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Zhang M, Chang D, Guan Q, Dong R, Zhang R, Zhang W, Wang H, Wang J. High-density lipoprotein cholesterol trajectory and new-onset metabolic dysfunction-associated fatty liver disease incidence: a longitudinal study. Diabetol Metab Syndr 2024; 16:223. [PMID: 39261925 PMCID: PMC11389356 DOI: 10.1186/s13098-024-01457-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 08/25/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Although high-density lipoprotein cholesterol (HDL-C) exerts a significant influence on the development of metabolic dysfunction-associated fatty liver disease (MAFLD), the association of dynamic changes in HDL-C levels with the risk of MAFLD remains unclear. Thus, the aim of the current study was to explore the association between the changing trajectories of HDL-C and new-onset MAFLD. The findings of this study may provide a theoretical basis for future personalized intervention and prevention targeting MAFLD. METHODS A total of 1507 participants who met the inclusion criteria were recruited from a community-based physical examination population in Nanjing, China from 2017 to 2021. Group-based trajectory models were constructed to determine the heterogeneous HDL-C trajectories. The incidence of MAFLD in each group in 2022 was followed up, and the Cox proportional hazards regression model was applied to investigate the associations between different HDL-C trajectories and the risk of new-onset MAFLD. RESULTS The incidences of MAFLD in the low-stable, moderate-stable, moderate-high-stable, and high-stable groups of HDL-C trajectory were 26.5%, 13.8%, 7.2% and 2.6%, respectively. The incidence rate of MAFLD in the order of the above trajectory groups exhibited a decreasing trend (χ2 = 72.55, Ptrend<0.001). After adjusting for confounders, the risk of MAFLD onset in HDL-C low-stable group was still 5.421 times (95%CI: 1.303-22.554, P = 0.020) higher than that in the high-stable group. Subgroup analyses of the combined (moderate high-stable and high-stable groups combined), moderate-stable and low-stable groups showed that sex, age, and overweight/obesity did not affect the association between HDL-C trajectory and MAFLD risk. CONCLUSIONS Persistently low HDL-C level is a risk factor for the onset of MAFLD. Long-term monitoring of HDL-C levels and timely intervention for those experiencing persistent declines are crucial for early prevention of MAFLD.
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Grants
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
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Affiliation(s)
- Mengting Zhang
- Department of Gastroenterology, the Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Dongchun Chang
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Qing Guan
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Rui Dong
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Ru Zhang
- School of Nursing and Midwifery, Jiangsu College of Nursing, Huai'an, 223003, Jiangsu, China
| | - Wei Zhang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, 200032, China
| | - Hongliang Wang
- Department of General Practice, Ninghai Road Community Health Service Center, Gulou District, Nanjing, 210024, Jiangsu, China
| | - Jie Wang
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
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Liang S, Yang T. Analysis of the Association Between Changes in the GGT/HDL-C Ratio and the Risk of Diabetes Mellitus Based on a Latent Class Growth Mixed Modeling: A Longitudinal Cohort Study of Adults in China. Diabetes Metab Syndr Obes 2024; 17:3139-3150. [PMID: 39206418 PMCID: PMC11352797 DOI: 10.2147/dmso.s475067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024] Open
Abstract
Objective Longitudinal cohort analysis was performed to identify the association between changes in the gamma-glutamyl transferase (GGT)/high-density lipoprotein cholesterol (HDL-C) ratio trajectory and the risk of developing diabetes mellitus. Methods This was a retrospective cohort study. We analyzed the latent trajectory classes of changes in the GGT/HDL-C ratio by applying a latent class mixture model with healthy individuals who underwent medical checkups from January 2017 to December 2021 as the study subjects. To analyze the effect of the GGT/HDL-C ratio trajectory classes on new-onset diabetes mellitus, we then applied a multivariate Cox proportional risk regression model. Statistical analysis was performed using the R-software with the LCMM package. Results The study cohort comprised 3410 participants. All participants were followed up for 5 years, and 95 developed diabetes (4-year incidence of 2.78%). By applying the latent class mixed model, we categorized participants into three trajectory groups: low-stability group (n = 2253), medium-increase group (n = 941), and high-increase group (n = 216). The Cox proportional risk regression model analysis showed that the hazard ratio (95% confidence interval) for the incidence of diabetes mellitus was 1.73 (1.04-2.87) in the medium-increase group and 3.96 (2.11-7.44) in the high-increase group. Moreover, we calculated the estimated model-based levels and linear slopes of the GGT/HDL-C ratios for each age group between 26 and 85 years at 10-year intervals, respectively. The results indicated the strongest correlation between the GGT/HDL-C ratio slope and diabetes in the 46-55 year age group, with an odds ratio of 1.51 (1.25-1.83). Conclusion A large increase in the GGT/HDL-C ratio was highly associated with the risk of developing diabetes mellitus. This result suggests that vigilance for changes in the GGT/HDL-C ratio trajectory during community health screening can help identify potential patients with diabetes, enabling early intervention and treatment.
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Affiliation(s)
- Shichao Liang
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China
| | - Tengfei Yang
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China
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Vegda HS, Patel B, Girdhar GA, Pathan MSH, Ahmad R, Haque M, Sinha S, Kumar S. Role of Nonalcoholic Fatty Liver Disease in Periodontitis: A Bidirectional Relationship. Cureus 2024; 16:e63775. [PMID: 39100036 PMCID: PMC11297857 DOI: 10.7759/cureus.63775] [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: 06/20/2024] [Accepted: 07/03/2024] [Indexed: 08/06/2024] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) and periodontitis share common risk factors such as obesity, insulin resistance (IR), and dyslipidemia, which contribute to systemic inflammation. It has been suggested that a bidirectional relationship exists between NAFLD and periodontitis, indicating that one condition may exacerbate the other. NAFLD is characterized by excessive fat deposition in the liver and is associated with low-grade chronic inflammation. There are several risk factors for the development of NAFLD, including gender, geriatric community, race, ethnicity, poor sleep quality and sleep deprivation, physical activity, nutritional status, dysbiosis gut microbiota, increased oxidative stress, overweight, obesity, higher body mass index (BMI), IR, type 2 diabetes mellitus (T2DM), metabolic syndrome (MetS), dyslipidemia (hypercholesterolemia), and sarcopenia (decreased skeletal muscle mass). This systemic inflammation can contribute to the progression of periodontitis by impairing immune responses and exacerbating the inflammatory processes in the periodontal tissues. Furthermore, individuals with NAFLD often exhibit altered lipid metabolism, which may affect oral microbiota composition, leading to dysbiosis and increased susceptibility to periodontal disease. Conversely, periodontitis has been linked to the progression of NAFLD through mechanisms involving systemic inflammation and oxidative stress. Chronic periodontal inflammation can release pro-inflammatory cytokines and bacterial toxins into the bloodstream, contributing to liver inflammation and exacerbating hepatic steatosis. Moreover, periodontitis-induced oxidative stress may promote hepatic lipid accumulation and IR, further aggravating NAFLD. The interplay between NAFLD and periodontitis underscores the importance of comprehensive management strategies targeting both conditions. Lifestyle modifications such as regular exercise, a healthy diet, and proper oral hygiene practices are crucial for preventing and managing these interconnected diseases. Additionally, interdisciplinary collaboration between hepatologists and periodontists is essential for optimizing patient care and improving outcomes in individuals with NAFLD and periodontitis.
