of 0.80 and 0.81, respectively. The serum ceruloplasmin levels in NAS 5 patients were significantly lower than those in NAS<5 patients (p< 0.001). Serum ceruloplasmin levels were also negatively correlated with ferritin levels. Lower serum ceruloplasmin levels were associated with more severe histopathological findings. Conclusions Low serum ceruloplasmin and high serum ferritin are correlated with NASH. A high concentration of serum ferritin is a viable clinical biomarker of NASH, and low serum ceruloplasmin may participate in the occurrence of NASH by regulating iron load, which can be used as a non-invasive diagnostic marker of NASH.
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Affiliation(s)
- Ziqiang Xia
- Wenzhou people's hospital, Department of Gastroenterology, Wenzhou, China
| | - Mei Hu
- Wenzhou people's hospital, Department of Gastroenterology, Wenzhou, China
| | - Liang Zheng
- Wenzhou people's hospital, Department of Gastroenterology, Wenzhou, China
| | - Endian Zheng
- Wenzhou people's hospital, Department of Gastroenterology, Wenzhou, China
| | - Min Deng
- The First Affiliated Hospital of Jiaxing College, Department of Infectious Diseases, Jiaxing, China
| | - Jinming Wu
- The First Affiliated Hospital of Wenzhou Medical University, Department of Gastroenterology, Wenzhou, China
| | - Xiong Sheng
- The First Affiliated Hospital of Jiaxing College, Department of Infectious Diseases, Jiaxing, China
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11
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Zhang Y, Liu T, Zhang L, Pu Z, Yan Z, Hua H. Wendan decoction in the treatment of nonalcoholic fatty liver disease: A systematic review and meta-analysis. Front Pharmacol 2022; 13:1039611. [PMID: 36324682 PMCID: PMC9618729 DOI: 10.3389/fphar.2022.1039611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/03/2022] [Indexed: 06/24/2024] Open
Abstract
Introduction: The use of Wendan decoction (WDD) as a therapy for nonalcoholic fatty liver disease (NAFLD) has been studied in many clinical trials, and some of them showed that WDD is effective for treating this condition. However, no comprehensive research to evaluate the clinical efficacy of WDD in NAFLD patients had been performed. This systematic review and meta-analysis sought to provide an in-depth inquiry into the data currently available about the safety and effectiveness of WDD to treat NAFLD. Methods: We examined the primary database for any reports of randomized controlled trials (RCTs) including WDD and its effectiveness in treating NAFLD. We used the Jadad rating scale to determine the overall quality of the selected RCTs, and we searched the Cochrane Reviewer's Handbook for criteria for potential bias. The primary findings from the included RCTs were recorded, and the meta-analysis was performed using RevMan5.4 software developed by the Cochrane Collaboration. Results: We retrieved ten RCTs that were suitable for this evaluation and included them in a systematic review and meta-analysis. The quality and risk of bias in the included RCTs were assessed. The meta-analysis showed that the total clinical effective rate was substantially greater in the WDD cohort compared with that in the control cohort, and liver function, blood lipid indices, and blood glucose-related indicators were substantially improved in the WDD-treated cohort compared with those in the control cohort. There was no significant difference in the incidence of adverse events between the two cohorts. Conclusion: WDD is safe and effective for treating NAFLD, which is advantageous for the patients' liver function as well as their blood lipid indices and blood glucose-related indicators.
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Affiliation(s)
- Yufeng Zhang
- Department of Pulmonary and Critical Care Medicine, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin Hospital Affiliated to Nanjing University of Chinese Medicine, Jiangyin, China
| | - Ting Liu
- Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin Hospital Affiliated to Nanjing University of Chinese Medicine, Jiangyin, China
| | - Lianyue Zhang
- Department of Hepatology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin Hospital Affiliated to Nanjing University of Chinese Medicine, Jiangyin, China
| | - Zhongping Pu
- Department of Hepatology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin Hospital Affiliated to Nanjing University of Chinese Medicine, Jiangyin, China
| | - Zheng Yan
- Department of Internal Medicine, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin Hospital Affiliated to Nanjing University of Chinese Medicine, Jiangyin, China
| | - Haibing Hua
- Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin Hospital Affiliated to Nanjing University of Chinese Medicine, Jiangyin, China
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12
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Mao Z, Lin X, Wang P, Yan H. Iron oxide nanoparticles for biomedical applications: an updated patent review (2015-2021). Expert Opin Ther Pat 2022; 32:939-952. [PMID: 35929879 DOI: 10.1080/13543776.2022.2109413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Iron oxide nanoparticles (IONPs) hold the edges of great magnetic properties and fine nanoparticle characteristics, making them an attractive therapeutic agent. In the past seven years, more in-depth investigations were devoted to the intrinsic structure, magnetic properties, and biological effects of IONPs, expanding the range of their therapeutic application scenes. AREAS COVERED This review focuses on the development of IONPs for biomedical applications from the angle of the patent literature reported during the period 2015-2021. EXPERT OPINION While the magnetic properties of IONPs have been extensively explored, the precise control of IONP behavior through external magnetic fields remains a challenge. Further digging into the biological effects of IONPs will facilitate the development of IONP-based immune therapies. Long-term reliable safety evaluations are of necessity and significance to promote the process of clinical translation.
