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Rodríguez-Hernández N, Lazo-de-la-Vega-Monroy ML, Ruiz-Noa Y, Preciado-Puga MDC, Garcia-Ramirez JR, Jordan-Perez B, Garnelo-Cabañas S, Ibarra-Reynoso LDR. Predictive Models for Non-Alcoholic Fatty Liver Disease Diagnosis in Mexican Patients with Gallstone Disease: Sex-Specific Insights. Diagnostics (Basel) 2024; 14:1487. [PMID: 39061624 PMCID: PMC11275442 DOI: 10.3390/diagnostics14141487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/29/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Background: Evidence regarding Non-Alcoholic Fatty Liver Disease (NAFLD) diagnosis is limited in the context of patients with gallstone disease (GD). This study aimed to assess the predictive potential of conventional clinical and biochemical variables as combined models for diagnosing NAFLD in patients with GD. (2) Methods: A cross-sectional study including 239 patients with GD and NAFLD diagnosed by ultrasonography who underwent laparoscopic cholecystectomy and liver biopsy was conducted. Previous clinical indices were also determined. Predictive models for the presence of NAFLD stratified by biological sex were obtained through binary logistic regression and sensitivity analyses were performed. (3) Results: For women, the model included total cholesterol (TC), age and alanine aminotransferase (ALT) and showed an area under receiver operating characteristic curve (AUC) of 0.727 (p < 0.001), sensitivity of 0.831 and a specificity of 0.517. For men, the model included TC, body mass index (BMI) and aspartate aminotransferase (AST), had an AUC of 0.898 (p < 0.001), sensitivity of 0.917 and specificity of 0.818. In both sexes, the diagnostic performance of the designed equations was superior to the previous indices. (4) Conclusions: These models have the potential to offer valuable guidance to healthcare providers in clinical decision-making, enabling them to achieve optimal outcomes for each patient.
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Affiliation(s)
- Nemry Rodríguez-Hernández
- Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Leon de los Aldama 37320, Mexico; (N.R.-H.); (M.-L.L.-d.-l.-V.-M.); (Y.R.-N.)
| | - María-Luisa Lazo-de-la-Vega-Monroy
- Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Leon de los Aldama 37320, Mexico; (N.R.-H.); (M.-L.L.-d.-l.-V.-M.); (Y.R.-N.)
| | - Yeniley Ruiz-Noa
- Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Leon de los Aldama 37320, Mexico; (N.R.-H.); (M.-L.L.-d.-l.-V.-M.); (Y.R.-N.)
| | - Monica-del-Carmen Preciado-Puga
- Department of Medicine and Nutrition, Health Sciences Division, University of Guanajuato, Leon Campus, Leon de los Aldama 37320, Mexico; (M.-d.-C.P.-P.); (J.-R.G.-R.)
| | - Juana-Rosalba Garcia-Ramirez
- Department of Medicine and Nutrition, Health Sciences Division, University of Guanajuato, Leon Campus, Leon de los Aldama 37320, Mexico; (M.-d.-C.P.-P.); (J.-R.G.-R.)
| | - Benjamin Jordan-Perez
- Department of Surgery, General Hospital Leon, Leon de los Aldama 37320, Mexico; (B.J.-P.); (S.G.-C.)
| | - Serafin Garnelo-Cabañas
- Department of Surgery, General Hospital Leon, Leon de los Aldama 37320, Mexico; (B.J.-P.); (S.G.-C.)
| | - Lorena-del-Rocío Ibarra-Reynoso
- Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Leon de los Aldama 37320, Mexico; (N.R.-H.); (M.-L.L.-d.-l.-V.-M.); (Y.R.-N.)