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Affiliation(s)
- Hardika S Vegda
- Department of Periodontology and Implantology, School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Bhavin Patel
- Department of Periodontology and Implantology, School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Gaurav A Girdhar
- Department of Periodontology and Implantology, School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Mohd Shabankhan H Pathan
- Department of Periodontology and Implantology, School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Rahnuma Ahmad
- Department of Physiology, Medical College for Women and Hospital, Dhaka, BGD
| | - Mainul Haque
- Department of Research, Karnavati Scientific Research Center (KSRC) School of Dentistry, Karnavati University, Gandhinagar, IND
- Department of Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
| | - Susmita Sinha
- Department of Physiology, Enam Medical College and Hospital, Dhaka, BGD
| | - Santosh Kumar
- Department of Periodontology and Implantology, School of Dentistry, Karnavati University, Gandhinagar, IND
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Solleiro-Villavicencio H, Méndez-García LA, Ocampo-Aguilera NA, Baltazar-Pérez I, Arreola-Miranda JA, Aguayo-Guerrero JA, Alfaro-Cruz A, González-Chávez A, Fonseca-Sánchez MA, Fragoso JM, Escobedo G. Decreased Hepatic and Serum Levels of IL-10 Concur with Increased Lobular Inflammation in Morbidly Obese Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:862. [PMID: 38929479 PMCID: PMC11205754 DOI: 10.3390/medicina60060862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is associated with obesity and ranges from simple steatosis to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. Accumulating evidence in animal models suggests that loss of interleukin-10 (IL-10) anti-inflammatory actions might contribute to lobular inflammation, considered one of the first steps toward NASH development. However, the role of IL-10 in lobular inflammation remains poorly explored in humans. We examined mRNA and protein levels of IL-10 in liver biopsies and serum samples from morbidly obese patients, investigating the relationship between IL-10 and lobular inflammation degree. Materials and Methods: We prospectively enrolled morbidly obese patients of both sexes, assessing the lobular inflammation grade by the Brunt scoring system to categorize participants into mild (n = 7), moderate (n = 19), or severe (n = 13) lobular inflammation groups. We quantified the hepatic mRNA expression of IL-10 by quantitative polymerase chain reaction and protein IL-10 levels in liver and serum samples by Luminex Assay. We estimated statistical differences by one-way analysis of variance (ANOVA) and Tukey's multiple comparison test. Results: The hepatic expression of IL-10 significantly diminished in patients with severe lobular inflammation compared with the moderate lobular inflammation group (p = 0.01). The hepatic IL-10 protein levels decreased in patients with moderate or severe lobular inflammation compared with the mild lobular inflammation group (p = 0.008 and p = 0.0008, respectively). In circulation, IL-10 also significantly decreased in subjects with moderate or severe lobular inflammation compared with the mild lobular inflammation group (p = 0.005 and p < 0.0001, respectively). Conclusions: In liver biopsies and serum samples of morbidly obese patients, the protein levels of IL-10 progressively decrease as lobular inflammation increases, supporting the hypothesis that lobular inflammation develops because of the loss of the IL-10-mediated anti-inflammatory counterbalance.
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Affiliation(s)
| | - Lucía Angélica Méndez-García
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (N.A.O.-A.); (I.B.-P.); (J.A.A.-M.); (J.A.A.-G.)
| | - Nydia A. Ocampo-Aguilera
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (N.A.O.-A.); (I.B.-P.); (J.A.A.-M.); (J.A.A.-G.)
| | - Itzel Baltazar-Pérez
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (N.A.O.-A.); (I.B.-P.); (J.A.A.-M.); (J.A.A.-G.)
| | - José A. Arreola-Miranda
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (N.A.O.-A.); (I.B.-P.); (J.A.A.-M.); (J.A.A.-G.)
| | - José A. Aguayo-Guerrero
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (N.A.O.-A.); (I.B.-P.); (J.A.A.-M.); (J.A.A.-G.)
| | - Ana Alfaro-Cruz
- Pathological Anatomy Department, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico;
| | - Antonio González-Chávez
- Clínica de Atención Integral para Pacientes con Diabetes y Obesidad (CAIDO), General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico;
| | | | - José Manuel Fragoso
- Department of Molecular Biology, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico;
| | - Galileo Escobedo
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (N.A.O.-A.); (I.B.-P.); (J.A.A.-M.); (J.A.A.-G.)
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Pajuelo-Vasquez R, Benites-Meza JK, Durango-Chavez HV, Salinas-Sedo G, Toro-Huamanchumo CJ. Diagnostic performance of the GGT/HDL-C ratio for NAFLD in adults with obesity undergoing bariatric surgery. Diabetes Res Clin Pract 2024; 211:111649. [PMID: 38574896 DOI: 10.1016/j.diabres.2024.111649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 04/01/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) has become the most frequent liver disease, closely related with metabolic risk factors such as obesity, insulin resistance, dyslipidemia, diabetes mellitus, and metabolic syndrome. In this context, γ-Glutamyl transpeptidase (GGT) and high-density lipoprotein cholesterol (HDL-C) have shown correlations with steatosis severity and metabolic syndrome, respectively. This positions the GGT/HDL-C ratio as a potential diagnostic indicator for NAFLD. OBJECTIVE To assess the diagnostic performance of the GGT/HDL-C ratio for NAFLD in adults with obesity undergoing bariatric surgery. METHODS We conducted an analytical cross-sectional study, designed as a diagnostic test evaluation. A secondary database of 249 adults with obesity was analyzed. The optimal cut-off point was ascertained using three methodologies, and five adjustment models were constructed for the total population, further stratified by sex. RESULTS The optimal cut-off point was 20.5 U/mmol and the AUC of the ratio was 0.81 (95% CI: 0.64-0.98), with sensitivity and specificity being 82.5% and 77.8%, respectively. In the overall group with an elevated GGT/HDL-C ratio, the prevalence of NAFLD increased by 14% (PR: 1.14; 95% CI: 1.04-1.33). Specifically, women displaying this altered ratio showed a 19% increased prevalence (PR: 1.19; 95% CI: 1.07-1.42) compared to those with normal values. CONCLUSIONS The GGT/HDL-C ratio is a promising biomarker for the diagnosis of NAFLD in an adult population living with obesity.
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Affiliation(s)
- Renzo Pajuelo-Vasquez
- CHANGE Research Working Group, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Universidad Científica del Sur, Lima, Peru
| | - Jerry K Benites-Meza
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru; Grupo Peruano de Investigación Epidemiológica, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | | | | | - Carlos J Toro-Huamanchumo
- OBEMET Center for Obesity and Metabolic Health, Lima, Peru; Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru; Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
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Yang S, Xu J. Elevated small dense low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio is associated with an increased risk of metabolic dysfunction associated fatty liver disease in Chinese patients with type 2 diabetes mellitus. J Diabetes Investig 2024; 15:634-642. [PMID: 38251808 PMCID: PMC11060163 DOI: 10.1111/jdi.14148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/06/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION It is demonstrated that elevated small dense low-density lipoprotein cholesterol (sdLDL-C), and reduced high-density lipoprotein cholesterol (HDL-C) is associated with Metabolic dysfunction-associated fatty liver disease (MAFLD). This study aims to explore the relationship between sdLDL-C to HDL-C ratio (SHR) and MAFLD in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS A cross-sectional study was performed among 1904 patients with T2DM. Weighted multivariable logistic regression analysis was conducted to explore the relationship between the SHR and the risk of MAFLD. In addition, this study used a two-part linear regression model to identify threshold effects. Subgroup analysis, interaction tests and receiver operating characteristic (ROC) curve analysis were also carried out. RESULTS The overall MAFLD prevalence reached 48.1%. Multiple logistic regression analysis showed that SHR was positively correlated with the risk of MAFLD (OR = 2.37, 95% CI = 1.80-3.12). Subgroup analysis stratified by age, gender, hypertension and BMI showed that there was a consistent positive correlation. A non-linear relationship and saturation effect between SHR and MAFLD risk were identified, with an inverted L shaped curve and an inflection point at 1.02. The area under the curve (AUC) for SHR in the ROC analysis was significantly greater than sdLDL-C and HDL-C, with a sensitivity of 71.2% and a specificity of 62.1%. CONCLUSIONS Elevated levels of SHR is independently associated with an increased risk of MAFLD in patients with T2DM. SHR may be taken as practical indicators to assess the risk of MAFLD in T2DM patients.
