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Ookura R, Usuki N, Miki Y. Correlation between Pancreatic Fat Deposition and Metabolic Syndrome: Relationships with Location in the Pancreas and Sex. Intern Med 2024; 63:2113-2123. [PMID: 38171856 PMCID: PMC11358728 DOI: 10.2169/internalmedicine.2450-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/02/2023] [Indexed: 01/05/2024] Open
Abstract
Objective To investigate the correlation between pancreatic fat deposition and metabolic syndrome (MetS) parameters, focusing on the locations of fat deposition in the pancreas and sex differences. Methods Degrees of fat deposition in the head, body, and tail of the pancreas were evaluated using computed tomography (CT). We examined the relationships between pancreatic fat deposition and the age, body mass index (BMI), visceral and subcutaneous fat, serum lipid profiles, hepatic steatosis, diabetes mellitus (DM), and hypertension (HTN). Results In this retrospective study, greater fat deposition was associated with a higher BMI, visceral and subcutaneous fat accumulation, and hepatic steatosis, with the pancreatic head showing the strongest correlation. Correlations of pancreatic fat deposition with the BMI and visceral and subcutaneous fat accumulation were stronger in females than in males, while correlations with hepatic steatosis were stronger in males than in females. In addition, a multivariate analysis did not suggest a direct causal relationship between pancreatic fat deposition and DM and HTN, but there was a significant correlation between pancreatic fat deposition in the pancreatic head and visceral fat area. Conclusion Pancreatic fat deposition, as evaluated by CT, especially in the part of the pancreatic head adjacent to the ampulla of Vater, is a sensitive indicator of MetS. The correlations between pancreatic fat deposition and MetS parameters tended to be stronger in females than in males. These results may help further elucidate the pathophysiology of MetS and provide opportunities for its diagnosis.
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Affiliation(s)
- Ryusuke Ookura
- Department of Diagnostic and Interventional Radiology, Japan Community Healthcare Organization Osaka Hospital, Japan
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Japan
| | - Noriaki Usuki
- Department of Diagnostic and Interventional Radiology, Japan Community Healthcare Organization Osaka Hospital, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Japan
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Feng T, Hu S, Song C, Zhong M. Establishment of a novel weight reduction model after laparoscopic sleeve gastrectomy based on abdominal fat area. Front Surg 2024; 11:1390045. [PMID: 38826810 PMCID: PMC11140024 DOI: 10.3389/fsurg.2024.1390045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/17/2024] [Indexed: 06/04/2024] Open
Abstract
In light of ongoing research elucidating the intricacies of obesity and metabolic syndrome, the role of abdominal fat (especially visceral fat) has been particularly prominent. Studies have revealed that visceral adipose tissue can accelerate the development of metabolic syndrome by releasing various bioactive compounds and hormones, such as lipocalin, leptin and interleukin. A retrospective analysis was performed on the clinical data of 167 patients with obesity. Among them, 105 patients who satisfied predefined inclusion and exclusion criteria were included. The parameters evaluated included total abdominal fat area (TAFA), laboratory indicators and anthropometric measurements. Weight reduction was quantified through percent total weight loss (%TWL) and percent excess weight loss (%EWL) postoperatively. Binary logistic regression analysis and receiver operating characteristic (ROC) curve analysis were employed to identify predictors of weight loss. Binary logistic regression analysis emphasized that total abdominal fat area was an independent predictor of %EWL ≥75% (p < 0.001). Total abdominal fat area (p = 0.033) and BMI (p = 0.003) were independent predictors of %TWL ≥30%. In our cohort, %TWL ≥30% at 1 year after surgery was closely related to the abdominal fat area and BMI. Based on these results, we formulated a novel model based on these factors, exhibiting superior predictive value for excellent weight loss.
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Affiliation(s)
- Tianyi Feng
- Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Sanyuan Hu
- Department of General Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Changrong Song
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
| | - Mingwei Zhong
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
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Shi R, Zhu JX, Zhu L, Zhao WM, Li H, Chen QC, Pan HF, Wang DG. Exploring the nexus between fatigue, body composition, and muscle strength in hemodialysis patients. Eur J Med Res 2024; 29:266. [PMID: 38698469 PMCID: PMC11067273 DOI: 10.1186/s40001-024-01852-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/19/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Fatigue is a relatively prevalent condition among hemodialysis patients, resulting in diminished health-related quality of life and decreased survival rates. The purpose of this study was to investigate the relationship between fatigue and body composition in hemodialysis patients. METHODS This cross-sectional study included 92 patients in total. Fatigue was measured by Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) (cut-off ≤ 34). Body composition was measured based on quantitative computed tomography (QCT), parameters including skeletal muscle index (SMI), intermuscular adipose tissue (IMAT), and bone mineral density (BMD). Handgrip strength was also collected. To explore the relationship between fatigue and body composition parameters, we conducted correlation analyses and binary logistic regression. RESULTS The prevalence of fatigue was 37% (n = 34), abnormal bone density was 43.4% (n = 40). There was a positive correlation between handgrip strength and FACIT-F score (r = 0.448, p < 0.001). Age (r = - 0.411, p < 0.001), IMAT % (r = - 0.424, p < 0.001), negatively associated with FACIT-F score. Multivariate logistic regression analysis shows that older age, lower serum phosphorus, higher IMAT% are associated with a high risk of fatigue. CONCLUSION The significantly increased incidence and degree of fatigue in hemodialysis patients is associated with more intermuscular adipose tissue in paraspinal muscle.
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Affiliation(s)
- Rui Shi
- Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
| | - Jia-Xin Zhu
- Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
| | - Li Zhu
- Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
| | - Wen-Man Zhao
- Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
| | - Huai Li
- Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
| | - Qi-Chun Chen
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China
| | - Hai-Feng Pan
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, China.
| | - De-Guang Wang
- Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China.
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, China.
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Sato-Espinoza K, Chotiprasidhi P, Huaman MR, Díaz-Ferrer J. Update in lean metabolic dysfunction-associated steatotic liver disease. World J Hepatol 2024; 16:452-464. [PMID: 38577539 PMCID: PMC10989317 DOI: 10.4254/wjh.v16.i3.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/19/2024] [Accepted: 02/28/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD). They are now defined as metabolic dysfunction-associated steatotic liver disease (MASLD), which includes cardiometabolic criteria in adults. This condition, extensively studied in obese or overweight patients, constitutes around 30% of the population, with a steady increase worldwide. Lean patients account for approximately 10%-15% of the MASLD population. However, the pathogenesis is complex and is not well understood. AIM To systematically review the literature on the diagnosis, pathogenesis, characteristics, and prognosis in lean MASLD patients and provide an interpretation of these new criteria. METHODS We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023, specifically focusing on lean NAFLD, MAFLD, or MASLD patients. We include original articles with patients aged 18 years or older, with a lean body mass index categorized according to the World Health Organization criteria, using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian population. RESULTS We include 85 studies in our analysis. Our findings revealed that, for lean NAFLD patients, the prevalence rate varied widely, ranging from 3.8% to 34.1%. The precise pathogenesis mechanism remained elusive, with associations found in genetic variants, epigenetic modifications, and adaptative metabolic response. Common risk factors included metabolic syndrome, hypertension, and type 2 diabetes mellitus, but their prevalence varied based on the comparison group involving lean patients. Regarding non-invasive tools, Fibrosis-4 index outperformed the NAFLD fibrosis score in lean patients. Lifestyle modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles, with some medications showing efficacy to a lesser extent. However, lean NAFLD patients exhibited a worse prognosis compared to the obese or overweight counterpart. CONCLUSION MASLD is a complex disease comprising epigenetic, genetic, and metabolic factors in its pathogenesis. Results vary across populations, gender, and age. Limited data exists on clinical practice guidelines for lean patients. Future studies employing this new nomenclature can contribute to standardizing and generalizing results among lean patients with steatotic liver disease.