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Baek SU, Won JU, Lee YM, Yoon JH. Association between long working hours and metabolic dysfunction-associated steatotic liver disease: a nationwide population-based study in Korea. Public Health 2024; 232:188-194. [PMID: 38796916 DOI: 10.1016/j.puhe.2024.04.034] [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: 11/18/2023] [Revised: 04/13/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES Long working hour is a known risk factor for metabolic diseases. We explored the association between working hours and metabolic dysfunction-associated steatotic liver disease (MASLD). STUDY DESIGN Data on working hours among 22,818 workers (11,999 females) from the Korea National Health and Nutrition Examination Survey (2013-2021) were used for this study. METHODS MASLD was defined as a combination of hepatic steatosis combined with one or more of cardiometabolic risk factors (overweight/obesity, prediabetes/diabetes, raised blood pressure, hypertriglyceridemia, low high-density lipoprotein cholesterol). Hepatic steatosis was assessed using the hepatic steatosis index. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The overall prevalence of MASLD was 30.4% in men and 18.1% in women. Among male workers, 20.2% worked ≥55 h/week, whereas among female workers, 10.1% worked ≥55 h/week. Compared with working 35-40 h/week, working ≥55 h/week was positively associated with overweight/obesity (OR: 1.21; 95% CI: 1.05-1.40), pre-diabetes mellitus (pre-DM)/DM (OR: 1.20; 95% CI: 1.04-1.38), raised blood pressure (OR: 1.17; 95% CI: 1.02-1.35), and presence of any cardiometabolic risk factors (OR: 1.56; 95% CI: 1.21-2.02). The adjusted OR (95% CI) of the association between working hours and MASLD was 1.27 (1.09-1.47) for ≥55 h/week compared with working 35-40 h/week in male workers. In female workers, long working hours were not clearly associated with cardiometabolic risk factors and MASLD. CONCLUSION Long working hours are positively associated with MASLD among Korean male workers. Policy interventions are needed to mitigate the adverse metabolic effects of prolonged working hours.
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Affiliation(s)
- S-U Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea; Graduate School, Yonsei University College of Medicine, Seoul, South Korea
| | - J-U Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
| | - Y-M Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
| | - J-H Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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Cao L, An Y, Liu H, Jiang J, Liu W, Zhou Y, Shi M, Dai W, Lv Y, Zhao Y, Lu Y, Chen L, Xia Y. Global epidemiology of type 2 diabetes in patients with NAFLD or MAFLD: a systematic review and meta-analysis. BMC Med 2024; 22:101. [PMID: 38448943 PMCID: PMC10919055 DOI: 10.1186/s12916-024-03315-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) and metabolic-associated fatty liver disease (MAFLD) shares common pathophysiological mechanisms with type 2 diabetes, making them significant risk factors for type 2 diabetes. The present study aimed to assess the epidemiological feature of type 2 diabetes in patients with NAFLD or MAFLD at global levels. METHODS Published studies were searched for terms that included type 2 diabetes, and NAFLD or MAFLD using PubMed, EMBASE, MEDLINE, and Web of Science databases from their inception to December 2022. The pooled global and regional prevalence and incidence density of type 2 diabetes in patients with NAFLD or MAFLD were evaluated using random-effects meta-analysis. Potential sources of heterogeneity were investigated using stratified meta-analysis and meta-regression. RESULTS A total of 395 studies (6,878,568 participants with NAFLD; 1,172,637 participants with MAFLD) from 40 countries or areas were included in the meta-analysis. The pooled prevalence of type 2 diabetes among NAFLD or MAFLD patients was 28.3% (95% confidence interval 25.2-31.6%) and 26.2% (23.9-28.6%) globally. The incidence density of type 2 diabetes in NAFLD or MAFLD patients was 24.6 per 1000-person year (20.7 to 29.2) and 26.9 per 1000-person year (7.3 to 44.4), respectively. CONCLUSIONS The present study describes the global prevalence and incidence of type 2 diabetes in patients with NAFLD or MAFLD. The study findings serve as a valuable resource to assess the global clinical and economic impact of type 2 diabetes in patients with NAFLD or MAFLD.