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Affiliation(s)
- Zeyuan Mao
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, People's Republic of China
| | - Xin Lin
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, People's Republic of China
| | - Pengfei Wang
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, People's Republic of China
| | - Hailong Yan
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, People's Republic of China
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13
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Younossi ZM, Ong JP, Takahashi H, Yilmaz Y, Eguc Hi Y, El Kassas M, Buti M, Diago M, Zheng MH, Fan JG, Yu ML, Wai-Sun Wong V, Alswat K, Chan WK, Mendez-Sanchez N, Burra P, Bugianesi E, Duseja AK, George J, Papatheodoridis GV, Saeed H, Castera L, Arrese M, Kugelmas M, Romero-Gomez M, Alqahtani S, Ziayee M, Lam B, Younossi I, Racila A, Henry L, Stepanova M. A Global Survey of Physicians Knowledge About Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2022; 20:e1456-e1468. [PMID: 34229038 DOI: 10.1016/j.cgh.2021.06.048] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Despite rapidly increasing nonalcoholic fatty liver disease (NAFLD) prevalence, providers' knowledge may be limited. We assessed NAFLD knowledge and associated factors among physicians of different specialties globally. METHODS NAFLD knowledge surveys containing 54 and 59 questions covering 3 domains (epidemiology/pathogenesis, diagnostics, and treatment) were completed electronically by hepatologists, gastroenterologists (GEs), endocrinologists (ENDOs), and primary care physicians (PCPs) from 40 countries comprising 5 Global Burden of Disease super-regions. Over 24 months, 2202 surveys were completed (488 hepatologists, 758 GEs, 148 ENDOs, and 808 PCPs; 50% high-income Global Burden of Disease super-region, 27% from North Africa and Middle East, 12% Southeast Asia, and 5% South Asian and Latin America). RESULTS Hepatologists saw the greatest number of NAFLD patients annually: median 150 (interquartile range, 60-300) vs 100 (interquartile range, 35-200) for GEs, 100 (interquartile range, 30-200) for ENDOs, and 10 (interquartile range, 4-50) for PCPs (all P < .0001). The primary sources of NAFLD knowledge acquisition for hepatologists were international conferences (33% vs 8%-26%) and practice guidelines for others (39%-44%). The Internet was the second most common source of NAFLD knowledge for PCPs (28%). NAFLD knowledge scores were higher for hepatologists than GEs: epidemiology, 62% vs 53%; diagnostics, 80% vs 73%; and treatment, 61% vs 58% (P < .0001), and ENDOs scores were higher than PCPs: epidemiology, 70% vs 60%; diagnostics, 71% vs 64%; and treatment, 79% vs 68% (P < .0001). Being a hepatologist or ENDO was associated with higher knowledge scores than a GE or PCP, respectively (P < .05). Higher NAFLD knowledge scores were associated independently with a greater number of NAFLD patients seen (P < .05). CONCLUSIONS Despite the growing burden of NAFLD, a significant knowledge gap remains for the identification, diagnosis, and management of NAFLD.
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Affiliation(s)
- Zobair M Younossi
- Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia; Inova Medicine, Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia.
