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Khalifa O, Al-Akl NS, Arredouani A. Differential expression of cardiometabolic and inflammation markers and signaling pathways between overweight/obese Qatari adults with high and low plasma salivary α-amylase activity. Front Endocrinol (Lausanne) 2024; 15:1421358. [PMID: 39411310 PMCID: PMC11473332 DOI: 10.3389/fendo.2024.1421358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 09/02/2024] [Indexed: 10/19/2024] Open
Abstract
Background The relationship between salivary α-amylase activity (sAAa) and susceptibility to cardiovascular disorders lacks a definitive consensus in available studies. To fill this knowledge gap, the present study endeavors to investigate this association among overweight/obese otherwise healthy Qatari adults. The study specifically categorizes participants based on their sAAa into high and low subgroups, aiming to provide a more comprehensive understanding of the potential link between sAAa levels and cardiovascular and inflammation markers in this population. Methods Plasma samples of 264 Qatari overweight/obese (Ow/Ob) participants were used to quantify the sAAa and to profile the proteins germane to cardiovascular, cardiometabolic, metabolism, and organ damage in low sAAa (LsAAa) and high sAAa (HsAAa) subjects using the Olink technology. Comprehensive statistical tools as well as chemometric and enrichments analyses were used to identify differentially expressed proteins (DEPs) and their associated signaling pathways and cellular functions. Results A total of ten DEPs were detected, among them five were upregulated (QPCT, LCN2, PON2, DPP7, CRKL) while five were down regulated in the LsAAa subgroup compared to the HsAAa subgroup (ARG1, CTSH, SERPINB6, OSMR, ALDH3A). Functional enrichment analysis highlighted several relevant signaling pathways and cellular functions enriched in the DEPs, including myocardial dysfunction, disorder of blood pressure, myocardial infraction, apoptosis of cardiomyocytes, hypertension, chronic inflammatory disorder, immunes-mediated inflammatory disease, inflammatory response, activation of leukocytes and activation of phagocytes. Conclusion Our study unveils substantial alterations within numerous canonical pathways and cellular or molecular functions that bear relevance to cardiometabolic disorders among Ow/Ob Qatari adults exhibiting LsAAa and HsAAa in the plasma. A more comprehensive exploration of these proteins and their associated pathways and functions offers the prospect of elucidating the mechanistic underpinnings inherent in the documented relationship between sAAa and metabolic disorders.
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Affiliation(s)
- Olfa Khalifa
- Diabetes Research Center, Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Neyla S. Al-Akl
- Diabetes Research Center, Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Abdelilah Arredouani
- Diabetes Research Center, Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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2
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Peng H, Yuan J, Wang Z, Mo B, Wang Y, Wang Y, Wang Q. NR4A3 prevents diabetes induced atrial cardiomyopathy by maintaining mitochondrial energy metabolism and reducing oxidative stress. EBioMedicine 2024; 106:105268. [PMID: 39098108 PMCID: PMC11334830 DOI: 10.1016/j.ebiom.2024.105268] [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: 12/21/2023] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Atrial cardiomyopathy (ACM) is responsible for atrial fibrillation (AF) and thromboembolic events. Diabetes mellitus (DM) is an important risk factor for ACM. However, the potential mechanism between ACM and DM remains elusive. METHODS Atrial tissue samples were obtained from patients diagnosed with AF or sinus rhythm (SR) to assess alterations in NR4A3 expression, and then two distinct animal models were generated by subjecting Nr4a3-/- mice and WT mice to a high-fat diet (HFD) and Streptozotocin (STZ), while db/db mice were administered AAV9-Nr4a3 or AAV9-ctrl. Subsequently, in vivo and in vitro experiments were conducted to assess the impact of NR4A3 on diabetes-induced atrial remodeling through electrophysiological, biological, and histological analyses. RNA sequencing (RNA-seq) and metabolomics analysis were employed to unravel the downstream mechanisms. FINDINGS The expression of NR4A3 was significantly decreased in atrial tissues of both AF patients and diabetic mice compared to their respective control groups. NR4A3 deficiency exacerbated atrial hypertrophy and atrial fibrosis, and increased susceptibility to pacing-induced AF. Conversely, overexpression of NR4A3 alleviated atrial structural remodeling and reduced AF induction rate. Mechanistically, we confirmed that NR4A3 improves mitochondrial energy metabolism and reduces oxidative stress injury by preserving the transcriptional expression of Sdha, thereby exerting a protective influence on atrial remodeling induced by diabetes. INTERPRETATION Our data confirm that NR4A3 plays a protective role in atrial remodeling caused by diabetes, so it may be a new target for treating ACM. FUNDING This study was supported by the major research program of National Natural Science Foundation of China (NSFC) No: 82370316 (to Q-S. W.), No. 81974041 (to Y-P. W.), and No. 82270447 (to Y-P. W.) and Fundation of Shanghai Hospital Development Center (No. SHDC2022CRD044 to Q-S. W.).
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Affiliation(s)
- Hong Peng
- Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jiali Yuan
- Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Zhengshuai Wang
- Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Binfeng Mo
- Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yihui Wang
- The Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuepeng Wang
- Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| | - Qunshan Wang
- Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
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3
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Hosseini SA, Alipour M, Sarvandian S, Haghighat N, Bazyar H, Aghakhani L. Assessment of the appropriate cutoff points for anthropometric indices and their relationship with cardio-metabolic indices to predict the risk of metabolic associated fatty liver disease. BMC Endocr Disord 2024; 24:79. [PMID: 38834991 DOI: 10.1186/s12902-024-01615-3] [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: 01/06/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Research on Metabolic Associated Fatty Liver Disease (MAFLD) is still in its early stages, with few studies available to identify and predict effective indicators of this disease. On the other hand, early diagnosis and intervention are crucial to reduce the burden of MAFLD. Therefore, the aim of this research was to investigate the effectiveness of eleven anthropometric indices and their appropriate cut-off values as a non-invasive method to predict and diagnose MAFLD in the Iranian population. METHODS In this cross-sectional study, we analyzed baseline data from the Hoveyzeh Cohort Study, a prospective population-based study conducted in Iran that enrolled a total of 7836 subjects aged 35 to 70 years from May 2016 through August 2018. RESULTS The optimal cut-off values of anthropometric indices for predicting MAFLD risk were determined for waist circumference(WC) (102.25 cm for males and 101.45 cm for females), body mass index (BMI) (27.80 kg/m2 for males and 28.75 kg/m2 for females), waist-to-hip ratio (WHR) (0.96 for both males and females), waist-to-height ratio (WHtR) (0.56 for males and 0.63 for females), body adiposity index (BAI) (23.24 for males and 32.97 for females), visceral adiposity index (VAI) (1.64 for males and 1.88 for females), weight-adjusted waist index (WWI) (10.63 for males and 11.71 for females), conicity index (CI) (1.29 for males and 1.36 for females), body roundness index (BRI) (4.52 for males and 6.45 for females), relative fat mass (RFM) (28.18 for males and 44.91 for females) and abdominal volume index (AVI) (18.85 for males and for 21.37 females). VAI in males (sensitivity: 77%, specificity: 60%, Youden's Index: 0.37) and RFM in females (sensitivity: 76%, specificity: 59%, Youden's Index: 0.35) were found to have higher sensitivity and specificity compared to other anthropometric indices. Furthermore, anthropometric indices demonstrated statistically significant correlations with various hepatic and cardiometabolic indices. Among these, the strongest positive correlations were observed between WC, BMI, BAI, BRI, and AVI with the Hepatic Steatosis Index (HSI), TyG-BMI, and TyG-WC, as well as between VAI and the Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP), Cardiometabolic Index (CMI), and the Triglyceride and Glucose (TyG) Index. CONCLUSION Anthropometric indices are effective in predicting MAFLD risk among Iranian adults, with WWI, VAI, and RFM identified as the strongest predictors. The proposed cutoff values could serve as a straightforward and non-invasive methods for the early diagnosis of MAFLD.
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Affiliation(s)
- Seyed Ahmad Hosseini
- Nutrition and Metabolic Disease Research CenterClinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Meysam Alipour
- Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Sara Sarvandian
- Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Neda Haghighat
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Bazyar
- Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran
- Student Research Committee, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Ladan Aghakhani
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Thupakula S, Nimmala SSR, Dawood SM, Padiya R. Synergistic anti-diabetic effect of phloroglucinol and total procyanidin dimer isolated from Vitisvinifera methanolic seed extract potentiates via suppressing oxidative stress: in-vitro evaluation studies. 3 Biotech 2024; 14:76. [PMID: 38371900 PMCID: PMC10866825 DOI: 10.1007/s13205-024-03929-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
Diabetes is often associated with increased oxidative stress caused by an imbalance between detoxification and ROS production. Unfortunately, many commercial drugs available today for treating this disease have adverse side effects and ultimately fail to restore glucose homeostasis. Therefore, finding a dietary anti-diabetic remedy that is safe, effective, and economical is crucial. In this study, GC-MS analysis, subsequent HPLC-assisted fractionation, and SPE-based purification led to identifying and purifying of key components such as phloroglucinol and total procyanidin dimer (procyanidin dimer and procyanidin dimer gallate) from methanolic seed extract of Vitis vinifera. In-vitro anti-diabetic screening of various fractions derived from methanolic extract along with individual components and their combinations revealed the potential synergistic behaviour of phloroglucinol and total procyanidin dimer with the lowest IC50 of 48.21 ± 3.54 µg/mL for α-glucosidase and 63.06 ± 5.38 µg/mL for α-amylase inhibition which is found to be superior to the effect shown by the standard Epigallocatechin gallate. Later Glucose utilization studies demonstrated the concentration-dependent effect of Phloroglucinol and total procyanidin dimer, and that has raised the glucose uptake by approximately 36-57% in HepG2 cells and 35-58% in L6 myocytes over a concentration of 50-100 µg/mL. The superior anti-diabetic effect of Phloroglucinol and total procyanidin dimer was proved by the suppression of oxidative stress with an IC50 of 7.92 ± 0.36 µg/mL for DPPH scavenging and 16.87 ± 1.24 µg/mL for SOD scavenging which is competent with the standard ascorbic acid. According to this study, suppressing ROS levels by phloroglucinol and total procyanidin dimer would be the underlying mechanism for the synergistic anti-diabetic effect of this combination. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-024-03929-4.