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Affiliation(s)
- Karina Sato-Espinoza
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55902, United States.
| | - Perapa Chotiprasidhi
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55902, United States
| | - Mariella R Huaman
- Obesity and Metabolic, Center for Obesity and Metabolic Health, Lima 02002, Lima, Peru
| | - Javier Díaz-Ferrer
- Hepatology Service, Department of Digestive Diseases, Hospital Nacional Edgardo Rebagliati Martins, Lima 02002, Lima, Peru
- Medicine Faculty, Universidad San Martin de Porres, Lima 02002, Lima, Peru
- Gastroenterology Service, Clinica Internacional, Lima 02002, Lima, Peru
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Song X, Wu H, Wang B, Sun H. Association of body fat and muscle tissue parameters with fatty liver disease identified by ultrasound. Lipids Health Dis 2023; 22:167. [PMID: 37794426 PMCID: PMC10548726 DOI: 10.1186/s12944-023-01933-w] [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: 08/19/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023] Open
Abstract
AIMS To examine the association between body fat and muscle parameters and FLD in individuals of Chinese descent. METHODS A total of 515 participants who underwent routine check-ups between November 2019 and August 2021 were reviewed. Based on ultrasound performance, the subjects were categorized into the non-FLD group and the FLD group. The prevalence of FLD in sex subgroups was analyzed using logistic regression to calculate the odds ratios (ORs) of body composition parameters with adjustment for confounders. RESULTS A total of 262 males and 253 females aged 20-84 years were reviewed. In both males and females, higher fat mass index (FMI) (OR: 1.989 for males vs. 1.389 for females), fat mass percent (FM%) (OR: 1.253 for males vs. 1.149 for females), visceral adipose tissue (VAT) (OR: 1.002 for males vs. 1.002 for females), and body mass index (BMI) (OR: 1.530 for males vs. 1.247 for females)were associated with increased ORs of FLD while higher lean mass percent (LM%) (OR: 0.839 for males vs. 0.856 for females)was associated with decreased ORs of FLD. Despite accounting for confounding factors, the associations remained present. Logistic regression of the quartiles of the indices showed associations with the prevalence of FLD. The trends still existed even after adjusting for confounders. CONCLUSION Independently of age, lipid profiles and other confounders, lower VAT, FM, FMI, FM% and BMI tended to be associated with a lower prevalence of FLD, while lower LM% trended to be associated with a higher prevalence of FLD in both sexes of the general population.
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Affiliation(s)
- Xuan Song
- Department of Medical Ultrasound, Shandong Provincial Qianfoshan Hospital and Health Key Laboratory of Abdominal Medical Imaging, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China
| | - Hongxia Wu
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.
| | - Bei Wang
- Department of Medical Ultrasound, Shandong Provincial Qianfoshan Hospital and Health Key Laboratory of Abdominal Medical Imaging, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China
| | - Hongjun Sun
- Department of Medical Ultrasound, Shandong Provincial Qianfoshan Hospital and Health Key Laboratory of Abdominal Medical Imaging, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China
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Yu B, Sun Y, Wang Y, Wang B, Tan X, Lu Y, Zhang K, Wang N. Associations of artificially sweetened beverages, sugar-sweetened beverages, and pure fruit/vegetable juice with visceral adipose tissue mass. Diabetes Metab Syndr 2023; 17:102871. [PMID: 37801867 DOI: 10.1016/j.dsx.2023.102871] [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: 04/15/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE To test the associations of sugar-sweetened beverage, artificially sweetened beverage, and pure fruit/vegetable juice consumption with visceral adipose tissue (VAT) mass at baseline and follow-up and to determine whether BMI and genetic risk of VAT mass modified the associations. METHODS A total of 203,348 participants from UK Biobank with consumption data on three beverages were included. Participants were categorized into nonconsumers and consumers with >0-1, >1-2 and >2 L/week. A sex-specific prediction model was used to calculate VAT mass. A weighted genetic risk score for high VAT mass was calculated. RESULTS The participants with a sugar-sweetened beverage and artificially sweetened beverage consumption of >2 L/week had the greatest B values [B (95% CI): 24.02 (16.53, 31.51) and 60.81 (52.08, 69.54) in men, respectively; 10.20 (5.92, 14.48) and 24.72 (20.80, 28.64) in women]. Low and moderate intake of pure fruit/vegetable juices showed a significantly inverse association with VAT mass in men [-10.52 (-15.37, -5.67); -6.46 (-11.27, -1.65)] and women [-6.70 (-8.99, -4.41); -5.93 (-8.33, -3.54)]. Regarding changes in VAT mass, participants who consumed >2 L/week of sugar-sweetened beverages and artificially sweetened beverages had greater changes. BMI but not genetic risk modified the associations between beverage intake and VAT mass, which were strengthened in participants with BMI ≥25 kg/m2 for sugar-sweetened and artificially sweetened beverage consumption. CONCLUSIONS Higher consumption of sugar-sweetened beverages or artificially sweetened beverages was associated with greater VAT mass regardless of genetic risk. Mild-to-moderate intake of pure fruit/vegetable juices was linked to lower VAT mass.
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Affiliation(s)
- Bowei Yu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ying Sun
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yuying Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Bin Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiao Tan
- School of Public Health, Zhejiang University, Hangzhou, China; Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
| | - Kun Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
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Lavin B, Eykyn TR, Phinikaridou A, Xavier A, Kumar S, Buqué X, Aspichueta P, Sing-Long C, Arrese M, Botnar RM, Andia ME. Characterization of hepatic fatty acids using magnetic resonance spectroscopy for the assessment of treatment response to metformin in an eNOS -/- mouse model of metabolic nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. NMR IN BIOMEDICINE 2023:e4932. [PMID: 36940044 DOI: 10.1002/nbm.4932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease worldwide. Liver biopsy remains the gold standard for diagnosis and staging of disease. There is a clinical need for noninvasive diagnostic tools for risk stratification, follow-up, and monitoring treatment response that are currently lacking, as well as preclinical models that recapitulate the etiology of the human condition. We have characterized the progression of NAFLD in eNOS-/- mice fed a high fat diet (HFD) using noninvasive Dixon-based magnetic resonance imaging and single voxel STEAM spectroscopy-based protocols to measure liver fat fraction at 3 T. After 8 weeks of diet intervention, eNOS-/- mice exhibited significant accumulation of intra-abdominal and liver fat compared with control mice. Liver fat fraction measured by 1 H-MRS in vivo showed a good correlation with the NAFLD activity score measured by histology. Treatment of HFD-fed NOS3-/- mice with metformin showed significantly reduced liver fat fraction and altered hepatic lipidomic profile compared with untreated mice. Our results show the potential of in vivo liver MRI and 1 H-MRS to noninvasively diagnose and stage the progression of NAFLD and to monitor treatment response in an eNOS-/- murine model that represents the classic NAFLD phenotype associated with metabolic syndrome.
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Affiliation(s)
- Begoña Lavin
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK
- BHF Centre of Research Excellence, Cardiovascular Division, King's College London, London, UK
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University, Madrid, Spain
| | - Thomas R Eykyn
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK
- BHF Centre of Research Excellence, Cardiovascular Division, King's College London, London, UK
| | - Alkystis Phinikaridou
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK
- BHF Centre of Research Excellence, Cardiovascular Division, King's College London, London, UK
| | - Aline Xavier
- Biomedical Engineering, Faculty of Engineering, Universidad de Santiago de Chile, Santiago, Chile
- ANID - Millennium Science Initiative Program - Millennium Institute Intelligent Healthcare Engineering, Santiago, Chile
| | - Shravan Kumar
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK
| | - Xabier Buqué
- Physiology Department, School of Medicine and Nursing, Universidad del País Vasco UPV/EHU, Vizcaya, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Patricia Aspichueta
- Physiology Department, School of Medicine and Nursing, Universidad del País Vasco UPV/EHU, Vizcaya, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- CIBER de enfermedades hepáticas y digestivas (CIBERehd), Spain
| | - Carlos Sing-Long
- ANID - Millennium Science Initiative Program - Millennium Institute Intelligent Healthcare Engineering, Santiago, Chile
- School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marco Arrese
- ANID - Millennium Science Initiative Program - Millennium Institute Intelligent Healthcare Engineering, Santiago, Chile
- Gastroenterology Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK
- BHF Centre of Research Excellence, Cardiovascular Division, King's College London, London, UK
- ANID - Millennium Science Initiative Program - Millennium Institute Intelligent Healthcare Engineering, Santiago, Chile
- School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcelo E Andia
- ANID - Millennium Science Initiative Program - Millennium Institute Intelligent Healthcare Engineering, Santiago, Chile
- School of Medicine and Centro de Envejecimiento y Regeneración (CARE), Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
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Gu S, Hu S, Wang S, Qi C, Shi C, Fan G. Bidirectional association between NAFLD and gallstone disease: a systematic review and meta-analysis of observational studies. Expert Rev Gastroenterol Hepatol 2023; 17:283-293. [PMID: 36726224 DOI: 10.1080/17474124.2023.2175671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Growing evidence indicates an association between NAFLD and gallstone disease (GD), while some does not support this. The aim of this meta-analysis was to evaluate the bidirectional association between NAFLD and GD. RESEARCH DESIGN AND METHODS Five electronic databases were searched from inception to May 2022. The association was analyzed based on the odds ratio (OR) and 95% confidence interval (CI) with Reviewer Manager 5.3. RESULTS Ten studies involving 284,512 participants met the criteria for GD predicting the onset of NAFLD. GD patients had a higher incidence of NAFLD (OR:1.48, CI:1.32-1.65, p < 0.00001), especially the incidence of moderate-to-severe NAFLD (OR:1.63; CI:1.40-1.79), with females at a higher risk (OR: 1.84; CI: 1.48-2.29). The inverse association was explored in eight studies involving 326,922 participants. The GD incidence in NAFLD patients was higher (OR:1.71, CI:1.63-1.79, p < 0.00001) and may increase due to female sex (OR: 4.18; CI: 1.21-14.37) and high BMI (OR: 1.80; CI: 1.36-2.56), compared with the non-NAFLD group. Besides, this bidirectional association was also confirmed in the Chinese population. CONCLUSIONS The findings supported positive concurrent and bidirectional relationships between NAFLD and GD. Therefore, clinicians may alert the possibility of NAFLD in patients with GD and vice versa.
