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Fu DF, Chen B. The relationship between the systemic immune inflammation index and the nonalcoholic fatty liver disease in American adolescents. BMC Gastroenterol 2024; 24:233. [PMID: 39044158 PMCID: PMC11267776 DOI: 10.1186/s12876-024-03324-6] [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: 02/23/2024] [Accepted: 07/15/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a growing health crisis in the general population of the United States (U.S.), but the relationship between systemic immune-inflammation (SII) index and NAFLD is not known. METHODS We collected data from the National Health and Nutrition Examination Survey 2017-2018. Next, propensity score matching (PSM), collinearity analysis, restricted cubic spline (RCS) plot, logistic regression, quantile regression analysis, subgroup analysis, mediation analysis, and population attributable fraction were used to explore the association of the SII with risk of NAFLD. RESULTS A total of 665 participants including the 532 Non-NAFLD and 133 NAFLD were enrolled for further analysis after PSM analysis. The RCS results indicated that there was a linear relationship between the SII and controlled attenuation parameter (p for nonlinear = 0.468), the relationship also existed after adjustment for covariates (p for nonlinear = 0.769). The logistic regression results indicated that a high SII level was an independent risk factor for NAFLD (OR = 3.505, 95% CI: 1.092-11.249, P < 0.05). The quantile regression indicated that at higher quantiles (0.90, and 0.95) the SII was significantly associated with NAFLD (p < 0.05). Mediation analysis indicated that alanine aminotransferase (ALT), triglycerides, and blood urea nitrogen (BUN) were partially contribute to the relationship between SII and NAFLD. The population attributable fractions indicated that 23.19% (95% CI: 8.22%, 38.17%) of NAFLD cases could be attributed to SII corresponding to 133 NAFLD cases. CONCLUSION There was a positive linear relationship between the SII and the risk of NAFLD. The ALT, triglycerides, and BUN had a partial mediating effect on the relationship between the SII and NAFLD.
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Affiliation(s)
- Dong-Fang Fu
- Department of Ultrasound, Hangzhou Xiaoshan First People's Hospital, No.199, Shixin South Road, Xiaoshan District, Hangzhou, Zhejiang, 311201, China
| | - Bin Chen
- Department of Ultrasound, Hangzhou Xiaoshan First People's Hospital, No.199, Shixin South Road, Xiaoshan District, Hangzhou, Zhejiang, 311201, China.
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2
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Wang R, Yan R, Jiao J, Li F, Zhang H, Chang Z, Wei H, Yan S, Li J. Fruit and vegetable intake and the risk of non-alcoholic fatty liver disease: a meta-analysis of observational studies. Front Nutr 2024; 11:1398184. [PMID: 38974809 PMCID: PMC11224539 DOI: 10.3389/fnut.2024.1398184] [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: 03/09/2024] [Accepted: 06/03/2024] [Indexed: 07/09/2024] Open
Abstract
Purpose This systematic review and meta-analysis of clinical observational studies aims to clarify the correlation between the intake levels of fruits and vegetables and non-alcoholic fatty liver disease (NAFLD). Materials and methods PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies on the association between vegetable or fruit intake with the risk of NAFLD from the foundation of each database up until September 2023. The relative risk (OR) and the 95% confidence interval (CI) were pooled for both the highest and lowest consumption levels of vegetables and fruits to explore their association with the incidence of NAFLD. Results The meta-analysis encompassed 11 studies with a total of 493,682 patients. A higher consumption of vegetables (OR = 0.78, 95% CI = 0.67-0.91) and fruits (OR = 0.88, 95% CI = 0.83-0.93) was found to have a negative correlation with the risk of NAFLD, denoting an inverse association. This correlation, however, varied among different ethnic groups and gender. Conclusions Our results indicate that increased consumption of vegetables and fruits is associated with a reduced likelihood of developing NAFLD. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, identifier: CRD42023460430.
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Affiliation(s)
- Rui Wang
- The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Ruijuan Yan
- Department of Hepatology, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Junzhe Jiao
- Department of Hepatology, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Feilong Li
- School of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, China
| | - Haibo Zhang
- Advanced Instituted of Medicine Sciences, Dalian Medical University, Dalian, China
| | - Zhanjie Chang
- Department of Hepatology, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Hailiang Wei
- Department of General Surgery, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Shuguang Yan
- The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Jingtao Li
- Department of Hepatology, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
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Skudder-Hill L, Sequeira-Bisson IR, Ko J, Cho J, Poppitt SD, Petrov MS. Remnant cholesterol, but not low-density lipoprotein cholesterol, is associated with intra-pancreatic fat deposition. Diabetes Obes Metab 2023; 25:3337-3346. [PMID: 37529874 DOI: 10.1111/dom.15233] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 08/03/2023]
Abstract
AIM To investigate the associations of components of the lipid panel (and its derivatives) with intra-pancreatic fat deposition (IPFD). METHODS All participants underwent abdominal magnetic resonance imaging on the same 3.0-Tesla scanner and IPFD was quantified. Blood samples were collected in the fasted state for analysis of lipid panel components. A series of linear regression analyses was conducted, adjusting for age, sex, ethnicity, body mass index, fasting plasma glucose, homeostatic model assessment of insulin resistance, and liver fat deposition. RESULTS A total of 348 participants were included. Remnant cholesterol (P = 0.010) and triglyceride levels (P = 0.008) were positively, and high-density lipoprotein cholesterol level (P = 0.001) was negatively, associated with total IPFD in the most adjusted model. Low-density lipoprotein cholesterol and total cholesterol were not significantly associated with total IPFD. Of the lipid panel components investigated, remnant cholesterol explained the greatest proportion (9.9%) of the variance in total IPFD. CONCLUSION Components of the lipid panel have different associations with IPFD. This may open up new opportunities for improving outcomes in people at high risk for cardiovascular diseases (who have normal low-density lipoprotein cholesterol) by reducing IPFD.
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Affiliation(s)
| | - Ivana R Sequeira-Bisson
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
- High Value Nutrition, National Science Challenge, Auckland, New Zealand
| | - Juyeon Ko
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - Jaelim Cho
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sally D Poppitt
- School of Medicine, University of Auckland, Auckland, New Zealand
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
- High Value Nutrition, National Science Challenge, Auckland, New Zealand
| | - Maxim S Petrov
- School of Medicine, University of Auckland, Auckland, New Zealand
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Zhang C, Zhang D, Huang H, Lu X, Shi H, Liu K, Guo X, Zhang R, Wang H. Cathepsin D mediates prenatal caffeine exposure-caused NAFLD susceptibility in male rat offspring by regulating autophagy. Free Radic Biol Med 2023; 208:684-699. [PMID: 37743032 DOI: 10.1016/j.freeradbiomed.2023.09.026] [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: 05/03/2023] [Revised: 09/16/2023] [Accepted: 09/22/2023] [Indexed: 09/26/2023]
Abstract
Epidemiological evidence has revealed that non-alcoholic fatty liver disease (NAFLD) harbors an intrauterine origin. Autophagy is known to be involved in the protective mechanism in the development of adult NAFLD, but whether it engages in the occurrence of fetal-originated NAFLD remains unclear. In this study, a rat model of fetal-originated NAFLD was established by giving a high-fat diet or chronic stress after birth on prenatal caffeine exposure (PCE) male offspring. The alterations of liver morphologic analysis, lipid metabolism, and autophagy before and after birth were determined to confirm autophagy mechanism, NAFLD susceptibility, and intrauterine origin in PCE male adult offspring. Our results revealed that PCE-induced intrauterine high concentration of corticosterone exposure blocked autophagic flux by inhibiting cathepsin D expression in hepatocytes, leading to β-oxidation inhibition and lipid accumulation in the liver. Moreover, high concentration of corticosterone upregulated miR-665 by activating the glucocorticoid receptor to suppress cathepsin D, thus causing lysosomal degradation dysfunction and autophagy flux blockade. Notably, hepatic overexpression of cathepsin D could reverse PCE-induced postnatal NAFLD susceptibility in male rat offspring. This study elucidates the epigenetic programming mechanism of intrauterine autophagy-related fetal-originated NAFLD susceptibility, and identifies cathepsin D as its early intervention target, providing an experimental basis for exploring early prevention and treatment strategies for fetal-originated NAFLD.
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Affiliation(s)
- Cong Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Dingmei Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Hegui Huang
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China; Wuhan No.1 Hospital, Wuhan, 430022, China
| | - Xiaoqian Lu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Huasong Shi
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Kexin Liu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Xiaoling Guo
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Rui Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Hui Wang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
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Xu J, Tian H, Ji Y, Dong L, Liu Y, Wang Y, Gao X, Shi H, Li H, Yang L. Urolithin C reveals anti-NAFLD potential via AMPK-ferroptosis axis and modulating gut microbiota. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:2687-2699. [PMID: 37126194 DOI: 10.1007/s00210-023-02492-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/11/2023] [Indexed: 05/02/2023]
Abstract
The pharmacology of urolithin C (UroC) on non-alcoholic fatty liver disease (NAFLD) is largely undetermined. We sought to investigate the potential for NAFLD improvement by administration of UroC and the underlying mechanisms. We verified the therapeutic effect of UroC on choline-deficient amino acid-defined high fat diet (CDAHFD) induced NAFLD mice via evaluating NAFLD activity score (NAS), AST, ALT, hepatic phosphorylated AMPK, and 4-hydroxynonenal. Oleic acid-induced AML12 cell was appraised by oil red staining and western blotting to explore the effect and mechanism of UroC in vitro. Transcriptional regulation of UroC was explored by liver RNA sequencing, gut microbiota composition was explored by 16SrRNA sequencing, and colorectal tight junctional proteins were detected by western blotting and immunohistochemistry. The detrimental effects of CDAHFD included the increased liver index, AST, ALT, hepatic 4-hydroxynonenal, impaired intestinal mucosal barrier, and most importantly, pathological damage in liver. Oral administration of UroC largely protected against these harmful alterations. Remarkably, both RNA sequencing and western blotting results indicated an activation in hepatic AMPK signaling pathway which was thought to inhibit ferroptosis response to UroC in vivo, while no change were found in AMPK-ferroptosis axis response to UroC in oleic acid-induced AML12 cells, hinted an indispensable linkage between UroC and hepatic AMPK, presumably the gut-liver axis. Furthermore, UroC could neither alleviate lipid deposition nor inhibit ferroptosis in vitro. The 16SrRNA showed UroC partially counteracted the dysbiosis induced by CDAHFD. Specifically, UroC reversed the elevated proportion of Firmicutes/Bacteroidota and enhanced the level of Parabacteroides goldsteinii and Lactobacillus vaginalis, which played a beneficial role in metabolic disorders. Oral administration of Urolithin C protected against the detrimental impact of CDAHFD via regulating AMPK-ferroptosis axis, maintaining intestinal mucosal barrier and counteracting gut dysbiosis.
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Affiliation(s)
- Jingyuan Xu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
- Department of Gastroenterology, Shanghai Pudong Hospital, Shanghai, 201399, China
| | - Hongyang Tian
- Department of Gastroenterology, Shanghai Pudong Hospital, Shanghai, 201399, China
- Minhang District Shenxin Community Health Service Center, Shanghai, 201108, China
| | - Yajun Ji
- Department of Gastroenterology, Shanghai Pudong Hospital, Shanghai, 201399, China
- Huamu Community Health Service Center, Shanghai, 201204, China
| | - Lei Dong
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Yandong Liu
- Department of Gastroenterology, Shanghai Pudong Hospital, Shanghai, 201399, China
| | - Yatao Wang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Xuefen Gao
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Haitao Shi
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.
| | - Hong Li
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.
| | - Longbao Yang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.