| | - Janus P Ong
- University of the Philippines, College of Medicine, Manila, Philippines
| | | | - Yusuf Yilmaz
- Department of Gastroenterology, School of Medicine, Istanbul, Turkey; Liver Research Unit, Institute of Gastroenterology, Marmara University, Istanbul, Turkey
| | - Yuichiro Eguc Hi
- Locomedical General Institute, Locomedical Medical Cooperation, Ogi, Saga, Japan
| | - Mohamed El Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Maria Buti
- Liver Unit, Vall d'Hebron University Hospital, CIBER-EHD del Instituto Carlos III, Barcelona, Spain
| | - Moisés Diago
- Departamento de Patología Digestiva, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Ming-Hua Zheng
- Nonalcoholic Fatty Liver Disease Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jian-Gao Fan
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiatong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Ming-Lung Yu
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Khalid Alswat
- Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nahum Mendez-Sanchez
- Liver Research Unit, Medica Sur Clinic and Foundation, National Autonomous University of Mexico, Mexico City, Mexico
| | - Patrizia Burra
- Multivisceral Transplant Unit, Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Elisabetta Bugianesi
- Division of Gastroenterology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Ajay K Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jacob George
- Storr Liver Centre, Westmead Hospital, University of Sydney, Sydney, Australia
| | | | - Hamid Saeed
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Laurent Castera
- Department of Hepatology, Hôpital Beaujon, University of Paris, Clichy, France
| | - Marco Arrese
- Departmento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | | | - Manuel Romero-Gomez
- Digestive Diseases Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville, University of Seville, Seville, Spain
| | - Saleh Alqahtani
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Center for Outcomes Research in Liver Disease, Washington, District of Columbia
| | - Mariam Ziayee
- Center for Outcomes Research in Liver Disease, Washington, District of Columbia
| | - Brian Lam
- Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia; Inova Medicine, Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia
| | - Issah Younossi
- Center for Outcomes Research in Liver Disease, Washington, District of Columbia
| | - Andrei Racila
- Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia; Inova Medicine, Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia
| | - Linda Henry
- Center for Outcomes Research in Liver Disease, Washington, District of Columbia
| | - Maria Stepanova
- Center for Outcomes Research in Liver Disease, Washington, District of Columbia
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Sun L, Yang L, Liu X, Tang L, Zeng Q, Gao Y, Chen Q, Liu Z, Peng B. Optimization of Cervical Cancer Screening: A Stacking-Integrated Machine Learning Algorithm Based on Demographic, Behavioral, and Clinical Factors. Front Oncol 2022; 12:821453. [PMID: 35242711 PMCID: PMC8886038 DOI: 10.3389/fonc.2022.821453] [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: 11/24/2021] [Accepted: 01/19/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The purpose is to accurately identify women at high risk of developing cervical cancer so as to optimize cervical screening strategies and make better use of medical resources. However, the predictive models currently in use require clinical physiological and biochemical indicators, resulting in a smaller scope of application. Stacking-integrated machine learning (SIML) is an advanced machine learning technique that combined multiple learning algorithms to improve predictive performance. This study aimed to develop a stacking-integrated model that can be used to identify women at high risk of developing cervical cancer based on their demographic, behavioral, and historical clinical factors. METHODS The data of 858 women screened for cervical cancer at a Venezuelan Hospital were used to develop the SIML algorithm. The screening data were randomly split into training data (80%) that were used to develop the algorithm and testing data (20%) that were used to validate the accuracy of the algorithms. The random forest (RF) model and univariate logistic regression were used to identify predictive features for developing cervical cancer. Twelve well-known ML algorithms were selected, and their performances in predicting cervical cancer were compared. A correlation coefficient matrix was used to cluster the models based on their performance. The SIML was then developed using the best-performing techniques. The sensitivity, specificity, and area under the curve (AUC) of all models were calculated. RESULTS The RF model identified 18 features predictive of developing cervical cancer. The use of hormonal contraceptives was considered as the most important risk factor, followed by the number of pregnancies, years of smoking, and the number of sexual partners. The SIML algorithm had the best overall performance when compared with other methods and reached an AUC, sensitivity, and specificity of 0.877, 81.8%, and 81.9%, respectively. CONCLUSION This study shows that SIML can be used to accurately identify women at high risk of developing cervical cancer. This model could be used to personalize the screening program by optimizing the screening interval and care plan in high- and low-risk patients based on their demographics, behavioral patterns, and clinical data.
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Affiliation(s)
- Lin Sun
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Lingping Yang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiyao Liu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lan Tang
- Department of Physical Examation, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qi Zeng
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yuwen Gao
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Qian Chen
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Zhaohai Liu
- Information Section, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bin Peng
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
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15
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Cheng X, Fu Z, Xie W, Zhu L, Meng J. Preoperative circulating peroxiredoxin 1 levels as a predictor of non-alcoholic fatty liver disease remission after laparoscopic bariatric surgery. Front Endocrinol (Lausanne) 2022; 13:1072513. [PMID: 36619535 PMCID: PMC9810748 DOI: 10.3389/fendo.2022.1072513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is associated with obesity and insulin resistance and can be improved after bariatric surgery. Circulating Peroxiredoxin 1 (Prdx1) protein was reported to regulate energy metabolism and inflammation. This study aimed to investigate the roles of serum prdx1 in NAFLD patients with obesity undergoing LSG and to develop a prognostic model to predict the remission of severe NAFLD. METHODS The data of 93 participants from a tertiary hospital were assessed. Before laparoscopic sleeve gastrectomy (LSG) and three months after LSG, anthropometric parameters, laboratory biochemical data, and abdominal B-ultrasound results were collected, and their hepatic steatosis index (HSI) and triglyceride-glucose index (TyG) were calculated. A NAFLD improvement (NAFLD-I) nomogram prediction model was constructed using the least absolute shrinkage and selection operator (LASSO) regression and multiple regression, and its predictive ability was verified in a validation cohort. RESULTS The baseline Prdx1 (OR: 0.887, 95% CI: 0.816-0.963, p=0.004), preoperative TyG (OR: 8.207, 95% CI: 1.903-35.394, p=0.005) and HSI (OR: 0.861, 95% CI: 0.765-0.969, p=0.013) levels were independently associated with NAFLD-I at three months after LSG in NAFLD patients with obesity. In the primary and validation cohorts, the area under the receiver operating characteristic (AUC) of the developed nomogram model was 0.891 and 0.878, respectively. The preoperative circulating Prdx1 levels of NAFLD patients with obesity were significantly reduced after LSG (25.32 [18.99-30.88] vs. 23.34 [15.86-26.42], p=0.001). Prdx1 was related to obesity and hepatic steatosis based on correlation analysis. CONCLUSION The nomogram based on preoperative serum prdx1, HSI and TyG could be an effective tool for predicting remission of severe NAFLD after LSG.