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Affiliation(s)
- Shengying Gu
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 200080, Shanghai, China
| | - Shanshan Hu
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 200080, Shanghai, China
| | - Shuowen Wang
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 200080, Shanghai, China
| | - Chendong Qi
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 200080, Shanghai, China
| | - Chenyang Shi
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 200080, Shanghai, China
| | - Guorong Fan
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 200080, Shanghai, China
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Liu J, Peng H, Wang C, Wang Y, Wang R, Liu J, Zhou T, Yao S. Correlation between the Severity of Metabolic Dysfunction-Associated Fatty Liver Disease and Serum Uric Acid to Serum Creatinine Ratio. Int J Endocrinol 2023; 2023:6928117. [PMID: 36686319 PMCID: PMC9859690 DOI: 10.1155/2023/6928117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/23/2022] [Accepted: 12/31/2022] [Indexed: 01/14/2023] Open
Abstract
PURPOSE As one of the most common chronic liver diseases, metabolic dysfunction-associated fatty liver disease (MAFLD) had different prognoses between mild and moderate-severe levels. Serum uric acid to serum creatinine ratio (sUA/Cr) can reflect the overall metabolic status of the body. To explore a convenient indicator to screen MAFLD and distinguish the severity of the disease, this study analyzed the correlation between sUA/Cr and the severity of MAFLD. METHODS 228 participants were enrolled and divided into 2 groups, including mild MAFLD and non-MAFLD group and moderate-severe MAFLD group, based on liver/spleen computed tomography (CT) ratios. The correlations between sUA/Cr and the severity of MAFLD were analyzed by logistic and linear regression. Receiver operating characteristics (ROCs) analyzed the predictive ability of sUA/Cr for the severity of MAFLD expressed by the area under curve (AUC). RESULTS The level of sUA/Cr was higher in themoderate-severe MAFLD group than mild MAFLD and non-MAFLD group (6.14 ± 1.55 vs. 5.51 ± 1.19, P = 0.008). After adjustment for confounders, the correlation analysis showed that patients with elevated sUA/Cr had a higher risk of moderate-severe MAFLD (OR: 1.350, P = 0.036). A higher sUA/Cr level was associated with lower liver CT values (β = -0.133, P = 0.039) and liver/spleen CT ratio (β = -0.154, P = 0.016). sUA/Cr had the ability to discriminate the severity of MAFLD (AUC: 0.623). CONCLUSION sUA/Cr was positively associated with the risk of moderate-severe MAFLD and had the predictive ability to discriminate the moderate-severe MAFLD from mild MAFLD and non-MAFLD. The sUA/Cr level was suggested to be monitored and controlled in the screening and treatment of MAFLD.
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Affiliation(s)
- Jing Liu
- Graduate School of Peking Union Medical College, Beijing 100730, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Hongye Peng
- Department of Infection, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Che Wang
- School of Qi Huang, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yutong Wang
- School of Qi Huang, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Rongrui Wang
- Beijing University of Chinese Medicine, Beijing 100029, China
| | - Jixiang Liu
- Beijing University of Chinese Medicine, Beijing 100029, China
| | - Tianhui Zhou
- Beijing University of Chinese Medicine, Beijing 100029, China
| | - Shukun Yao
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
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Association of Visceral Fat Area and Hyperuricemia in Non-Obese US Adults: A Cross-Sectional Study. Nutrients 2022; 14:nu14193992. [PMID: 36235645 PMCID: PMC9570922 DOI: 10.3390/nu14193992] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
This study aimed to investigate the relationship between visceral fat area (VFA) and hyperuricemia (HUA) among non-obese adults. We extracted data from 6224 US adults aged 20−59 years from the National Health and Nutrition Examination Survey (NHANES) from 2011−2018. The VFA was divided into four quartiles (Q1−Q4). We used multivariable logistic regression models to control for known confounders. A generalized additive model (GAM) and restricted cubic spines were used to examine the association between VFA and HUA stratified by sex, and a two-piecewise linear regression model was used to calculate the threshold effect among males. The results revealed that the prevalence of HUA was 11.8% (men 15.8%, women 7.2%). In the fully adjusted model, there was a positive association between VFA and HUA [as a quartile variable, Q4 vs. Q1, odds ratio (OR): 3.77 and 95% confidence interval (CI): (2.47~5.75), p < 0.001, p for trend < 0.001; as a continuous variable, per 10 cm2 increment, OR (95%CI):1.10(1.07,1.14), p < 0.001]. Besides, this positive association remained significantly stratified by sex. Interestingly, we observed a nonlinear dose-response relationship between VFA and HUA in males (inflection point: 107.46 cm2). In conclusion, our study confirmed a significant positive relationship between VFA and HUA among non-obese adults and remained statistically significant when stratified by sex.
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Li M, Shu W, Zunong J, Amaerjiang N, Xiao H, Li D, Vermund SH, Hu Y. Predictors of non-alcoholic fatty liver disease in children. Pediatr Res 2022; 92:322-330. [PMID: 34580427 DOI: 10.1038/s41390-021-01754-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/09/2021] [Accepted: 09/12/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Abdominal obesity is strongly associated with the development of non-alcoholic fatty liver disease (NAFLD). Early identification and intervention may reduce the risk. We aim to improve pediatric NAFLD screening by comparing discriminative performance of six abdominal obesity indicators. METHODS We measured anthropometric indicators (waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]), body composition indicators (trunk fat index [TFI], visceral fat area [VFA]), and endocrine indicator (visceral adiposity index [VAI]) among 1350 Chinese children aged 6-8 years. Using Spearman correlation, receiver operating characteristic (ROC) curves, and Logistic regression, we validated their ability to predict NAFLD. RESULTS All six indicators can predict NAFLD robustly, with area under the curve (AUC) values ranged from 0.69 to 0.96. TFI, WC, and VFA rank in the top three for the discriminative performance. TFI was the best predictor with AUC values of 0.94 (0.92-0.97) and 0.96 (0.92-0.99), corresponding to cut-off values of 1.83 and 2.31 kg/m2 for boys and girls, respectively. Boys with higher TFI (aOR = 13.8), VFA (aOR = 11.1), WHtR (aOR = 3.1), or VAI (aOR = 2.8), and girls with higher TFI (aOR = 21.0) or VFA (aOR = 17.5), were more likely to have NAFLD. CONCLUSION User-friendly body composition indicators like TFI can identify NAFLD and help prevent the progress of liver disease. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR) ( www.chictr.org.cn/enIndex.aspx , No. ChiCTR2100044027); retrospectively registered on 6 March 2021. IMPACT Abdominal obesity increases the risk of pediatric non-alcoholic fatty liver disease (NAFLD). This study compared the discriminative performance of multiple abdominal obesity indicators measured by different methods in terms of accuracy and fastidious cut-off values through a population-based child cohort. Our results provided solid evidence of abdominal obesity indicators as an optimal screening tool for pediatric NAFLD, with area under the curve (AUC) values ranged from 0.69 to 0.96. User-friendly body composition indicators like TFI show a greater application potential in helping physicians perform easy, reliable, and interpretable weight management to prevent the progress of liver damage.
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Affiliation(s)
- Menglong Li
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Wen Shu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Jiawulan Zunong
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Nubiya Amaerjiang
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Huidi Xiao
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Dan Li
- Yale School of Public Health, Yale University, New Haven, CT, 06510-3201, USA
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, CT, 06510-3201, USA
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China.