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Affiliation(s)
- Sreenu Thupakula
- Department of Biochemistry, University College of Science, Osmania University, Amberpet, Hyderabad, Telangana State 500007 India
| | - Shiva Shankar Reddy Nimmala
- Department of Biochemistry, University College of Science, Osmania University, Amberpet, Hyderabad, Telangana State 500007 India
| | - Shauq Mumtaz Dawood
- Department of Biochemistry, University College of Science, Osmania University, Amberpet, Hyderabad, Telangana State 500007 India
| | - Raju Padiya
- Department of Biochemistry, University College of Science, Osmania University, Amberpet, Hyderabad, Telangana State 500007 India
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5
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Lv Q, Han Q, Wen Z, Pan Y, Chen J. The association between atherosclerosis and nonalcoholic fatty liver disease. Medicine (Baltimore) 2024; 103:e36815. [PMID: 38181273 PMCID: PMC10766323 DOI: 10.1097/md.0000000000036815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
Atherosclerosis (AS) is closely related to nonalcoholic fatty liver disease (NAFLD), which promotes and exacerbates the development of AS. However, it is uncertain how the precise underlying mechanism occurs. Here, we attempted to further explore the association underlying atherosclerosis and nonalcoholic fatty liver disease through integrated bioinformatics analysis. Microarray data for atherosclerosis and nonalcoholic fatty liver disease were retrieved from the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) was used to identify the genes related to atherosclerosis and nonalcoholic fatty liver disease showing co-expression. Additionally, the common gene targets associated with atherosclerosis and nonalcoholic fatty liver disease were also analyzed and screened using data from 3 public databases [comparative toxicogenomics database (CTD), DISEASES, and GeneCards]. The Gene Ontology (GO) enrichment analysis and the Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis were performed using Metascape R, respectively. The protein-protein interaction networks (PPI) network was constructed using Cytoscape. According to the results of an analysis of common genes, matrix metalloproteinase 9 (MMP9) is co-expressed up-regulated in AS and NAFLD and is enriched in inflammatory and immune-related collaterals. Consequently, MMP9 may work together through immunity and inflammation to treat AS and NAFLD and may be a potential therapeutic target in the future. The findings of this study provide new insights into the shared association between AS and NAFLD. MMP9 is co-expressed up-regulated in AS and NAFLD, which be able to reveal the presence of co-expressed genes in atherosclerosis and NAFLD.
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Affiliation(s)
- Qing Lv
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Qianqian Han
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Ziyun Wen
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Yunyun Pan
- Clinical Pharmacy Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jisheng Chen
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
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6
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Mooring M, Yeung GA, Luukkonen P, Liu S, Akbar MW, Zhang GJ, Balogun O, Yu X, Mo R, Nejak-Bowen K, Poyurovsky MV, Booth CJ, Konnikova L, Shulman GI, Yimlamai D. Hepatocyte CYR61 polarizes profibrotic macrophages to orchestrate NASH fibrosis. Sci Transl Med 2023; 15:eade3157. [PMID: 37756381 PMCID: PMC10874639 DOI: 10.1126/scitranslmed.ade3157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/18/2023] [Indexed: 09/29/2023]
Abstract
Obesity is increasing worldwide and leads to a multitude of metabolic diseases, including cardiovascular disease, type 2 diabetes, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis (NASH). Cysteine-rich angiogenic inducer 61 (CYR61) is associated with the progression of NASH, but it has been described to have anti- and proinflammatory properties. We sought to examine the role of liver CYR61 in NASH progression. CYR61 liver-specific knockout mice on a NASH diet showed improved glucose tolerance, decreased liver inflammation, and reduced fibrosis. CYR61 polarized infiltrating monocytes promoting a proinflammatory/profibrotic phenotype through an IRAK4/SYK/NF-κB signaling cascade. In vitro, CYR61 activated a profibrotic program, including PDGFa/PDGFb expression in macrophages, in an IRAK4/SYK/NF-κB-dependent manner. Furthermore, targeted-antibody blockade reduced CYR61-driven signaling in macrophages in vitro and in vivo, reducing fibrotic development. This study demonstrates that CYR61 is a key driver of liver inflammation and fibrosis in NASH.
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Affiliation(s)
- Meghan Mooring
- Department of Cellular and Molecular Pathology, University of Pittsburgh, School of Medicine; Pittsburgh, Pennsylvania 15261, USA
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics; Yale School of Medicine; New Haven, Connecticut 06514, USA
- These authors contributed equally to this work
| | - Grace A. Yeung
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics; Yale School of Medicine; New Haven, Connecticut 06514, USA
- These authors contributed equally to this work
| | - Panu Luukkonen
- Department of Internal Medicine, Yale School of Medicine; New Haven, Connecticut 06514, USA
| | - Silvia Liu
- Department of Pathology, School of Medicine, University of Pittsburgh
- Pittsburgh Liver Research Center, University of Pittsburgh, School of Medicine; Pittsburgh, Pennsylvania 15261, USA
| | - Muhammad Waqas Akbar
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics; Yale School of Medicine; New Haven, Connecticut 06514, USA
| | - Gary J. Zhang
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics; Yale School of Medicine; New Haven, Connecticut 06514, USA
| | - Oluwashanu Balogun
- Department of Cellular and Molecular Pathology, University of Pittsburgh, School of Medicine; Pittsburgh, Pennsylvania 15261, USA
- Department of Pathology, School of Medicine, University of Pittsburgh
| | - Xuemei Yu
- Kadmon Corporation, LLC; 450 East 29th Street, New York, New York 10016, USA
| | - Rigen Mo
- Kadmon Corporation, LLC; 450 East 29th Street, New York, New York 10016, USA
| | - Kari Nejak-Bowen
- Department of Cellular and Molecular Pathology, University of Pittsburgh, School of Medicine; Pittsburgh, Pennsylvania 15261, USA
- Department of Pathology, School of Medicine, University of Pittsburgh
- Pittsburgh Liver Research Center, University of Pittsburgh, School of Medicine; Pittsburgh, Pennsylvania 15261, USA
| | - Masha V. Poyurovsky
- Kadmon Corporation, LLC; 450 East 29th Street, New York, New York 10016, USA
| | - Carmen J. Booth
- Department of Comparative Medicine; Yale School of Medicine; New Haven, Connecticut 06514, USA
| | - Liza Konnikova
- Section of Neonatology; Department of Pediatrics; Yale School of Medicine; New Haven, Connecticut 06514, USA
| | - Gerald I. Shulman
- Department of Internal Medicine, Yale School of Medicine; New Haven, Connecticut 06514, USA
- Department of Cellular & Molecular Physiology, Yale School of Medicine; New Haven, Connecticut 06514, USA
| | - Dean Yimlamai
- Department of Cellular and Molecular Pathology, University of Pittsburgh, School of Medicine; Pittsburgh, Pennsylvania 15261, USA
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics; Yale School of Medicine; New Haven, Connecticut 06514, USA
- Pittsburgh Liver Research Center, University of Pittsburgh, School of Medicine; Pittsburgh, Pennsylvania 15261, USA
- The Yale Liver Center, Yale School of Medicine; New Haven, Connecticut 06514, USA
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7
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Copur S, Yavuz F, Kanbay M. Thyroid hormone Beta receptor agonists for treatment of kidney disease: A promising agent? Eur J Clin Invest 2023; 53:e13939. [PMID: 36537819 DOI: 10.1111/eci.13939] [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: 11/13/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Chronic kidney disease is a common disorder affecting a significant portion of the adult population with high mortality and morbidity. Obesity and hyperlipidemia are prevalent in chronic kidney disease, and they may trigger fat accumulation in renal parenchyma and eventually fatty kidney. Chronic kidney disease and fatty kidney are also strongly associated with nonalcoholic fatty liver disease. Because they both lead to detrimental effects on organ function, they both need to be treated effectively to improve the outcome. AIM In this narrative review, we have hypothesized that thyroid hormone beta receptor agonists, a novel drug group, may potentially be beneficial in the management of chronic kidney disease due to its promising outcomes among patients with nonalcoholic fatty liver disease, a condition sharing multiple common underlying pathophysiological mechanisms. RESULTS AND CONCLUSION Thyroid hormone beta receptors are abundantly expressed in liver and kidney tissues, while both nonalcoholic fatty liver disease and chronic kidney disease share various similar pathophysiological mechanisms and triggers. Therefore, thyroid hormone beta receptor agonists may become a promising tool in the management of patients with chronic kidney disease.