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Affiliation(s)
- Xiaoyun Cheng
- Department of Pulmonary and Critical Care Medicine, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Pulmonary and Critical Care Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Organ Fibrosis, Central South University, Changsha, Hunan, China
| | - Zhibing Fu
- Department of General Surgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Wei Xie
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China
| | - Liyong Zhu
- Hunan Key Laboratory of Organ Fibrosis, Central South University, Changsha, Hunan, China
- *Correspondence: Jie Meng, ; Liyong Zhu,
| | - Jie Meng
- Department of Pulmonary and Critical Care Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Organ Fibrosis, Central South University, Changsha, Hunan, China
- *Correspondence: Jie Meng, ; Liyong Zhu,
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16
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Kontrick AV, VanWagner LB, Yeh C, Courtney DM. Hepatic Steatosis: An Incidental Finding That Deserves Attention. Acad Emerg Med 2021; 28:578-581. [PMID: 33210438 DOI: 10.1111/acem.14174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/05/2020] [Accepted: 11/13/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Amy V. Kontrick
- From the Department of Emergency Medicine and Medical Education Northwestern University Feinberg School of Medicine Chicago ILUSA
| | - Lisa B. VanWagner
- the Department of Medicine‐Gastroenterology & Hepatology and Preventive Medicine‐Epidemiology Northwestern University Feinberg School of Medicine Chicago ILUSA
| | - Chen Yeh
- and the Division of Biostatistics Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago ILUSA
| | - D. Mark Courtney
- and the Department of Emergency Medicine UT Southwestern Medical Center Dallas TXUSA
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Altajar S, Baffy G. Skeletal Muscle Dysfunction in the Development and Progression of Nonalcoholic Fatty Liver Disease. J Clin Transl Hepatol 2020; 8:414-423. [PMID: 33447525 PMCID: PMC7782111 DOI: 10.14218/jcth.2020.00065] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/08/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023] Open
Abstract
The association between the pathogenesis and natural course of nonalcoholic fatty liver disease (NAFLD) and skeletal muscle dysfunction is increasingly recognized. These obesity-associated disorders originate primarily from sustained caloric excess, gradually disrupting cellular and molecular mechanisms of the adipose-muscle-liver axis resulting in end-stage tissue injury exemplified by cirrhosis and sarcopenia. These major clinical phenotypes develop through complex organ-tissue interactions from the earliest stages of NAFLD. While the role of adipose tissue expansion and remodeling is well established in the development of NAFLD, less is known about the specific interplay between skeletal muscle and the liver in this process. Here, the relationship between skeletal muscle and liver in various stages of NAFLD progression is reviewed. Current knowledge of the pathophysiology is summarized with the goal of better understanding the natural history, risk stratification, and management of NAFLD.