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Avelar-Rodríguez D, Peña-Vélez R, Popov J, Hill L, Ryan PM. Probiotics and non-alcoholic fatty liver disease in children and adolescents: a systematic review. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2023; 115:418-427. [PMID: 36412490 DOI: 10.17235/reed.2022.8796/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND non-alcoholic fatty liver disease (NAFLD) in childhood is an increasing global public health issue with significant long-term consequences. NAFLD management mainly consists of lifestyle modifications, however, adjunct pharmacological therapies are currently lacking. Gut microbiota manipulation via probiotics may alter the course of pediatric NAFLD. The objective of this systematic review was to synthesize all the available literature on the use of probiotics in children and adolescents with NAFLD. METHODS PubMed, EBSCOhost, Scopus, Web of Science, and Cochrane Library were systematically searched for trials on the use of probiotics in pediatric NAFLD. A quantitative DerSimonian Laird random effects meta-analysis was performed when possible; otherwise, a narrative summary of the study outcomes was presented and discussed. A separate search was completed to include all the ongoing registered trials on probiotics use in pediatric NAFLD. RESULTS five randomized controlled trials met the inclusion criteria. Of these, four trials were included in the final quantitative analysis. Probiotic therapy significantly reduced the levels of alanine aminotransferase (ALT) (mean difference: -10.39 [-19.85, -0.93]), however significant heterogeneity between studies was identified (I2, 93 %). CONCLUSIONS there is insufficient evidence to support probiotics in the treatment of pediatric NAFLD given the substantial degree of discordance amongst the available trials. Lifestyle modifications focusing on maintaining a normal BMI and regular exercise continue to be the gold standard approach to treating NAFLD in children.
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Affiliation(s)
| | - Rubén Peña-Vélez
- Gastroenterología y Nutrición, Hospital General de Puebla "Dr. Eduardo Vázquez N", México
| | - Jelena Popov
- College of Medicine and Health. University College Cork
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What do we know about nutrient-based strategies targeting molecular mechanisms associated with obesity-related fatty liver disease? Ann Hepatol 2023; 28:100874. [PMID: 36371078 DOI: 10.1016/j.aohep.2022.100874] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022]
Abstract
Obesity is a risk factor for developing nonalcoholic fatty liver disease (NAFLD), and the associated molecular mechanisms could be targeted with nutrient-based strategies. Therefore, it is necessary to review the current mechanisms to propose further treatments. Obesity facilitates the onset of insulin resistance, lipidic abnormalities, hepatic fat accumulation, lipid peroxidation, mitochondrial dysfunction, excessive reactive oxygen species (ROS) production, and inflammation, all related to further steatosis progression and fibrosis. Microbiota alterations can also influence liver disease by the translocation of pathogenic bacteria, energy extraction from short chain fatty acids (SCFAs), intestinal suppression of the expression of fasting-induced adipose factor (FIAF), reduction of bile acids, and altered choline metabolism. There are also genetic polymorphisms in metabolic proteins that predispose to a higher risk of liver diseases, such as those found in the patatin-like phospholipase domain-containing 3 (PNPLA3), transmembrane 6 superfamily member 2 (TM6SF2), membrane-bound O-acyltransferase domain-containing 7 (MBOAT7) or also known as lysophosphatidylinositol acyltransferase 1 (LPIAT1), transmembrane channel-like 4 genes (TMC4), fat mass and obesity-associated protein (FTO), the b Klotho (KLB) and carboxylesterase (CES1). No clear dietary guidelines target all mechanisms related to NAFLD development and progression. However, energy and carbohydrate intake restriction, regular physical exercise, supplementation of antioxidants, and restoration of gut microbiota seem to have beneficial effects on the new proposed features of NAFLD.
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He B, Zhang Q, Guo Y, Ao Y, Tie K, Xiao H, Chen L, Xu D, Wang H. Prenatal smoke (Nicotine) exposure and offspring's metabolic disease susceptibility in adulthood. Food Chem Toxicol 2022; 168:113384. [PMID: 36041661 DOI: 10.1016/j.fct.2022.113384] [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: 01/24/2022] [Revised: 08/06/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022]
Abstract
Exposure to smoking (nicotine) during pregnancy not only directly affects fetal development, but also increases susceptibility to metabolic diseases in adulthood, but the mechanism of action remains unclear. Here, we review epidemiological and laboratory studies linking these relationships. In addition to the direct effect of nicotine on the fetus, intrauterine neuroendocrine-metabolic programming mediated by maternal glucocorticoid overexposure also plays an important role, involving glucocorticoid-insulin-like growth factor 1 (GC-IGF1) axis, hypothalamic-pituitary-adrenal (HPA) axis, renin-angiotensin system (RAS) and other endocrine systems. Epigenetics is involved in intrauterine neuroendocrine-metabolic programming, metabolic disease susceptibility and multigenerational inheritance. There are "two programming" and "two strikes" mechanisms for the occurrence of fetal-originated metabolic diseases in adulthood. These innovative research summaries and academic viewpoints provide experimental and theoretical basis for systematically elucidating the occurrence and development of fetal-originated metabolic diseases.
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Affiliation(s)
- Bo He
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, 650500, China
| | - Qi Zhang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Yu Guo
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Ying Ao
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Kai Tie
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Hao Xiao
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Liaobin Chen
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Dan Xu
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China; Department of Pharmacy, Zhongnan Hospital of Wuhan University, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China.
| | - Hui Wang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
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Association between rs738408, rs738409 and rs139051polymorphisms in PNPLA3 gene and non-alcoholic fatty liver disease. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2021.101472] [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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Gluvic Z, Tomasevic R, Bojovic K, Obradovic M, Isenovic ER. Non-alcoholic fatty liver disease: a multidisciplinary clinical practice approach—the institutional adaptation to existing Clinical Practice Guidelines. EMERGENCY AND CRITICAL CARE MEDICINE 2021; 2:12-22. [DOI: 10.1097/ec9.0000000000000016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Abstract
Non-alcoholic fatty liver disease (NAFLD) is among the most frequently encountered chronic liver diseases in everyday clinical practice. It is considered the hepatic manifestation of metabolic syndrome. Today, liver biopsy is still the gold standard for NAFLD confirmation and assessing NAFLD's possible progression to non-alcoholic steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Because of the high prevalence of NAFLD and potential associated risks of invasive diagnostic procedures, it is of great interest to recruit the patients for liver biopsy. However, as the presence of liver fibrosis determines the further clinical course, liver biopsy is expectedly reserved for those with increased fibrosis risk. The quality of liver biopsy recruitment and patient monitoring could be significantly improved by using non-invasive tools to assess liver fibrosis presence and interactive collaboration between general practitioners, gastroenterologists, and endocrinologists. As a result, the quality of liver biopsy recruitment and patients monitoring could be significantly improved. Here, we proposed clinical practice guidelines that could be implemented for everyday clinical practice in NAFLD patients.
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Affiliation(s)
- Zoran Gluvic
- University Clinical-Hospital Centre Zemun-Belgrade, Clinic of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ratko Tomasevic
- University Clinical-Hospital Centre Zemun-Belgrade, Clinic of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ksenija Bojovic
- Clinical Centre of Serbia, Clinic of Infectious and Tropical Diseases, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Obradovic
- Department of Radiobiology and Molecular Genetics, “VINČA” Institute of Nuclear Sciences – National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Esma R. Isenovic
- Department of Radiobiology and Molecular Genetics, “VINČA” Institute of Nuclear Sciences – National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Maternal high-fat diet consumption programs male offspring to mitigate complications in liver regeneration. J Dev Orig Health Dis 2021; 13:575-582. [PMID: 34857059 DOI: 10.1017/s2040174421000659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the last decades, obesity and nonalcoholic fatty liver disease (NAFLD) have become increasingly prevalent in wide world. Fatty liver can be detrimental to liver regeneration (LR) and offspring of obese dams (HFD-O) are susceptible to NAFLD development. Here we evaluated LR capacity in HFD-O after partial hepatectomy (PHx). HFD-O re-exposed or not to HFD in later life were evaluated for metabolic parameters, inflammation, proliferation, tissue repair markers and survival rate after PHx. Increasing adiposity and fatty liver were observed in HFD-O. Despite lower IL-6 levels, Ki67 labeling, cells in S phase and Ciclin D1/PCNA protein content, a lower impact on survival rate was found after PHx, even when re-exposed to HFD. However, no difference was observed between offspring of control dams (SC-O) and HFD-O after surgery. Although LR impairment is dependent of steatosis development, offspring of obese dams are programmed to be protected from the damage promoted by HFD.
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Parameswaran M, Hasan HA, Sadeque J, Jhaveri S, Avanthika C, Arisoyin AE, Dhanani MB, Rath SM. Factors That Predict the Progression of Non-alcoholic Fatty Liver Disease (NAFLD). Cureus 2021; 13:e20776. [PMID: 35111461 PMCID: PMC8794413 DOI: 10.7759/cureus.20776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2021] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) refers to a spectrum of diseases involving the deposition of fat in the hepatocytes of people with little to no alcohol consumption. NAFLD is associated with hypertension, diabetes, obesity, etc. As their prevalence increases, the propensity and severity of NAFLD might increase. As per the recently developed multi-hit hypothesis, factors like oxidative stress, genetic predisposition, lipotoxicity, and insulin resistance have been found to play a key role in the development of NAFLD and its associated complications. This article focuses on NAFLD, its pathophysiology, risk factors, and the various genetic and epigenetic factors involved in its development along with possible treatment modalities. We conducted an all-language literature search on Medline, Cochrane, Embase, and Google Scholar until October 2021. The following search strings and Medical Subject Heading (MeSH) terms were used: “NAFLD,” “NASH,” “Fibrosis,” and “Insulin Resistance.” We explored the literature on NAFLD for its epidemiology, pathophysiology, the role of various genes, and how they influence the disease and associated complications about the disease and its hepatic and extrahepatic complications. With its rapidly increasing prevalence rates across the world and serious complications like NASH and hepatocellular carcinoma, NAFLD is becoming a major public health issue and more research is needed to formulate better screening tools and treatment protocols.
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Affiliation(s)
| | | | - Jafor Sadeque
- Internal Medicine, Al Mostaqbal Hospital, Jeddah, SAU
| | - Sharan Jhaveri
- Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | | | | | - Maulik B Dhanani
- Internal Medicine, Southwestern University School of Medicine, Cebu City, PHL
| | - Swaroopa M Rath
- Medicine, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, IND
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Shen L, Xie L, Chen L, Liu L, Shi X, Wang X, Chen D, Wang H, Quan S, Wang Z. Resveratrol reverses the programmed high-susceptibility to non-alcoholic fatty liver disease by targeting the hepatic SIRT1-SREBP1c pathway in prenatal ethanol-exposed rat offspring. J Toxicol Sci 2021; 46:413-423. [PMID: 34470993 DOI: 10.2131/jts.46.413] [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: 11/02/2022]
Abstract
An increased susceptibility to non-alcoholic fatty liver disease (NAFLD) in female rat offspring that experienced prenatal ethanol exposure (PEE) has been previously demonstrated. The present study further investigated the potential mechanism. Based on the results from both fetal and adult studies of offspring rats that experienced PEE (4 g/kg/day), the fetal weight, serum glucose and triglyceride levels decreased significantly and hepatocellular ultra-structure was altered. Fetal livers exhibited inhibited expression and activity of sirtuin 1 (SIRT1), enhanced expression of lipogenic genes: sterol regulatory element binding protein 1c (SREBP1c), fatty acid synthase (FASN), acetyl-coenzyme A carboxylase α (ACCα), stearyl-coenzyme A desaturase 1 (SCD1). In adult offspring fed with high-fat diet, the PEE offspring revealed obviously catch-up growth, increased food intake, elevated serum metabolic phenotypes, suppressed hepatic SIRT1-SREBP1c pathway, and formation of NAFLD. Resveratrol (the chemical activator of SIRT1) could remarkably reverse the serum metabolic phenotypes and alleviate the hepatocyte steatosis in relation to the PEE offspring through activating the hepatic SIRT1-SREBP1c pathway. Therefore, increased susceptibility to diet-induced NAFLD in PEE offspring appears to be mediated by intrauterine programming of hepatic lipogenesis via the SIRT1-SREBP1c pathway. This altered programming effect could partially be reversed by resveratrol intervention after birth in PEE offspring rats.