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Affiliation(s)
- Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Furkan Yavuz
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
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8
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Prinz S, Murray JM, Strack C, Nattenmüller J, Pomykala KL, Schlemmer HP, Badde S, Kleesiek J. Novel measures for the diagnosis of hepatic steatosis using contrast-enhanced computer tomography images. Eur J Radiol 2023; 160:110708. [PMID: 36724687 DOI: 10.1016/j.ejrad.2023.110708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/23/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
PURPOSE Hepatic steatosis is often diagnosed non-invasively. Various measures and accompanying diagnostic thresholds based on contrast-enhanced CT and virtual non-contrast images have been proposed. We compare these established criteria to novel and fully automated measures. METHOD CT data sets of 197 patients were analyzed. Regions of interest (ROIs) were manually drawn for the liver, spleen, portal vein, and aorta to calculate four established measures of liver-fat. Two novel measures capturing the deviation between the empirical distributions of HU measurements across all voxels within the liver and spleen were calculated. These measures were calculated with both manual ROIs and using fully automated organ segmentations. Agreement between the different measures was evaluated using correlational analysis, as well as their ability to discriminate between fatty and healthy liver. RESULTS Established and novel measures of fatty liver were at a high level of agreement. Novel methods were statistically indistinguishable from the established ones when taking established diagnostic thresholds or physicians' diagnoses as ground truth and this high performance level persisted for automatically selected ROIs. CONCLUSION Automatically generated organ segmentations led to comparable results as manual ROIs, suggesting that the implementation of automated methods can prove to be a valuable tool for incidental diagnosis. Differences in the distribution of HU measurements across voxels between liver and spleen can serve as surrogate markers for the liver-fat-content. Novel measures do not exhibit a measurable disadvantage over established methods based on simpler measures such as across-voxel averages in a population with low incidence of fatty liver.
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Affiliation(s)
- Sebastian Prinz
- Division of Radiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany.
| | - Jacob M Murray
- Division of Radiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany; Institute for AI in Medicine (IKIM), University Medicine Essen, 45131 Essen, Germany
| | - Christian Strack
- Division of Radiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany
| | - Johanna Nattenmüller
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, Germany; Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Kelsey L Pomykala
- Institute for AI in Medicine (IKIM), University Medicine Essen, 45131 Essen, Germany
| | - Heinz-Peter Schlemmer
- Division of Radiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Stephanie Badde
- Department of Psychology, Tufts University, 02511 Medford, MA, USA
| | - Jens Kleesiek
- Institute for AI in Medicine (IKIM), University Medicine Essen, 45131 Essen, Germany; German Cancer Consortium (DKTK), Partner Sites Heidelberg and Essen, 69120 Heidelberg, Germany; Cancer Research Center Cologne Essen, West German Cancer Center Essen, 45122 Essen, Germany
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9
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Amelioration of Hepatic Steatosis by the Androgen Receptor Inhibitor EPI-001 in Mice and Human Hepatic Cells Is Associated with the Inhibition of CYP2E1. Int J Mol Sci 2022; 23:ijms232416063. [PMID: 36555703 PMCID: PMC9785868 DOI: 10.3390/ijms232416063] [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: 11/01/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is recognized as a metabolic disease characterized by hepatic steatosis. Despite the growing burden of NAFLD, approved pharmacological treatment is lacking. As an inhibitor of androgen receptor (AR), EPI-001 is being explored for the treatment of prostate cancer. This study aimed to investigate the potential of EPI-001 for treating NAFLD in free fatty acids (FFAs)-induced human hepatic cells and high-fat-high-sugar (HFHS)-feeding mice. Our results showed that EPI-001 reduced lipid accumulation in hepatic cells and ameliorated hepatic steatosis in mouse livers. Further exploration suggested that the effect of EPI-001 was associated with CYP2E1-mediated reduction of reactive oxygen species (ROS). This provides encouraging evidence for further studies on EPI-001 therapy for NAFLD.
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10
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Berberine in Non-Alcoholic Fatty Liver Disease—A Review. Nutrients 2022; 14:nu14173459. [PMID: 36079717 PMCID: PMC9459907 DOI: 10.3390/nu14173459] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Abstract
The incidence of Non-Alcoholic Fatty Liver Disease (NAFLD) has been rapidly increasing during the last decade. It is a relevant health problem that affects 25% of the general population. NAFLD involves an extensive array of clinical conditions. So far, no approved pharmacological therapy for NAFLD has been developed. Multiple bioactive compounds have been proposed to treat NAFLD. One of the most promising is Berberine (BBR). Its pleiotropic effect positively impacts various cardiometabolic aspects. In this review, we summarize NAFLD, its metabolic and cardiovascular complications, the hepatoprotective effects of BBR due to its broad spectrum of pharmacological effects, and the potential role of BBR in NAFLD therapy. BBR ameliorates NAFLD by affecting numerous abnormalities. It inhibits lipogenesis and gluconeogenesis, improves insulin resistance and lipid profile, and modulates gut microbiota. The exact mechanism underlying these effects is not yet entirely explained. A growing amount of evidence confirming the positive effects of BBR on multiple metabolic pathways, such as lipids and glucose metabolism, energy homeostasis, or gut microbiota modulation, allows us to speculate about the importance of this natural bioactive substance for NAFLD therapy.
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11
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Vahedi H, Atefi M, Entezari MH, Hassanzadeh A. The effect of sesame oil consumption compared to sunflower oil on lipid profile, blood pressure, and anthropometric indices in women with non-alcoholic fatty liver disease: a randomized double-blind controlled trial. Trials 2022; 23:551. [PMID: 35804451 PMCID: PMC9264500 DOI: 10.1186/s13063-022-06451-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in the world. There is strong evidence that dyslipidemia and other cardio-metabolic disorders are highly prevalent in patients with NAFLD. This trial aimed at examining the effect of sesame oil (SO) in the context of a weight loss program on lipid profile, blood pressure, and anthropometric indices in women with NAFLD. METHODS This randomized, double-blind, controlled trial was carried out on 60 women with NAFLD. Subjects were randomly assigned to the SO group (n = 30) and sunflower oil (SFO) group (n = 30), each person consuming 30 g of oil per day for 12 weeks. All the participants received a hypocaloric diet (- 500 kcal/day) during the study. Lipid profile, blood pressure, and anthropometric indices were assessed at pre- and post-intervention phases. RESULTS In total, 53 participants completed the study. Following 12 weeks of intervention, anthropometric indices (p < 0.001) and systolic blood pressure (SBP) (p < 0.05) were significantly decreased in both groups and diastolic blood pressure (DBP) was significantly decreased in So group (p = 0.03). There was no significant change in lipid profile in both groups (p > 0.05). After adjusting for confounders, DBP (p = 0.031) and total cholesterol (TC) divided by high-density lipoprotein cholesterol (HDL-C) (p = 0.039) in the SO group were significantly reduced compared to the SFO group (p < 0.05). CONCLUSIONS The present clinical trial revealed that SO and SFO may not differently affect anthropometric indices, SBP, and lipid profile except for TC/HDL-C. In addition, SO may be effective in improvement of DBP and TC/HDL-C compared to the SFO group. TRIAL REGISTRATION Ethical approval of this trial was obtained at Isfahan University of Medical Sciences with the reference number of IR.MUI. RESEARCH REC.1399.548 ( https://ethics. RESEARCH ac.ir/ProposalCertificateEn.php?id=158942&Print=true&NoPrintHeader=true&NoPrintFooter=true&NoPrintPageBorder=true&LetterPrint=true ), and it was registered before the start of the patient recruitment on December 12th, 2020 in the Iranian Registry of Clinical Trials (IRCT) with the registration number of IRCT20140208016529N6 .
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Affiliation(s)
- Hamid Vahedi
- Department of Gastroenterology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Masoumeh Atefi
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Mohammad Hassan Entezari
- Food Security Research Centre and Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
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12
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Sabir U, Irfan HM, Alamgeer, Umer I, Niazi ZR, Asjad HMM. Phytochemicals targeting NAFLD through modulating the dual function of forkhead box O1 (FOXO1) transcription factor signaling pathways. Naunyn Schmiedebergs Arch Pharmacol 2022; 395:741-755. [PMID: 35357518 DOI: 10.1007/s00210-022-02234-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/18/2022] [Indexed: 02/06/2023]
Abstract
Literature evidence reveals that natural compounds are potential candidates for ameliorating obesity-associated non-alcoholic fatty liver disease (NAFLD) by targeting forkhead box O1 (FOXO1) transcription factor. FOXO1 has a dual and complex role in regulating both increase and decrease in lipid accumulation in hepatocytes and adipose tissues (AT) at different stages of NAFLD. In insulin resistance (IR), it is constitutively expressed, resulting in increased hepatic glucose output and lipid metabolism irregularity. The studies on different phytochemicals indicate that dysregulation of FOXO1 causes disturbance in cellular nutrients homeostasis, and the natural entities have an enduring impact on the mitigation of these abnormalities. The current review communicates and evaluates certain phytochemicals through different search engines, targeting FOXO1 and its downstream cellular pathways to find lead compounds as potential therapeutic agents for treating NAFLD and related metabolic disorders. The findings of this review confirm that polyphenols, flavonoids, alkaloids, terpenoids, and anthocyanins are capable of modulating FOXO1 and associated signaling pathways, and they are potential therapeutic agents for NAFLD and related complications. HIGHLIGHTS: • FOXO1 has the potential to be targeted by novel drugs from natural sources for the treatment of NAFLD and obesity. • FOXO1 regulates cellular autophagy, inflammation, oxidative stress, and lipogenesis through alternative mechanisms. • Phytochemicals treat NAFLD by acting on FOXO1 or SREBP1c and PPARγ transcription factor signaling pathways.