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Affiliation(s)
- Sarah Altajar
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Gyorgy Baffy
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Medicine, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- *Correspondence to: Gyorgy Baffy, Section of Gastroenterology, VA Boston Healthcare System, 150 South Huntington Avenue, Room A6-46, Boston, MA 12130, USA. Tel/Fax: +1-857-364-4327, E-mail:
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Editorial Comment on "Liver Steatosis Categorization on Contrast-Enhanced CT Using a Fully Automated Deep Learning Volumetric Segmentation Tool: Evaluation in 1204 Healthy Adults Using Unenhanced CT as a Reference Standard". AJR Am J Roentgenol 2020; 217:367. [PMID: 32997510 DOI: 10.2214/ajr.20.24764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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19
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Han MAT, Vipani A, Noureddin N, Ramirez K, Gornbein J, Saouaf R, Baniesh N, Cummings-John O, Okubote T, Setiawan VW, Rotman Y, Loomba R, Alkhouri N, Noureddin M. MR elastography-based liver fibrosis correlates with liver events in nonalcoholic fatty liver patients: A multicenter study. Liver Int 2020; 40:2242-2251. [PMID: 32652744 DOI: 10.1111/liv.14593] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/23/2020] [Accepted: 07/01/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Liver fibrosis assessed by liver biopsy is predictive of clinical liver events in patients with nonalcoholic fatty liver disease (NAFLD). Magnetic resonance elastography (MRE) correlates with liver biopsy in assessing liver fibrosis. However, data assessing the relationship between MRE and clinical liver events are lacking. We investigated the association between MRE and clinical liver events/death and identified the cut-off to predict clinical liver events in NAFLD patients. METHODS We conducted a multicenter retrospective study of NAFLD patients who underwent MRE between 2016 and 2019. Clinical liver events were defined as decompensation events and death. We categorized patients into noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Fisher's exact test was used to test association strength. Receiver operative curve methods were used to determine the optimal cut-off of MRE liver stiffness and to maximize the accuracy for classifying noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Logistic regression modelling was used to predict decompensation. RESULTS The study included 320 NAFLD patients who underwent MRE. The best threshold for distinguishing cirrhosis from noncirrhosis was 4.39 kPa (AUROC 0.92) and from decompensated cirrhosis was 6.48 kPa (AUROC 0.71). Odds of decompensation increased as liver stiffness increased (OR 3.28) (P < .001). Increased liver stiffness was associated with ascites, hepatic encephalopathy, oesophageal variceal bleeding and mortality (median 7.10, 10.15 and 10.15 kPa respectively). CONCLUSION In NAFLD patients, liver stiffness measured by MRE with a cut-off of ≥6.48 kPa is associated with decompensation and mortality, and specific MRE cut-offs are predictive of individual clinical liver events.
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Affiliation(s)
- Ma Ai Thanda Han
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aarshi Vipani
- Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Nabil Noureddin
- Department of Internal Medicine, University of Nevada, Las Vegas, NV, USA
| | - Kim Ramirez
- Fatty Liver Program, Division of Digestive and Liver Diseases, Comprehensive Transplant Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jeffrey Gornbein
- Department of Biostatistics, University of California at Los Angeles, Los Angeles, CA, USA
| | - Rola Saouaf
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Nader Baniesh
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | | | - Yaron Rotman
- Liver & Energy Metabolism Unit, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, MD, USA
| | - Rohit Loomba
- Division of Gastroenterology, NAFLD Translational Research Unit, Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, USA
| | - Naim Alkhouri
- Division of Liver, Texas Liver Institute, San Antonio, TX, USA
| | - Mazen Noureddin
- Fatty Liver Program, Division of Digestive and Liver Diseases, Comprehensive Transplant Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Schaapman JJ, Tushuizen ME, Coenraad MJ, Lamb HJ. Multiparametric MRI in Patients With Nonalcoholic Fatty Liver Disease. J Magn Reson Imaging 2020; 53:1623-1631. [PMID: 32822095 PMCID: PMC8247423 DOI: 10.1002/jmri.27292] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease in the world, affecting more than 25% of the adult population. NAFLD covers a spectrum including simple steatosis, in which lipid accumulation in hepatocytes is the predominant histological characteristic, and nonalcoholic steatohepatitis (NASH), which is characterized by additional hepatic inflammation with or without fibrosis. Liver biopsy is currently the reference standard to discriminate between hepatic steatosis and steatohepatitis. Since liver biopsy has several disadvantages, noninvasive diagnostic methods with high sensitivity and specificity are desirable for the analysis of NAFLD. Improvements in magnetic resonance imaging (MRI) technology are continuously being implemented in clinical practice, specifically multiparametric MRI methods such as proton density fat‐fraction (PDFF), T2*, and T1 mapping, along with MR elastography. Multiparametric imaging of the liver has a promising role in the clinical management of NAFLD with quantification of fat content, iron load, and fibrosis, which are features in NAFLD. In the present article, we review the utility and limitations of multiparametric quantitative imaging of the liver for diagnosis and management of patients with NAFLD. Level of Evidence 5. Technical Efficacy Stage 3.