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Affiliation(s)
- Shouxing Yang
- Department of GastroenterologyThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Jing Xu
- Department of EndocrinologyThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
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Lizarbe-Lezama ML, Rodriguez-Macedo JE, Fernandez-Guzman D, Alcantara-Diaz AL, Salinas-Sedo G, Toro-Huamanchumo CJ. Association between gamma glutamyl transpeptidase to HDL-Cholesterol (GGT/HDL-C) ratio and metabolic syndrome resolution after sleeve gastrectomy. Diab Vasc Dis Res 2024; 21:14791641241252553. [PMID: 38702054 PMCID: PMC11069333 DOI: 10.1177/14791641241252553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVE To evaluate the association between GGT/HDL-C ratio and resolution of MetS in adults after sleeve gastrectomy (SG). METHODS We conducted a retrospective cohort study using secondary data from a Peruvian bariatric center. The study population consisted of adults aged 18 and above who underwent laparoscopic SG and were diagnosed with MetS prior to the surgery. The main outcome measured was MetS resolution 6 months post-surgery and the exposure variable was the GGT/HDL-C ratio. RESULTS We analyzed 137 patients with a mean age of 38.9 ± 10.9 years; 64.2% were females. The median GGT/HDL-C ratio was 1.1 [0.7 - 1.5], and 83.9% of patients experienced resolution of MetS. Furthermore, both the middle tertile of GGT/HDL-C (aRR: 1.28; 95% CI: 1.04 - 1.58; p = .019) and the lowest tertile (aRR: 1.27; 95% CI: 1.01 - 1.60; p = .038) showed a significant association with the resolution of MetS. CONCLUSION Eight out of 10 patients undergoing SG experience resolution of MetS within 6 months after surgery. Patients in the middle and lower tertiles of the GGT/HDL-C were more likely to achieve this outcome. Therefore, the GGT/HDL-C ratio should be considered a valuable and efficient biomarker for preoperative assessment of bariatric surgery candidates.
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Affiliation(s)
| | | | | | | | | | - Carlos J. Toro-Huamanchumo
- OBEMET Center for Obesity and Metabolic Health, Lima, Peru
- Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Suwała S, Białczyk A, Koperska K, Rajewska A, Krintus M, Junik R. Prevalence and Crucial Parameters in Diabesity-Related Liver Fibrosis: A Preliminary Study. J Clin Med 2023; 12:7760. [PMID: 38137829 PMCID: PMC10744287 DOI: 10.3390/jcm12247760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/28/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023] Open
Abstract
Diabetes and obesity have been recognized as confirmed risk factors for the occurrence of liver fibrosis. Despite the long-standing acknowledgment of "diabesity", the simultaneous existence of diabetes and obesity, scholarly literature has shown limited attention to this topic. The aim of this pilot study was to assess the prevalence of liver fibrosis among individuals with diabetes (specifically those who are obese) in order to identify the key factors associated with hepatofibrosis and determine the most important associations and differences between patients with and without liver fibrosis. The research included a total of 164 participants (48.17% had comorbid obesity). Liver elastography (Fibroscan) was performed on these individuals in addition to laboratory tests. Liver fibrosis was found in 34.76% of type 2 diabetes patients; male gender almost doubled the risk of hepatofibrosis (RR 1.81) and diabesity nearly tripled this risk (RR 2.81; however, in degree III of obesity, the risk was elevated to 3.65 times higher). Anisocytosis, thrombocytopenia, or elevated liver enzymes raised the incidence of liver fibrosis by 1.78 to 2.47 times. In these individuals, liver stiffness was negatively correlated with MCV, platelet count, and albumin concentration; GGTP activity and HbA1c percentage were positively correlated. The regression analysis results suggest that the concentration of albumin and the activity of GGTP are likely to have a substantial influence on the future management of liver fibrosis in patients with diabesity. The findings of this study can serve as the basis for subsequent investigations and actions focused on identifying potential therapeutic and diagnostic avenues.
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Affiliation(s)
- Szymon Suwała
- Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland;
| | - Aleksandra Białczyk
- Evidence-Based Medicine Students Scientific Club of Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland; (A.B.); (K.K.); (A.R.)
| | - Kinga Koperska
- Evidence-Based Medicine Students Scientific Club of Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland; (A.B.); (K.K.); (A.R.)
| | - Alicja Rajewska
- Evidence-Based Medicine Students Scientific Club of Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland; (A.B.); (K.K.); (A.R.)
| | - Magdalena Krintus
- Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland;
| | - Roman Junik
- Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland;
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Gong S, Gan S, Zhang Y, Zhou H, Zhou Q. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio is a more powerful marker than TyG index for predicting metabolic syndrome in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14:1248614. [PMID: 37854188 PMCID: PMC10579940 DOI: 10.3389/fendo.2023.1248614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023] Open
Abstract
Purpose The prevalence of metabolic syndrome (MetS) is increasing globally and has become a global and national public health problem that cannot be ignored as an independent predictor of cardiovascular events, cancer and all-cause mortality. γ-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) are associated with insulin resistance, dyslipidemia and oxidative stress. This study was designed to explore the relationship and predictive performance between γ-glutamyl transferase high-density lipoprotein cholesterol ratio (GGT/HDL-C) and MetS. Methods This was a cross-sectional study. MetS was diagnosed from biochemical and anthropometric data in subjects with T2DM. Multivariate logistic regression was used to analyses the relationship between GGT/HDL-C ratio, TyG index and HOMA-IR and MetS in subjects with T2DM. Receiver operating characteristic (ROC) curve was drawn and the areas under the curve (AUC) were used to assess the ability of these indexes in screening MetS in subjects with T2DM. Statistical differences between the AUC values of these indexes were compared. In addition, we performed subgroup analyses and interactions. Results 769 (70.55%) patients with T2DM were defined as having MetS. patients with MetS had higher anthropometric values and biochemical indicators compared to those without MetS. Multivariate logistic regression analysis of GGT/HDL-C ratio was an independent risk factor for MetS (Per 1 SD increase, OR = 2.49, 95% CI: 1.51, 4.10). According to ROC curve analysis, the value of GGT/HDL-C ratio in predicting MetS in subjects with T2DM was superior to that of TyG index and HOMA-IR. The best cut-off value for GGT/HDL-C prediction was 19.94. Conclusions GGT/HDL-C ratio may be an important predictor of MetS in subjects with T2DM, and its predictive power is stronger than that of TyG index and HOMA-IR. The risk of MetS in subjects with T2DM is increased in the presence of a higher GGT/HDL-C ratio.