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Affiliation(s)
- Usman Sabir
- Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | - Hafiz Muhammad Irfan
- Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Pakistan.
| | - Alamgeer
- Punjab University College of Pharmacy, University of the Punjab Lahore, Lahore, Pakistan
| | - Ihtisham Umer
- Pharmacy Department, Comsat International University Lahore Campus, Lahore, Pakistan
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13
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Nelidova AV, Livzan MA, Nikolaev NA, Krolevets TS. Cardiovascular Diseases and Non-Alcoholic Fatty Liver Disease: Relationship and Pathogenetic Aspects of Pharmacotherapy. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022; 17:880-888. [DOI: 10.20996/1819-6446-2021-12-14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2024] Open
Abstract
The association of non-alcoholic fatty liver disease (NAFLD) and cardiovascular risk is currently one of the actively studied areas. The incidence of non-alcoholic fatty liver disease continues to grow worldwide. In the structure of mortality rate of patients with non-alcoholic fatty liver disease, the first place is occupied by cardiovascular events: stroke and myocardial infarction. Studies have shown that the presence of severe liver fibrosis (F3-4) in NAFLD not only increases the risk of cardiovascular diseases (CVD), but also increases the risk of overall mortality by 69% due to mortality from cardiovascular causes. The degree of increased risk is associated with the degree of activity of non-alcoholic steatohepatitis (NASH). Despite the large number of works on this topic, we do not have a clear opinion on the impact on cardiovascular risk, interaction and the contribution of various factors, as well as algorithms for managing patients with non-alcoholic fatty liver disease to reduce the risk of cardiovascular diseases. This article describes the pathogenetic factors of formation of cardiovascular risks in patients with non-alcoholic fatty liver disease, proposed the idea of stratification of cardiovascular risks in these patients, taking into account changes in the structure of the liver (fibrosis) and function (clinical and biochemical activity) and also it describes the main directions of drug therapy, taking into account the common pathogenetic mechanisms for non-alcoholic fatty liver disease and cardiovascular diseases. The role of obesity, local fat depots, adipokines, and endothelial dysfunction as the leading pathogenetic factors of increased cardiovascular risk in patients with NAFLD is discussed. Among pathogenetically justified drugs in conditions of poly and comorbidity, hypolipidemic (statins, fibrates), angiotensin II receptor antagonists, beta-blockers, etc. can be considered. According to numerous studies, it becomes obvious that the assessment of cardiovascular risks in patients with NAFLD will probably allow prescribing cardiological drugs, selecting individualized therapy regimens, taking into account the form of NAFLD, and on the other hand, building curation taking into account the identified cardiovascular risks.
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14
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Bae J, Kim SH, Won YJ, Kim YM. Age- and Sex-Specific Differences in Distribution of Cardiometabolic Diseases and Associations of Hand-Grip Strength Indices with Type 2 Diabetes in Korean Adults. Metab Syndr Relat Disord 2022; 20:199-209. [PMID: 35020479 DOI: 10.1089/met.2021.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: To evaluate age- and sex-specific differences in the distribution of cardiometabolic diseases and associations of hand-grip strength (HGS) indices with type 2 diabetes (T2D). Methods: This cross-sectional observational study enrolled participants from the Korea National Health and Nutrition Examination Survey (n = 16,126, age ≥19 years). Information on cardiometabolic diseases was obtained through surveys or proper criteria applied for undiagnosed participants. Absolute and body size-adjusted HGS indices were evaluated. Clinical manifestations were compared, and associations of HGS indices with T2D were estimated by using odd ratio (OR). Results: Prevalence of T2D in all, younger, and older groups were 13.1%, 4.2%, and 21.4%, respectively. Proportions of cardiometabolic diseases were all higher in those with than without T2D in sex-stratified age groups, whereas obesity (OB) and nonalcoholic fatty liver disease (NAFLD) were higher in younger T2D, and hypertension (HTN) was higher in older T2D in both sexes. Adjusted HGS significantly correlated with cardiometabolic parameters, and thus, high ORs for T2D in low tertiles of adjusted HGS were shown in all groups, whereas high ORs for T2D in low tertiles of absolute HGS were observed only in older men. Conclusions: Among highly prevalent cardiometabolic diseases associated with T2D, OB and NAFLD were more prevalent in younger T2D, but HTN was more prevalent in older T2D in both sexes. Low adjusted HGS was associated with higher T2D risk in all groups, whereas low absolute HGS was associated with higher T2D risk in older men. Thus, adjusted HGS might be useful in screening especially younger or obese T2D.
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Affiliation(s)
- Jaehyun Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Se Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Young Jun Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Yoo Mee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
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15
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Huang YH, Wang FS, Wang PW, Lin HY, Luo SD, Yang YL. Heat Shock Protein 60 Restricts Release of Mitochondrial dsRNA to Suppress Hepatic Inflammation and Ameliorate Non-Alcoholic Fatty Liver Disease in Mice. Int J Mol Sci 2022; 23:ijms23010577. [PMID: 35009003 PMCID: PMC8745303 DOI: 10.3390/ijms23010577] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 02/08/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease, consists of fat deposited (steatosis) in the liver due to causes besides excessive alcohol use. The folding activity of heat shock protein 60 (HSP60) has been shown to protect mitochondria from proteotoxicity under various types of stress. In this study, we investigated whether HSP60 could ameliorate experimental high-fat diet (HFD)-induced obesity and hepatitis and explored the potential mechanism in mice. The results uncovered that HSP60 gain not only alleviated HFD-induced body weight gain, fat accumulation, and hepatocellular steatosis, but also glucose tolerance and insulin resistance according to intraperitoneal glucose tolerance testing and insulin tolerance testing in HSP60 transgenic (HSP60Tg) compared to wild-type (WT) mice by HFD. Furthermore, overexpression of HSP60 in the HFD group resulted in inhibited release of mitochondrial dsRNA (mt-dsRNA) compared to WT mice. In addition, overexpression of HSP60 also inhibited the activation of toll-like receptor 3 (TLR3), melanoma differentiation-associated gene 5 (MDA5), and phosphorylated-interferon regulatory factor 3 (p-IRF3), as well as inflammatory biomarkers such as mRNA of il-1β and il-6 expression in the liver in response to HFD. The in vitro study also confirmed that the addition of HSP-60 mimics in HepG2 cells led to upregulated expression level of HSP60 and restricted release of mt-dsRNA, as well as downregulated expression levels of TLR3, MDA5, and pIRF3. This study provides novel insight into a hepatoprotective effect, whereby HSP60 inhibits the release of dsRNA to repress the TLR3/MDA5/pIRF3 pathway in the context of NAFLD or hepatic inflammation. Therefore, HSP60 may serve as a possible therapeutic target for improving NAFLD.
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Affiliation(s)
- Ying-Hsien Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital Chang, Kaohsiung 833, Taiwan;
- College of Medicine, Gung University, Taoyuan 333, Taiwan
| | - Feng-Sheng Wang
- Center for Mitochondrial Research and Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
- Core Laboratory for Phenomics & Diagnostics, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan;
| | - Pei-Wen Wang
- Core Laboratory for Phenomics & Diagnostics, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan;
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Hung-Yu Lin
- Research Assistant Center, Show Chwan Memorial Hospital, Changhua 500, Taiwan;
| | - Sheng-Dean Luo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan;
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Ya-Ling Yang
- College of Medicine, Gung University, Taoyuan 333, Taiwan
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Correspondence:
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16
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Furthner D, Anderwald CH, Bergsten P, Forslund A, Kullberg J, Ahlström H, Manell H, Ciba I, Mangge H, Maruszczak K, Koren P, Schütz S, Brunner SM, Schneider AM, Weghuber D, Mörwald K. Single Point Insulin Sensitivity Estimator in Pediatric Non-Alcoholic Fatty Liver Disease. Front Endocrinol (Lausanne) 2022; 13:830012. [PMID: 35185803 PMCID: PMC8848352 DOI: 10.3389/fendo.2022.830012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Attenuated insulin-sensitivity (IS) is a central feature of pediatric non-alcoholic fatty liver disease (NAFLD). We recently developed a new index, single point insulin sensitivity estimator (SPISE), based on triglycerides, high-density-lipoprotein and body-mass-index (BMI), and validated by euglycemic-hyperinsulinemic clamp-test (EHCT) in adolescents. This study aims to assess the performance of SPISE as an estimation of hepatic insulin (in-)sensitivity. Our results introduce SPISE as a novel and inexpensive index of hepatic insulin resistance, superior to established indices in children and adolescents with obesity. MATERIALS AND METHODS Ninety-nine pubertal subjects with obesity (13.5 ± 2.0 years, 59.6% males, overall mean BMI-SDS + 2.8 ± 0.6) were stratified by MRI (magnetic resonance imaging) into a NAFLD (>5% liver-fat-content; male n=41, female n=16) and non-NAFLD (≤5%; male n=18, female n=24) group. Obesity was defined according to WHO criteria (> 2 BMI-SDS). EHCT were used to determine IS in a subgroup (n=17). Receiver-operating-characteristic (ROC)-curve was performed for diagnostic ability of SPISE, HOMA-IR (homeostatic model assessment for insulin resistance), and HIRI (hepatic insulin resistance index), assuming null hypothesis of no difference in area-under-the-curve (AUC) at 0.5. RESULTS SPISE was lower in NAFLD (male: 4.8 ± 1.2, female: 4.5 ± 1.1) than in non-NAFLD group (male 6.0 ± 1.6, female 5.6 ± 1.5; P< 0.05 {95% confidence interval [CI]: male NAFLD 4.5, 5.2; male non-NAFLD 5.2, 6.8; female NAFLD 4.0, 5.1, female non-NAFLD 5.0, 6.2}). In males, ROC-AUC was 0.71 for SPISE (P=0.006, 95% CI: 0.54, 0.87), 0.68 for HOMA-IR (P=0.038, 95% CI: 0.48, 0.88), and 0.50 for HIRI (P=0.543, 95% CI: 0.27, 0.74). In females, ROC-AUC was 0.74 for SPISE (P=0.006), 0.59 for HOMA-IR (P=0.214), and 0.68 for HIRI (P=0.072). The optimal cutoff-level for SPISE between NAFLD and non-NAFLD patients was 5.18 overall (Youden-index: 0.35; sensitivity 0.68%, specificity 0.67%). CONCLUSION SPISE is significantly lower in juvenile patients with obesity-associated NAFLD. Our results suggest that SPISE indicates hepatic IR in pediatric NAFLD patients with sensitivity and specificity superior to established indices of hepatic IR.