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Affiliation(s)
- Jelte J Schaapman
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maarten E Tushuizen
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Minneke J Coenraad
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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21
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Boursier J, Shreay S, Fabron C, Torreton E, Fraysse J. Hospitalization costs and risk of mortality in adults with nonalcoholic steatohepatitis: Analysis of a French national hospital database. EClinicalMedicine 2020; 25:100445. [PMID: 32775971 PMCID: PMC7403878 DOI: 10.1016/j.eclinm.2020.100445] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) has reached high prevalence, paralleling the obesity pandemic. The aggressive form of the disease, nonalcoholic steatohepatitis (NASH), is characterized by fatty infiltration and inflammation of the liver, can progress to compensated cirrhosis (CC) and end-stage liver disease (ESLD: decompensated cirrhosis [DCC] and hepatocellular carcinoma [HCC]), and may ultimately require liver transplantation (LT). Real-world data on the burden of NAFLD/NASH are limited. This study aimed to evaluate the clinical and economic burden of NAFLD/NASH to the French hospital system. METHODS This retrospective cohort study used data from the French PMSI-MCO database. Adults with NAFLD/NASH diagnosis identified between 2009 and 2015 were categorized into disease severity cohorts (NAFLD/NASH, CC, DCC, HCC, and LT). Demographic and clinical data were assessed at the index (diagnosis) date. Hospitalization resource utilization and costs were assessed in the pre- and post-index periods. Rates of liver disease progression and death were evaluated for each cohort. FINDINGS During the median follow-up of 34.8 months, of the 131,656 patients included, 1491 patients developed CC (1.1%), 7846 developed DCC (5.9%), 1144 developed HCC (0.9%), and 52 required LT (0.04%). The diagnosis of NAFLD/NASH was associated with increasing annual costs: €7736 vs €5076 before the diagnosis. Rates of comorbidities, hospitalization resource utilization, and costs increased with disease progression. The rate of death at seven-year follow-up was 7.9% in NAFLD/NASH, CC: 18.0%, DCC: 34.9%, and HCC: 48.8%. INTERPRETATION NAFLD/NASH is associated with high economic burden and imparts substantial risk of negative clinical outcomes and mortality at all stages of disease.
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Affiliation(s)
- Jérôme Boursier
- Laboratoire HIFIH UPRES EA3859, SFR 4208, Université d'Angers, Angers, France
- Service d'Hépato-Gastroentérologie et Oncologie Digestive, Centre Hospitalier Universitaire d'Angers, Angers, France
- Corresponding author at: Service d'Hépato-Gastroentérologie et Oncologie Digestive, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49933 Angers cedex 09, France.
| | - Sanatan Shreay
- Gilead Sciences, Health Economics Outcomes Research, Foster City, United States
| | | | | | - Jeremy Fraysse
- Gilead Sciences, Health Economics Outcomes Research, Foster City, United States
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22
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Kamada Y, Morishita K, Koseki M, Nishida M, Asuka T, Naito Y, Yamada M, Takamatsu S, Sakata Y, Takehara T, Miyoshi E. Serum Mac-2 Binding Protein Levels Associate with Metabolic Parameters and Predict Liver Fibrosis Progression in Subjects with Fatty Liver Disease: A 7-Year Longitudinal Study. Nutrients 2020; 12:nu12061770. [PMID: 32545650 PMCID: PMC7353396 DOI: 10.3390/nu12061770] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/02/2020] [Accepted: 06/10/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Mac-2 binding protein (M2BP) is a highly glycosylated secreted glycoprotein that is involved in immune defense and regulation. Our cross-sectional studies indicated that serum M2BP was a useful liver fibrosis biomarker for nonalcoholic fatty liver disease (NAFLD). In this study, we conducted a 7-year longitudinal study to investigate the significance of serum M2BP levels (baseline and at 7-year follow-up) and their relationships with other metabolic parameters of fatty liver disease. Methods: We enrolled 715 study subjects (521 male and 194 female) during health examinations. Study subjects received blood sampling tests and abdominal ultrasound tests at baseline and follow-up. Results: Univariate analyses demonstrated that serum M2BP levels were significantly correlated with various parameters related to metabolic risk (body mass index (BMI), systolic blood pressure, triglyceride, high density lipoprotein (HDL)-cholesterol) and metabolic syndrome diseases (obesity, hypertension, dyslipidemia, diabetes mellitus, fatty liver (FL)). Multiple logistic regression analyses demonstrated that BMI and FL were independent determinants for serum M2BP levels. Baseline serum M2BP levels were significant independent determinants for changes in platelet count, Fibrosis-4 (FIB4) index, and NAFLD fibrosis score. Higher serum M2BP levels (>1.80 μg/mL) strongly correlated with changes in the FIB4-index. Conclusions: The results of this study suggest that changes in serum M2BP levels reflect changes in specific metabolic disease-related parameters, and baseline serum M2BP levels could predict changes in liver fibrosis.
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Affiliation(s)
- Yoshihiro Kamada
- Department of Molecular Biochemistry and Clinical Investigation, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (Y.K.); (K.M.); (M.N.); (T.A.); (Y.N.); (S.T.)