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Affiliation(s)
- Shijun Gong
- Department of Medicine, Jishou University, Jishou, China
| | - Shenglian Gan
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, China
| | - YuHua Zhang
- Department of Medicine, Jishou University, Jishou, China
| | - HaiFeng Zhou
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, China
| | - Quan Zhou
- Department of Science and Education, The First People’s Hospital of Changde City, Changde, China
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Kim H, Lee K, Kim JY, Shim JJ, Lim J, Kim JY, Lee JL. Lactobacillus helveticus Isolated from Raw Milk Improves Liver Function, Hepatic Steatosis, and Lipid Metabolism in Non-Alcoholic Fatty Liver Disease Mouse Model. Microorganisms 2023; 11:2466. [PMID: 37894124 PMCID: PMC10609090 DOI: 10.3390/microorganisms11102466] [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: 09/06/2023] [Revised: 09/18/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023] Open
Abstract
Here, we show that Lactiplantibacillus plantarum LP158 (LP158), Lactobacillus helveticus HY7804 (HY7804), and Lacticaseibacillus paracasei LPC226 (LPC226) isolated from raw milk alleviate non-alcoholic fatty acid disease (NAFLD) in a C57BL/6 mouse model. Lactic acid bacteria (LAB) were screened for their ability to inhibit fatty acid accumulation in palmitic acid (PA)-treated HepG2 cells, and three strains were selected based on the results. We also investigated hemolytic activity and antibiotic resistance of the three strains. LP158, HY7804, and LPC226 suppressed expression of mRNA encoding genes related to lipogenesis, and increased expression of genes related to β-oxidation, in a PA-induced HepG2 cell model. Moreover, when LP158, HY7804, and LPC226 were administered at 109 CFU/kg/day for 8 weeks to mice with dietary-induced NAFLD, they all modulated blood biochemistry markers and reduced steatosis in liver tissue. Also, all three strains significantly reduced expression of mRNA encoding lipogenesis genes (Fasn, Acaca, and Srebp-1c) and inflammatory factors (Tnfα and Ccl-2) and fibrosis factors, and increased expression of a β-oxidation gene (Acox1) in the liver. In particular, HY7804 showed the strongest effects both in vitro and in vivo. Therefore, HY7804, LP158, and LPC226 can be proposed as potential supplements that can improve NAFLD through anti-steatosis, anti-inflammatory, and anti-fibrotic effects.
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Affiliation(s)
- Hyeonji Kim
- R&BD Center, hy Co., Ltd., 22, Giheungdanji-ro 24beon-gil, Giheung-gu, Yongin-si 17086, Republic of Korea; (H.K.); (K.L.); (J.-Y.K.); (J.-J.S.)
| | - Kippeum Lee
- R&BD Center, hy Co., Ltd., 22, Giheungdanji-ro 24beon-gil, Giheung-gu, Yongin-si 17086, Republic of Korea; (H.K.); (K.L.); (J.-Y.K.); (J.-J.S.)
| | - Ju-Yeon Kim
- R&BD Center, hy Co., Ltd., 22, Giheungdanji-ro 24beon-gil, Giheung-gu, Yongin-si 17086, Republic of Korea; (H.K.); (K.L.); (J.-Y.K.); (J.-J.S.)
| | - Jae-Jung Shim
- R&BD Center, hy Co., Ltd., 22, Giheungdanji-ro 24beon-gil, Giheung-gu, Yongin-si 17086, Republic of Korea; (H.K.); (K.L.); (J.-Y.K.); (J.-J.S.)
| | - Junghyun Lim
- Department of Pharmacy, School of Pharmacy, Jeonbuk National University, Jeonju 54896, Republic of Korea;
| | - Joo-Yun Kim
- R&BD Center, hy Co., Ltd., 22, Giheungdanji-ro 24beon-gil, Giheung-gu, Yongin-si 17086, Republic of Korea; (H.K.); (K.L.); (J.-Y.K.); (J.-J.S.)
| | - Jung-Lyoul Lee
- R&BD Center, hy Co., Ltd., 22, Giheungdanji-ro 24beon-gil, Giheung-gu, Yongin-si 17086, Republic of Korea; (H.K.); (K.L.); (J.-Y.K.); (J.-J.S.)
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11
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Jung DH, Park B, Ryu HE, Lee YJ. Sex-specific associations of γ-glutamyltransferase to HDL-cholesterol ratio and the incident risk of cardiovascular disease: three Korean longitudinal cohorts from different regions. Front Endocrinol (Lausanne) 2023; 14:1231502. [PMID: 37649976 PMCID: PMC10464609 DOI: 10.3389/fendo.2023.1231502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
Background The combination of gamma-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) (GGT/HDL-C) is a novel noninsulin-based marker for assessing the risk of nonalcoholic fatty liver disease and type 2 diabetes mellitus. However, whether the GGT/HDL-C ratio is related to the risk of incident cardiovascular disease (CVD) risk is not well known. Therefore, we aimed to investigate the longitudinal effect of GGT/HDL-C ratio on incident CVD risk in three large cohorts of Korean men and women. Methods Data were assessed from 27,643 participants without CVD from the Korean Genome and Epidemiology Study (KoGES), Health Risk Assessment Study (HERAS), and Korea Health Insurance Review and Assessment (HIRA) (HERAS-HIRA) datasets. The participants were divided into four groups according to the GGT/HDL-C quartiles. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for CVD using multivariate Cox proportional-hazard regression models over a 50-month period following the baseline survey. Results During the follow-up period, 949 patients (3.4%; 529 men and 420 women) developed CVD. The HRs of CVD for GGT/HDL-C quartiles 2-4 were 1.36 (95% CI, 0.91-2.02), 1.54 (95% CI, 1.05-2.26), and 1.66 (95% CI, 1.12-2.47) after adjusting for metabolic parameters in women, but GGT/HDL-C did not show a trend toward increases in incident CVD in men. Regional discrepancies were evident in the results; the increase in HR in the metropolitan hospital cohort was more pronounced than that in the urban cohort, and the risk was not increased in the rural cohort. Conclusion GGT/HDL-C ratio may be a useful predictive marker for CVD in women. Furthermore, the prevalence of CVD was strongly correlated with the GGT/HDL-C ratio in metropolitan areas, and this correlation was more significant than that observed with GGT or HDL-C in isolation.