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Affiliation(s)
- Dieter Furthner
- Department of Pediatrics, Salzkammergutklinikum Voecklabruck, Voecklabruck, Austria
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Christian-Heinz Anderwald
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
- Direction, Arnoldstein Healthcare Centre, Arnoldstein, Austria
| | - Peter Bergsten
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Anders Forslund
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Joel Kullberg
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Håkan Ahlström
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Hannes Manell
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Iris Ciba
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Graz, Austria
| | - Katharina Maruszczak
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Pia Koren
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Sebastian Schütz
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Susanne Maria Brunner
- Research Program for Receptor Biochemistry and Tumor Metabolism, Department of Pediatrics, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - Anna Maria Schneider
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Weghuber
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- *Correspondence: Daniel Weghuber,
| | - Katharina Mörwald
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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17
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Longo L, Rampelotto PH, Filippi-Chiela E, de Souza VEG, Salvati F, Cerski CT, da Silveira TR, Oliveira CP, Uribe-Cruz C, Álvares-da-Silva MR. Gut dysbiosis and systemic inflammation promote cardiomyocyte abnormalities in an experimental model of steatohepatitis. World J Hepatol 2021; 13:2052-2070. [PMID: 35070008 PMCID: PMC8727214 DOI: 10.4254/wjh.v13.i12.2052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/20/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cardiovascular disease is the main cause of death in metabolic-associated fatty liver disease, and gut microbiota dysbiosis is associated with both of them.
AIM To assess the relationship between gut dysbiosis and cardiovascular risk (CVR) in an experimental model of steatohepatitis.
METHODS Adult male Sprague-Dawley rats were randomized to a control group (n = 10) fed a standard diet and an intervention group (n = 10) fed a high-fat choline-deficient diet for 16 wk. Biochemical, molecular, hepatic, and cardiac histopathology. Gut microbiota variables were evaluated.
RESULTS The intervention group had a significantly higher atherogenic coefficient, Castelli’s risk index (CRI)-I and CRI-II, interleukin-1β, tissue inhibitor of metalloproteinase-1 (all P < 0.001), monocyte chemoattractant protein-1 (P = 0.005), and plasminogen activator inhibitor-1 (P = 0.037) than the control group. Gene expression of miR-33a increased (P = 0.001) and miR-126 (P < 0.001) decreased in the intervention group. Steatohepatitis with fibrosis was seen in the intervention group, and heart computerized histological imaging analysis showed a significant decrease in the percentage of cardiomyocytes with a normal morphometric appearance (P = 0.007), reduction in the mean area of cardiomyocytes (P = 0.037), and an increase of atrophic cardiomyocytes (P = 0.007). There were significant correlations between the cardiomyocyte morphometry markers and those of progression and severity of liver disease and CVR. The intervention group had a lower Shannon diversity index and fewer changes in the structural pattern of gut microbiota (both P < 0.001) than controls. Nine microbial families that are involved in lipid metabolism were differentially abundant in intervention group and were significantly correlated with markers of liver injury and CVR.
CONCLUSION The study found a link between gut dysbiosis and significant cardiomyocyte abnormalities in animals with steatohepatitis.
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Affiliation(s)
- Larisse Longo
- Experimental Laboratory of Hepatology and Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Rio Grande do Sul, Brazil
| | - Pabulo Henrique Rampelotto
- Experimental Laboratory of Hepatology and Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
- Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
| | - Eduardo Filippi-Chiela
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Rio Grande do Sul, Brazil
- Center of Biotechnology, Universidade Federal do Rio Grande do Sul, Porto Alegre 91501-970, Rio Grande do Sul, Brazil
- Department of Morphological Sciences, Universidade Federal do Rio Grande do SulPorto Alegre 90050-170, Rio Grande do Sul, Brazil
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
| | - Valessa Emanoele Gabriel de Souza
- Experimental Laboratory of Hepatology and Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
| | - Fernando Salvati
- School of Medicine, Instituto Meridional de Educação-IMED, Passo Fundo 99070-220, Rio Grande do Sul, Brazil
| | - Carlos Thadeu Cerski
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Rio Grande do Sul, Brazil
- Unit of Surgical Pathology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
| | - Themis Reverbel da Silveira
- Experimental Laboratory of Hepatology and Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
| | - Cláudia P Oliveira
- Department of Gastroenterology (LIM07), Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246903, Brazil
| | - Carolina Uribe-Cruz
- Experimental Laboratory of Hepatology and Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Rio Grande do Sul, Brazil
| | - Mário Reis Álvares-da-Silva
- Experimental Laboratory of Hepatology and Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Rio Grande do Sul, Brazil
- Division of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil
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Córdova-Gallardo J, Keaveny AP, Qi X, Méndez-Sánchez N. Metabolic associated fatty liver disease and acute-on-chronic liver failure: common themes for common problems. Eur J Gastroenterol Hepatol 2021; 33:e84-e93. [PMID: 34985050 DOI: 10.1097/meg.0000000000002335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Metabolic associated fatty liver disease (MAFLD) affects 20-30% of the worldwide population and is becoming the most common cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC). MAFLD is the hepatic expression of metabolic dysfunction correlated with a variety of metabolic comorbidities including obesity, dyslipidemia, hypertension and type 2 diabetes (T2DM). Obesity, altered gut permeability, chronic inflammation and dysbiosis related to MAFLD might predispose patients with cirrhosis to the development of acute-on-chronic liver failure (ACLF); however, this relationship remains unclear. ACLF is a syndrome with high short-term mortality, presenting with acute hepatic decompensation associated with organ failures in patients with underlying chronic liver disease with or without an identifiable precipitating event. While this syndrome can occur in any patient with cirrhosis, the increasing prevalence of cirrhosis due to MAFLD is of great concern because, in a recent analysis, MAFLD was the fastest rising cause of cirrhosis associated with ACLF among patients listed for LT in the US. In this review, we will discuss the current knowledge on MAFLD and the development of ACLF.
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Affiliation(s)
- Jacqueline Córdova-Gallardo
- Department of Hepatology, Service of Surgery and Obesity Clinic, General Hospital "Dr. Manuel Gea González"
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Andrew P Keaveny
- Department of Transplantation, Mayo Clinic, Jacksonville, Florida, USA
| | - Xingshun Qi
- General Hospital of Northern Theater Command
- Shenyang Pharmaceutical University, Shenyang, China
| | - Nahum Méndez-Sánchez
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
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19
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Kergomard J, Carrière F, Barouh N, Villeneuve P, Vié V, Bourlieu C. Digestibility and oxidative stability of plant lipid assemblies: An underexplored source of potentially bioactive surfactants? Crit Rev Food Sci Nutr 2021:1-20. [PMID: 34839771 DOI: 10.1080/10408398.2021.2005532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Most lipids in our diet come under the form of triacylglycerols that are often redispersed and stabilized by surfactants in processed foods. In plant however, lipid assemblies constitute interesting sources of natural bioactive and functional ingredients. In most photosynthetic sources, polar lipids rich in ω3 fatty acids are concentrated. The objective of this review is to summarize all the knowledge about the physico-chemical composition, digestive behavior and oxidative stability of plant polar lipid assemblies to emphasize their potential as functional ingredients in human diet and their potentialities to substitute artificial surfactants/antioxidants. The specific composition of plant membrane assemblies is detailed, including plasma membranes, oil bodies, and chloroplast; emphasizing its concentration in phospholipids, galactolipids, peculiar proteins, and phenolic compounds. These molecular species are hydrolyzed by specific digestive enzymes in the human gastrointestinal tract and reduced the hydrolysis of triacylglycerols and their subsequent absorption. Galactolipids specifically can activate ileal break and intrinsically present an antioxidant (AO) activity and metal chelating activity. In addition, their natural association with phenolic compounds and their physical state (Lα state of digalactosyldiacylglycerols) in membrane assemblies can enhance their stability to oxidation. All these elements make plant membrane molecules and assemblies very promising components with a wide range of potential applications to vectorize ω3 polyunsaturated fatty acids, and equilibrate human diet.