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan;
| | - Koichi Morishita
- Department of Molecular Biochemistry and Clinical Investigation, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (Y.K.); (K.M.); (M.N.); (T.A.); (Y.N.); (S.T.)
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (M.K.); (Y.S.)
| | - Mayu Nishida
- Department of Molecular Biochemistry and Clinical Investigation, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (Y.K.); (K.M.); (M.N.); (T.A.); (Y.N.); (S.T.)
| | - Tatsuya Asuka
- Department of Molecular Biochemistry and Clinical Investigation, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (Y.K.); (K.M.); (M.N.); (T.A.); (Y.N.); (S.T.)
| | - Yukiko Naito
- Department of Molecular Biochemistry and Clinical Investigation, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (Y.K.); (K.M.); (M.N.); (T.A.); (Y.N.); (S.T.)
| | | | - Shinji Takamatsu
- Department of Molecular Biochemistry and Clinical Investigation, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (Y.K.); (K.M.); (M.N.); (T.A.); (Y.N.); (S.T.)
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (M.K.); (Y.S.)
| | - Tetsuo Takehara
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan;
| | - Eiji Miyoshi
- Department of Molecular Biochemistry and Clinical Investigation, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (Y.K.); (K.M.); (M.N.); (T.A.); (Y.N.); (S.T.)
- Correspondence: ; Tel.: +81-6-6879-2590
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Loomba R, Wong R, Fraysse J, Shreay S, Li S, Harrison S, Gordon SC. Nonalcoholic fatty liver disease progression rates to cirrhosis and progression of cirrhosis to decompensation and mortality: a real world analysis of Medicare data. Aliment Pharmacol Ther 2020; 51:1149-1159. [PMID: 32372515 DOI: 10.1111/apt.15679] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/17/2020] [Accepted: 02/12/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Risk factors and timing associated with disease progression and mortality in nonalcoholic fatty liver disease (NAFLD) are poorly understood. AIMS To evaluate the impact of disease severity, demographics and comorbidities on risk of mortality and time to progression in a large, real-world cohort of diagnosed NAFLD patients. METHODS Claims data from a 20% Medicare representative sample between 2007 and 2015 were analysed retrospectively. Adults were categorised into disease severity groups: NAFLD/nonalcoholic steatohepatitis (NASH) alone, compensated cirrhosis, decompensated cirrhosis, liver transplant or hepatocellular carcinoma. Cumulative incidence of mortality and disease progression were calculated for each group and multivariate analyses performed adjusting for demographics, comorbidities and disease severity. RESULTS A total of 10 826 456, patients were assessed and the prevalence of NAFLD was 5.7% (N = 621 253). Among patients with NAFLD, 71.1% had NAFLD/NASH alone and 28.9% had NAFLD cirrhosis. Overall, 85.5% of patients had hypertension, 84.1% dyslipidemia, 68.7% had cardiovascular disease and 55.5% diabetes. The cumulative risk of progression of NAFLD to cirrhosis, and compensated cirrhosis to decompensated cirrhosis was 39% and 45%, respectively, over 8 years of follow-up. The independent predictors of progression included cardiovascular disease, renal impairment, dyslipidemia and diabetes. The cumulative risk of mortality for NAFLD, NAFLD cirrhosis, decompensated cirrhosis and hepatocellular carcinoma was 12.6%, 31.1%, 51.4% and 76.2%, respectively. CONCLUSIONS The present report (a) demonstrates that NAFLD is grossly underdiagnosed in real-world clinical settings and (b) provides new evidence on the progression rates of NAFLD and risk factors of mortality across the spectrum of severity of NAFLD and cirrhosis.