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12
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Li X, Zhang Y, Xie Y, Lu R, Tao H, Chen S. Correlation Between Bone Mineral Density (BMD) and Paraspinal Muscle Fat Infiltration Based on QCT: A Cross-Sectional Study. Calcif Tissue Int 2022; 110:666-673. [PMID: 35006307 DOI: 10.1007/s00223-022-00944-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 01/04/2022] [Indexed: 12/18/2022]
Abstract
To investigate the correlation between fatty infiltration of the paraspinal muscle and bone mineral density (BMD). In total, 367 subjects (182 men and 185 women) who underwent quantitative computed tomography (QCT) examination were enrolled in this study. A QCT Pro workstation was used to obtain the mean BMD of the lower lumbar spine (L3, L4, L5) and fat fraction (FF) of the paraspinal muscle (psoas and erector spinae) at the corresponding levels. The patient's age, sex, body mass index, number of previous vertebral fractures, physical activity level, and visual analog scale (VAS) score for lower back pain were recorded. For categorical variables, one-way ANOVA and independent-samples t tests were performed. Spearman and Pearson correlation coefficients were used to analyze the correlations among continuous variables. Influential factors were analyzed by multivariate linear regression analysis. Regarding the mean paraspinal muscle FF, there were significant differences between the different vertebral fracture groups (P < 0.05). Age and VAS score showed a positive correlation with the mean paraspinal muscle FF (r = 0.389, 0.454). BMD showed a negative correlation with the mean paraspinal muscle FF (r = - 0.721). The multiple linear regression analysis showed that vertebral fracture (β = 0.851, P = 0.021) and BMD (β = - 4.341, P = 0.004) were independent factors of the mean paraspinal muscle FF. This study demonstrated that an advanced age, a greater VAS score, a higher number of vertebral fractures, and a lower BMD may be associated with more severe fatty infiltration of the paraspinal muscle.
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Affiliation(s)
- Xiangwen Li
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuyang Zhang
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuxue Xie
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Rong Lu
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongyue Tao
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuang Chen
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China.
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Li X, Xie Y, Lu R, Zhang Y, Tao H, Chen S. Relationship between oseteoporosis with fatty infiltration of paraspinal muscles based on QCT examination. J Bone Miner Metab 2022; 40:518-527. [PMID: 35239028 DOI: 10.1007/s00774-022-01311-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/07/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION To investigate the correlation between paraspinal muscles features and osteoporosis in lumbar spine. MATERIALS AND METHODS A total of 367 subjects who underwent quantitative computed tomography (QCT) examination were enrolled in this study. QCT pro workstation was used to obtain the mean bone mineral density (BMD) of the lower lumbar spine. Fat fraction (FF) and cross-section area (CSA) of the paraspinal muscles at the corresponding levels were measured. All participants were divided into normal, osteopenia, and osteoporosis groups. One-way ANOVA and independent samples t tests were performed to compare differences between groups. Pearson and Spearman correlation coefficients and partial correlation analysis after controlling for confounding factors were used to analyze the correlation between BMD and paraspinal muscles measurements. RESULTS Among the 367 participants included, 116 were in the normal group, 130 in the osteopenia group and 121 in the osteoporosis group. There were significant differences among the three groups for the mean and multifidus FF. BMD showed negative correlations with the FF of the paraspinal muscles. Multifidus and mean FF showed the best correlation (r = - 0.654, - 0.777). There were also significant differences in the mean and multifidus FF between different age groups, while after controlling for confounding factors, there was no correlation between age and FF of the paraspinal muscles. CONCLUSION This preliminary study demonstrated the association of BMD with fatty infiltration of paraspinal muscles. Different muscles might have specific effects in different sex and age groups.
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Affiliation(s)
- Xiangwen Li
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, 200040, China
| | - Yuxue Xie
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, 200040, China
| | - Rong Lu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, 200040, China
| | - Yuyang Zhang
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, 200040, China
| | - Hongyue Tao
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, 200040, China
| | - Shuang Chen
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, 200040, China.
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A Al-Samhari G, M Al-Mushiki G, Tamrakar R, Abdullahi G, Lin YD, Tang XY. Fasting, Nutrition and Weight Loss: An Approach to Refine Non-Alcoholic Fatty Liver Disease. J Nutr Sci Vitaminol (Tokyo) 2022; 67:366-374. [PMID: 34980714 DOI: 10.3177/jnsv.67.366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is considered as one of the most common causes of chronic liver disease. It includes a group of conditions associated with fat deposition in liver cells. Also, NAFLD is strongly associated with obesity and insulin resistance (IR). Until now, there is no pharmacological treatment validated for this disease. Fasting, nutritional intervention, and weight loss can be considered the first line in treating hepatic steatosis. This review is based on the scientific evidence showing the results of these interventions in the past years. The results include fasting and nutritional support for NAFLD treatment in humans. In clinical trials and cohort studies, an increase in hepatic fat content was correlated with a weight loss of at least 7% and a diet resembling the Mediterranean diet (MD) improving hepatic biomarkers and histological regression of NAFLD. Fasting is a dietary approach known to improve the lipid profile in healthy and obese populations by decreasing overall cholesterol, triglycerides, LDL, and increasing HDL. Bariatric surgery helps improve liver fat content in patients with serious health problems due to overweight.
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Affiliation(s)
| | | | - Rashi Tamrakar
- Internal Medicine, The First Affiliated Hospital of Guangxi Medical University
| | - Gibirima Abdullahi
- Internal Medicine, The First Affiliated Hospital of Guangxi Medical University
| | - Yue-Dong Lin
- School of Public Health, Guangxi Medical University
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15
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Zheng CS, Wen HQ, Lin WS, Luo XW, Shen LS, Zhou X, Zou FY, Li QL, Hu HJ, Guo RM. Quantification of lumbar vertebral fat deposition: Correlation with menopausal status, non-alcoholic fatty liver disease and subcutaneous adipose tissue. Front Endocrinol (Lausanne) 2022; 13:1099919. [PMID: 36714601 PMCID: PMC9878446 DOI: 10.3389/fendo.2022.1099919] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/27/2022] [Indexed: 01/15/2023] Open
Abstract
PURPOSE To assess abdominal fat deposition and lumbar vertebra with iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) and investigate their correlation with menopausal status. MATERIALS AND METHODS Two hundred forty women who underwent routine abdominal MRI and IDEAL-IQ between January 2016 and April 2021 were divided into two cohorts (first cohort: 120 pre- or postmenopausal women with severe fatty livers or without fatty livers; second cohort: 120 pre- or postmenopausal women who were obese or normal weight). The fat fraction (FF) values of the liver (FFliver) and lumbar vertebra (FFlumbar) in the first group and the FF values of subcutaneous adipose tissue (SAT) (FFSAT) and FFlumbar in the second group were measured and compared using IDEAL-IQ. RESULTS Two hundred forty women were evaluated. FFlumbar was significantly higher in both pre- and postmenopausal women with severe fatty liver than in patients without fatty livers (premenopausal women: p < 0.001, postmenopausal women: p < 0.001). No significant difference in the FFlumbar was observed between obese patients and normal-weight patients among pre- and postmenopausal women (premenopausal women: p = 0.113, postmenopausal women: p = 0.092). Significantly greater lumbar fat deposition was observed in postmenopausal women than in premenopausal women with or without fatty liver and obesity (p < 0.001 for each group). A high correlation was detected between FFliver and FFlumbar in women with severe fatty liver (premenopausal women: r=0.76, p<0.01; postmenopausal women: r=0.82, p<0.01). CONCLUSION Fat deposition in the vertebral marrow was significantly associated with liver fat deposition in postmenopausal women.