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Affiliation(s)
- Jeanne Kergomard
- INRAE/UM/Institut Agro, UMR 1208 IATE, Montpellier France.,IPR Institute of Physics, UMR UR1 CNRS 6251, Rennes 1 University, Rennes, France
| | - Frédéric Carrière
- Aix Marseille Université, CNRS, UMR7281 Bioénergétique et lngénierie des Protéines, Marseille, France
| | | | | | - Véronique Vié
- IPR Institute of Physics, UMR UR1 CNRS 6251, Rennes 1 University, Rennes, France
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20
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Tutunchi H, Naeini F, Ebrahimi-Mameghani M, Najafipour F, Mobasseri M, Ostadrahimi A. Metabolically healthy and unhealthy obesity and the progression of liver fibrosis: A cross-sectional study. Clin Res Hepatol Gastroenterol 2021; 45:101754. [PMID: 34303827 DOI: 10.1016/j.clinre.2021.101754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The development of liver fibrosis is the most important predictor of adverse outcomes in patients with non-alcoholic fatty liver disease (NAFLD). Little is known regarding the risk factors for the progression of NAFLD to liver fibrosis. The present cross-sectional study aimed to examine the association of liver fibrosis with metabolically healthy and unhealthy obesity among patients with NAFLD. METHODS The severity of fatty liver was examined using ultrasonography. We used the NAFLD fibrosis score to determine the severity of liver fibrosis. Anthropometric indices, physical activity, and body composition were assessed. Blood samples were collected to determine serum metabolic parameters. Participants without any component of metabolic syndrome and homeostasis model assessment of insulin resistance (HOMA-IR) <2.5 were considered as metabolically healthy. To examine the association of liver fibrosis with metabolically healthy and unhealthy obesity, multivariable-adjusted odds ratios (ORs) were applied. RESULTS The current study included a total of 246 patients with NAFLD and low probability of fibrosis. 46.3% of subjects were metabolically healthy and 53.7% were metabolically unhealthy. Among metabolically healthy subjects, multivariable-adjusted ORs (CIs) for worsening of NAFLD fibrosis score comparing body mass indexes (BMIs) 23.0-24.9, 25-29.9, and ≥30 with a BMI=18.5-22.9 kg/m2 were 1.28 (1.09-1.56), 1.99 (1.49-2.63), and 3.96 (2.89-4.71), respectively. The corresponding ORs (95% CIs) among metabolically unhealthy subjects were 1.39 (1.32-1.64), 2.27 (1.98-2.49), and 4.11 (3.12-4.93), respectively. Moreover, in both healthy and unhealthy individuals, higher percentages of body fat and waist circumference were significantly associated with worsening of NAFLD fibrosis score. CONCLUSION Excess body fat contributes to the progression of liver fibrosis regardless of metabolic health status.
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Affiliation(s)
- Helda Tutunchi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Naeini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran university of medical science, Tehran, Iran
| | - Mehrangiz Ebrahimi-Mameghani
- Social Determinant of Health Research Center, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzad Najafipour
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Mobasseri
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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21
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Gutiérrez-Cuevas J, Santos A, Armendariz-Borunda J. Pathophysiological Molecular Mechanisms of Obesity: A Link between MAFLD and NASH with Cardiovascular Diseases. Int J Mol Sci 2021; 22:ijms222111629. [PMID: 34769060 PMCID: PMC8583943 DOI: 10.3390/ijms222111629] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity is now a worldwide epidemic ensuing an increase in comorbidities’ prevalence, such as insulin resistance, type 2 diabetes (T2D), metabolic dysfunction-associated fatty liver disease (MAFLD), nonalcoholic steatohepatitis (NASH), hypertension, cardiovascular disease (CVD), autoimmune diseases, and some cancers, CVD being one of the main causes of death in the world. Several studies provide evidence for an association between MAFLD and atherosclerosis and cardio-metabolic disorders, including CVDs such as coronary heart disease and stroke. Therefore, the combination of MAFLD/NASH is associated with vascular risk and CVD progression, but the underlying mechanisms linking MAFLD/NASH and CVD are still under investigation. Several underlying mechanisms may probably be involved, including hepatic/systemic insulin resistance, atherogenic dyslipidemia, hypertension, as well as pro-atherogenic, pro-coagulant, and pro-inflammatory mediators released from the steatotic/inflamed liver. MAFLD is strongly associated with insulin resistance, which is involved in its pathogenesis and progression to NASH. Insulin resistance is a major cardiovascular risk factor in subjects without diabetes. However, T2D has been considered the most common link between MAFLD/NASH and CVD. This review summarizes the evidence linking obesity with MAFLD, NASH, and CVD, considering the pathophysiological molecular mechanisms involved in these diseases. We also discuss the association of MAFLD and NASH with the development and progression of CVD, including structural and functional cardiac alterations, and pharmacological strategies to treat MAFLD/NASH and cardiovascular prevention.
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Affiliation(s)
- Jorge Gutiérrez-Cuevas
- Department of Molecular Biology and Genomics, Institute for Molecular Biology in Medicine and Gene Therapy, University of Guadalajara, CUCS, Guadalajara 44340, Jalisco, Mexico
- Correspondence: (J.G.-C.); (J.A.-B.); Tel.: +52-331-062-2083 (J.G.-C.); +52-333-677-8741 (J.A.-B.)
| | - Arturo Santos
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Campus Guadalajara, Zapopan 45201, Jalisco, Mexico;
| | - Juan Armendariz-Borunda
- Department of Molecular Biology and Genomics, Institute for Molecular Biology in Medicine and Gene Therapy, University of Guadalajara, CUCS, Guadalajara 44340, Jalisco, Mexico
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Campus Guadalajara, Zapopan 45201, Jalisco, Mexico;
- Correspondence: (J.G.-C.); (J.A.-B.); Tel.: +52-331-062-2083 (J.G.-C.); +52-333-677-8741 (J.A.-B.)
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22
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Marin-Alejandre BA, Cantero I, Perez-Diaz-Del-Campo N, Monreal JI, Elorz M, Herrero JI, Benito-Boillos A, Quiroga J, Martinez-Echeverria A, Uriz-Otano JI, Huarte-Muniesa MP, Tur JA, Martinez JA, Abete I, Zulet MA. Effects of two personalized dietary strategies during a 2-year intervention in subjects with nonalcoholic fatty liver disease: A randomized trial. Liver Int 2021; 41:1532-1544. [PMID: 33550706 DOI: 10.1111/liv.14818] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/11/2021] [Accepted: 01/27/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Nonalcoholic fatty liver disease (NAFLD) management is focused on lifestyle modifications, but long-term maintenance is a challenge for many individuals. This study aimed to evaluate the long-term effects of two personalized energy-restricted dietary strategies on weight loss, metabolic and hepatic outcomes in overweight/obese subjects with NAFLD. METHODS Ninety-eight subjects from the Fatty Liver in Obesity (FLiO) study (NCT03183193) were randomly assigned to the American Heart Association (AHA) or the FLiO dietary group in a 2-year controlled trial. Anthropometry, body composition (DXA), biochemical parameters and hepatic status (ultrasonography, Magnetic Resonance Imaging, and elastography) were assessed at baseline, 6, 12 and 24 months. RESULTS Both the AHA and FLiO diets significantly reduced body weight at 6 (-9.7% vs -10.1%), 12 (-6.7% vs -9.6%), and 24 months (-4.8% vs -7.6%) with significant improvements in body composition, biochemical and liver determinations throughout the intervention. At the end of the follow-up, the FLiO group showed a greater decrease in ALT, liver stiffness and Fatty Liver Index, among others, compared to AHA group, although these differences were attenuated when the analyses were adjusted by weight loss percentage. The FLiO group also showed a greater increase in adiponectin compared to AHA group. CONCLUSIONS The AHA and FLiO diets were able to improve body weight and body composition, as well as metabolic and hepatic status of participants with overweight/obesity and NAFLD within a 2-year follow-up. These findings show that both strategies are suitable alternatives for NAFLD management. However, the FLiO strategy may provide more persistent benefits in metabolic and hepatic parameters.
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Affiliation(s)
- Bertha A Marin-Alejandre
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - Irene Cantero
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - Nuria Perez-Diaz-Del-Campo
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - Jose I Monreal
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Chemistry Department, Clinica Universidad de Navarra, Pamplona, Spain
| | - Mariana Elorz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Jose I Herrero
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Alberto Benito-Boillos
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Jorge Quiroga
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.,Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain
| | - Ana Martinez-Echeverria
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Juan I Uriz-Otano
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Maria P Huarte-Muniesa
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Josep A Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & Balearic Islands Institute for Health Research (IDISBA), Palma, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose A Martinez
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria A Zulet
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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Liver Enzymes and Their Association with Some Cardiometabolic Diseases: Evidence from a Large Kurdish Cohort. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5584452. [PMID: 34235221 PMCID: PMC8216792 DOI: 10.1155/2021/5584452] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/04/2021] [Indexed: 02/03/2023]
Abstract
Objective According to reports, liver enzymes might play a role in the incidence and development of cardiometabolic diseases such as metabolic syndrome (MetS), hypertension (HTN), and cardiovascular diseases (CVD). We conducted a study to investigate this hypothesis among the Iranian Kurdish population. Methods We analyzed data from the baseline phase of the Ravansar noncommunicable disease (RaNCD) cohort. The association between liver enzymes (ALT, AST, ALT/AST ratio, GGT, and ALP) with cardiometabolic disease risk factors was investigated by multiple linear regression. The odds ratio of cardiometabolic diseases in each quartile category of liver enzyme concentration was estimated using multivariable logistic regression. Results The mean age of participants was 47.3 ± 4.1 years (48.1 years in males and 51.8 years in females). In the adjusted model, all enzymes were positively associated with MetS, HTN, and CVD risk factors except for the ALT/AST ratio with SBP and DBP. In the adjusted model, subjects in the fourth quartile for GGT, ALT/AST ratio, ALT, ALP, and AST had 3.29-, 2.94-, 2.45-, 2.00-, and 1.19-fold increased risk for MetS compared with subjects in the first quartile. Increased levels of GGT and ALP were positively associated with the risk of HTN (ORs = 1.33, 95%CI = 1.03-1.71 for GGT; ORs = 1.32, 95%CI = -1.68 for ALP). An increased GGT level was significantly associated with CVD (ORs = 1.54, 95%CI = 1.03-1.68). Within the normal range quartile, ALT had a significant correlation with the incidence of MetS. Conclusion According to the present study, the levels of liver enzymes could be considered for early diagnosis of MetS, HTN, and CVD.