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Affiliation(s)
- Dong Hyuk Jung
- Department of Family Medicine, Yongin Severance Hospital, Yongin-si, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byoungjin Park
- Department of Family Medicine, Yongin Severance Hospital, Yongin-si, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ha Eun Ryu
- Department of Family Medicine, Yongin Severance Hospital, Yongin-si, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea
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Xie Y, Huang K, Zhang X, Wu Z, Wu Y, Chu J, Kong W, Qian G. Association of serum uric acid-to-high-density lipoprotein cholesterol ratio with non-alcoholic fatty liver disease in American adults: a population-based analysis. Front Med (Lausanne) 2023; 10:1164096. [PMID: 37256087 PMCID: PMC10225665 DOI: 10.3389/fmed.2023.1164096] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/14/2023] [Indexed: 06/01/2023] Open
Abstract
Objective Non-invasive disease indicators are currently limited and need further research due to the increased non-alcoholic fatty liver disease (NAFLD) prevalence worldwide. The serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) has been recognized as a novel inflammatory and metabolic marker. Herein, we explored the correlation between UHR and the risk of NAFLD in-depth. Methods A total of 3,766 participants were included in our survey, and the National Health and Nutrition Examination Survey (NHANES) 2017-2018 cycle provided the cross-sectional study population. Weighted multivariable logistic regression and multivariate linear regression analyses were performed to assess the association between the UHR and the odds of NAFLD and liver steatosis and fibrosis severity, respectively. Moreover, we explored the non-linear relationship between the UHR and NAFLD by the generalized additive model. Results NAFLD probabilities were statistically demonstrated to be positively correlated with the UHR (OR = 1.331 per SD increase, 95% CI: 1.100, 1.611). The positive connection of the UHR with NAFLD risk persisted significantly in female subjects but not in male subjects in subgroup analyses stratified by gender. The non-linear relationship analysis demonstrated that a UHR between ~20 and 30% suggested a saturation effect of NAFLD risk. Furthermore, a dramatically positive correlation was found between the UHR and hepatic steatosis severity but not fibrosis. Finally, the receiver operating characteristic analysis suggested that UHR had a better predictive value for NAFLD than either serum uric acid (sUA) or high-density lipoprotein cholesterol (HDL) alone [UHR (area under curve): 0.6910; 95% CI: 0.6737-0.7083; P < 0.0001]. Conclusion Our investigation revealed that the elevated UHR level was independently related to an increased NAFLD risk and the severity of liver steatosis in American individuals. The correlation differed according to sex. This non-invasive indicator may enhance the capacity to predict the onset of NAFLD and may uncover alternative therapeutic interventional targets.
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Affiliation(s)
- Yilian Xie
- Department of Infectious Diseases, Ningbo First Hospital, Ningbo, Zhejiang, China
- Department of Hepatology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Kai Huang
- Department of General Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Xiangyu Zhang
- Department of Nephrology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Zhouxiao Wu
- Department of Infectious Diseases, Ningbo First Hospital, Ningbo, Zhejiang, China
- Department of Hepatology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Yiyi Wu
- Department of Infectious Diseases, Ningbo First Hospital, Ningbo, Zhejiang, China
- Department of Hepatology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Jinguo Chu
- Department of Hepatology, Ningbo First Hospital, Ningbo, Zhejiang, China
- Department of General Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Weiliang Kong
- Department of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Guoqing Qian
- Department of Infectious Diseases, Ningbo First Hospital, Ningbo, Zhejiang, China
- Department of Hepatology, Ningbo First Hospital, Ningbo, Zhejiang, China
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13
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Zhao Y, Xin X, Luo XP. The relationship between the ratio of gamma-glutamyltransferase to high-density lipoprotein cholesterol and the risk of diabetes mellitus using publicly available data: a secondary analysis based on a longitudinal study in Japan. Lipids Health Dis 2023; 22:7. [PMID: 36650520 PMCID: PMC9843936 DOI: 10.1186/s12944-023-01772-9] [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] [Received: 06/16/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The ratio of gamma-glutamyltransferase to high-density lipoprotein cholesterol (GGT/HDL-C) has been highlighted in nonalcoholic fatty liver disease (NAFLD) by previous studies. However, there have been fewer investigations into the correlation between the GGT/HDL-C ratio and type 2 diabetes mellitus (T2DM) incidence. Our secondary analysis used published data from a Japanese population and aimed to investigate the role of the GGT/HDL-C ratio in the incidence of T2DM. METHODS The research was a longitudinal cohort study completed by Okamura, Takuro et al. We obtained the data from the DATADRYAD website and used it for secondary analysis only. The participants recruited from a medical program called the NAGALA database received regular medical examinations and standardized questionnaires to obtain the baseline variables. Abdominal ultrasound was used to diagnose fatty liver disease. The participants were followed up, and the duration and occurrence of T2DM were documented. The GGT/HDL-C ratio evaluated at baseline served as the independent variable, while the occurrence of diabetes served as the dependent variable. RESULTS A total of 15,453 cases (8,419 men and 7,034 women) were included in our study. After adjusting for age, sex, BMI, DBP, SBP, ALT, AST, TG, TC, HbA1C, FPG, drinking status, smoking status, exercise status, and fatty liver, we observed that the GGT/HDL-C ratio was positively associated with the incidence of T2DM (hazard ratio = 1.005, 95% confidence interval: 1.000 to 1.010, P = 0.0667). The results were consistent when the GGT/HDL-C quartile was used as a categorical variable (P for trend < 0.00396). A curvilinear relationship with a threshold effect was identified between the GGT/HDL-C ratio and the risk of incident T2DM. On the left of the point, a one-unit increase in the GGT/HDL-C ratio was associated with a 1.5-fold increase in the risk of incident T2DM (hazard ratio 2.57, 95% confidence interval 1.20 to 5.49). On the right of the point, when GGT/HDL-C was greater than 6.53, their relationship became saturated. CONCLUSION The GGT/HDL-C ratio correlated with the incidence of T2DM in a curvilinear form with a threshold effect. Their positive relationship could be observed when GGT/HDL-C was less than 6.53.
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Affiliation(s)
- Yue Zhao
- grid.412793.a0000 0004 1799 5032Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing Xin
- grid.412793.a0000 0004 1799 5032Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-ping Luo
- grid.412793.a0000 0004 1799 5032Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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14
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Xie Q, Lu S, Kuang M, He S, Yu C, Hu C, Zou Y. Assessing the longitudinal association between the GGT/HDL-C ratio and NAFLD: a cohort study in a non-obese Chinese population. BMC Gastroenterol 2022; 22:500. [PMID: 36471271 PMCID: PMC9724423 DOI: 10.1186/s12876-022-02598-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND A cross-sectional association between the combination indicator of high-density lipoprotein cholesterol (HDL-C) and gamma-glutamyl transferase (GGT) and fatty liver has been described in several recent studies, and this study aims to further evaluate the longitudinal relationship between the ratio of GGT to HDL-C (GGT/HDL-C ratio) and nonalcoholic fatty liver disease (NAFLD). METHODS This cohort study included 12,126 individuals without NAFLD at baseline, followed prospectively for 5 years, and the endpoint of interest was new-onset NAFLD. The relationship of the GGT/HDL-C ratio with new-onset NAFLD and the shape of the association was assessed by Cox regression models and restricted cubic spline (RCS) regression, respectively. Time-dependent receiver operator characteristics (ROC) curves were constructed to evaluate the predictive value of GGT, HDL-C, GGT/HDL-C ratio and BMI for the occurrence of NAFLD at different time points in the future. RESULTS The prevalence of NAFLD was 72.46/1000 person-years during the 5-year follow-up period. Results of multivariate Cox regression analysis showed a positive association of the GGT/HDL-C ratio with new-onset NAFLD after adequate adjustment of the related confounding factors, and the degree of correlation was slightly higher than that of GGT, and further subgroup analysis found that this association was more significant in the population with elevated systolic blood pressure (SBP). In addition, we also found a nonlinear relationship of the GGT/HDL-C ratio with the risk of new-onset NAFLD using the RCS regression, where the saturation threshold was about 31.79 U/mmol. Time-dependent ROC analysis results showed that the GGT/HDL-C ratio was increasingly valuable in predicting NAFLD over time, and was better than HDL-C in predicting NAFLD in the early stage (1-3 years), but was not superior to BMI and GGT. CONCLUSIONS In this large longitudinal cohort study based on a Chinese population, our results supported that the GGT/HDL-C ratio was positively and nonlinearly associated with the risk of new-onset NAFLD in a non-obese population. In the assessment of future NAFLD risk, the GGT/HDL-C ratio was slightly better than GGT alone; However, the GGT/HDL-C ratio did not appear to have a significant advantage over GGT and BMI alone in predicting NAFLD.