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Affiliation(s)
- Lang Shen
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, China
| | - Lijia Xie
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, China
| | - Li Chen
- Guangzhou Institute of Pediateics, Guangzhou Women and Children's Medical Center, China
| | - Li Liu
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, China
| | - Xiao Shi
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, China
| | - Xiaocong Wang
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, China
| | - Donghong Chen
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, China
| | - Hui Wang
- Department of Pharmacology, Basic Medical School of Wuhan University, China.,Hubei Provincial Key Laboratory of Developmentally Originated Disease, China
| | - Song Quan
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, China
| | - Zhijian Wang
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, China
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Poon SWY, Wong WHS, Tsang AMC, Poon GWK, Tung JYL. Who should return for an oral glucose tolerance test? A proposed clinical pathway based on retrospective analysis of 332 children. J Pediatr Endocrinol Metab 2021; 34:877-884. [PMID: 33866699 DOI: 10.1515/jpem-2020-0689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/13/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Fasting plasma glucose or oral glucose tolerance test (OGTT) is the traditional diagnostic tool for type 2 diabetes (T2DM). However, fasting is required and implementation in all overweight/obese subjects is not practical. This study aimed to formulate a clinical pathway to stratify subjects according to their risk of abnormal OGTT. METHODS This retrospective study included patients with overweight or obesity who had undergone OGTT in a tertiary paediatric unit from 2012 to 2018. The optimal haemoglobin A1c (HbA1c) cutoff that predicts abnormal OGTT was evaluated. Other non-fasting parameters, in combination with this HbA1c cutoff, were also explored as predictors of abnormal OGTT. RESULTS Three hundred and thirty-two patients (boys: 54.2%, Chinese: 97.3%) were included for analysis, of which, 272 (81.9%) patients had normal OGTT while 60 (18.0%) patients had abnormal OGTT (prediabetes or T2DM). Optimal HbA1c predicting abnormal OGTT was 5.5% (AUC 0.71; sensitivity of 66.7% and specificity of 71%). When HbA1c≥5.5% was combined with positive family history and abnormal alanine transaminase (ALT) level, the positive predictive value for abnormal OGTT was increased from 33.6 to 61.6%. CONCLUSIONS HbA1c, family history of T2DM and ALT level could be used to derive a clinical pathway to stratify children who have high risk of abnormal OGTT.
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Affiliation(s)
- Sarah Wing-Yiu Poon
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Wilfred Hing-Sang Wong
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Anita Man-Ching Tsang
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Grace Wing-Kit Poon
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Joanna Yuet-Ling Tung
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
- Department of Paediatrics, Hong Kong Children's Hospital, Hong Kong, Hong Kong
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El Amrousy D, El Ashry H, Maher S, Ganna S, Hasan S. Pulmonary function test abnormalities in children and adolescents with non-alcoholic fatty liver disease. Eur J Pediatr 2021; 180:1693-1699. [PMID: 33479799 DOI: 10.1007/s00431-021-03941-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 02/06/2023]
Abstract
Association between pulmonary function tests (PFTs) and non-alcoholic fatty liver disease (NAFLD) has been reported in adult studies; however, there is lack of pediatric studies. Our study aimed to evaluate PFTs in children with NAFLD. A total of 137 children with NAFLD and 100 healthy children of matched age and sex were included in the study. Different PFTs including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, residual volume (RV), and total lung capacity (TLC) were performed for all included children. Lipid profile, insulin resistance, fasting and postprandial glucose level, and high sensitive C reactive protein (hs-CRP) were measured. FEV1 %, FVC %, FEV1/FVC ratio, RV, and TLC were significantly lower in the patient group compared with the control group (P < 0.05), while RV and hs-CRP were significantly higher in children with NAFLD. Restrictive lung dysfunction was the commonest pulmonary dysfunction detected in children with NAFLD (21.9%). PFT indices were significantly correlated with grade and duration of NAFLD, insulin resistance, waist circumference, and hs-CRP. Regression analysis revealed that insulin resistance and hs-CRP were independently associated with decreased PFT indices.Conclusion: PFT indices were impaired in children with NAFLD and this impairment was independently associated with insulin resistance and hs-CRP. What is Known: • Pulmonary function tests (PFTs) abnormalities are common in adults with nonalcoholic fatty liver disease (NAFLD). • Studies involving PFTs abnormalities in pediatric NAFLD are lacking. What is New: • It is the first study that assessed PFT in pediatric patients with NAFLD. • PFTs abnormalities are present in children with NAFLD. • Insulin resistance and high sensitive C reactive protein are independently associated with the decline of PFTs in children with NAFLD.
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Affiliation(s)
- Doaa El Amrousy
- Pediatric Department, Faculty of Medicine, Tanta University, El motasem street No 6, Tanta, Egypt.
| | - Heba El Ashry
- Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Sara Maher
- Theodor Bilharz Research Institute, Cairo, Egypt
| | - Salwa Ganna
- Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Samir Hasan
- Pediatric Department, Faculty of Medicine, Tanta University, El motasem street No 6, Tanta, Egypt
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Katz SF, Rodriguez F, Knowles JW. Health disparities in cardiometabolic risk among Black and Hispanic youth in the United States. Am J Prev Cardiol 2021; 6:100175. [PMID: 34327498 PMCID: PMC8315636 DOI: 10.1016/j.ajpc.2021.100175] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/10/2021] [Accepted: 03/12/2021] [Indexed: 12/18/2022] Open
Abstract
Cardiometabolic risk factors in children and adolescents track into adulthood and are associated with increased risk of atherosclerotic cardiovascular disease. The purpose of this review is to examine the pervasive race and ethnic disparities in cardiometabolic risk factors among Black and Hispanic youth in the United States. We focus on three traditional cardiometabolic risk factors (obesity, type 2 diabetes mellitus, and dyslipidemia) as well as on the emerging cardiometabolic risk factor of non-alcoholic fatty liver disease. Additionally, we highlight interventions aimed at improving cardiometabolic health among these minority pediatric populations. Finally, we advocate for continued research on effective prevention strategies to reduce cardiometabolic risk and avert further disparities in cardiovascular morbidity and mortality.
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Affiliation(s)
- Sophia Figueroa Katz
- Stanford Department of Medicine, Cardiovascular Medicine, Cardiovascular Institute, Prevention Research Center, Stanford University, Room CV273, MC 5406, 300 Pasteur Drive, Stanford, CA 94305, USA
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, 9500 Euclid Avenue NA21, Cleveland, OH 44195, USA
| | - Fatima Rodriguez
- Stanford Department of Medicine, Cardiovascular Medicine, Cardiovascular Institute, Prevention Research Center, Stanford University, Room CV273, MC 5406, 300 Pasteur Drive, Stanford, CA 94305, USA
| | - Joshua W. Knowles
- Stanford Department of Medicine, Cardiovascular Medicine, Cardiovascular Institute, Prevention Research Center, Stanford University, Room CV273, MC 5406, 300 Pasteur Drive, Stanford, CA 94305, USA
- The FH Foundation, Pasadena, CA 91101, USA
- Stanford Diabetes Research Center, Stanford, CA 94305, USA
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Mehmood A, Zhao L, Wang Y, Pan F, Hao S, Zhang H, Iftikhar A, Usman M. Dietary anthocyanins as potential natural modulators for the prevention and treatment of non-alcoholic fatty liver disease: A comprehensive review. Food Res Int 2021; 142:110180. [PMID: 33773656 DOI: 10.1016/j.foodres.2021.110180] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 01/18/2021] [Accepted: 01/24/2021] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) refers to a metabolic syndrome linked with type 2 diabetes mellitus, obesity, and cardiovascular diseases. It is characterized by the accumulation of triglycerides in the hepatocytes in the absence of alcohol consumption. The prevalence of NAFLD has abruptly increased worldwide, with no effective treatment yet available. Anthocyanins (ACNs) belong to the flavonoid subclass of polyphenols, are commonly present in various edible plants, and possess a broad array of health-promoting properties. ACNs have been shown to have strong potential to combat NAFLD. We critically assessed the literature regarding the pharmacological mechanisms and biopharmaceutical features of the action of ACNs on NAFLD in humans and animal models. We found that ACNs ameliorate NAFLD by improving lipid and glucose metabolism, increasing antioxidant and anti-inflammatory activities, and regulating gut microbiota dysbiosis. In conclusion, ACNs have potential to attenuate NAFLD. However, further mechanistic studies are required to confirm these beneficial impacts of ACNs on NAFLD.
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Affiliation(s)
- Arshad Mehmood
- Beijing Advance Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
| | - Lei Zhao
- Beijing Advance Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China.
| | - Yong Wang
- Academy of National Food and Strategic Reserves Administration, Beijing 100037, China
| | - Fei Pan
- Beijing Advance Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
| | - Shuai Hao
- Beijing Advance Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
| | - Huimin Zhang
- Beijing Advance Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
| | - Asra Iftikhar
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, The University of Faisalabad, Faisalabad 38000, Pakistan
| | - Muhammad Usman
- Beijing Advance Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
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Sun Y, Tan Z, Jiang Z, Li M, Wang W, Huang Y, Sun J. Comparative efficacy and safety of traditional Chinese patent medicine for NAFLD in childhood or adolescence: A protocol for a Bayesian network meta analysis. Medicine (Baltimore) 2021; 100:e24277. [PMID: 33546051 PMCID: PMC7837984 DOI: 10.1097/md.0000000000024277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease is a common reason for chronic liver disease in children and adults. The increasing incidence of the disease has become one of the most critical public health problems in the 21st century, closely related to genetic and environmental factors. So far, apart from changing lifestyle and diet, modern medicine still lacks effective treatment measures. Chinese patent medicine has the advantages of apparent curative effect, overall regulation and fewer side effects. However, there is a lack of research on the simultaneous comparison of various Chinese patent medicines. Therefore, we used a reticular meta-analysis to indirectly compare the efficacy and safety of different oral Chinese patent medicines through standard reference. METHOD We will conduct a comprehensive and systematic search of Chinese and English databases from the beginning to December 2020. All randomized controlled trials (RCTs) of oral Chinese patent medicine for NAFLD in children will be searched. The 2 researchers then independently filter the retrieved literature, extract the data according to the data extraction table and assess the risk of bias. We will perform a pair of meta-analyses and a Bayesian network meta-analysis. STATA and Win BUGS software will be used for data analysis. RESULTS This study will thoroughly compare and analyze the differences in the efficacy of all kinds of TCPM in NAFLD treatment in childhood or adolescence. CONCLUSION This study will provide reference and evidence support for clinical drug selection optimization. ETHICS AND DISSEMINATION This study does not require ethical approval. INPLASY REGISTRATION NUMBER 2020120068.