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Su W, Wang Y, Chen K, Wang J, Wang A, Tang X, Yan L, Luo Z, Qin G, Chen L, Ning G, Mu Y. Association between nonalcoholic fatty liver and increased low-level albuminuria in postmenopausal women in China: A cross-sectional study. J Diabetes 2021; 13:494-505. [PMID: 33200507 DOI: 10.1111/1753-0407.13134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 11/01/2020] [Accepted: 11/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Several studies have suggested that nonalcoholic fatty liver disease (NAFLD) is associated with cardiovascular disease (CVD). The excretion of low-level albuminuria (LLA) elevates as the prevalence of CVD increases. However, few studies have explored the association between NAFLD and LLA. METHODS This cross-sectional study included 31 147 Chinese adults (7664 men and 23 483 women). The "normal" level of albuminuria as determined by the urinary albumin to creatinine ratio (UACR) was below 30 mg/g. LLA was defined as a higher level within the "normal" albuminuria range (5.54 mg/g < LLA≤29.9 mg/g). The participants with NAFLD were defined as having a fatty liver index (FLI) ≥ 60. The FLI was calculated using the Bedogni equation. RESULTS A positive association was found between UACR and FLI through multivariate linear regression analyses (nonstandardized β ± SE: .047 ± 0.004, P <.001). The logistic regression analyses revealed that NAFLD had adjusted odds ratios (ORs) showing a significant relationship with LLA in models 1 to 4 (all subjects: OR, 1.207; 95% CI, 1.098-1.326; women: OR, 1.43; 95% CI, 1.26-1.63; all P <.001); however, we did not find significant adjusted ORs among the men. In the stratified analyses, the relationship between NAFLD and LLA was significant among postmenopausal women with a body mass index ≥24 but <28 kg/m2 , fasting plasma glucose ≥5.6 but <7.0 mmol/L, or postprandial plasma glucose ≥7.8 but <11.1 mmol/L and those aged below 60 years without moderate-intensity exercise. CONCLUSIONS A noteworthy association between NAFLD and LLA was found among postmenopausal women who had borderline blood glucose values, were overweight, and did not engage in moderate-intensity physical activity.
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Affiliation(s)
- Wanlu Su
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yuxia Wang
- Department of Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Kang Chen
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jie Wang
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Anping Wang
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanz7hou, Gansu, China. Department of Endocrinology, Center Hospital of Dalian, Dalian, China
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Guijun Qin
- Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lulu Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Wuhan, China
| | - Guang Ning
- Department of Endocrinology, Shanghai National Research Center for Endocrine and Metabolic Disease, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Disease, Ruijin Hospital. Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiming Mu
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China
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Tutunchi H, Naeini F, Mobasseri M, Ostadrahimi A. Triglyceride glucose (TyG) index and the progression of liver fibrosis: A cross-sectional study. Clin Nutr ESPEN 2021; 44:483-487. [PMID: 34330512 DOI: 10.1016/j.clnesp.2021.04.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/07/2021] [Accepted: 04/22/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver (NAFLD) is a multi-factorial liver disease and its incidence is globally rising. Little is known about the association between triglyceride glucose (TyG) index and liver fibrosis progression in NAFLD patients. AIM To examine the association of liver fibrosis with TyG index among patients with NAFLD in a sample of Iranian adults. METHODS The NAFLD fibrosis score and the fibrosis-4 (FIB-4) index were used for the detection of hepatic fibrosis. Multivariable-adjusted odds ratios (ORs) were applied to assess the association of liver fibrosis with TyG index. RESULTS The current study included a total of 230 participants with NAFLD and low probability of fibrosis. The TyG index quartiles were higher in patients with higher body mass index (BMI), higher systolic blood pressure (SBP), and less physical activity than in participants with lower BMI, lower SBP and more physical activity, respectively. Moreover, higher serum levels of total cholesterol, triglyceride, LDL-C, aspartate and aminotransferases, and homeostatic model assessment for insulin resistance (HOMA-IR), and lower serum level of HDL-C were observed in patients with higher quartiles of TyG index (all P < 0.01). The severity of NAFLD significantly increased with increment in the quartiles of TyG index. Increased TyG index was positively associated with worsening of NAFLD fibrosis score and FIB-4 index. Based on NAFLD fibrosis score, the multivariable-adjusted ORs (95% CIs) were 1.98 (1.33-2.22), 2.33 (2.09-2.94), and 3.44 (2.63-4.25) in the 2nd, 3rd, and 4th quantiles of TyG index when compared to the 1st quantile of TyG index. A similar trend was observed in the analysis using FIB-4 index. CONCLUSION According to the results of the current study, excess TyG index contributes to the development of liver fibrosis.
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Affiliation(s)
- Helda Tutunchi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Naeini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Majid Mobasseri
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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26
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Jichitu A, Bungau S, Stanescu AMA, Vesa CM, Toma MM, Bustea C, Iurciuc S, Rus M, Bacalbasa N, Diaconu CC. Non-Alcoholic Fatty Liver Disease and Cardiovascular Comorbidities: Pathophysiological Links, Diagnosis, and Therapeutic Management. Diagnostics (Basel) 2021; 11:689. [PMID: 33921359 PMCID: PMC8069361 DOI: 10.3390/diagnostics11040689] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) has a growing prevalence in recent years. Its association with cardiovascular disease has been intensively studied, and certain correlations have been identified. The connection between these two entities has lately aroused interest regarding therapeutic management. In order to find the best therapeutic options, a detailed understanding of the pathophysiology that links (NAFLD) to cardiovascular comorbidities is needed. This review focuses on the pathogenic mechanisms that are behind these two diseases and on the therapeutic management available at this time.
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Affiliation(s)
- Alexandra Jichitu
- Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania; (A.J.); (C.C.D.)
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
| | - Ana Maria Alexandra Stanescu
- Department 5, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Cosmin Mihai Vesa
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (C.M.V.); (C.B.)
| | - Mirela Marioara Toma
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
| | - Cristiana Bustea
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (C.M.V.); (C.B.)
| | - Stela Iurciuc
- Department of Cardiology, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Rus
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Nicolae Bacalbasa
- Department 13, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Surgery, “Ion Cantacuzino” Clinical Hospital, 030167 Bucharest, Romania
| | - Camelia Cristina Diaconu
- Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania; (A.J.); (C.C.D.)
- Department 5, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
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Lingonberry Improves Non-Alcoholic Fatty Liver Disease by Reducing Hepatic Lipid Accumulation, Oxidative Stress and Inflammatory Response. Antioxidants (Basel) 2021; 10:antiox10040565. [PMID: 33917360 PMCID: PMC8067338 DOI: 10.3390/antiox10040565] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally and there is a pressing need for effective treatment. Lipotoxicity and oxidative stress are the important mediators in NAFLD pathogenesis. Lingonberry (Vaccinium vitis-idaea L.) is rich in anthocyanins that have antioxidant and anti-inflammatory properties. The present study investigated the effect of lingonberry supplementation on liver injury in C57BL/6J male mice fed a high-fat diet (HFD) for 12 weeks. Mice fed HFD displayed liver injury with steatosis, increased lipid peroxidation and inflammatory cytokine expression in the liver as compared to mice fed a control diet. Lingonberry supplementation for 12 weeks alleviated HFD-induced liver injury, attenuated hepatic lipid accumulation, and inflammatory cytokine expression. Lingonberry supplementation inhibited the expression of sterol regulatory element-binding protein-1c (SREBP-1c) and acetyl-CoA carboxylase-1 (AAC-1) as well as activated AMP-activated protein kinase (AMPK) in the liver. It also decreased HFD-induced hepatic oxidative stress and aggregation of inflammatory foci. This was associated with a restoration of nuclear factor erythroid 2-related factor 2 (Nrf2) and glutathione level in the liver. These results suggest that lingonberry supplementation can protect against HFD-induced liver injury partly through attenuation of hepatic lipid accumulation, oxidative stress, and inflammatory response.