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Affiliation(s)
- Limin Cao
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Yu An
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Huiyuan Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research On Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Jinguo Jiang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research On Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Wenqi Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research On Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Yuhan Zhou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research On Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Mengyuan Shi
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research On Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Wei Dai
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research On Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Yanling Lv
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research On Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Yanhui Lu
- School of Nursing, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China.
- Liaoning Key Laboratory of Precision Medical Research On Major Chronic Disease, Liaoning Province, Shenyang, China.
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Baek SU, Won JU, Lee YM, Yoon JH. Association between long working hours and diet quality and patterns: A latent profile analysis of a nationally representative sample of Korean workers. Prev Med 2024; 180:107890. [PMID: 38336280 DOI: 10.1016/j.ypmed.2024.107890] [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: 12/20/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Long working hours are associated with cardiovascular and metabolic diseases. This study investigated the relationship between the working hours and dietary qualities and patterns in Korean workers. METHODS Data from 24,523 workers were extracted from the Korea National Health and Nutrition Examination Survey, 2013-2021. The Korean Healthy Eating Index (KHEI), which ranges from 0 to 100, with a higher score indicating greater adherence to Korean dietary guidelines and superior dietary quality, was used for dietary assessment. We identified dietary patterns and classified workers using latent profile analysis. Logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Five distinct dietary patterns emerged: healthy diet (24.8%), low-vegetable diet (14.0%), average diet (7.8%), low-fruit diet (31.4%), and poor diet (22.0%). The mean KHEI score was 60.8, with the highest score observed in the healthy diet pattern (71.3) and the lowest, in the poor diet pattern (50.0). Compared with working 35-40 h/week, working ≥55 h/week was negatively associated with KHEI scores (β: -1.08; 95% CI: -1.67, -0.49). Those working ≥55 h/week were less likely to have a healthy diet pattern (OR: 0.81; 95% CI: 0.72, 0.91) and more likely to have a low-fruit diet (OR: 1.36; 95% CI: 1.20, 1.55) or poor diet pattern (OR: 1.23; 95% CI: 1.05, 1.43) compared with those working 35-40 h/week. CONCLUSION Long working hours are associated with undesirable dietary quality and patterns. Policy interventions aimed at enhancing dietary quality are needed to alleviate the health burdens associated with long working hours.
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Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu-Min Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Padilla J, Osman NM, Bissig-Choisat B, Grimm SL, Qin X, Major AM, Yang L, Lopez-Terrada D, Coarfa C, Li F, Bissig KD, Moore DD, Fu L. Circadian dysfunction induces NAFLD-related human liver cancer in a mouse model. J Hepatol 2024; 80:282-292. [PMID: 37890720 PMCID: PMC10929560 DOI: 10.1016/j.jhep.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/21/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND & AIMS Chronic circadian dysfunction increases the risk of non-alcoholic fatty liver disease (NAFLD)-related hepatocellular carcinoma (HCC), but the underlying mechanisms and direct relevance to human HCC have not been established. In this study, we aimed to determine whether chronic circadian dysregulation can drive NAFLD-related carcinogenesis from human hepatocytes and human HCC progression. METHODS Chronic jet lag of mice with humanized livers induces spontaneous NAFLD-related HCCs from human hepatocytes. The clinical relevance of this model was analysed by biomarker, pathological/histological, genetic, RNA sequencing, metabolomic, and integrated bioinformatic analyses. RESULTS Circadian dysfunction induces glucose intolerance, NAFLD-associated human HCCs, and human HCC metastasis independent of diet in a humanized mouse model. The deregulated transcriptomes in necrotic-inflammatory humanized livers and HCCs bear a striking resemblance to those of human non-alcoholic steatohepatitis (NASH), cirrhosis, and HCC. Stable circadian entrainment of hosts rhythmically paces NASH and HCC transcriptomes to decrease HCC incidence and prevent HCC metastasis. Circadian disruption directly reprogrammes NASH and HCC transcriptomes to drive a rapid progression from hepatocarcinogenesis to HCC metastasis. Human hepatocyte and tumour transcripts are clearly distinguishable from mouse transcripts in non-parenchymal cells and tumour stroma, and display dynamic changes in metabolism, inflammation, angiogenesis, and oncogenic