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Affiliation(s)
- Chu-Shan Zheng
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hui-Quan Wen
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wu-Sheng Lin
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiao-Wen Luo
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Li-Shan Shen
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiang Zhou
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Feng-Yun Zou
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qing-Ling Li
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of VIP Medical Center, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- *Correspondence: Qing-Ling Li, ; Hui-Jun Hu, ; Ruo-Mi Guo,
| | - Hui-Jun Hu
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- *Correspondence: Qing-Ling Li, ; Hui-Jun Hu, ; Ruo-Mi Guo,
| | - Ruo-Mi Guo
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Qing-Ling Li, ; Hui-Jun Hu, ; Ruo-Mi Guo,
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Lee S, Kim KW, Lee J, Park T, Khang S, Jeong H, Song GW, Lee SG. Visceral adiposity as a risk factor for lean non-alcoholic fatty liver disease in potential living liver donors. J Gastroenterol Hepatol 2021; 36:3212-3218. [PMID: 34169561 DOI: 10.1111/jgh.15597] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/01/2021] [Accepted: 06/19/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIM This study aimed to investigate the relationship between hepatic steatosis (HS) evaluated by biopsy and visceral adiposity assessed by computed tomography in lean living liver donor candidates and to determine the risk factors for lean non-alcoholic fatty liver disease (NAFLD). METHODS This retrospective study included 250 lean (body mass index, < 23 kg/m2 ) potential living liver donors (mean age, 31.1 ± 8.6 years; 141 men) who had undergone liver biopsy and abdominal computed tomography between 2017 and 2018. Anthropometry, laboratory parameters, body composition, and the degree of HS were evaluated. Logistic regression was used to identify independent predictors of lean NAFLD. RESULTS The visceral fat area (VFA) was significantly correlated with the degree of HS in men (r = 0.408; P < 0.001) and women (r = 0.360; P < 0.001). The subcutaneous fat area was significantly correlated with the degree of HS in men (r = 0.398; P < 0.001), but not in women. The skeletal muscle area did not correlate with the degree of HS in either men or women. In the multivariable logistic regression analysis, the VFA (odds ratio [OR], 1.028; 95% confidence interval [CI], 1.013-1.044; P < 0.001) and subcutaneous fat area (OR, 1.016; 95% CI, 1.004-1.028; P = 0.009) were independent risk factors for lean NAFLD in men, and the VFA (OR, 1.036; 95% CI, 1.013-1.059; P = 0.002) was an independent risk factor for lean NAFLD in women. CONCLUSIONS The severity of non-alcoholic fatty liver was positively correlated with visceral fat accumulation in a lean Asian population. Visceral adiposity may be a risk factor for lean NAFLD in potential living liver donors.
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Affiliation(s)
- Sunyoung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Taeyong Park
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Seungwoo Khang
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Heeryeol Jeong
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Gi-Won Song
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Gyu Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Idilman IS, Low HM, Gidener T, Philbrick K, Mounajjed T, Li J, Allen AM, Yin M, Venkatesh SK. Association between Visceral Adipose Tissue and Non-Alcoholic Steatohepatitis Histology in Patients with Known or Suspected Non-Alcoholic Fatty Liver Disease. J Clin Med 2021; 10:jcm10122565. [PMID: 34200525 PMCID: PMC8228492 DOI: 10.3390/jcm10122565] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 01/29/2023] Open
Abstract
(1) Purpose: To determine the association between visceral adipose tissue (VAT) and proton density fat fraction (PDFF) with magnetic resonance imaging (MRI), and hepatic steatosis (HS), non-alcoholic steatohepatitis (NASH) and hepatic fibrosis (HF) in patients with known or suspected non-alcoholic fatty liver disease (NAFLD). (2) Methods: 135 subjects that had a liver biopsy performed within 3 months (bariatric cohort) or 1 month (NAFLD cohort) of an MRI exam formed the study group. VAT volume was quantified at L2-L3 level on opposed-phase images with signal intensity-based painting using a semi-quantitative software. Liver PDFF and pancreas PDFF were calculated on fat fraction maps. Liver volume (Lvol) and spleen volume (Svol) were also calculated using a semi-automated 3D volume tool available on PACS. A histological analysis was performed by an expert hepatopathologist blinded to imaging findings. (3) Results: The mean Lvol, Svol, liver PDFF, pancreas PDFF and VAT of the study population were 2492.2 mL, 381.6 mL, 13.2%, 12.7% and 120.6 mL, respectively. VAT showed moderate correlation with liver PDFF (r = 0.41, p < 0.001) and weak correlation with Lvol (r = 0.38, p < 0.001), Svol (r = 0.20, p = 0.025) and pancreas PDFF (rs = 0.29, p = 0.001). VAT, Lvol and liver PDFF were significantly higher in patients with HS (p < 0.001), NASH (p < 0.05) and HF (p < 0.05). VAT was also significantly higher in the presence of lobular inflammation (p = 0.019) and hepatocyte ballooning (p = 0.001). The cut-off VAT volumes for predicting HS, NASH and HF were 101.8 mL (AUC, 0.7), 111.8 mL (AUC, 0.64) and 111.6 mL (AUC, 0.66), respectively. (4) Conclusion: The MRI determined VAT can be used for predicting the presence of HS, NASH and HF in patients with known or suspected NAFLD.
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Affiliation(s)
- Ilkay S. Idilman
- Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (I.S.I.); (H.M.L.); (T.G.); (K.P.); (J.L.); (M.Y.)
- Department of Radiology, School of Medicine, Hacettepe University, Ankara 06100, Turkey
| | - Hsien Min Low
- Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (I.S.I.); (H.M.L.); (T.G.); (K.P.); (J.L.); (M.Y.)
- Department of Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Tolga Gidener
- Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (I.S.I.); (H.M.L.); (T.G.); (K.P.); (J.L.); (M.Y.)
| | - Kenneth Philbrick
- Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (I.S.I.); (H.M.L.); (T.G.); (K.P.); (J.L.); (M.Y.)
| | - Taofic Mounajjed
- Division of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905, USA;
| | - Jiahui Li
- Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (I.S.I.); (H.M.L.); (T.G.); (K.P.); (J.L.); (M.Y.)
| | - Alina M. Allen
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA;
| | - Meng Yin
- Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (I.S.I.); (H.M.L.); (T.G.); (K.P.); (J.L.); (M.Y.)
| | - Sudhakar K. Venkatesh
- Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (I.S.I.); (H.M.L.); (T.G.); (K.P.); (J.L.); (M.Y.)
- Correspondence:
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Kang MK, Baek JH, Kweon YO, Tak WY, Jang SY, Lee YR, Hur K, Kim G, Lee HW, Han MH, Choi JH, Park SY, Park JG. Association of Skeletal Muscle and Adipose Tissue Distribution with Histologic Severity of Non-Alcoholic Fatty Liver. Diagnostics (Basel) 2021; 11:diagnostics11061061. [PMID: 34207587 PMCID: PMC8227703 DOI: 10.3390/diagnostics11061061] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Adipose tissue and skeletal muscle is associated with non-alcoholic fatty liver disease (NAFLD). This study evaluates the association between body composition and histologic severity in patients with NAFLD. Using the cross-sectional CT images at the level of L3 vertebra and the histologic findings of 178 patients with biopsy-proven NAFLD, we analyzed the correlation of the histologic findings to the skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI), and visceral adipose tissue index (VATI), which is defined as the body composition area (cm2) by height squared (m2). The clinical and laboratory features with body composition were analyzed to determine the risk factors for advanced fibrosis. The VATI significantly increased in severe non-alcoholic steatohepatitis (NASH) or advanced fibrosis. In addition, the VATI was correlated with the NAFLD activity score (NAS) and the fibrosis stage. In multivariate analyses, age (odds ratio (OR), 1.09; 95% confidence interval (CI), 1.02–1.19; p = 0.025), severe NASH (OR, 8.66; 95% CI, 2.13–46.40; p = 0.005), and visceral adiposity (OR, 6.77; 95% CI, 1.81–29.90; p = 0.007) were independently associated with advanced fibrosis in patients with NAFLD. Visceral adiposity is correlated with the histologic severity of NAFLD, which is independently associated with advanced fibrosis.
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Affiliation(s)
- Min-Kyu Kang
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea; (M.-K.K.); (J.-H.B.)
| | - Jung-Hun Baek
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea; (M.-K.K.); (J.-H.B.)
| | - Young-Oh Kweon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Korea; (Y.-O.K.); (W.-Y.T.); (S.-Y.J.); (Y.-R.L.)
| | - Won-Young Tak
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Korea; (Y.-O.K.); (W.-Y.T.); (S.-Y.J.); (Y.-R.L.)
| | - Se-Young Jang
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Korea; (Y.-O.K.); (W.-Y.T.); (S.-Y.J.); (Y.-R.L.)
| | - Yu-Rim Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Korea; (Y.-O.K.); (W.-Y.T.); (S.-Y.J.); (Y.-R.L.)
| | - Keun Hur
- Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University, Daegu 41944, Korea; (K.H.); (G.K.)
| | - Gyeonghwa Kim
- Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University, Daegu 41944, Korea; (K.H.); (G.K.)
| | - Hye-Won Lee
- Department of Pathology, School of Medicine, Keimyung University Dongsan Hospital, Daegu 42601, Korea;
| | - Man-Hoon Han
- Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Korea;
| | - Joon-Hyuk Choi
- Department of Pathology, College of Medicine, Yeungnam University, Daegu 42415, Korea;
| | - Soo-Young Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Korea; (Y.-O.K.); (W.-Y.T.); (S.-Y.J.); (Y.-R.L.)