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Affiliation(s)
- Rohit Loomba
- Department of Medicine, NAFLD Research Center, La Jolla, CA, USA.,Division of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Robert Wong
- Division of Gastroenterology and Hepatology, Alameda Health System, Highland Hospital, Oakland, CA, USA
| | - Jeremy Fraysse
- Health Economics Outcomes Research, Gilead Sciences, Foster City, CA, USA
| | - Sanatan Shreay
- Health Economics Outcomes Research, Gilead Sciences, Foster City, CA, USA
| | - Suying Li
- Chronic Disease Research Group, Minneapolis, MN, USA
| | | | - Stuart C Gordon
- Department of Gastroenterology and Hepatology, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, MI, USA
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Ding HR, Tang ZT, Tang N, Zhu ZY, Liu HY, Pan CY, Hu AY, Lin YZ, Gou P, Yuan XW, Cai JH, Dong CL, Wang JL, Ren HZ. Protective Properties of FOXO1 Inhibition in a Murine Model of Non-alcoholic Fatty Liver Disease Are Associated With Attenuation of ER Stress and Necroptosis. Front Physiol 2020; 11:177. [PMID: 32218743 PMCID: PMC7078343 DOI: 10.3389/fphys.2020.00177] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/17/2020] [Indexed: 12/19/2022] Open
Abstract
Aim The pathogenesis of non-alcoholic fatty liver disease is currently unclear, however, lipid accumulation leading to endoplasmic reticulum stress appears to be pivotal in the process. At present, FOXO1 is known to be involved in NAFLD progression. The relationship between necroptosis and non-alcoholic steatohepatitis has been of great research interest more recently. However, whether FOXO1 regulates ER stress and necroptosis in mice fed with a high fat diet is not clear. Therefore, in this study we analyzed the relationship between non-alcoholic steatohepatitis, ER stress, and necroptosis. Main Methods Male C57BL/6J mice were fed with an HFD for 14 weeks to induce non-alcoholic steatohepatitis. ER stress and activation of necroptosis in AML12 cells were evaluated after inhibition of FOXO1 in AML12 cells. In addition, mice were fed with AS1842856 for 14 weeks. Liver function and lipid accumulation were measured, and further, ER stress and necroptosis were evaluated by Western Blot and Transmission Electron Microscopy. Key Findings Mice fed with a high fat diet showed high levels of FOXO1, accompanying activation of endoplasmic reticulum stress and necroptosis. Further, sustained PA stimulation caused ER stress and necroptosis in AML12 cells. At the same time, protein levels of FOXO1 increased significantly. Inhibition of FOXO1 with AS1842856 alleviated ER stress and necroptosis. Additionally, treatment of mice with a FOXO1 inhibitor ameliorated liver function after they were fed with a high fat diet, displaying better liver condition and lighter necroptosis. Significance Inhibition of FOXO1 attenuates ER stress and necroptosis in a mouse model of non-alcoholic steatohepatitis.
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Affiliation(s)
- Hao-Ran Ding
- Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Department of Hepatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.,Department of Hepatobiliary Surgery, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhen-Ting Tang
- Department of Pediatrics, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Ning Tang
- Department of Hepatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Zheng-Yi Zhu
- Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Han-Yi Liu
- Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Chen-Yan Pan
- Department of Hepatobiliary Surgery, Nanjing University of Chinese Medicine, Nanjing, China
| | - An-Yin Hu
- Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yun-Zhen Lin
- Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Peng Gou
- Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xian-Wen Yuan
- Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jia-Hui Cai
- Department of Hepatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Chun-Long Dong
- Department of Hepatobiliary Surgery, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing-Lin Wang
- Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Department of Hepatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.,Department of Hepatobiliary Surgery, Nanjing University of Chinese Medicine, Nanjing, China
| | - Hao-Zhen Ren
- Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Department of Hepatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.,Department of Hepatobiliary Surgery, Nanjing University of Chinese Medicine, Nanjing, China
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Caveolin-1 alleviates lipid accumulation in NAFLD associated with promoting autophagy by inhibiting the Akt/mTOR pathway. Eur J Pharmacol 2020; 871:172910. [PMID: 31926991 DOI: 10.1016/j.ejphar.2020.172910] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/13/2019] [Accepted: 01/06/2020] [Indexed: 12/22/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most burgeoning chronic liver disease worldwide whose pathogenesis is complex and controversial. Here, we investigated the impact of caveolin-1 (CAV1), a scaffolding protein of caveolae for lipid homeostasis and endocytosis, on the pathogenesis of NAFLD. CAV1 and caveolae play crucial roles in the regulation of autophagy and hepatic energy metabolism. However, it remains unclear whether CAV1 could affect hepatic lipid metabolism by regulating autophagy. In this study, results showed that the expressions of CAV1 and autophagy-related proteins (Beclin1 and LC3-II/Ⅰ) were decreased, while the level of p62 was increased in HFD (high-fat diet) fed mice liver and in A/O (alcohol and oleic acid mixture) treated L02 cells, compared to the corresponding controls. In vivo study, upregulation of CAV1 with CAV1 scaffolding domain peptides (CSD, amino acids 82-101 of caveolin-1) could alleviate lipid accumulation and promote autophagy in NAFLD mice. In vitro study, CAV1 overexpression plasmid and its small interfering RNA were cultured with A/O treated L02 cells respectively. The results also demonstrated that CAV1 reduced lipid accumulation and promoted autophagy in L02 cells. Treatment with chloroquine, an inhibitor of autophagic degradation, abrogated CAV1 plasmid-mediated alleviation of lipid accumulation. Mechanistically, the inhibition of Akt/mTOR pathway was involved in the protective role of CAV1 in autophagy induction and lipid metabolism in NAFLD. Together, these results provided novel perception into the function of CAV1 in liver through autophagy and emphasized its positive role in NAFLD.
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