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Affiliation(s)
- Qiyang Xie
- grid.260463.50000 0001 2182 8825Medical College of Nanchang University, Nanchang, 330006 China ,grid.415002.20000 0004 1757 8108Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006 China
| | - Song Lu
- grid.260463.50000 0001 2182 8825Medical College of Nanchang University, Nanchang, 330006 China ,grid.415002.20000 0004 1757 8108Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006 China
| | - Maobin Kuang
- grid.260463.50000 0001 2182 8825Medical College of Nanchang University, Nanchang, 330006 China ,grid.415002.20000 0004 1757 8108Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006 China
| | - Shiming He
- grid.260463.50000 0001 2182 8825Medical College of Nanchang University, Nanchang, 330006 China ,grid.415002.20000 0004 1757 8108Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006 China
| | - Changhui Yu
- grid.260463.50000 0001 2182 8825Medical College of Nanchang University, Nanchang, 330006 China ,grid.415002.20000 0004 1757 8108Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006 China
| | - Chong Hu
- grid.415002.20000 0004 1757 8108Gastroenterology Department, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006 China
| | - Yang Zou
- grid.415002.20000 0004 1757 8108Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006 China
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Li Q, Han Y, Hu H, Zhuge Y. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio has a non-linear association with non-alcoholic fatty liver disease: A secondary prospective cohort study in non-obese Chinese adults. Front Med (Lausanne) 2022; 9:995749. [PMID: 36465946 PMCID: PMC9712445 DOI: 10.3389/fmed.2022.995749] [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: 07/16/2022] [Accepted: 10/21/2022] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE The evidence for a relationship between the ratio of gamma-glutamyl transferase (GGT) to high-density lipoprotein cholesterol (HDL-c) and non-alcoholic fatty liver disease (NAFLD) is currently inadequate. This study aimed to investigate the relationship between the GGT/HDL-c ratio and NAFLD. MATERIALS AND METHODS This study is a prospective cohort study that recruited a total of 11,891 non-obese volunteers in a Chinese hospital from January 2010 to December 2014 in a non-selective manner. The Cox proportional-hazards regression model was then used to investigate the relationship between baseline GGT/HDL-c ratio and the probability of developing NAFLD. The non-linear link between the GGT/HDL-c ratio and NAFLD was identified using a Cox proportional hazards regression with cubic spline functions and smooth curve fitting (cubic spline smoothing). Furthermore, we conducted several sensitivity and subgroup analyses. Data had been uploaded to the DATADRYAD website. RESULTS The mean age of study participants was 43.29 ± 14.95 years old, and 6,502 (54.68%) were male. The median (interquartile ranges) of GGT/HDL-c ratio was 15.56 (10.73-23.84). During a median follow-up of 29.35 months, 2028 (17.05%) participants were diagnosed with NAFLD. After adjusting for covariates, the results showed that GGT/HDL-c ratio was positively associated with incident NAFLD (HR = 1.014, 95% CI 1.011-1.017). There was also a non-linear relationship between GGT/HDL-c ratio and NAFLD, and the inflection point of the GGT/HDL-c ratio was 20.35. The effect sizes (HR) on the left and right sides of the inflection point were 1.113 (95% CI 1.096, 1.130) and 1.003 (95% CI 1.000-1.007), respectively. Moreover, the sensitivity analysis demonstrated the robustness of our results. Subgroup analysis showed that GGT/HDL-c ratio was more strongly associated with incident NAFLD in triglyceride (TG) < 1.7 mmol/L participants. In contrast, the weaker association was probed in those with TG ≥ 1.7 mmol/L. CONCLUSION The present study reveals a positive and non-linear relationship between the GGT/HDL-c ratio and NAFLD risk in a non-obese Chinese population. GGT/HDL-c ratio is strongly associated with NAFLD when GGT/HDL-c ratio is less than 20.35. Therefore, maintaining the GGT/HDL-c ratio lower than the inflection point is recommended from a treatment perspective.
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Affiliation(s)
- Qiming Li
- Department of Gastroenterology, Nanjing Medical University Drum Tower Clinical Medical School, Nanjing, Jiangsu, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Yuzheng Zhuge
- Department of Gastroenterology, Nanjing Medical University Drum Tower Clinical Medical School, Nanjing, Jiangsu, China
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Hu H, Han Y, Guan M, Wei L, Wan Q, Hu Y. Elevated gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio has a non-linear association with incident diabetes mellitus: A second analysis of a cohort study. J Diabetes Investig 2022; 13:2027-2037. [PMID: 36056709 DOI: 10.1111/jdi.13900] [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: 05/19/2022] [Revised: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Evidence regarding the association between the GGT/HDL-c ratio and incident diabetes is still limited. On that account, our research aims to survey the link of the GGT/HDL-c ratio with the risk of diabetes. METHODS In this retrospective cohort study, data of 15,171 participants who participated in the medical examination program were collected in Murakami Memorial Hospital in Japan from 2004 to 2015. The independent and dependent variables were the baseline GGT/HDL-c ratio and diabetes during the follow-up, respectively. The Cox proportional-hazards regression model was used to explore the association between the GGT/HDL-c ratio and diabetes risk. A Cox proportional hazards regression with the cubic spline smoothing was used to recognize non-linear relationships between the GGT/HDL-c ratio and incident diabetes. RESULTS After adjusting covariates, the results showed that the GGT/HDL-c ratio was positively associated with incident diabetes (HR = 1.013, 95% CI: 1.002, 1.024). There was also a non-linear relationship between the GGT/HDL-c ratio and the risk of diabetes, and the inflection point of the GGT/HDL-c ratio was 6.477. The HR on the left and right sides of the inflection point was 2.568 (1.157, 5.699) and 1.012 (1.001, 1.023), respectively. The sensitivity analysis demonstrated the robustness of the results. Besides, the performance of the FPG + GGT/HDL-c ratio was better than FPG + GGT, FPG + HDL-c, and FPG in predicting diabetes. CONCLUSION This study demonstrates a positive and non-linear relationship between the GGT/HDL-c ratio and incident diabetes in the Japanese population. The GGT/HDL-c ratio is strongly related to diabetes risk when it is <6.477.