signalling in NASH, progressing to hepatocyte malignant transformation and immunosuppressive tumour stroma in HCCs. Metabolomic analysis defines specific bile acids as prognostic biomarkers that change dynamically during hepatocarcinogenesis and in response to circadian disruption at all disease stages. CONCLUSION Chronic circadian dysfunction is independently carcinogenic to human hepatocytes. Mice with humanized livers provide a powerful preclinical model for studying the impact of the necrotic-inflammatory liver environment and neuroendocrine circadian dysfunction on hepatocarcinogenesis and anti-HCC therapy. IMPACT AND IMPLICATIONS Human epidemiological studies have linked chronic circadian dysfunction to increased hepatocellular carcinoma (HCC) risk, but direct evidence that circadian dysfunction is a human carcinogen has not been established. Here we show that circadian dysfunction induces non-alcoholic steatohepatitis (NASH)-related carcinogenesis from human hepatocytes in a murine humanized liver model, following the same molecular and pathologic pathways observed in human patients. The gene expression signatures of humanized HCC transcriptomes from circadian-disrupted mice closely match those of human HCC with the poorest prognostic outcomes, while those from stably circadian entrained mice match those from human HCC with the best prognostic outcomes. Our studies establish a new model for defining the mechanism of NASH-related HCC and highlight the importance of circadian biology in HCC prevention and treatment.
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Affiliation(s)
- Jennifer Padilla
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Noha M Osman
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Beatrice Bissig-Choisat
- Department of Pediatrics, Division of Medical Genetics, Y.T. and Alice Chen Pediatric Genetics and Genomics Research Center, Duke University, Durham, NC 27710, USA
| | - Sandra L Grimm
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Xuan Qin
- NMR and Drug Metabolic Core, Baylor College of Medicine, Houston, TX 77030, USA; Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Angela M Major
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Li Yang
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Dolores Lopez-Terrada
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Cristian Coarfa
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Feng Li
- NMR and Drug Metabolic Core, Baylor College of Medicine, Houston, TX 77030, USA; Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Karl-Dimiter Bissig
- Department of Pediatrics, Division of Medical Genetics, Y.T. and Alice Chen Pediatric Genetics and Genomics Research Center, Duke University, Durham, NC 27710, USA
| | - David D Moore
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, CA94720, USA.
| | - Loning Fu
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA.
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Zhang S, Liu Z, Yang Q, Hu Z, Zhou W, Ji G, Dang Y. Impact of smoking cessation on non-alcoholic fatty liver disease prevalence: a systematic review and meta-analysis. BMJ Open 2023; 13:e074216. [PMID: 38072477 PMCID: PMC10729067 DOI: 10.1136/bmjopen-2023-074216] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES The negative effects of smoking on numerous cardiovascular and metabolic diseases have been widely acknowledged. However, the potential effect of smoking cessation is relatively unelucidated. The objective of this study is to explore whether the prevalence of non-alcoholic fatty liver disease (NAFLD) in former smokers differs from the prevalence in current smokers. DESIGN Systematic review and meta-analysis. DATA SOURCES Four databases, that is, PubMed, Web of Science, Journal@Ovid and Scopus were searched from inception to 31 January 2023. ELIGIBILITY CRITERIA Population-based cross-sectional studies, including the baseline data of cohort studies with identified NAFLD diagnostic methods, and smoking status (current smoker or former smoker) of participants were included. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted the data including cigarette smoking status, country/region of studies, NAFLD diagnostic methods, sex, the average age and body mass index (BMI) of NAFLD participants and assessed the risk of bias with Agency for Healthcare Research and Quality (AHRQ) methodology checklist. Risk ratio (RR) of NAFLD prevalence in former smokers was pooled using the random-effects model. RESULTS 28 studies involving 4 465 862 participants were included. Compared with current smokers, the RR of overall NAFLD prevalence in former smokers was 1.13 (95% CI: 1.08 to 1.19, prediction interval: 0.92-1.39). This result persisted after adjustment for diagnostic methods, country/region, sex, age and BMI. Sensitivity analysis and risk of bias assessment indicated a stable conclusion. CONCLUSIONS NAFLD prevalence in former smokers was at least not lower than that in current smokers and was partially related to increased BMI after smoking cessation, indicating that smoking cessation was possibly not a protective factor against NAFLD. Although the meta-analysis based on cross-sectional studies cannot conclude the causal relationships between smoking cessation and NAFLD onset, the potential onset of NAFLD associated with smoking cessation should be highlighted. PROSPERO REGISTRATION NUMBER CRD42023394944.