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Affiliation(s)
- Yuli Sun
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Zhaofeng Tan
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Zhenyuan Jiang
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Min Li
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Weiqin Wang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Yaoyao Huang
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Jianguang Sun
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
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Intrauterine growth restriction: Clinical consequences on health and disease at adulthood. Reprod Toxicol 2021; 99:168-176. [DOI: 10.1016/j.reprotox.2020.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 02/06/2023]
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20
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Mohan V, Mehreen T, Harish R, Kamalesh R, Anjana R. Non-alcoholic fatty liver disease in Asian Indian adolescents and young adults: Prevalence and its associated risk factors. JOURNAL OF DIABETOLOGY 2021. [DOI: 10.4103/jod.jod_104_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Anti-inflammatory Mechanism of Ruzu Bitters on Diet-Induced Nonalcoholic Fatty Liver Disease in Male Wistar Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:5246725. [PMID: 32774420 PMCID: PMC7395997 DOI: 10.1155/2020/5246725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/13/2020] [Indexed: 01/17/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) has become notorious globally. Increasingly emerging evidence shows that NAFLD is strongly associated with inflammation, with proinflammatory cytokines such as interleukin-2 (IL-2), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α) playing a vital role in its progression. In this work, an attempt was made to verify the anti-inflammatory activity of Ruzu herbal bitters (RHB), an antiobesity medicinal concoction, on NAFLD induced by a high-fat diet (HFD) in albino Wistar rats. Twenty-five (25) rats were divided into five groups as follows: Group 1, the normal control, was maintained on standard rat chow and received normal saline (1 ml/kg body weight (BW)/day) for twelve weeks. The other groups were maintained on HFD for twelve weeks. Thereafter, groups 2–5 were treated with pioglitazone (4 mg/kg BW/day), RHB (0.6 ml/kg BW/day), normal saline (1 ml/kg BW/day), and fenofibrate (10 mg/kg BW/day), respectively. The animals were sacrificed after the experimental period. Biochemical indicators of oxidative stress and inflammation were assayed in the liver according to standard methods. The histological features of the liver were also compared to assess liver damage. RHB significantly (p < 0.05) reduced body weight and liver index, inhibited oxidative stress, boosted antioxidant enzymes by increasing the activity and level of SOD and GSH, reduced proinflammatory markers (IL-2, IL-6, TNF-α), and reversed histological alterations induced by NAFLD in rat liver. In conclusion, the anti-inflammatory activity of RHB in the prevention of NAFLD in rats has been confirmed.
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Qi J, Kim JW, Zhou Z, Lim CW, Kim B. Ferroptosis Affects the Progression of Nonalcoholic Steatohepatitis via the Modulation of Lipid Peroxidation-Mediated Cell Death in Mice. THE AMERICAN JOURNAL OF PATHOLOGY 2019; 190:68-81. [PMID: 31610178 DOI: 10.1016/j.ajpath.2019.09.011] [Citation(s) in RCA: 177] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/28/2019] [Accepted: 09/19/2019] [Indexed: 02/06/2023]
Abstract
Oxidative stress and its associated lipid peroxidation play a key role in nonalcoholic steatohepatitis (NASH). Ferroptosis is a recently recognized type of cell death characterized by an iron-dependent and lipid peroxidation-mediated nonapoptotic cell death. We demonstrate the impact of ferroptosis on the progression of NASH induced by methionine/choline-deficient diet (MCD) feeding for 10 days. RSL-3 (a ferroptosis inducer) treatment showed decreased hepatic expression of glutathione peroxidase 4 (GPX4) and conversely increased 12/15-lipoxygenase, and apoptosis-inducing factor, indicating that ferroptosis plays a key role in NASH-related lipid peroxidation and its associated cell death. Consistently, levels of serum biochemical, hepatic steatosis, inflammation, and apoptosis in MCD-fed mice were exacerbated with RSL-3 treatment. However, MCD-fed mice treated with sodium selenite (a GPX4 activator) showed increase of hepatic GPX4, accompanied by reduced NASH severity. To chelate iron, deferoxamine mesylate salt was used. Administration of deferoxamine mesylate salt significantly reduced NASH severity and abolished the harmful effects of RSL-3 in MCD-fed mice. Finally, treatment with liproxstatin-1 (a ferroptosis inhibitor) repressed hepatic lipid peroxidation and its associated cell death, resulting in decreased NASH severity. Consistent with the in vivo findings, modulation of ferroptosis/GPX4 affected hepatocellular death in palmitic acid-induced in vitro NASH milieu. We conclude that GPX4 and its related ferroptosis might play a major role in the development of NASH.
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Affiliation(s)
- Jing Qi
- Biosafety Research Institute and College of Veterinary Medicine (BK21 Plus Program), Jeonbuk National University, Iksan, South Korea
| | - Jong-Won Kim
- Biosafety Research Institute and College of Veterinary Medicine (BK21 Plus Program), Jeonbuk National University, Iksan, South Korea
| | - Zixiong Zhou
- Biosafety Research Institute and College of Veterinary Medicine (BK21 Plus Program), Jeonbuk National University, Iksan, South Korea
| | - Chae-Woong Lim
- Biosafety Research Institute and College of Veterinary Medicine (BK21 Plus Program), Jeonbuk National University, Iksan, South Korea
| | - Bumseok Kim
- Biosafety Research Institute and College of Veterinary Medicine (BK21 Plus Program), Jeonbuk National University, Iksan, South Korea.
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The Number of Liver Galectin-3 Positive Cells Is Dually Correlated with NAFLD Severity in Children. Int J Mol Sci 2019; 20:ijms20143460. [PMID: 31337151 PMCID: PMC6679049 DOI: 10.3390/ijms20143460] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/03/2019] [Accepted: 07/12/2019] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a complex disease ranging from steatosis to non-alcoholic steatohepatitis (NASH). Galectin-3 (Gal-3), which is a β-galactoside binding protein, has been associated with liver fibrosis, but its role in NAFLD remains elusive. We investigated the expression of Gal-3 in liver resident cells and its potential association with liver damage in 40 children with biopsy-proven NAFLD. We found that several liver cells expressed Gal-3. The number of total Gal-3 positive cells decreased with the severity of disease and the cells were correlated with the presence of steatosis and the diagnosis of NASH. CD68 macrophages expressed Gal-3 but the number CD68/Gal-3 positive cells was significantly reduced in patients diagnosed with steatosis and NASH. Triple CD68/CD206/Gal-3, which represented the subpopulation of M2 macrophages, were mainly present in patients without NASH, and clearly reduced in patients with steatosis and NASH. On the contrary, the number of α-smooth muscle actin (SMA)/Gal-3 positive cells increased with the severity of fibrosis in children with NAFLD. Our data demonstrated that the number of Gal-3 positive cells was associated with tissue damage in different ways, which suggests a dual role of this protein in the pathogenesis of pediatric NAFLD, even if the role of Gal-3 deserves further studies.
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Hull NC, Schooler GR, Lee EY. Hepatobiliary MR Imaging in Children:. Magn Reson Imaging Clin N Am 2019; 27:263-278. [DOI: 10.1016/j.mric.2019.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tayyem RF, Al-Dayyat HM, Rayyan YM. Relationship between lifestyle factors and nutritional status and non-alcoholic fatty liver disease among a group of adult Jordanians. Arab J Gastroenterol 2019; 20:44-49. [PMID: 30872135 DOI: 10.1016/j.ajg.2019.01.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 12/02/2018] [Accepted: 01/26/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND STUDY AIMS Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. NAFLD may progress from simple steatosis to nonalcoholic steatohepatitis, cirrhosis and finally decompensated liver failure. This study aims at assessing the relationship between lifestyle factors and nutrients intake and the development of non-alcoholic fatty liver disease (NAFLD) in a group of Jordanian adults 30-60 years of age. PATIENTS AND METHODS In this case-control study, a total of 120 Jordanian adults 30-60 years of age were recruited. Sixty NAFLD patients and 60 control subjects were enrolled. The diagnosis of NAFLD was made based on the basis of ultrasonography. Weight, height and waist circumference (WC) were measured and body mass index (BMI) was calculated. Nutrients intake and physical activity level were assessed using validated questionnaires. RESULTS The results showed that patients with NAFLD had a higher significant difference in BMI, WC, and weight compared to controls (p = 0.001). Physical activity level was significantly higher in control subjects than in cases (p = 0.001). The metabolic parameters were significantly different both groups. The mean daily intakes of macronutrients were significantly higher in cases than in control subjects (p = 0.001). A significant difference was detected in the daily intake of some vitamins and minerals among cases compared to control subjects (p < 0.05). CONCLUSION The present study supports the findings of the presence of a relationship between macro- and micronutrients intake and some anthropometric and biochemical variables and NAFLD.
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Affiliation(s)
- Reema Fayez Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan.
| | - Hanaa Mahmoud Al-Dayyat
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan
| | - Yaser Mohammed Rayyan
- Department of Gastroenterology & Hepatology, School of Medicine, University of Jordan, Amman, Jordan
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Panera N, Barbaro B, Della Corte C, Mosca A, Nobili V, Alisi A. A review of the pathogenic and therapeutic role of nutrition in pediatric nonalcoholic fatty liver disease. Nutr Res 2018; 58:1-16. [DOI: 10.1016/j.nutres.2018.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 02/06/2023]
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27
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Zhao J, Wang Y, Wu X, Tong P, Yue Y, Gao S, Huang D, Huang J. Inhibition of CCL19 benefits non‑alcoholic fatty liver disease by inhibiting TLR4/NF‑κB‑p65 signaling. Mol Med Rep 2018; 18:4635-4642. [PMID: 30221732 DOI: 10.3892/mmr.2018.9490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 08/21/2018] [Indexed: 11/06/2022] Open
Abstract
Non‑alcoholic fatty liver disease (NAFLD), which affects approximately one‑third of the general population, has become a global health problem. Thus, more effective treatments for NAFLD are urgently required. In the present study, high levels of C‑C motif ligand 19 (CCL19), signaling pathways such as Toll‑like receptor 4 (TLR4)/nuclear factor‑κB (NF‑κB), and proinflammatory factors including interleukin‑6 (IL‑6) and tumor necrosis factor‑α (TNF‑α) were detected in NAFLD patients, thereby indicating that there may be an association between CCL19 and these factors in NAFLD progression. Using a high‑fat diet (HFD), the present study generated a Sprague‑Dawley rat model of NAFLD, which displayed dyslipidemia with increased levels of plasma aspartate aminotransferase, alanine aminotransferase, total cholesterol and triglyceride. Dyslipidemia, liver histopathology and gene expression analyses indicated that the NAFLD model was successfully induced by HFD, and metformin and berberine (BBR) were effective treatments for NAFLD. HFD‑induced CCL19 levels and associated factors were markedly reduced by the two drug treatments. In addition, metformin or BBR alone significantly promoted adenosine monophosphate‑activated protein kinase (AMPK) phosphorylation, which was inhibited by HFD. These results demonstrated that metformin and BBR could improve NAFLD, which may be via the activation of AMPK signaling, and the high expression of CCL19 in NAFLD was significantly reduced by metformin and BBR. It could be inferred that inhibition of CCL19 may be an effective treatment for NAFLD.