- Correspondence: (S.-Y.P.); (J.-G.P.); Tel.: +82-53-200-5516 or +82-9205-3619 (S.-Y.P.); +82-53-620-3837 or +82-10-2957-1798 (J.-G.P.); Fax: +82-53-426-8773 (S.-Y.P.); +82-53-654-8386 (J.-G.P.)
| | - Jung-Gil Park
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea; (M.-K.K.); (J.-H.B.)
- Correspondence: (S.-Y.P.); (J.-G.P.); Tel.: +82-53-200-5516 or +82-9205-3619 (S.-Y.P.); +82-53-620-3837 or +82-10-2957-1798 (J.-G.P.); Fax: +82-53-426-8773 (S.-Y.P.); +82-53-654-8386 (J.-G.P.)
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Zubáňová V, Červinková Z, Kučera O, Palička V. The Connection between MicroRNAs from Visceral Adipose Tissue and Non-Alcoholic Fatty Liver Disease. ACTA MEDICA (HRADEC KRÁLOVÉ) 2021; 64:1-7. [PMID: 33855952 DOI: 10.14712/18059694.2021.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Non-Alcoholic Fatty Liver Disease (NAFLD) is one of the most important causes of liver disease worldwide leading the foreground cause of liver transplantation. Recently miRNAs, small non-coding molecules were identified as an important player in the negative translational regulation of many protein-coding genes involved in hepatic metabolism. Visceral adipose tissue was found to take part in lipid and glucose metabolism and to release many inflammatory mediators that may contribute to progression of NAFLD from simple steatosis to Non-Alcoholic SteatoHepatitis. Since visceral adipose tissue enlargement and dysregulated levels of miRNAs were observed in patients with NAFLD, the aim of this paper is to reflect the current knowledge of the role of miRNAs released from visceral adipose tissue and NAFLD.
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Affiliation(s)
- Veronika Zubáňová
- Department of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic.
| | - Zuzana Červinková
- Department of Physiology, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
| | - Otto Kučera
- Department of Physiology, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
| | - Vladimír Palička
- Department of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
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20
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Chiyanika C, Wong VWS, Wong GLH, Chan HLY, Hui SCN, Yeung DKW, Chu WCW. Implications of Abdominal Adipose Tissue Distribution on Nonalcoholic Fatty Liver Disease and Metabolic Syndrome: A Chinese General Population Study. Clin Transl Gastroenterol 2021; 12:e00300. [PMID: 33600104 PMCID: PMC7889374 DOI: 10.14309/ctg.0000000000000300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Visceral adipose tissue (VAT) has been found to play a critical role in the development of metabolic syndrome and nonalcoholic fatty liver disease (NAFLD) independent of generalized obesity. METHODS In this secondary study of prospectively acquired data, 625 participants underwent magnetic resonance spectroscopy and chemical shift fat-water separation MRI (2-point Dixon) of the liver and whole abdomen, respectively, in a 3 Tesla magnet. Whole abdominal VAT and subcutaneous adipose tissue (SAT) were extracted from the 2-point Dixon image series using an automated method. Clinical/anthropometric/blood biochemistry parameters were measured. Using region-specific body mass index, participants were classified into 3 paired subgroups (lean, overweight, and obese) and presence of NAFLD (liver fat content ≥ 5.5%). RESULTS All relevant clinical/anthropometric/blood biochemistry characteristics and liver enzymes were statistically significant between groups (P < 0.001). NAFLD was found in 12.1%, 43.8%, and 68.3% and metabolic syndrome in 51.1%, 61.9%, and 65% of the lean, overweight, and obese, respectively. Odds ratio for metabolic syndrome and NAFLD was increased by 2.73 (95% confidence interval [CI] 2.18-3.40) and 2.53 (95% CI 2.04-3.12), respectively, for 1SD increase in VAT volume while prevalence of metabolic syndrome was increased by 2.26 (95% CI 1.83-2.79) for 1SD increase in liver fat content (%). VAT/SAT ratio in the lean with fatty liver showed the highest ratio (0.54) among all the subgroups, without a significant difference between the lean and obese with NAFLD (P = 0.127). DISCUSSION Increased VAT volume/disproportional distribution of VAT/SAT may be vital drivers to the development of metabolic syndrome and NAFLD irrespective of body mass index category.
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Affiliation(s)
- Chileka Chiyanika
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Wai-Sun Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Grace Lai-Hung Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Henry Lik-Yuen Chan
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Steve C. N. Hui
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David K. W. Yeung
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie C. W. Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
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21
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Wang C, Cai Z, Deng X, Li H, Zhao Z, Guo C, Zhang P, Li L, Gu T, Yang L, Zhao L, Wang D, Yuan G. Association of Hepatic Steatosis Index and Fatty Liver Index with Carotid Atherosclerosis in Type 2 Diabetes. Int J Med Sci 2021; 18:3280-3289. [PMID: 34400897 PMCID: PMC8364463 DOI: 10.7150/ijms.62010] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background/aim: Previous studies have suggested that the hepatic steatosis index (HSI) and fatty liver index (FLI) can be used as a predictor of non-alcoholic fatty liver disease (NAFLD). The aim of our study was to determine whether non-invasive indices of hepatic steatosis (HSI and FLI) are associated with carotid atherosclerosis in type 2 diabetes mellitus (T2DM). Methods: This was a cross-sectional study conducted in the T2DM patients (n=768). Carotid intima-media thickness (CIMT) was measured by the Color Doppler ultrasound. The HSI was calculated based on gender, body mass index (BMI), and transaminases level. The FLI was based on BMI, waist circumference (WC), triacylglycerols (TG) and g-glutamyl transferase (GGT). Results: Raised HSI and FLI levels was associated with increased CIMT levels in T2DM patients. Patients with greater CIMT had higher HSI (39.10 ± 5.70 vs 36.10 ± 4.18, P < 0.001) and FLI (46.35 (29.96, 65.54) vs 36.93 (18.7, 57.93), P < 0.001) than those with lower CIMT. Subjects with existing carotid plaque had higher HSI (38.28 ± 5.63 vs 35.69 ± 3.45 P < 0.001) and FLI (47.41 (27.77, 66.62) vs 37.19 (17.71, 51.78), P < 0.001) accordingly. HSI (r = 0.343, P < 0.001) and FLI (r = 0.184, P < 0.001) were positively related with the CIMT. In the linear regression, after full adjustment metabolic risk factors, smoking, and measures of insulin resistance, HSI and FLI were independently associated with CIMT (HSI: β = 0.011, FLI: β = 0.001, all P < 0.01). Further, logistic regression analyses showed that higher HSI and FLI had an impact on the risk for carotid atherosclerosis [HSI: OR (95%CI): 1.174 (1.123-1.228), FLI: OR (95%CI): 1.011(1.004-1.019), all P < 0.01]. Overall, increasing values of HSI and FLI were associated with CIMT (P < 0.05) significantly across different categories of age and hypertension. Conclusion: Current data suggest HSI and FLI are independently correlated with carotid atherosclerosis in T2DM. They may be a simple and useful marker for assessing the progression of diabetic macrovascular complications.
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Affiliation(s)
- Chenxi Wang
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Zhensheng Cai
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Xia Deng
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Haoxiang Li
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Zhicong Zhao
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Chang Guo
- Department of Nephrology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Panpan Zhang
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Lian Li
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Tian Gu
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Ling Yang
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Li Zhao
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Dong Wang
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
| | - Guoyue Yuan
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China
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Hernández-Conde M, Llop E, Carrillo CF, Tormo B, Abad J, Rodriguez L, Perelló C, Gomez ML, Martínez-Porras JL, Puga NF, Trapero-Marugan M, Fraga E, Aracil CF, Panero JLC. Estimation of visceral fat is useful for the diagnosis of significant fibrosis in patients with non-alcoholic fatty liver disease. World J Gastroenterol 2020; 26:6658-6668. [PMID: 33268953 PMCID: PMC7673970 DOI: 10.3748/wjg.v26.i42.6658] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease (NAFLD), although obese patients with NAFLD do not always develop significant fibrosis. The distribution of body fat could predict the risk of NAFLD progression.
AIM To investigate the role of bioelectrical impedance-estimated visceral fat (VF) in assessing NAFLD severity.