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Affiliation(s)
- Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, China
| | - Mijie Guan
- Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, China
| | - Ling Wei
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, China
| | - Qijun Wan
- Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yanhua Hu
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, China
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Xie W, Liu B, Tang Y, Yang T, Song Z. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio: A valuable predictor of type 2 diabetes mellitus incidence. Front Endocrinol (Lausanne) 2022; 13:1026791. [PMID: 36246883 PMCID: PMC9557082 DOI: 10.3389/fendo.2022.1026791] [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] [Received: 08/24/2022] [Accepted: 09/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Gamma-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) have been proven to be valuable predictors of type 2 diabetes mellitus (T2DM). The aim of this study was to investigate the association between GGT/HDL-C ratio and incident T2DM. METHODS The study retrospectively analyzed 15453 participants from 2004 to 2015. Cox proportional hazards regression models and Kaplan-Meier curves were used to elucidate the effect of GGT/HDL-C ratio on T2DM. Restricted cubic spline (RCS) analysis was performed to explore any non-linear correlation between GGT/HDL-C ratio and the risk of T2DM. The predictive performance of GGT, HDL-C and GGT/HDL-C ratio for T2DM was evaluated utilizing receiver-operating-characteristic (ROC) curves. RESULTS During a median follow-up of 5.39 years, 373 cases of incident T2DM were observed. Kaplan-Meier curves showed that the cumulative probabilities of T2DM increased in the participants with higher GGT/HDL-C ratio significantly (P < 0.001). Cox models further clarified that high GGT/HDL-C ratio was an independent risk factor for T2DM (HR = 1.01, 95% CI = 1.00-1.01, P = 0.011). Linear positive correlation between GGT/HDL-C ratio and the risk of T2DM was demonstrated through RCS analysis. In the ROC analysis, GGT/HDL-C ratio (AUC = 0.75, 95% CI = 0.73-0.77) showed competitive role in the prediction of T2DM compared with single GGT and HDL-C. CONCLUSIONS The GGT/HDL-C ratio could serve as a valuable predictor of T2DM, and the risk of T2DM increases in the condition of higher GGT/HDL-C ratio.
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Affiliation(s)
- Wangcheng Xie
- Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bin Liu
- Department of Gastrointestinal Surgery, Anqing First People’s Hospital, Anhui Medical University, Anqing, China
| | - Yansong Tang
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tingsong Yang
- Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Zhenshun Song, ; Tingsong Yang,
| | - Zhenshun Song
- Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Zhenshun Song, ; Tingsong Yang,
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Xing Y, Chen J, Liu J, Ma H. Associations Between GGT/HDL and MAFLD: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2022; 15:383-394. [PMID: 35177915 PMCID: PMC8843704 DOI: 10.2147/dmso.s342505] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To explore the association between γ-glutamyl transpeptidase to high-density lipoprotein ratio (GGT/HDL), triglyceride glucose-body mass index (TYG-BMI), and metabolic associated fatty liver disease (MAFLD) in a Chinese population with type 2 diabetes (T2DM) by cross-sectional analysis. To investigate the role of GGT/HDL played in MAFLD by TYG-BMI. PATIENTS AND METHODS A total of 1434 adult patients hospitalized with T2DM at Hebei General Hospital (Shijiazhuang, China) were included in the study. Patients' demographic and clinical data were collected. Spearman correlation was used to test for an association between GGT/HDL or TYG-BMI and related risk factors of MAFLD among T2DM patients. Multiple logistic regression analyses were performed to investigate the association between GGT/HDL or TYG-BMI and MAFLD. Mediation analysis was used to explore whether TYG-BMI mediated the association between GGT/HDL and MAFLD. RESULTS A total of 1434 T2DM patients were enrolled, the MAFLD group showed a higher level of GGT/HDL compared to the non-MAFLD group. There was a progressive increase in the prevalence of MAFLD with increasing tertiles of GGT/HDL. After adjusting for confounding factors, multivariate logistic regression analysis revealed that high levels of GGT/HDL were independent risk factors for MAFLD in T2DM patients. BMI further grouped the patients: ≤ 23kg/m2,>23kg/m2. GGT/HDL was found to be an independent risk factor for MAFLD but only in T2DM patients with a BMI greater than 23 kg/m2. Mediation analysis indicated that GGT/HDL had a significant direct effect on MAFLD. CONCLUSION GGT/HDL was positively associated with MAFLD incidence in T2DM patients with a BMI greater than 23 Kg/m2, and TYG-BMI partly mediated the association.
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Affiliation(s)
- Yuling Xing
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, 050017, People’s Republic of China
| | - Jinhu Chen
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, 050017, People’s Republic of China
| | - Jing Liu
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, 050017, People’s Republic of China
| | - Huijuan Ma
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
- Correspondence: Huijuan Ma, Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China, Tel +86 18032838686, Email
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Qiu F, Xu Y, Ji X, Pu J, Zhou J, Huang Y. Incidence and correlation of metabolic syndrome and kidney stones in a healthy screening population. Transl Androl Urol 2021; 10:3646-3655. [PMID: 34733660 PMCID: PMC8511539 DOI: 10.21037/tau-21-689] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/15/2021] [Indexed: 12/31/2022] Open
Abstract
Background To study the incidence of metabolic syndrome (MetS) and kidney stones in a healthy screening population and to explore the correlation between them. Methods The physical examination data of 11,827 people screened at the First Affiliated Hospital of Soochow University from August 2019 to July 2020 were analyzed. MetS diagnostic criteria were based on the 2004 guidelines of Chinese Diabetes Society (CDS). Multivariate logistic regression was used to analyze the correlation between MetS and various characteristics and kidney stones. Trend analysis was represented by P value, and P<0.05 indicated statistical significance. Results The present study comprised 6,570 males (55.6%, aged 46.15±13.653 years) and 5,257 females (44.4%, aged 41.41±11.712 years). Of these, 1,036 (8.8%) had kidney stones and 1,552 (13.1%) had MetS. Among the MetS patients, 35.1% had a body mass index (BMI) ≥25, 27.7% had hypertension, 10.8% had hyperglycemia, and 31.2% had dyslipidemia. Kidney stone morbidity was 14.5% in the MetS group and 7.9% in the non-MetS group (P<0.05). As the number of MetS characteristics increased, kidney stone morbidity showed a linear increasing trend (P<0.05 for trend). With an increase in BMI and blood triglycerides (TG), and a decrease in lipoprotein cholesterol (HDL-C), the incidence of kidney stones had an increasing trend (P<0.05 for trend). Sex, age and MetS were independent risk factors for the occurrence of kidney stones, with and odds ratio (OR) of 1.493 [95% confidence interval (CI): 1.264–1.763] for MetS. Of the MetS characteristics, BMI ≥25 and blood pressure (BP) ≥140/90 mmHg were independent risk factors for kidney stones, with OR values of 1.209 (95% CI: 1.047–1.396) and 1.248 (95% CI: 1.071–1.453), respectively. Conclusions MetS is an independent risk factor for kidney stones. Appropriate medication and dietary advice may help to correct urinary metabolic abnormalities and prevent the recurrence of kidney stones.