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Affiliation(s)
- Shengan Zhang
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhidong Liu
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qinghua Yang
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai, China
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Zichun Hu
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai, China
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Wenjun Zhou
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guang Ji
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanqi Dang
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai, China
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El-Eshmawy MM. Impact of obesity on liver function tests: is nonalcoholic fatty liver disease the only player? A review article. Porto Biomed J 2023; 8:e228. [PMID: 37846300 PMCID: PMC10575409 DOI: 10.1097/j.pbj.0000000000000228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 10/18/2023] Open
Abstract
Objectives Obesity and nonalcoholic fatty liver disease (NAFLD) are common worldwide health problems with a strong relationship in between. NAFLD is currently the most common cause of abnormal liver function tests (LFT) because of obesity pandemic. The question is NAFLD the only player of abnormal LFT in obesity? Methodology This article reviews the most important topics regarding the derangements of LFT in obesity through a PubMed search strategy for all English-language literature. Results The reported abnormal LFT in obesity were increased serum levels of transaminases (alanine aminotransaminase, aspartate aminotransaminase), gamma glutamyl transferase, and alkaline phosphatase and decreased serum levels of bilirubin and albumin. Besides novel potential hepatic markers of NAFLD/NASH such as triglycerides/high-density lipoprotein cholesterol ratio, sex hormone-binding globulin, fibroblast growth factor 21, and markers of hepatocyte apoptosis i.e. cytokeratin 18 and microribonucleic acids (miRNAs). Beyond NAFLD, there are other underlying players for the abnormal LFT in obesity such as oxidative stress, inflammation, and insulin resistance. Conclusion Derangements of LFT in obesity are attributed to NAFLD but also to obesity itself and its related oxidative stress, insulin resistance, and chronic inflammatory state. Abnormal LFT predict more than just liver disease.
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Affiliation(s)
- Mervat M. El-Eshmawy
- Department of Internal Medicine, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Egypt
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Lim GY, Chang Y, Kim I, Ryu S, Kwon R, Song J. Long working hours and increased risks of lean non-alcoholic fatty liver disease among Korean men and women. Sci Rep 2023; 13:12230. [PMID: 37507409 PMCID: PMC10382542 DOI: 10.1038/s41598-023-39154-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Despite the increasing prevalence of lean nonalcoholic fatty liver disease (NAFLD), its risk factors are not well established. We examined the association between long working hours and incident NAFLD in lean Korean workers with emphasis on sex-based effect modification. This cohort study involved 46,113 non-overweight (BMI < 23 kg/m2) and NAFLD-free Korean workers (mean age, 35.5 years). Working hours were categorized into 35-40 (reference), 41-52, and ≥ 53 h. The presence of fatty liver and its severity were determined using ultrasonography and NAFLD fibrosis score (NFS), respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using parametric proportional hazards models. Incident cases of 5901 lean NAFLD developed over a median follow-up of 3.8 years. The incidence of lean NAFLD increased with increasing working hours with a stronger association in men than in women (P for interaction < 0.001). For men, multivariable-adjusted HRs (95% CIs) for lean NAFLD in time-dependent models comparing working hours of 41-52 and ≥ 53 h compared to the reference category were 1.17 (1.07-1.28) and 1.25 (1.12-1.39), respectively. The excess relative risk of developing lean NAFLD with intermediate/high NFS was observed in working hours of 41-52 and ≥ 53 h with a corresponding HR of 1.66 (1.13-2.43) and 1.54 (0.94-2.51), respectively. Conversely, no significant associations were found between working hours and incidence of lean NAFLD in women. In conclusion, long working hours were significantly associated with an increased incidence of lean NAFLD and its severe form in men but not in women.