METHODS In this cross-sectional study, patients with biopsy-proven NAFLD were prospectively included. All patients underwent anthropometric evaluation, blood tests and bioelectrical impedance analysis.
RESULTS Between 2017 and 2020, 119 patients were included [66.4% male, 56 years (SD 10.7), 62.2% obese, 61.3% with metabolic syndrome]. Sixty of them (50.4%) showed significant fibrosis (≥ F2) in liver biopsy. Age, VF and metabolic syndrome were associated with significant fibrosis (61 years vs 52 years, 16.4 vs 13.1, 73.3% vs 49.2%, respectively; P < 0.001 for all). In the multivariate analysis, VF and age were independently associated with significant fibrosis (VF, OR: 1.11, 95%CI: 1.02-1.22, P = 0.02; age, OR: 1.08, 95%CI: 1.03-1.12, P < 0.01). A model including these variables showed and area under the receiver operating characteristic curve (AUROC) of 0.75, which was not inferior to transient elastography or NAFLD fibrosis score AUROCs. We developed a nomogram including age and VF for assessing significant fibrosis in routine practice.
CONCLUSION VF is a surrogate marker of liver fibrosis in patients with NAFLD. Bioelectrical impedance analysis is an inexpensive and simple method that can be combined with age to guide patient referral when other resources may be unavailable.
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Affiliation(s)
- Marta Hernández-Conde
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
| | - Elba Llop
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
- Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Carlos Fernández Carrillo
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
- Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Beatriz Tormo
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
| | - Javier Abad
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
| | - Luis Rodriguez
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
| | - Christie Perelló
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
| | - Marta López Gomez
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
| | - José Luis Martínez-Porras
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
| | - Natalia Fernández Puga
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
| | - Maria Trapero-Marugan
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
- Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Enrique Fraga
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
- Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Carlos Ferre Aracil
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
| | - José Luis Calleja Panero
- Gastroenterology and Hepatology Department, IDIPHISA, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
- Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas, Instituto de Salud Carlos III, Madrid 28029, Spain
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Yasukawa K, Shimizu A, Yokoyama T, Kubota K, Notake T, Seki H, Kobayashi A, Soejima Y. Preventive Effect of High-Dose Digestive Enzyme Management on Development of Nonalcoholic Fatty Liver Disease after Pancreaticoduodenectomy: A Randomized Controlled Clinical Trial. J Am Coll Surg 2020; 231:658-669. [PMID: 32927075 DOI: 10.1016/j.jamcollsurg.2020.08.761] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is a complication of pancreaticoduodenectomy (PD). We conducted a randomized clinical trial to determine if high-dose digestive enzymes prevented the development of NAFLD after PD. STUDY DESIGN This parallel-group, nonblinded, multicenter study enrolled patients undergoing elective PD at Shinshu University School of Medicine, from June 2011 to April 2017. Patients were randomly assigned to receive normal-dose (Excelase: 3.0 g/day [Meiji Seika Pharma Holdings Co, Ltd]) or high-dose digestive enzyme treatment (Excelase: 3.0 g/day; Pancreatin [Tokyo Chemical Industry Co Ltd]: 3.0 g/day; Berizym [Kyowa Pharmaceutical Industry Co Ltd]: 3.0 g/day; and Toughmac-E [Ono Pharmaceutical Co, Ltd]: 3.0 g/day) within 1 week after surgery. Because patients in the control group switched interventions upon receiving a diagnosis of NAFLD, intention-to-treat analysis was used. The primary endpoint was incidence of NAFLD within 1 year, and the secondary endpoints were the incidences of NAFLD at 1, 3, 6, and 12 months and the rate of improvement in NAFLD with high-dose transfer in the control group. The secondary analysis comprised assessment of risk factors for the development of NAFLD. RESULTS Eighty-four patients were randomly assigned (42 per group), 80 of whom were finally analyzed (39 normal-dose, 41 high-dose). The incidence of NAFLD was significantly lower in the high-dose (8 of 41) compared with the normal-dose (25 of 39) patients (p < 0.001). Multivariate analysis identified normal-dose (odds ratio [OR] 14.65, p < 0.001), total protein ≤ 6.5g/dL (OR 9.01, p = 0.018), pre-albumin ≤ 22.0 mg/dL (OR 7.71, p = 0.018), and pancreatic function diagnostic test ≤ 70% (OR 6.66, p = 0.009) as independent risk factors. There were no adverse effects. The model was accurate (c-index = 0.92) and reliable (Hosmer-Lemeshow test p = 0.32). CONCLUSIONS High-dose administration of digestive enzymes significantly reduced the onset of NAFLD after PD compared with normal-dose administration. Registration number: UMIN000005595 (http://www.umin.ac.jp/ctr/).
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Affiliation(s)
- Koya Yasukawa
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation, and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
| | - Akira Shimizu
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation, and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takahide Yokoyama
- Gastroenterological Surgery, National Hospital Organization Shinshu Ueda Medical Center, Ueda, Japan
| | - Koji Kubota
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation, and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tsuyoshi Notake
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation, and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hitoshi Seki
- Gastroenterological Surgery, Nagano Municipal Hospital, Nagano, Japan
| | - Akira Kobayashi
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation, and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuji Soejima
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation, and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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Kenngott HG, Nickel F, Wise PA, Wagner F, Billeter AT, Nattenmüller J, Nabers D, Maier-Hein K, Kauczor HU, Fischer L, Müller-Stich BP. Weight Loss and Changes in Adipose Tissue and Skeletal Muscle Volume after Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: a Prospective Study with 12-Month Follow-Up. Obes Surg 2020; 29:4018-4028. [PMID: 31309523 DOI: 10.1007/s11695-019-04087-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study aimed to evaluate changes in body tissue composition with obesity surgery regarding visceral fat, subcutaneous fat, and skeletal muscle. DESIGN Prospective non-randomized single-center cohort study METHODS: Whole-body magnetic resonance imaging (MRI) measured volumes of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle (SM) in 31 patients with laparoscopic sleeve gastrectomy (LSG, 20) or Roux-en-Y gastric bypass (RYGB, 11) preoperatively, at three- and 12-months follow-up. RESULTS Body mass index (BMI) went down from 45.2 ± 6.5 preoperatively to 37.2 ± 5.6 (p < 0.001) at three months and 32.2 ± 5.3 kg/m2 (p < 0.001) at 12 months. SAT went down from 55.0 ± 14.0 L (liter) to 42.2 ± 13.3 L (p < 0.001) at three months and 31.7 ± 10.5 L (p < 0.001) at 12 months (- 42.3%). VAT went down from 6.5 ± 2.3 to 4.5 ± 1.7 (p < 0.001) at three months and 3.1 ± 1.7 L (p < 0.001) at 12 months (- 52.3%). SM went down from 22.7 ± 4.8 to 20.4 ± 3.6 (p = 0.008) at three months and remained 20.2 ± 4.6 L at 12 months (p = 0.17 relative three-month; p = 0.04 relative preop, - 11.1%). Relative loss was higher for VAT than that for SAT (52.3 ± 18.2% vs. 42.3 ± 13.8%; p = 0.03). At 12 months, there was no difference between LSG and RYGB for relative changes in BMI or body tissue composition. CONCLUSION Postoperatively, there was higher net loss of SAT but higher relative loss of VAT with weight loss. SM was lost only during the first three months. MRI provides accurate evaluation of surgeries' effect on individual patients' tissue composition. This can benefit risk assessment for related cardiovascular and metabolic health but cost-related factors will likely reserve the used methods for research.
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Affiliation(s)
- Hannes Götz Kenngott
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Philipp Anthony Wise
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Felix Wagner
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Adrian Theophil Billeter
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Johanna Nattenmüller
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Diana Nabers
- Division of Medical Image Computing, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Klaus Maier-Hein
- Division of Medical Image Computing, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Lars Fischer
- Department of Surgery, Hospital Mittelbaden, Balgerstrasse 50, 76532, Baden-Baden, Germany
| | - Beat Peter Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
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Sawazaki H, Kitamura Y, Yagi K, Arai Y. Impact of Androgen Deprivation Therapy on Non-Alcoholic Fatty Liver Disease in Patients with Prostate Cancer: A CT Evaluation. Urol Int 2020; 104:425-430. [PMID: 32396918 DOI: 10.1159/000507351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/18/2020] [Indexed: 01/14/2023]
Abstract
PURPOSE The aim of this study was to investigate the influence of androgen deprivation therapy (ADT) on the progression of non-alcoholic fatty liver disease (NAFLD) in patients with prostate cancer (PCa) by evaluation of hepatic steatosis on computed tomography (CT). METHODS The study included 77 PCa patients who underwent abdominal CT at baseline and after 6 months of ADT. The degree of hepatic steatosis was evaluated according to the attenuation value for liver parenchyma (CTLP), the attenuation ratio for liver and spleen (LSratio), and the difference in attenuation between LS (LSdif). The associations between these 3 indices and various metabolic syndrome-related factors were analyzed. RESULTS The number of NAFLD patients increased from 9 (11.6%) at baseline to 16 (20.7%) after ADT. The CTLP, LSratio, and LSdif values were significantly lower after ADT than before (p < 0.05). There were significant correlations between the percent change in CTLP and the percent change in HbA1c, between the percent change in LSratio and the percent change in abdominal circumference, and between the percent change in LSdif and the percent change in BMI. CONCLUSIONS Six months of ADT was associated with significant progression of NAFLD in PCa patients. This progression was strongly correlated with changes in HbA1c, abdominal circumference, and BMI.