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Affiliation(s)
- Feng Qiu
- Department of Urology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yunfeng Xu
- Department of Urology, KunShan Second People's Hospital, Suzhou, China
| | - Xiaodong Ji
- Department of Health Management Center, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jinxian Pu
- Department of Urology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jian Zhou
- Center for Reproductive Medicine, Dushuhu Public Hospital Affiliated to Soochow University, Suzhou, China
| | - Yuhua Huang
- Department of Urology, the First Affiliated Hospital of Soochow University, Suzhou, China
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Akkiz H, Carr BI, Guerra V, Donghia R, Yalçın K, Karaoğullarından U, Altıntaş E, Özakyol A, Şimşek H, Balaban HY, Balkan A, Uyanıkoğlu A, Ekin N, Delik A. Plasma lipids, tumor parameters and survival in HCC patients with HBV and HCV. JOURNAL OF TRANSLATIONAL SCIENCE 2021; 7:10.15761/jts.1000421. [PMID: 34457356 PMCID: PMC8389344 DOI: 10.15761/jts.1000421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION AND AIMS Hepatocellular carcinoma (HCC) is a consequence of chronic liver disease, particularly from hepatitis B or C and increasingly from obesity and metabolic syndrome. Since lipids are an important component of cell membranes and are involved in cell signaling and tumor cell growth, we wished to evaluate the relationship between HCC patient plasma lipids and maximum tumor diameter and other indices of HCC human biology. METHODS We examined prospectively-collected data from a multi-institutional collaborative Turkish HCC working group, from predominantly HBV-based patients, for plasma lipid profiles, consisting of triglycerides, total cholesterol, LDL-cholesterol (LDL) and HDL-cholesterol (HDL) and compared these with the associated patient maximum tumor diameter (MTD), portal vein thrombosis, alpha-fetoprotein (AFP) and also with patient survival. RESULTS We found that both low HDL (p=0.0002) and high LDL (p=0.003) levels were significantly associated with increased MTD, as well as in a final multiple linear regression model on MTD. The combination of low HDL combined with high HDL levels were significant in a regression model on MTD, PVT and an HCC Aggressiveness Index (Odds Ratio 12.91 compared to an Odds Ratio of 1 for the reference). Furthermore, in a Cox regression model on death, the HDL plus LDL combination had a significantly higher Hazard Ratio than the reference category. CONCLUSIONS Low plasma HDL, high plasma LDL and especially the combination, were significantly related to more aggressive HCC phenotype and the combination was significantly related to a higher Hazard Ratio for death.
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Affiliation(s)
- H Akkiz
- Çukurova University, Adana, Turkey
| | - BI Carr
- İnonu University, Malatya, Turkey
| | - V Guerra
- National Institute of Gastroenterology, S. de Bellis Research hospital, Castellana Grotte (BA), Italy
| | - R Donghia
- National Institute of Gastroenterology, S. de Bellis Research hospital, Castellana Grotte (BA), Italy
| | - K Yalçın
- Dikle University, Diyarbakır, Turkey
| | | | | | - A Özakyol
- Eskişehir Osmangazi University, Eskişehir, Turkey
| | - H Şimşek
- Hacettepe University, Ankara, Turkey
| | | | - A Balkan
- Gaziantep University, Gazientep, Turkey
| | | | - N Ekin
- Dikle University, Diyarbakır, Turkey
| | - A Delik
- Çukurova University, Adana, Turkey
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21
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Implications of SCFAs on the Parameters of the Lipid and Hepatic Profile in Pregnant Women. Nutrients 2021; 13:nu13061749. [PMID: 34063900 PMCID: PMC8224042 DOI: 10.3390/nu13061749] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 12/27/2022] Open
Abstract
Short-chain fatty acids (SCFAs) are the product of the anaerobic intestinal bacterial fermentation of dietary fiber and resistant starch. An abnormal intestinal microbiota may cause a reduction in the production of SCFAs, which stimulate the development of intestinal epithelial cells, nourish enterocytes, influence their maturation and proper differentiation, reduce the pH, and are an additional source of energy for the host. There have been reports of the special role of SCFAs in the regulation of glucose and lipid metabolism during pregnancy. AIM The aim of the study was to analyze the correlation of SCFAs with lipid and hepatic metabolism during pregnancy in relation to the body weight of pregnant women. MATERIAL AND METHODS This study was conducted in pregnant women divided into two groups: Obese (OW-overweight and obese women; n = 48) and lean (CG-control group; n = 48) individuals. The biochemical plasma parameters of lipid metabolism (TG, CH, LDL, HDL), inflammation (CRP), and liver function (ALT, AST, GGT) were determined in all of the subjects. SCFA analysis was performed in the stool samples to measure acetic acid (C 2:0), propionic acid (C 3:0), isobutyric acid (C 4:0 i), butyric acid (C 4:0 n), isovaleric acid (C 5:0 i) valeric acid (C 5:0 n), isocaproic acid (C 6:0 i), caproic acid (C 6:0 n), and heptanoic acid (C 7:0). RESULTS Statistically significant differences in the concentrations of C 3:0 and C 6:0 n were found between women in the OW group compared to the CG group. The other SCFAs tested did not differ significantly depending on BMI. The C 2:0, C 3:0, and C 4:0 n ratios showed differences in both OW and CG groups. In the OW group, no relationship was observed between the concentrations of the SCFAs tested and CRP, ALT, AST. A surprising positive relationship between C 5:0 n and all fractions of the tested lipids and branched C 5:0 with CHL, HDL, and LDL was demonstrated. In the OW group, HDL showed a positive correlation with C 3:0. However, lower GGT concentrations were accompanied by higher C 4:0 and C 5:0 values, and this tendency was statistically significant. CONCLUSIONS The results of our research show that some SCFAs are associated with hepatic lipid metabolism and CRP concentrations, which may vary with gestational weight. Obesity in pregnancy reduces the amount of SCFAs in the stool, and a decrease in the level of butyrate reduces liver function.
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Sheng G, Peng N, Hu C, Zhong L, Zhong M, Zou Y. The albumin-to-alkaline phosphatase ratio as an independent predictor of future non-alcoholic fatty liver disease in a 5-year longitudinal cohort study of a non-obese Chinese population. Lipids Health Dis 2021; 20:50. [PMID: 33993872 PMCID: PMC8126124 DOI: 10.1186/s12944-021-01479-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/06/2021] [Indexed: 02/06/2023] Open
Abstract
Background The albumin-to-alkaline phosphatase ratio (AAPR) is a newly developed index of liver function, but its association in patients with non-alcoholic fatty liver disease (NAFLD) has not been established. The aim of this study was to investigate the association between the AAPR and NAFLD in a non-obese Chinese population. Methods The study included 10,749 non-obese subjects without NAFLD at baseline and divided them into quintiles according to the AAPR. A Cox multiple regression model was used to examine the association between the AAPR and its quintiles and the incidence of NAFLD. Results The average age of the study population was 43.65 ± 15.15 years old. During the 5-year follow-up, 1860 non-obese subjects had NAFLD events. In the Cox multiple regression model, after adjusting the model according to important risk factors, the AAPR and NAFLD risk were independently correlated, and with a gradual increase in the AAPR, the NAFLD risk decreased gradually (HR: 0.61, 95% CI: 0.47, 0.81; P-trend< 0.0001). Additionally, there were significant interactions between the AAPR and BMI, blood pressure and lipids (P-interaction < 0.05). Stratified analysis showed that the risk of AAPR-related NAFLD decreased in people with normal blood pressure and lipid levels, while the risk of AAPR-related NAFLD increased abnormally in people who were underweight. Conclusions This longitudinal cohort study provides the first evidence that the AAPR is an independent predictor of future NAFLD events in non-obese people. For non-obese people with a low AAPR, especially those with BMI < 18.5 kg/m2, more attention should be given to the management of risk factors for NAFLD to prevent future NAFLD. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01479-9.
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Affiliation(s)
- Guotai Sheng
- Cardiology Department, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, 330006, China
| | - Nan Peng
- Cardiology Department, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, 330006, China
| | - Chong Hu
- Gastroenterology Department, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, 330006, China
| | - Ling Zhong
- Pediatrics Department, Lishui People's Hospital, Lishui, 323000, China
| | - Mingchun Zhong
- Cardiology Department, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, 330006, China
| | - Yang Zou
- Cardiology Department, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, 330006, China.
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