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Affiliation(s)
- Jiajing Zhao
- Department of Traditional Chinese Medicine, Putuo District People's Hospital of Shanghai City, Shanghai 200060, P.R. China
| | - Yingjue Wang
- Department of Traditional Chinese Medicine, Putuo District People's Hospital of Shanghai City, Shanghai 200060, P.R. China
| | - Xi Wu
- Department of Endocrinology, Huashan Hospital, Fu Dan University, Shanghai 200040, P.R. China
| | - Ping Tong
- Department of Endocrinology, Putuo District People's Hospital of Shanghai City, Shanghai 200060, P.R. China
| | - Yaohan Yue
- Department of Traditional Chinese Medicine, Putuo District People's Hospital of Shanghai City, Shanghai 200060, P.R. China
| | - Shurong Gao
- Department of Traditional Chinese Medicine, Putuo District People's Hospital of Shanghai City, Shanghai 200060, P.R. China
| | - Dongping Huang
- Department of General Surgery, Putuo District People's Hospital of Shanghai City, Shanghai 200060, P.R. China
| | - Jianwei Huang
- Department of General Surgery, Putuo District People's Hospital of Shanghai City, Shanghai 200060, P.R. China
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Fang YL, Chen H, Wang CL, Liang L. Pathogenesis of non-alcoholic fatty liver disease in children and adolescence: From “two hit theory” to “multiple hit model”. World J Gastroenterol 2018; 24:2974-2983. [PMID: 30038464 PMCID: PMC6054950 DOI: 10.3748/wjg.v24.i27.2974] [Citation(s) in RCA: 219] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/26/2018] [Accepted: 06/27/2018] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has become the dominant form of chronic liver disease in children and adolescents with the increasing prevalence of obesity worldwide. NAFLD represents a wide spectrum of conditions, ranging from fatty liver - which generally follows a benign, non-progressive clinical course - to non-alcoholic steatohepatitis, a subset of NAFLD that may progress to cirrhosis and end-stage liver disease or liver carcinoma. The underlying pathophysiological mechanism of “pediatric” NAFLD remains unclear, although it is strongly associated with obesity and insulin resistance. In this review we provide a general overview on the current understanding of NAFLD in children and adolescents, which underpins practice, enabling early diagnosis and appropriate therapeutic intervention for this life-threatening liver disease.
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Affiliation(s)
- Yan-Lan Fang
- Department of Pediatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Hong Chen
- College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Chun-Lin Wang
- Department of Pediatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Li Liang
- Department of Pediatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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29
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Al-Dayyat HM, Rayyan YM, Tayyem RF. Non-alcoholic fatty liver disease and associated dietary and lifestyle risk factors. Diabetes Metab Syndr 2018; 12:569-575. [PMID: 29571977 DOI: 10.1016/j.dsx.2018.03.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/16/2018] [Indexed: 12/11/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver disease worldwide with a reported prevalence ranging 20-30% depending on the studied populations. The high prevalence of NAFLD is probably due to the contemporary epidemics of obesity, unhealthy dietary pattern, and sedentary lifestyle. NAFLD patients are at increased risk of cardiovascular and liver related mortality. The cornerstone of any treatment regimen for patients with NAFLD is lifestyle modification focused on weight loss, exercise, and improving insulin sensitivity. The purpose of this review is to outline the effect of diet and lifestyle factors on developing NAFLD.
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Affiliation(s)
- Hana'a Mahmoud Al-Dayyat
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan
| | - Yaser Mohammed Rayyan
- Department of Gastroenterology & Hepatology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Reema Fayez Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan.
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30
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Zhou Y, Yu S, Cai C, Zhong L, Yu H, Shen W. LXRɑ participates in the mTOR/S6K1/SREBP-1c signaling pathway during sodium palmitate-induced lipogenesis in HepG2 cells. Nutr Metab (Lond) 2018; 15:31. [PMID: 29743930 PMCID: PMC5932778 DOI: 10.1186/s12986-018-0268-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/17/2018] [Indexed: 02/06/2023] Open
Abstract
Background The aim of this study was to investigate how the signaling pathway downstream of mTOR/S6K1 contributes to the regulation of SREBP-1c expression during lipogenesis in HepG2 cells. Methods The model of steatosis was established using human hepatocytes HepG2 and inducting them with sodium palmitate. mTOR, S6K1 and LXRα were inhibited by rapamycin, PF-4708671 and siRNA-LXRα, respectively. After a variety of different treatment, the levels of intracellular triglycerides, the accumulation of lipid droplets and the expression levels of related genes were detected. Results Rapamycin, PF-4708671 and siRNA-LXRα treatment could decrease the accumulation of triglycerides and lipid droplets induced by sodium palmitate in HepG2 cells, and the inhibitory effect could be enhanced by the combination of them. Sodium palmitate stimulated the expression of genes encoding mTOR, S6K1, LXRα, SREBP-1c and SREBP-1c target enzymes (FAS and ACC1) in HepG2 cells. Moreover, these genes were sensitive to rapamycin. PF-4708671 also decreased the expression of these genes, except for the mTOR gene, and the extent of reduction could be enhanced by combination with rapamycin. Knockdown of LXRα decreased the expression of SREBP-1c, FAS and ACC1, but it had no effect on the expression of mTOR or S6K1. Furthermore, rapamycin and PF-4708671 enhanced the inhibitory effect of siRNA-LXRα. Conclusions mTOR/S6K1 regulates the SREBP-1c signaling pathway through LXRα in sodium palmitate-induced HepG2 cells, suggesting LXRα might be a potential therapeutic target for NAFLD.
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Affiliation(s)
- Youping Zhou
- 1Department of Gastroenterology, 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, 400010 China
| | - Shengjie Yu
- 2Department of Urology, 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, 400010 China
| | - Can Cai
- 1Department of Gastroenterology, 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, 400010 China
| | - Li Zhong
- 1Department of Gastroenterology, 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, 400010 China
| | - Huihong Yu
- 1Department of Gastroenterology, 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, 400010 China
| | - Wei Shen
- 1Department of Gastroenterology, 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, 400010 China
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31
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Martin Agnoux A, El Ghaziri A, Moyon T, Pagniez A, David A, Simard G, Parnet P, Qannari EM, Darmaun D, Antignac JP, Alexandre-Gouabau MC. Maternal protein restriction during lactation induces early and lasting plasma metabolomic and hepatic lipidomic signatures of the offspring in a rodent programming model. J Nutr Biochem 2018; 55:124-141. [DOI: 10.1016/j.jnutbio.2017.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/12/2017] [Accepted: 11/14/2017] [Indexed: 02/01/2023]
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32
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Corte CD, Iasevoli S, Strologo AD, Sanseviero M, Nobili V. Omega-3 Fatty Acids and Fatty Liver Disease in Children. ADVANCES IN FOOD AND NUTRITION RESEARCH 2018; 85:59-77. [PMID: 29860977 DOI: 10.1016/bs.afnr.2018.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) represents the most common cause of chronic liver disease in Industrialized Countries in adults and children. It is estimated that NAFLD will become the main indication for liver transplantation in the next decade. NAFLD is also considered the hepatic feature of metabolic syndrome and therefore it is generally associated to the risk of developing some metabolic complications, with negative impact on patient's survival. Today, no pharmacological treatment has been identified for NAFLD, and behavioral approach, based on diet and regular physical exercise, represent the current recommended treatment, even if with disappointing results. For these reasons, several pharmacological trials have been conducted, in order to identify possible alternative therapy direct against pathogenetic targets of NAFLD. Several data have suggested the potential beneficial role of omega-3 fatty acids in NAFLD and its related metabolic disarray. In this chapter, we try to elucidate the molecular and clinical available evidence for the omega-3 supplementation in pediatric NAFLD patients.
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Affiliation(s)
| | | | | | | | - Valerio Nobili
- "Sapienza" University, Rome, Italy; Hepatogastroenterology Unit, "Bambino Gesù" Children's Hospital, Rome, Italy.
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33
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Gouda W, Ashour E, Shaker Y, Ezzat W. MTP genetic variants associated with non-alcoholic fatty liver in metabolic syndrome patients. Genes Dis 2017; 4:222-228. [PMID: 30258926 PMCID: PMC6147179 DOI: 10.1016/j.gendis.2017.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 09/27/2017] [Indexed: 02/08/2023] Open
Abstract
This study was performed for investigation the relationship between variants of MTP gene polymorphism and the development of NAFLD in patients with and without MS. The study was included 174 NAFLD patients (106 with MS and 68 without MS), and 141 healthy control subjects. The 493 G/T polymorphism of MTP gene was evaluated by PCR-RFLP method. The frequency of MTP TT genotype and T allele were significantly higher in NAFLD patients when compared to healthy controls. Moreover, a significant association in MTP gene polymorphism was observed in NAFLD patients with MS compared to NAFLD patients without MS and controls. Our study suggested that MTP 493 G/T gene polymorphism may act as susceptibility biomarker for NAFLD and MS.
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Affiliation(s)
- Weaam Gouda
- Biochemistry Dept., National Research Center, Dokki, Giza, Egypt
| | - Esmat Ashour
- Biochemistry Dept., National Research Center, Dokki, Giza, Egypt
| | - Yehia Shaker
- Biochemistry Dept., National Research Center, Dokki, Giza, Egypt
| | - Wafaa Ezzat
- Internal Medicine Dept., National Research Center, Dokki, Giza, Egypt
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34
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Which Method is Superior in the Diagnosis of Nonalcoholic Fatty Liver and Steatohepatatis in Children? HEPATITIS MONTHLY 2017. [DOI: 10.5812/hepatmon.13584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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35
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Bugianesi E, Bizzarri C, Rosso C, Mosca A, Panera N, Veraldi S, Dotta A, Giannone G, Raponi M, Cappa M, Alisi A, Nobili V. Low Birthweight Increases the Likelihood of Severe Steatosis in Pediatric Non-Alcoholic Fatty Liver Disease. Am J Gastroenterol 2017; 112:1277-1286. [PMID: 28555633 DOI: 10.1038/ajg.2017.140] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/03/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Small for gestational age (SGA) is associated with an increased risk of non-alcoholic fatty liver disease (NAFLD). Our aim was to investigate the correlation of birthweight with the severity of liver damage in a large cohort of children with NAFLD. METHODS Two hundred and eighty-eight consecutive Caucasian Italian overweight/obese children with biopsy-proven NAFLD were included in the study. We examined the relative association of each histological feature of NAFLD with metabolic alterations, insulin-resistance, I148M polymorphism in the patatin-like phospholipase domain-containing protein 3 (PNPLA3) gene, and birthweight relative to gestational age. RESULTS In the whole NAFLD cohort, 12.2% of patients were SGA, 62.8% appropriate for gestational age (AGA), and 25% large for gestational age (LGA). SGA children had a higher prevalence of severe steatosis (69%) and severe portal inflammation (14%) compared with the AGA and LGA groups. Notably, severe steatosis (>66%) was decreasing from SGA to AGA and LGA, whereas the prevalence of moderate steatosis (33-66%) was similar in three groups. The prevalence of type 1 NAFLD is higher in the LGA group with respect to the other two groups (25% vs.5.2% vs.9.4%), whereas the SGA group shows a higher prevalence of overlap type (85.8%) with respect to the LGA group (51.4%) but not compared with the AGA group (75%). At multivariable regression analysis, SGA at birth increased fourfold the likelihood of severe steatosis (odds ratio (OR) 4.0, 95% confidence interval (CI) 1.43-10.9, P=0.008) and threefold the likelihood of NAFLD Activity Score (NAS)≥5 (OR 2.98, 95% CI 1.06-8.33, P=0.037) independently of homeostasis model assessment of insulin resistance and PNPLA3 genotype. The PNPLA3-CC wild-type genotype was the strongest independent predictor of the absence of significant fibrosis (OR 0.26, 95% CI 0.13-0.52, P=<0.001). CONCLUSIONS In children with NAFLD, the risk of severe steatosis is increased by SGA at birth, independent of and in addition to other powerful risk factors (insulin-resistance and I148M variant of the PNPLA3 gene).