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Affiliation(s)
- Ga-Young Lim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 04514, Korea
- Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon, 16419, Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 04514, Korea.
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-Ro 2Ga, Jung-Gu, Seoul, 04514, Korea.
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, 06355, Korea.
| | - Inah Kim
- Hanyang University Graduate School of Public Health, Seoul, 04763, Korea
- Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, 04763, Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 04514, Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-Ro 2Ga, Jung-Gu, Seoul, 04514, Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, 06355, Korea
| | - Ria Kwon
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 04514, Korea
- Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon, 16419, Korea
| | - Jaechul Song
- Department of Occupational and Environmental Medicine, College of Medicine and Graduate School of Public Health, Hanyang University, 222 Wangshimni-Ro, Seoul, 04763, Korea.
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9
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Andrasfay T, Kim JK, Ailshire JA, Crimmins E. Aging on the Job? The Association Between Occupational Characteristics and Accelerated Biological Aging. J Gerontol B Psychol Sci Soc Sci 2023; 78:1236-1245. [PMID: 37004243 PMCID: PMC10292835 DOI: 10.1093/geronb/gbad055] [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: 07/13/2022] [Indexed: 04/03/2023] Open
Abstract
OBJECTIVES There is a common belief that demanding jobs can make workers age faster, but there is little empirical evidence linking occupational characteristics to accelerated biological aging. We examine how occupational categorizations and self-reported working conditions are associated with expanded biological age, which incorporates 22 biomarkers and captures physiologic dysregulation throughout several bodily systems. METHODS Data are from 1,133 participants in the Health and Retirement Study who were aged 51-60 and working for pay in the 2010 or 2012 wave and who participated in the 2016 Venous Blood Study. We estimate associations between occupational category (professional/managerial, sales/clerical, service, and manual) and self-reported working conditions (psychosocial demands, job control, heavy lifting, and working 55 or more hours per week) and expanded biological age. RESULTS Compared to same-age individuals working in professional or managerial positions, those working in service jobs appear 1.65 years older biologically even after adjusting for social and economic characteristics, self-reported working conditions, health insurance, and lifestyle-related risk factors. Low job control is associated with 1.40 years, heavy lifting with 2.08 years, and long working hours with 1.87 years of accelerated biological aging. DISCUSSION Adverse occupational characteristics held at midlife, particularly service work, low job control, heavy lifting, and long work hours, are associated with accelerated biological aging. These findings suggest that work may be important for the overall aging process beyond its associations with specific diseases or risk factors.
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Affiliation(s)
- Theresa Andrasfay
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Jung Ki Kim
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Jennifer A Ailshire
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Eileen Crimmins
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
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10
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de Assis LVM, Demir M, Oster H. The role of the circadian clock in the development, progression, and treatment of non-alcoholic fatty liver disease. Acta Physiol (Oxf) 2023; 237:e13915. [PMID: 36599410 DOI: 10.1111/apha.13915] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/25/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
The circadian clock comprises a cellular endogenous timing system coordinating the alignment of physiological processes with geophysical time. Disruption of circadian rhythms has been associated with several metabolic diseases. In this review, we focus on liver as a major metabolic tissue and one of the most well-studied organs with regard to circadian regulation. We summarize current knowledge about the role of local and systemic clocks and rhythms in regulating biological functions of the liver. We discuss how the disruption of circadian rhythms influences the development of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). We also critically evaluate whether NAFLD/NASH may in turn result in chronodisruption. The last chapter focuses on potential roles of the clock system in prevention and treatment of NAFLD/NASH and the interaction of current NASH drug candidates with liver circadian rhythms and clocks. It becomes increasingly clear that paying attention to circadian timing may open new avenues for the optimization of NAFLD/NASH therapies and provide interesting targets for prevention and treatment of these increasingly prevalent disorders.