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Affiliation(s)
- Harutake Sawazaki
- Department of Urology, Tama-Hokubu Medical Center, Higashimurayama, Japan,
| | - Yosuke Kitamura
- Department of Urology, National Defense Medical College, Tokorozawa, Japan
| | - Kota Yagi
- Department of Urology, National Defense Medical College, Tokorozawa, Japan
| | - Yuichi Arai
- Department of Urology, National Defense Medical College, Tokorozawa, Japan
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26
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Jamali R, Ebrahimi M, Faryabi A, Ashraf H. Which Metabolic Index is Appropriate for Predicting Non-alcoholic Steatohepatitis? Middle East J Dig Dis 2020; 12:99-105. [PMID: 32626562 PMCID: PMC7320990 DOI: 10.34172/mejdd.2020.168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There are controversial ideas about the application of metabolic indices for the prediction of nonalcoholic steatohepatitis (NASH). In this study, we evaluated some novel metabolic indices for the screening of NASH. METHODS This prospective case-control study was performed in a gastroenterology outpatient clinic. Consecutively selected patients with persistently elevated aminotransferase levels and evidence of fatty liver in ultrasonography were enrolled. Those with other etiologies of aminotransferase elevation were excluded. The remaining was presumed to have NASH. The control group consisted of age and sex-matched subjects with normal liver function tests and liver ultrasound examinations. RESULTS Finally, 94 patients with steatohepatitis and 106 controls were included in the project. The mean liver fat content (LFC), aspartate aminotransferase, and alanine aminotransferase levels were significantly lower in the control group than in the NASH group. LFC was independently associated with the presence of NASH in logistic regression analysis. LFC had a good area under the curve for the prediction of NASH in ROC (receiver operating characteristic curve) analysis. CONCLUSION LFC seems to be a reliable metabolic index for the detection of patients with NASH.
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Affiliation(s)
- Raika Jamali
- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Ebrahimi
- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Faryabi
- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Haleh Ashraf
- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Nonalcoholic Fatty Liver Disease: A Challenge from Mechanisms to Therapy. J Clin Med 2019; 9:jcm9010015. [PMID: 31861591 PMCID: PMC7019297 DOI: 10.3390/jcm9010015] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/05/2019] [Accepted: 12/16/2019] [Indexed: 12/11/2022] Open
Abstract
Focusing on previously published mechanisms of non-alcoholic fatty liver disease (NAFLD), their uncertainty does not always permit a clear elucidation of the grassroot alterations that are at the basis of the wide-spread illness, and thus curing it is still a challenge. There is somehow exceptional progress, but many controversies persist in NAFLD research and clinical investigation. It is likely that hidden mechanisms will be brought to light in the near future. Hereby, the authors present, with some criticism, classical mechanisms that stand at the basis of NAFLD, and consider contextually different emerging processes. Without ascertaining these complex interactions, investigators have a long way left ahead before finding an effective therapy for NAFLD beyond diet and exercise.
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28
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Influence of lifestyle factors and staple foods from the Mediterranean diet on non-alcoholic fatty liver disease among older individuals with metabolic syndrome features. Nutrition 2019; 71:110620. [PMID: 31838461 DOI: 10.1016/j.nut.2019.110620] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 09/26/2019] [Accepted: 10/06/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver morbidity. This condition often is accompanied by obesity, diabetes, and metabolic syndrome (MetS). The aim of this study was to evaluate the connection between lifestyle factors and NAFLD in individuals with MetS. METHODS A cross-sectional study with 328 participants (55-75 y of age) diagnosed with MetS participating in the PREDIMED-Plus trial was conducted. NAFLD status was evaluated using the non-invasive hepatic steatosis index (HSI). Sociodemographic, clinical, and dietary data were collected. Adherence to the Mediterranean diet (mainly assessed by the consumption of olive oil, nuts, legumes, whole grain foods, fish, vegetables, fruits, and red wine) and physical activity were assessed using validated questionnaires. RESULTS Linear regression analyses revealed that HSI values tended to be lower with increasing physical activity tertiles (T2, β = -1.47; 95% confidence interval [CI], -2.73 to -0.20; T3, β = -1.93; 95% CI, -3.22 to -0.65 versus T1, Ptrend = 0.001) and adherence to the Mediterranean diet was inversely associated with HSI values: (moderate adherence β = -0.70; 95% CI, -1.92 to 0.53; high adherence β = -1.57; 95% CI, -3.01 to -0.13 versus lower, Ptrend = 0.041). Higher tertiles of legume consumption were inversely associated with the highest tertile of HSI (T2, relative risk ratio [RRR], 0.45; 95% CI, 0.22-0.92; P = 0.028; T3, RRR, 0.48; 95% CI, 0.24-0.97; P = 0.041 versus T1). CONCLUSION Physical activity, adherence to the Mediterranean diet, and consumption of legumes were inversely associated with a non-invasive marker of NAFLD in individuals with MetS. This data can be useful in implementing precision strategies aimed at the prevention, monitoring, and management of NAFLD.
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Kadowaki S, Tamura Y, Someya Y, Takeno K, Kaga H, Sugimoto D, Kakehi S, Funayama T, Furukawa Y, Suzuki R, Nishitani-Yokoyama M, Shimada K, Daida H, Aoki S, Kanazawa A, Kawamori R, Watada H. Fatty Liver Has Stronger Association With Insulin Resistance Than Visceral Fat Accumulation in Nonobese Japanese Men. J Endocr Soc 2019; 3:1409-1416. [PMID: 31286107 PMCID: PMC6608549 DOI: 10.1210/js.2019-00052] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/14/2019] [Indexed: 02/07/2023] Open
Abstract
Context Asians have a high prevalence of insulin resistance, even in the nonobese state. Whereas both visceral fat accumulation (VFA) and fatty liver (FL) have been shown to be associated with insulin resistance, it is still unclear which is a better marker to predict insulin resistance in nonobese Asians. Objective The aim of this study was to investigate the relation between VFA or FL and insulin resistance in nondiabetic nonobese Japanese men who do not have diabetes. Design and Participants We studied 87 nonobese (body mass index <25 kg/m2) Japanese men without diabetes. Using a two-step hyperinsulinemic euglycemic clamp, we evaluated insulin sensitivity in adipose tissue, muscle, and liver. Intrahepatic lipid and abdominal visceral fat area were measured by 1H-magnetic resonance spectroscopy and MRI, respectively. Subjects were divided into four groups based on the presence or absence of VFA (visceral fat area ≥100 cm2) and FL (intrahepatic lipid ≥ 5%): control (non-VFA, non-FL; n = 54), VFA only (n = 18), FL only (n = 7), and VFA plus FL (n = 8). Results Subjects in the FL only and VFA plus FL groups had insulin resistance in adipose tissue and muscle, as well as relatively lower hepatic insulin sensitivity. The specific insulin sensitivities in these organs were comparable in the VFA only and control groups. Conclusions In nonobese Japanese men without diabetes, subjects with FL only or VFA plus FL but not VFA only had insulin resistance, suggesting that FL may be a more useful clinical marker than VFA to predict insulin resistance in nonobese Japanese men without diabetes.
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Affiliation(s)
- Satoshi Kadowaki
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshifumi Tamura
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Someya
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kageumi Takeno
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hideyoshi Kaga
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Daisuke Sugimoto
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Saori Kakehi
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takashi Funayama
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasuhiko Furukawa
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ruriko Suzuki
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | - Kazunori Shimada
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Daida
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akio Kanazawa
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryuzo Kawamori
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Center for Identification of Diabetic Therapeutic Targets, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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