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Affiliation(s)
- Elisabetta Bugianesi
- Division of Gastroenterology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Carla Bizzarri
- Unit of Endocrinology and Diabetes, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Chiara Rosso
- Division of Gastroenterology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Antonella Mosca
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Nadia Panera
- Liver Reseach Unit, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Silvio Veraldi
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Andrea Dotta
- Neonatal Surgery Unit, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Germana Giannone
- Department of Laboratory Medicine, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Massimiliano Raponi
- Medical Directorate, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Marco Cappa
- Unit of Endocrinology and Diabetes, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Anna Alisi
- Liver Reseach Unit, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Valerio Nobili
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital, IRCCS (Instituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
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Lazo-de-la-Vega-Monroy ML, Solís-Martínez MO, Romero-Gutiérrez G, Aguirre-Arzola VE, Wrobel K, Wrobel K, Zaina S, Barbosa-Sabanero G. 11 beta-hydroxysteroid dehydrogenase 2 promoter methylation is associated with placental protein expression in small for gestational age newborns. Steroids 2017; 124:60-66. [PMID: 28502862 DOI: 10.1016/j.steroids.2017.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 05/04/2017] [Accepted: 05/08/2017] [Indexed: 11/15/2022]
Abstract
Small for gestational age infants have greater risk of developing metabolic diseases in adult life. It has been suggested that low birth weight may result from glucocorticoid excess in utero, a key mechanism in fetal programming. The placental enzyme 11-beta hydroxysteroid dehydrogenase type 2 (11β-HSD2, HSD11B2 gene) acts as a barrier protecting the fetus from maternal corticosteroid deleterious effects. Low placental 11β-HSD2 transcription and activity have been associated with low birth weight, yet the mechanism regulating its protein expression is not fully understood. In the present study we aimed to analyze 11β-HSD2 protein expression in placentas of adequate and small for gestational age (AGA and SGA, respectively) newborns from healthy mothers, and to explore whether 11β-HSD2 protein expression could be modulated by DNA methylation. 11β-HSD2 protein levels were measured by western blot in placental biopsies from term AGA and SGA infants (n=10 per group). DNA methylation was profiled both globally and in the HSD11B2 promoter by liquid chromatography with UV detection and methylation-specific melting curve analysis, respectively. We found lower placental 11β-HSD2 protein expression and higher HSD11B2 promoter methylation in SGA compared to AGA. Promoter methylation was inversely correlated with both protein expression and, importantly, birth weight. No changes in global placental methylation were found. In conclusion, lower 11β-HSD2 protein expression is associated with higher HSD11B2 promoter methylation, correlating with birth weight in healthy pregnancy. Our data support the role of 11β-HSD2 in determining birth weight, providing evidence of its regulation by epigenetic mechanisms, which may affect postnatal metabolic disease risk.
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Affiliation(s)
| | | | | | | | - Katarzyna Wrobel
- Department of Chemistry, University of Guanajuato, Guanajuato, Mexico.
| | - Kazimierz Wrobel
- Department of Chemistry, University of Guanajuato, Guanajuato, Mexico.
| | - Silvio Zaina
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus, Mexico.
| | - Gloria Barbosa-Sabanero
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus, Mexico.
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Pediatric Non-Alcoholic Fatty Liver Disease. CHILDREN-BASEL 2017; 4:children4060048. [PMID: 28598410 PMCID: PMC5483623 DOI: 10.3390/children4060048] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/05/2017] [Accepted: 06/07/2017] [Indexed: 02/06/2023]
Abstract
With the increase in the prevalence of obesity, non-alcoholic fatty liver disease (NAFLD) has become among the leading causes of chronic liver disease in the pediatric age group. Once believed to be a “two-hit process”, it is now clear that the actual pathophysiology of NAFLD is complex and involves multiple pathways. Moreover, NAFLD is not always benign, and patients with non-alcoholic steatohepatitis (NASH) are at increased risk of developing advanced stages of liver disease. It has also been shown that NAFLD is not only a liver disease, but is also associated with multiple extrahepatic manifestations, including cardiovascular diseases, type 2 diabetes, and low bone mineral density. Although the data is scarce in the pediatric population, some studies have suggested that long-term mortality and the requirement of liver transplantation will continue to increase in patients with NAFLD. More studies are needed to better understand the natural history of NAFLD, especially in the pediatric age group.
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38
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Joo EJ, Chang Y, Yeom JS, Ryu S. Hepatitis B virus infection and decreased risk of nonalcoholic fatty liver disease: A cohort study. Hepatology 2017; 65:828-835. [PMID: 28035771 DOI: 10.1002/hep.28917] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/14/2016] [Accepted: 10/16/2016] [Indexed: 12/11/2022]
Abstract
UNLABELLED The presence of an association between chronic hepatitis B virus (HBV) infection and fatty liver is controversial. We examined the association between HBV infection and the development of nonalcoholic fatty liver disease (NAFLD). We conducted a cohort study of 83,339 participants without NAFLD at baseline who underwent serologic testing for hepatitis B surface antigen (HBsAg) between 2002 and 2006 and were followed annually or biennially until December 2014. NAFLD was defined as the presence of ultrasonographic fatty liver in the absence of excessive alcohol use or other identifiable causes. We used a parametric Cox model to estimate adjusted hazard ratios with 95% confidence intervals of incident NAFLD. During 484,736.1 person-years of follow-up, 20,200 incident NAFLD cases were identified. In models adjusted for age, sex, year of visit, smoking status, alcohol intake, regular exercise, education level, and body mass index, the adjusted hazard ratio (95% confidence interval) for incident NAFLD comparing HBsAg-positive to HBsAg-negative participants was 0.83 (0.73-0.94). After introducing HBV infection and confounders (including homeostasis model assessment of insulin resistance and metabolic factors) as time-dependent exposures, the association between HBV infection and decreased risk of incident NAFLD was attenuated but persisted. These associations were consistently observed across clinically relevant, prespecified subgroups. CONCLUSION In this large cohort of apparently healthy Korean adults, HBsAg seropositivity was associated with lower risk of developing NAFLD, indicating a possible effect of HBV infection on the pathogenesis of NAFLD development. (Hepatology 2017;65:828-835).
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Affiliation(s)
- Eun-Jeong Joo
- Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Yoosoo Chang
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.,Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Joon-Sup Yeom
- Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.,Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
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39
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Simpson J, Smith AD, Fraser A, Sattar N, Callaway M, Lindsay RS, Lawlor DA, Nelson SM. Cord Blood Adipokines and Lipids and Adolescent Nonalcoholic Fatty Liver Disease. J Clin Endocrinol Metab 2016; 101:4661-4668. [PMID: 27648968 PMCID: PMC5155695 DOI: 10.1210/jc.2016-2604] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/15/2016] [Indexed: 12/14/2022]
Abstract
CONTEXT Maternal adiposity in pregnancy is associated with offspring adiposity and metabolic dysfunction postnatally, including greater risk of nonalcoholic fatty liver disease (NAFLD). Recent genetic analyses suggest a causal effect of greater maternal body mass index on offspring birth weight and ponderal index, but the relative roles of the environment in utero or later in life remains unclear. OBJECTIVE We sought to determine whether markers of infant adiposity (birth weight, umbilical cord blood leptin, adiponectin, and lipids) were associated with markers of NAFLD in adolescence. DESIGN, SETTING, AND PARTICIPANTS This was a UK prospective birth cohort with 17 years of follow-up with liver function tests (aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase) (n = 1037 participants), and ultrasound scan assessed liver fat, volume, and sheer velocity at age 17 (n = 541 participants). Missing covariate data were imputed. MAIN OUTCOMES Ultrasound and biochemical measures of NAFLD were measured. RESULTS Birth weight, cord blood leptin, and adiponectin were not associated with a diagnosis of NAFLD. In adjusted analyses, 2 of 42 associations attained conventional 5% levels of significance. Birth weight was positively associated with liver volume (1.0% greater per 100 g [95% confidence interval 0.5%-2.0%]). Cord high-density lipoprotein-cholesterol was positively associated with alanine aminotransferase (11.6% higher per 1 mmol/L [95% confidence interval 0.3, 23.4]); however, this association was primarily mediated via offspring adiposity. CONCLUSIONS In this extensive analysis, we found little evidence measurements of infant fat mass and birth size were related to adolescent markers of NAFLD. The association between birth weight and adolescent liver volume may indicate the contribution of greater organ size to birth weight and tracking of organ size.
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Affiliation(s)
- Joy Simpson
- School of Medicine (J.S., S.M.N.), University of Glasgow, Glasgow G31 2ER, United Kingdom; Medical Research Council Integrative Epidemiology Unit (A.D.S., A.F., D.A.L.), School of Social and Community Medicine (A.D.S., A.F., D.A.L.), University of Bristol, Bristol BS13NY United Kingdom; Institute of Cardiovascular and Metabolic Medicine (N.S., R.S.L.), British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow G61 1QH, United Kingdom; and University Hospitals Bristol National Health Service Foundation Trust (M.C.), Bristol BS1 3NY, United Kingdom
| | - Andrew D Smith
- School of Medicine (J.S., S.M.N.), University of Glasgow, Glasgow G31 2ER, United Kingdom; Medical Research Council Integrative Epidemiology Unit (A.D.S., A.F., D.A.L.), School of Social and Community Medicine (A.D.S., A.F., D.A.L.), University of Bristol, Bristol BS13NY United Kingdom; Institute of Cardiovascular and Metabolic Medicine (N.S., R.S.L.), British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow G61 1QH, United Kingdom; and University Hospitals Bristol National Health Service Foundation Trust (M.C.), Bristol BS1 3NY, United Kingdom
| | - Abigail Fraser
- School of Medicine (J.S., S.M.N.), University of Glasgow, Glasgow G31 2ER, United Kingdom; Medical Research Council Integrative Epidemiology Unit (A.D.S., A.F., D.A.L.), School of Social and Community Medicine (A.D.S., A.F., D.A.L.), University of Bristol, Bristol BS13NY United Kingdom; Institute of Cardiovascular and Metabolic Medicine (N.S., R.S.L.), British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow G61 1QH, United Kingdom; and University Hospitals Bristol National Health Service Foundation Trust (M.C.), Bristol BS1 3NY, United Kingdom
| | - Naveed Sattar
- School of Medicine (J.S., S.M.N.), University of Glasgow, Glasgow G31 2ER, United Kingdom; Medical Research Council Integrative Epidemiology Unit (A.D.S., A.F., D.A.L.), School of Social and Community Medicine (A.D.S., A.F., D.A.L.), University of Bristol, Bristol BS13NY United Kingdom; Institute of Cardiovascular and Metabolic Medicine (N.S., R.S.L.), British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow G61 1QH, United Kingdom; and University Hospitals Bristol National Health Service Foundation Trust (M.C.), Bristol BS1 3NY, United Kingdom
| | - Mark Callaway
- School of Medicine (J.S., S.M.N.), University of Glasgow, Glasgow G31 2ER, United Kingdom; Medical Research Council Integrative Epidemiology Unit (A.D.S., A.F., D.A.L.), School of Social and Community Medicine (A.D.S., A.F., D.A.L.), University of Bristol, Bristol BS13NY United Kingdom; Institute of Cardiovascular and Metabolic Medicine (N.S., R.S.L.), British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow G61 1QH, United Kingdom; and University Hospitals Bristol National Health Service Foundation Trust (M.C.), Bristol BS1 3NY, United Kingdom
| | - Robert S Lindsay
- School of Medicine (J.S., S.M.N.), University of Glasgow, Glasgow G31 2ER, United Kingdom; Medical Research Council Integrative Epidemiology Unit (A.D.S., A.F., D.A.L.), School of Social and Community Medicine (A.D.S., A.F., D.A.L.), University of Bristol, Bristol BS13NY United Kingdom; Institute of Cardiovascular and Metabolic Medicine (N.S., R.S.L.), British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow G61 1QH, United Kingdom; and University Hospitals Bristol National Health Service Foundation Trust (M.C.), Bristol BS1 3NY, United Kingdom
| | - Debbie A Lawlor
- School of Medicine (J.S., S.M.N.), University of Glasgow, Glasgow G31 2ER, United Kingdom; Medical Research Council Integrative Epidemiology Unit (A.D.S., A.F., D.A.L.), School of Social and Community Medicine (A.D.S., A.F., D.A.L.), University of Bristol, Bristol BS13NY United Kingdom; Institute of Cardiovascular and Metabolic Medicine (N.S., R.S.L.), British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow G61 1QH, United Kingdom; and University Hospitals Bristol National Health Service Foundation Trust (M.C.), Bristol BS1 3NY, United Kingdom
| | - Scott M Nelson
- School of Medicine (J.S., S.M.N.), University of Glasgow, Glasgow G31 2ER, United Kingdom; Medical Research Council Integrative Epidemiology Unit (A.D.S., A.F., D.A.L.), School of Social and Community Medicine (A.D.S., A.F., D.A.L.), University of Bristol, Bristol BS13NY United Kingdom; Institute of Cardiovascular and Metabolic Medicine (N.S., R.S.L.), British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow G61 1QH, United Kingdom; and University Hospitals Bristol National Health Service Foundation Trust (M.C.), Bristol BS1 3NY, United Kingdom
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Zhang L, Shen L, Xu D, Wang L, Guo Y, Liu Z, Liu Y, Liu L, Magdalou J, Chen L, Wang H. Increased susceptibility of prenatal food restricted offspring to high-fat diet-induced nonalcoholic fatty liver disease is intrauterine programmed. Reprod Toxicol 2016; 65:236-247. [DOI: 10.1016/j.reprotox.2016.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 08/12/2016] [Accepted: 08/13/2016] [Indexed: 01/07/2023]
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A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence. Int J Mol Sci 2016; 17:ijms17060947. [PMID: 27314342 PMCID: PMC4926480 DOI: 10.3390/ijms17060947] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 02/07/2023] Open
Abstract
Non-Alcoholic Fatty Liver Disease (NAFLD) is now the most prevalent form of chronic liver disease, affecting 10%–20% of the general paediatric population. Within the next 10 years it is expected to become the leading cause of liver pathology, liver failure and indication for liver transplantation in childhood and adolescence in the Western world. While our understanding of the pathophysiological mechanisms underlying this disease remains limited, it is thought to be the hepatic manifestation of more widespread metabolic dysfunction and is strongly associated with a number of metabolic risk factors, including insulin resistance, dyslipidaemia, cardiovascular disease and, most significantly, obesity. Despite this, ”paediatric” NAFLD remains under-studied, under-recognised and, potentially, undermanaged. This article will explore and evaluate our current understanding of NAFLD in childhood and adolescence and how it differs from adult NAFLD, in terms of its epidemiology, pathophysiology, natural history, diagnosis and clinical management. Given the current absence of definitive radiological and histopathological diagnostic tests, maintenance of a high clinical suspicion by all members of the multidisciplinary team in primary and specialist care settings remains the most potent of diagnostic tools, enabling early diagnosis and appropriate therapeutic intervention.