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Affiliation(s)
| | - Münevver Demir
- Department of Hepatology and Gastroenterology, Charité University Medicine Berlin, Berlin, Germany
| | - Henrik Oster
- Institute of Neurobiology, Center of Brain Behavior & Metabolism, University of Lübeck, Lübeck, Germany
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11
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Blaschke S, Schad N, Schnitzius M, Pelster K, Mess F. The Connection between Non-Alcoholic Fatty-Liver Disease, Dietary Behavior, and Food Literacy in German Working Adults. Nutrients 2023; 15:nu15030648. [PMID: 36771354 PMCID: PMC9919132 DOI: 10.3390/nu15030648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 02/01/2023] Open
Abstract
(1) Background: German working adults are particularly at risk of non-alcoholic fatty-liver disease (NAFLD), which is connected to increased cardiovascular and overall morbidity and mortality. Dietary behavior (DB) and health knowledge are crucial factors in the conceptual NAFLD model, which can directly influence this disease. These two factors largely align with the concept of food literacy (FL), which deals with proficiency in food-related skills and knowledge to promote healthy DB and prevent NAFLD. However, the potential of FL for NAFLD prevention remains unknown, because FL has not been tested in connection with DB and NAFLD. Therefore, the current study examined the direct and indirect connections between FL, DB, and NAFLD in a mediation model. (2) Methods: A total of 372 working adults (38% female) participated in a cross-sectional study by completing self-report questionnaires on FL and DB. In addition, an independent physician assessed the fatty-liver index (FLI) as an indicator of NAFLD in an occupational health checkup. (3) Results: The mediation model revealed that FL had a direct moderate connection with DB (β = 0.25, p < 0.01), but no direct connection with the FLI (β = -0.05, p = 0.36). However, DB showed a small to moderate connection with the FLI (β = -0.14, p = 0.01), which could indicate the indirect-only mediation of the relationship between FL and NAFLD via DB. (4) Conclusion: These results confirm the value of DB for the prevention of NAFLD. In addition, FL might be a vital component for improving DB and thereby function as a resource in the prevention of NAFLD. However, future longitudinal research is needed to substantiate the value of FL with respect to NAFLD.
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Affiliation(s)
- Simon Blaschke
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
- Correspondence:
| | - Nele Schad
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
| | - Melina Schnitzius
- Department of Pedagogy and Psychology, University of Cooperative Education, 34225 Baunatal, Germany
| | - Klaus Pelster
- Health Management and Safety—Health Management, Environmental Protection, Siemens AG, 60528 Frankfurt am Main, Germany
| | - Filip Mess
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
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12
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Association between long working hours and liver enzymes: evidence from the Korea National Health and Nutrition Examination Survey, 2007–2017. Ann Occup Environ Med 2022; 34:e9. [PMID: 35801225 PMCID: PMC9209099 DOI: 10.35371/aoem.2022.34.e9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/20/2022] Open
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13
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Sheng G, Lu S, Xie Q, Peng N, Kuang M, Zou Y. The usefulness of obesity and lipid-related indices to predict the presence of Non-alcoholic fatty liver disease. Lipids Health Dis 2021; 20:134. [PMID: 34629059 PMCID: PMC8502416 DOI: 10.1186/s12944-021-01561-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/19/2021] [Indexed: 02/08/2023] Open
Abstract