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Affiliation(s)
- Chrystal Wittcopp
- Department of Pediatrics, Baystate Children's Hospital, Tufts University School of Medicine, Boston, MA
| | - Rushika Conroy
- Department of Pediatrics, Baystate Children's Hospital, Tufts University School of Medicine, Boston, MA
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Petta S, Valenti L, Bugianesi E, Targher G, Bellentani S, Bonino F, Lonardo A, Marra F, Mancini M, Miele L, Nobili V, Baroni GS, Alessandro F, Ballestri S, Rossana Brunetto M, Coco B, Grieco A, Fargion S, Kondili L, Nascimbeni F, Prinster A, Romagnoli D, Taddei S, Vanni E, Vella S. A "systems medicine" approach to the study of non-alcoholic fatty liver disease. Dig Liver Dis 2016; 48:333-42. [PMID: 26698409 DOI: 10.1016/j.dld.2015.10.027] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 10/18/2015] [Accepted: 10/31/2015] [Indexed: 02/07/2023]
Abstract
The prevalence of fatty liver (steatosis) in the general population is rapidly increasing worldwide. The progress of knowledge in the physiopathology of fatty liver is based on the systems biology approach to studying the complex interactions among different physiological systems. Similarly, translational and clinical research should address the complex interplay between these systems impacting on fatty liver. The clinical needs drive the applications of systems medicine to re-define clinical phenotypes, assessing the multiple nature of disease susceptibility and progression (e.g. the definition of risk, prognosis, diagnosis criteria, and new endpoints of clinical trials). Based on this premise and in light of recent findings, the complex mechanisms involved in the pathology of fatty liver and their impact on the short- and long-term clinical outcomes of cardiovascular, metabolic liver diseases associated with steatosis are presented in this review using a new "systems medicine" approach. A new data set is proposed for studying the impairments of different physiological systems that have an impact on fatty liver in different subsets of subjects and patients.
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Affiliation(s)
- Salvatore Petta
- Section of Gastroenterology, Di.Bi.M.I.S Policlinico Paolo Giaccone Hospital, University of Palermo, Italy
| | - Luca Valenti
- Internal Medicine, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Elisabetta Bugianesi
- Gastroenterology and Hepatology, Department of Medical Sciences, Città della Salute e della Scienza di Torino Hospital, University of Turin, Italy
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University Hospital of Verona, Italy
| | - Stefano Bellentani
- Shrewsbury and Telford NHS Trust, Department of Gastroenterology, Shrewsbury, UK; Fondazione Italiana Fegato, Bassovizza, Trieste, Italy
| | - Ferruccio Bonino
- General Medicine 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Italy.
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Nobili V, Alisi A, Musso G, Scorletti E, Calder PC, Byrne CD. Omega-3 fatty acids: Mechanisms of benefit and therapeutic effects in pediatric and adult NAFLD. Crit Rev Clin Lab Sci 2015; 53:106-20. [PMID: 26463349 DOI: 10.3109/10408363.2015.1092106] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is currently considered the most common liver disease in industrialized countries, and it is estimated that it will become the most frequent indication for liver transplantation in the next decade. NAFLD may be associated with moderate (i.e. steatosis) to severe (i.e. steatohepatitis and fibrosis) liver damage and affects all age groups. Furthermore, subjects with NAFLD may be at a greater risk of other obesity-related complications later in life, and people with obesity and obesity-related complications (e.g. metabolic syndrome, type 2 diabetes and cardiovascular disease) are at increased risk of developing NAFLD. To date, there is no licensed treatment for NAFLD and therapy has been mainly centered on weight loss and increased physical activity. Unfortunately, it is often difficult for patients to adhere to the advised lifestyle changes. Therefore, based on the known pathogenesis of NAFLD, several clinical trials with different nutritional supplementation and prescribed drugs have been undertaken or are currently underway. Experimental evidence has emerged about the health benefits of omega-3 fatty acids, a group of polyunsaturated fatty acids that are important for a number of health-related functions. Omega-3 fatty acids are present in some foods (oils, nuts and seeds) that also contain omega-6 fatty acids, and the best sources of exclusively omega-3 fatty acids are oily fish, krill oil and algae. In this review, we provide a brief overview of the pathogenesis of NAFLD, and we also discuss the molecular and clinical evidence for the benefits of different omega-3 fatty acid preparations in NAFLD.
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Affiliation(s)
| | - Anna Alisi
- b Liver Research Unit, "Bambino Gesù" Children's Hospital and IRCCS , Rome , Italy
| | - Giovanni Musso
- c Gradenigo Hospital, University of Turin , Turin , Italy
| | - Eleonora Scorletti
- d Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton , Southampton , UK , and.,e National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton , Southampton , UK
| | - Philip C Calder
- d Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton , Southampton , UK , and.,e National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton , Southampton , UK
| | - Christopher D Byrne
- d Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton , Southampton , UK , and.,e National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton , Southampton , UK
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Saad V, Wicklow B, Wittmeier K, Hay J, MacIntosh A, Venugopal N, Ryner L, Berard L, McGavock J. A clinically relevant method to screen for hepatic steatosis in overweight adolescents: a cross sectional study. BMC Pediatr 2015; 15:151. [PMID: 26450572 PMCID: PMC4599758 DOI: 10.1186/s12887-015-0465-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 09/25/2015] [Indexed: 12/16/2022] Open
Abstract
Background To develop a screening algorithm to detect hepatic steatosis in overweight and obese adolescents. Methods We performed a cross sectional study of 129 overweight adolescents 13–18 yrs. The primary outcome, hepatic steatosis was defined as an intracellular triglyceride content > 5.5 mg/g and quantified using 1H-magenetic resonance spectroscopy. Primary predictor variables included, alanine and aspartate transaminases (ALT/AST) and features of the metabolic syndrome. Results Hepatic steatosis was present in 33 % of overweight and obese adolescents. Adolescents with hepatic steatosis were more likely to be boys (adjusted OR: 4.8; 95 % CI: 2.5–10.5), display a higher waist circumference (111 ± 12 vs 100 ± 13 cm, p < 0.001) and have metabolic syndrome (adjusted OR: 5.1; 95 % CI: 1.6–16.4). Serum ALT predicted hepatic steatosis in boys (AUC: 0.82; 95 % CI: 0.70–0.95; p < 0.001) but not girls (AUC = 0.63; 95 % CI: 0.46–0.75, p = 0.16). An ALT >20 U/L, combined with the presence of metabolic syndrome, male gender and an elevated waist circumference provided the best model (AUC 0.85) with high sensitivity (72 %) and specificity (82 %) and positive and negative predictive values of 61 % and 89 % respectively. Conclusions Serum transaminases provide modest predictive value for hepatic steatosis in youth. The ALT threshold for predicting hepatic steatosis is significantly lower than current clinical thresholds for predicting non-alcoholic fatty liver disease. The addition of ALT, presence of the metabolic syndrome and male gender significant improve the ability to predict hepatic steatosis.
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Affiliation(s)
- Vera Saad
- Children's Hospital Research Institute of Manitoba, 511 JBRC. 715 McDermot Avenue, Winnipeg, Mb, R3E 3P4, Canada. .,The Diabetes Research Group, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 835 McDermot Avenue, Winnipeg, MB, R3E 0 T8, Canada.
| | - Brandy Wicklow
- Children's Hospital Research Institute of Manitoba, 511 JBRC. 715 McDermot Avenue, Winnipeg, Mb, R3E 3P4, Canada. .,Department of Pediatrics and Child Health, Faculty of Health Sciences, College of Medicine University of Manitoba, Manitoba Institute of Child Health, 511 JBRC. 715 McDermot Avenue, Winnipeg, MB, R3E 3P4, Canada. .,The Diabetes Research Group, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 835 McDermot Avenue, Winnipeg, MB, R3E 0 T8, Canada. .,Diabetes Research Envisioned and Accomplished in Manitoba Theme, 715 McDermot Avenue, Winnipeg, Mb, R3E 3P4, Canada.
| | - Kristy Wittmeier
- Children's Hospital Research Institute of Manitoba, 511 JBRC. 715 McDermot Avenue, Winnipeg, Mb, R3E 3P4, Canada. .,George and Fay Yee Centre for Healthcare Innovation, 300 Chown Building, 753 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada. .,The Diabetes Research Group, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 835 McDermot Avenue, Winnipeg, MB, R3E 0 T8, Canada. .,Diabetes Research Envisioned and Accomplished in Manitoba Theme, 715 McDermot Avenue, Winnipeg, Mb, R3E 3P4, Canada.
| | - Jacqueline Hay
- Children's Hospital Research Institute of Manitoba, 511 JBRC. 715 McDermot Avenue, Winnipeg, Mb, R3E 3P4, Canada. .,The Diabetes Research Group, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 835 McDermot Avenue, Winnipeg, MB, R3E 0 T8, Canada.
| | - Andrea MacIntosh
- Children's Hospital Research Institute of Manitoba, 511 JBRC. 715 McDermot Avenue, Winnipeg, Mb, R3E 3P4, Canada. .,The Diabetes Research Group, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 835 McDermot Avenue, Winnipeg, MB, R3E 0 T8, Canada.
| | - Niranjan Venugopal
- George and Fay Yee Centre for Healthcare Innovation, 300 Chown Building, 753 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada. .,The Diabetes Research Group, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 835 McDermot Avenue, Winnipeg, MB, R3E 0 T8, Canada.
| | - Lawrence Ryner
- George and Fay Yee Centre for Healthcare Innovation, 300 Chown Building, 753 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada. .,The Diabetes Research Group, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 835 McDermot Avenue, Winnipeg, MB, R3E 0 T8, Canada.
| | - Lori Berard
- CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB, R3E 0 V9, Canada. .,The Diabetes Research Group, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 835 McDermot Avenue, Winnipeg, MB, R3E 0 T8, Canada.
| | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, 511 JBRC. 715 McDermot Avenue, Winnipeg, Mb, R3E 3P4, Canada. .,Department of Pediatrics and Child Health, Faculty of Health Sciences, College of Medicine University of Manitoba, Manitoba Institute of Child Health, 511 JBRC. 715 McDermot Avenue, Winnipeg, MB, R3E 3P4, Canada. .,The Diabetes Research Group, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 835 McDermot Avenue, Winnipeg, MB, R3E 0 T8, Canada. .,Diabetes Research Envisioned and Accomplished in Manitoba Theme, 715 McDermot Avenue, Winnipeg, Mb, R3E 3P4, Canada.