Background Conicity index, body-shape index, lipid accumulation product (LAP), waist circumference (WC), triglyceride, triglyceride-glucose (TyG) index, hepatic steatosis index (HSI), waist-to-height ratio (WHtR), TyG index-related parameters (TyG-WHtR, TyG-BMI, TyG-WC), body mass index (BMI), visceral adiposity index, triglyceride to high-density lipoprotein cholesterol ratio and body roundness index have been reported as reliable markers of non-alcoholic fatty liver disease (NAFLD). However, there is debate about which of the above obesity and lipid-related indices has the best predictive performance for NAFLD risk. Methods This study included 6870 female and 7411 male subjects, and 15 obesity and lipid-related indices were measured and calculated. NAFLD was diagnosed by abdominal ultrasound. The area under the curve (AUC) of 15 obesity and lipid-related indices were calculated by receiver operating characteristic (ROC) analysis. Results Among the 15 obesity and lipid-related indices, the TyG index-related parameters had the strongest association with NAFLD. ROC analysis showed that except for ABSI, the other 14 parameters had high predictive value in identifying NAFLD, especially in female and young subjects. Most notably, TyG index-related parameters performed better than other parameters in predicting NAFLD in most populations. In the female population, the AUC of TyG-WC for predicting NAFLD was 0.9045, TyG-BMI was 0.9084, and TyG-WHtR was 0.9071. In the male population, the AUC of TyG-WC was 0.8356, TyG-BMI was 0.8428, and TyG-WHtR was 0.8372. In addition, BMI showed good NAFLD prediction performance in most subgroups (AUC>0.8). Conclusions Our data suggest that TyG index-related parameters, LAP, HSI, BMI, and WC appear to be good predictors of NAFLD. Of these parameters, TyG index-related parameters showed the best predictive potential. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01561-2.
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Affiliation(s)
- Guotai Sheng
- Department of Cardiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, PR China, 330006
| | - Song Lu
- Department of Cardiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, PR China, 330006
| | - Qiyang Xie
- Department of Cardiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, PR China, 330006
| | - Nan Peng
- Department of Cardiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, PR China, 330006
| | - Maobin Kuang
- Department of Cardiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, PR China, 330006
| | - Yang Zou
- From the Jiangxi Provincial Cardiovascular Institute, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, PR China, 330006.
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14
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Zhang C, Yang M. Current Options and Future Directions for NAFLD and NASH Treatment. Int J Mol Sci 2021; 22:ijms22147571. [PMID: 34299189 PMCID: PMC8306701 DOI: 10.3390/ijms22147571] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/12/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, with a broad spectrum ranging from simple steatosis to advanced stage of nonalcoholic steatohepatitis (NASH). Although there are many undergoing clinical trials for NAFLD treatment, there is no currently approved treatment. NAFLD accounts as a major causing factor for the development of hepatocellular carcinoma (HCC), and its incidence rises accompanying the prevalence of obesity and diabetes. Reprogramming of antidiabetic and anti-obesity medicine is a major treatment option for NAFLD and NASH. Liver inflammation and cellular death, with or without fibrosis account for the progression of NAFLD to NASH. Therefore, molecules and signaling pathways involved in hepatic inflammation, fibrosis, and cell death are critically important targets for the therapy of NAFLD and NASH. In addition, the avoidance of aberrant infiltration of inflammatory cytokines by treating with CCR antagonists also provides a therapeutic option. Currently, there is an increasing number of pre-clinical and clinical trials undergoing to evaluate the effects of antidiabetic and anti-obesity drugs, antibiotics, pan-caspase inhibitors, CCR2/5 antagonists, and others on NAFLD, NASH, and liver fibrosis. Non-invasive serum diagnostic markers are developed for fulfilling the need of diagnostic testing in a large amount of NAFLD cases. Overall, a better understanding of the underlying mechanism of the pathogenesis of NAFLD is helpful to choose an optimized treatment.
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Affiliation(s)
- Chunye Zhang
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, USA;
| | - Ming Yang
- Department of Surgery, University of Missouri, Columbia, MO 65211, USA
- Correspondence:
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