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Spahis S, Alvarez F, Dubois J, Ahmed N, Peretti N, Levy E. Plasma fatty acid composition in French-Canadian children with non-alcoholic fatty liver disease: Effect of n-3 PUFA supplementation. Prostaglandins Leukot Essent Fatty Acids 2015; 99:25-34. [PMID: 26066299 DOI: 10.1016/j.plefa.2015.04.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 04/22/2015] [Accepted: 04/27/2015] [Indexed: 12/12/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) represents one of the most common causes of liver disease worldwide. As the NAFLD pathogenesis is associated with diet and lifestyle, the aims of the present work are to assess fatty acid (FA) composition in NAFLD young French-Canadian, to determine whether treatment with n-3 FA improves the plasma FA profile, and to define the time on the effectiveness of n-3 FA supplementation. Baseline characteristics of the NAFLD subjects show increased, anthropometric and biochemical parameters. Their plasma FA composition is characterized by a percent increase in total n-6 FA and a high proportion of saturated and total monounsaturated FA, as well as a decrease in Δ5 and increase in Δ6 desaturases. In conclusion, our results document for the first time the composition of plasma FAs in NAFLD young French Canadian and the efficacy of 3-month supplementation to improve the proportion of n-3 FA in their plasma.
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Affiliation(s)
- S Spahis
- Research Centre, CHU Sainte-Justine Montreal, Montreal, Quebec, Canada, H3T 1C5; Department of Nutrition, Université de Montreal, Montreal, Quebec, Canada, H3T 1A8; Institute of Nutraceuticals and Functional foods (INAF), Université Laval, Quebec, Quebec, Canada, G1V 0A6
| | - F Alvarez
- Research Centre, CHU Sainte-Justine Montreal, Montreal, Quebec, Canada, H3T 1C5; Department of Pediatrics, Université de Montreal, Montreal, Quebec, Canada, H3T 1C5
| | - J Dubois
- Research Centre, CHU Sainte-Justine Montreal, Montreal, Quebec, Canada, H3T 1C5; Department of Radiology, Université de Montreal, Montreal, Quebec, Canada, H3T 1C5
| | - N Ahmed
- The Montreal Children's Hospital, McGill University Health Centre, Montreal Quebec, Canada, H3H 1P3
| | - N Peretti
- Centre de recherche Rhône-Alpes en nutrition humaine, Hôpital Edouard-Herriot, Faculté de Médicine, Université de Lyon-1, France
| | - E Levy
- Research Centre, CHU Sainte-Justine Montreal, Montreal, Quebec, Canada, H3T 1C5; Department of Nutrition, Université de Montreal, Montreal, Quebec, Canada, H3T 1A8; Institute of Nutraceuticals and Functional foods (INAF), Université Laval, Quebec, Quebec, Canada, G1V 0A6.
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Liccardo D, Mosca A, Petroni S, Valente P, Giordano U, Mico' AGA, Pescosolido S, Buzzonetti L, Nobili V. The association between retinal microvascular changes, metabolic risk factors, and liver histology in pediatric patients with non-alcoholic fatty liver disease (NAFLD). J Gastroenterol 2015; 50:903-12. [PMID: 25516385 DOI: 10.1007/s00535-014-1024-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/26/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND The prevalence of childhood obesity is increasing worldwide. Studies in adult populations show that retinal microvascular changes are associated with obesity and components of the metabolic syndrome. In our study we have assessed the effect of body mass index (BMI), metabolic parameters, and adiposity on the retinal microvasculature in children. METHODS Fifty-four consecutive children with biopsy-proven NAFLD were enrolled in this study. Anthropometric and laboratory parameters were obtained using standardized protocols. Retinal caliber was quantified from digital retinal images using well-known computer-based programs. Twenty-four-hour ambulatory blood pressure monitoring was measured using a standard protocol. RESULTS In our population, the prevalence of retinopathy was of 53 % (13 males). The 29 patients with retinopathy (mean age 10.91 ± 3.10) showed significantly higher values of triglycerides (mg/day) (105.57 vs. 90.20, p = 0.04), basal insulin (mUI/ml) (17.20 vs. 12.97, p = 0.02), and HOMA-IR (3.37 vs. 2.76, p = 0.04). The patients with a HOMA-IR >2.5 (OR = 3.34, p = 0.02; 95 % IC, 1.07-10.39), and systolic non-dipping (OR 4.16, p = 0.028, 95 % IC, 1.11-13.67), have an increased risk of retinopathy. Moreover, the study of correlation between all stages of liver biopsy (CRN criteria) and the grade of retinopathy showed a positive correlation with fibrosis (r = 0.31) and an NAS score (r = 0.28). CONCLUSIONS We found an association between metabolic parameters and nocturnal blood pressure on the retinal microvasculature among the obese children with NAFLD. Furthermore, for the first time, we report the positive relationship between hepatic fibrosis in pediatric NAFLD patients and the degree of retinopathy signs.
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Affiliation(s)
- D Liccardo
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
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Alterio A, Alisi A, Liccardo D, Nobili V. Non-alcoholic fatty liver and metabolic syndrome in children: a vicious circle. Horm Res Paediatr 2015; 82:283-9. [PMID: 25324136 DOI: 10.1159/000365192] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 06/10/2014] [Indexed: 11/19/2022] Open
Abstract
During the last decade, paediatricians have observed a dramatic increase of non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) in children. Furthermore, several lines of evidence have reported that a large part of children with NAFLD presents one or more traits of MS making plausible that, in the coming years, these subjects may present a rapid course of disease towards more severe cirrhosis and cardiovascular disease. Genetic susceptibility and the pressure of intrauterine environment and lifestyle are all crucial to activate molecular machinery that leads to development of NAFLD and MS in childhood. In this scenario, central obesity and consequent adipose tissue inflammation are critical to promote both MS-associated metabolic dysfunctions and NAFLD-related hepatic damage. An excessive dietary intake may in fact cause a specific lipid partitioning and induce metabolic stressors, which in turn promote insulin resistance and the release of several circulating factors. These molecules, on the one hand, trigger steatosis and the inflammatory response that characterize liver damage in NAFLD, and on the other hand contribute to the onset of other features of MS. This review provides an overview of current genetic, pathogenetic and clinical evidence of the vicious circle created by NAFLD and MS in children.
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Affiliation(s)
- Arianna Alterio
- Hepato-Metabolic Disease Unit and Liver Research Unit, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
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Xu D, Bai J, Zhang L, Shen L, Wang L, Liu Z, Xia L, Wang H. Prenatal nicotine exposure-induced intrauterine programming alteration increases the susceptibility of high-fat diet-induced non-alcoholic simple fatty liver in female adult offspring rats. Toxicol Res (Camb) 2015. [DOI: 10.1039/c4tx00092g] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
“Two intrauterine programming”, involved in the intrauterine origin of high-fat diet-induced NAFL in female offspring rats, induced by prenatal nicotine exposure.
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Affiliation(s)
- Dan Xu
- Department of Pharmacology
- Basic Medical School of Wuhan University
- Wuhan 430071
- China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease
| | - Jing Bai
- Department of Pharmacology
- Basic Medical School of Wuhan University
- Wuhan 430071
- China
| | - Li Zhang
- Department of Pharmacology
- Basic Medical School of Wuhan University
- Wuhan 430071
- China
| | - Lang Shen
- Department of Pharmacology
- Basic Medical School of Wuhan University
- Wuhan 430071
- China
| | - Linlong Wang
- Department of Pharmacology
- Basic Medical School of Wuhan University
- Wuhan 430071
- China
| | - Zhongfen Liu
- Department of Pharmacology
- Basic Medical School of Wuhan University
- Wuhan 430071
- China
| | - Liping Xia
- Renmin Hospital of Wuhan University
- Wuhan 430060
- China
| | - Hui Wang
- Department of Pharmacology
- Basic Medical School of Wuhan University
- Wuhan 430071
- China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease
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Cianfarani S, Inzaghi E, Alisi A, Germani D, Puglianiello A, Nobili V. Insulin-like growth factor-I and -II levels are associated with the progression of nonalcoholic fatty liver disease in obese children. J Pediatr 2014; 165:92-8. [PMID: 24607243 DOI: 10.1016/j.jpeds.2014.01.052] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 12/03/2013] [Accepted: 01/24/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To correlate circulating levels of insulin-like growth factor (IGF)-I, IGF-II, and IGF binding protein (IGFBP)-3 in a population of obese children with biopsy-proven nonalcoholic fatty liver disease (NAFLD) with clinical, biochemical, and histological features. STUDY DESIGN We conducted a cross-sectional study at the Hepatometabolic Unit of the Bambino Gesù Children's Hospital, Rome, Italy. Obese children (42 girls and 57 boys) underwent liver biopsy, anthropometry, biochemical assessment, and IGF system evaluation. Serum concentrations of IGF-I, IGF-II, and IGFBP-3 were measured. The liver biopsy features of each case were graded according to the NAFLD Activity Scoring system. The degrees of steatosis, inflammation, ballooning, and fibrosis were calculated. RESULTS Nonalcoholic steatohepatitis was diagnosed in 14/99 obese subjects. Stepwise regression analysis revealed that IGF-I was the major predictor of ballooning (β = -0.463; P < .0001) and NAFLD activity score (β = -0.457; P < .0001), IGF-I/IGFBP-3 ratio was the major predictor of liver inflammation (β = -0.285; P = .005), and IGF-II was the major predictor of liver fibrosis (β = 0.343; P < .005). CONCLUSION Circulating levels of IGF-I and IGF-II are associated with the histological stages of NAFLD and may represent novel markers of liver damage progression in obese children.
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Affiliation(s)
- Stefano Cianfarani
- Department of Pediatrics, University Hospital, Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy; Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
| | - Elena Inzaghi
- Department of Pediatrics, University Hospital, Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy
| | - Anna Alisi
- Hepatometabolic Disease Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Daniela Germani
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | - Valerio Nobili
- Hepatometabolic Disease Unit, Bambino Gesù Children's Hospital, Rome, Italy
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