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Evaluating the Efficacy of Carum Copticum Seeds on the Treatment of Patients with Nonalcoholic Fatty Liver Disease: A Multi-Center, Randomized, Triple–Blind, Placebo-Controlled Clinical Trial Study. HEPATITIS MONTHLY 2021. [DOI: 10.5812/hepatmon.110488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Background: The increased prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) has caused several concerns. Besides, there are concerns about the side effects of the drugs used to treat this condition. Since the current treatments are not effective in treating NAFLD, developing a novel therapeutic option based on some medicinal plants is necessary. Few studies have investigated the natural drugs and their effects (e.g., extracts of Carum Copticum Seeds (CCS)) on these patients. Objectives: The current study intended to evaluate the safety and efficacy of CCS extracts on liver enzymes, serum lipids, as well as the grade of fatty liver, and anthropometric measurements in patients with nonalcoholic fatty liver disease. Methods: In this multi-center, randomized, triple-blind, placebo-controlled clinical trial study, 90 patients with grades of 1 to 3 of nonalcoholic fatty liver disease referred to two medical centers located in Tehran (Iran) in 2019 are examined. Diet and exercise were recommended for patients three times a day in eight weeks, in addition to taking 500 mg capsules (aqueous extracts of Ajwain seeds and placebo for treatment and placebo groups). Results: Medical records of 68 patients were reviewed, 48 (71%) male and 20 (29%) female. Both groups were similar concerning demographic and baseline characteristics. The total score of the Leeds questionnaire [-14.03 vs. -7.49, P = 0.048], Triglyceride (TG) [-4.45 vs. 10.03, P = 0.017], and Alanine Aminotransferase (ALT) [-14.71 vs. -4.79, P = 0.012] were significantly changed in the treatment group compared to the control group. Nevertheless, a different situation was observed for Aspartate Aminotransferase (AST) [-7.08 vs. -4.84, P = 0.314], Fasting Blood Sugar (FBS) [-2.88 vs. -2.81, P = 0.207], and Body Mass Index (BMI) [-0.59 vs. -0.39, P = 0.095]. Although a significant change was found in both groups, the amount of decline was similar for both groups. In both groups, the cholesterol, High-Density Lipoprotein (HDL), and Low-Density Lipoprotein (LDL) did not change significantly. The sonographic findings indicated significantly higher improvements in the intervention group than the placebo group (RR = 2.43, 95% CI (1.15-5.65), and P value = 0.034). Conclusions: The result of this study supports the efficacy of Carum copticum seeds in the treatment of nonalcoholic fatty liver disease patients. It was found that CCS with a significant reduction in ALT, TG, and relative reduction of BMI can help physicians to manage other metabolic disorders associated with NAFLD, such as obesity and hyperlipidemia.
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Pemmasani G, Yandrapalli S, Aronow W. Sex differences in cardiovascular diseases and associated risk factors in non-alcoholic steatohepatitis. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2020; 10:362-366. [PMID: 33224584 PMCID: PMC7675172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Non-alcoholic steatohepatitis (NASH) is well recognized as an important cardiovascular disease (CVD) risk factor. However, not many studies have described the prevalence of traditional CVD risk factors and CV diseases, and respective sex differences, in patients with NASH. METHODS In this retrospective observational cohort study using the 2016 US National Readmissions Database, we studied adults with NASH to identify the prevalence of important CVD risk factors like age, obesity, hypertension, diabetes mellitus, renal failure, dyslipidemia, smoking, and drug abuse and cardiovascular diseases like coronary artery disease, myocardial infarction and coronary revascularization, peripheral vascular disease, cerebrovascular disease, and pulmonary vascular disease. We studied sex differences using the Pearson χ2 test for categorical variables, student t-test for continuous variables, and logistic regression for age-adjusted analysis. RESULTS Our study sample included 41,005 patients with NASH of which 15,758 (38.4%) were male and 25,247 (61.6%) were female. Hypertension was the most prevalent CVD risk factor (68%), followed by diabetes mellitus (62%), obesity (40%), dyslipidemia (37%), smoking (30%), and renal failure in 27%. Of the cardiovascular diseases studied, coronary artery disease (20.6%) and heart failure (19.6%) were highly prevalent followed by peripheral vascular disease (5.7%), stroke (4.7%), and pulmonary vascular disease (1.4%). Men had higher rates of most risk factors and diseases compared with women, except for higher rates of obesity and diabetes mellitus in women and a similar rate of drug abuse, stroke, and pulmonary vascular disease between the sex groups. CONCLUSION In patients with NASH, CVD risk factors and diseases were highly prevalent and important sex differences were present.
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Salehi-Sahlabadi A, Mokari A, Elhamkia M, Farahmand F, Jabbari M, Hekmatdost A. Dietary Total Antioxidant Capacity and Risk of Non-Alcoholic Fatty Liver Disease: A Case-Control Study. J Res Health Sci 2020; 20:e00486. [PMID: 33169718 PMCID: PMC7585767 DOI: 10.34172/jrhs.2020.18] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dietary total antioxidant capacity (DTAC) has been proposed as a tool for assessing the intake of antioxidants. This study aimed to assess whether a relationship exists between dietary total antioxidant capacity (TAC) and the odds of NAFLD. STUDY DESIGN A case-control study. METHODS In this age-and sex-matched case-control study in 2019, patients with NAFLD and healthy controls were recruited from a hospital clinic. All participants completed a validated 168-item food frequency questionnaire, the results of which were subsequently used to generate dietary TAC. Oxygen radical absorbance capacity values were used to calculate dietary TAC. RESULTS Altogether, 225 patients with NAFLD and 450 healthy controls were enrolled. Participants with NAFLD had a higher mean weight, BMI, energy (P<0.050), and lower physical activity and DTAC scores (P<0.050) than the control group. In an adjusted model, participants who were in the highest quartile of dietary TAC had a lower risk of NAFLD (odds ratio 0.78, 95% CI: 0.67, 0.91). CONCLUSION A high DTAC was related to a decreased risk of NAFLD. Suggest the intake of a diet with high antioxidant capacity is significant at preventing NAFLD. Increasingly itemized investigations in design of randomized control trials require to reveal more insight into these results.
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Affiliation(s)
- Ammar Salehi-Sahlabadi
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Mokari
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Elhamkia
- School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Farahmand
- School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Jabbari
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azita Hekmatdost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Validation of a Non-Laboratory Based Screening Tool for Predicting Non-Alcoholic Fatty Liver Disease in an Egyptian Setting. Am J Med Sci 2020; 360:662-677. [PMID: 32739036 DOI: 10.1016/j.amjms.2020.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 05/02/2020] [Accepted: 06/18/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disorder in more than 20% of the general population worldwide. Several combinations of non-invasive factors and scoring models were investigated as indicators of NAFLD. This study aimed to validate and adapt an established fatty liver score, which allows the identification of NAFLD based on routinely available clinical and laboratory data. MATERIALS AND METHODS The study cohort comprised 190 adults seeking health check-up at the out-patient clinic of a tertiary care hospital in Alexandria, Egypt. Anthropometric, clinical, and laboratory data were recorded and the status of fatty liver was diagnosed by abdominal ultrasound. A logistic regression model was built to determine the predictors of NAFLD. The performance of the derived risk scores was compared to other existing models. RESULTS Obesity (60.0%), metabolic syndrome (42.6%), and NAFLD (56.8%) were predominant features among the study population. Smoking [OR (95% CI) = 4.4 (0.9-21.4)], obesity [OR (95% CI) = 4.0 (1.7-9.7)], hypertension [OR (95% CI) = 2.4 (1.03-5.5)], elevated serum total cholesterol [OR (95% CI) = 4.8 (1.8-13.1)], triglycerides [OR (95% CI) = 11.8 (2.3-661.02)], and ALT [OR (95% CI) = 4.8 (1.8-13.1)] were multivariate predictors of NAFLD. A NAFLD screening questionnaire with values applicable for Egyptians was adapted from an existing model after validation. A total score ≥7 was suggestive of NAFLD [AUC = 0.810 (0.749-0.871); sensitivity = 87.0%; specificity = 62.2%; PPV = 75.2%; NPV = 78.5%]. CONCLUSIONS NAFLD can be sufficiently predicted among apparently healthy Egyptians by a tempted simple and non-invasive scoring index although external validation is warranted.
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Estimated Cardiorespiratory Fitness Attenuates the Impacts of Sarcopenia and Obesity on Non-Alcoholic Fatty Liver in Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113902. [PMID: 32486399 PMCID: PMC7312192 DOI: 10.3390/ijerph17113902] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 12/12/2022]
Abstract
This population-based, cross-sectional study examined the preventive role of non-exercise-based estimation of cardiorespiratory fitness (eCRF) against the impacts of sarcopenia and obesity on the non-alcoholic fatty liver (NAFL) in Korean adults. Data were obtained from the 2008–2011 Korea National Health and Nutrition Examination Surveys IV and V (n = 14,015 Koreans aged ≥ 18 years, 64% women). eCRF was calculated with the age- and sex-specific algorithms, and classified as lower (lowest 25%), middle (middle 50%) and upper (highest 25%). Individuals were classified as optimal (i.e., the absence of both sarcopenia and obesity), sarcopenia (i.e., the presence of sarcopenia), obesity (i.e., the presence of obesity) or sarcopenic obesity (i.e., the coexistence of sarcopenia and obesity). Limited to the sarcopenia phenotype, the adjusted odds ratio (OR) of NAFL was 2.2 (95% confidence interval, CI, 1.5–3.1) for the lower eCRF, 1.6 (95% CI, 1.3–2.1) for the middle eCRF and 2.1 (95% CI, 1.4–3.1) for the upper eCRF, compared to the optimal phenotype. Limited to the obesity phenotype, the adjusted OR of NAFL was 2.9 (95% CI, 2.0–4.2) for the lower eCRF, 3.5 (95% CI, 2.7–4.6) for the middle eCRF and 1.8 (95% CI, 1.2–2.8) for the upper eCRF, compared to the optimal phenotype. Limited to the sarcopenic obesity phenotype, the adjusted OR of NAFL was 5.9 (95% CI, 4.3–8.2) for the lower eCRF, 4.2 (95% CI, 3.2–5.5) for the middle eCRF and 2.5 (95% CI, 1.5–4.1) for the upper eCRF, compared to the optimal phenotype. The current findings suggest that high eCRF attenuates the individual and synergistic impacts of sarcopenia and obesity on NAFL in Korean adults.
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Therapeutic implications of shared mechanisms in non-alcoholic fatty liver disease and chronic kidney disease. J Nephrol 2020; 34:649-659. [PMID: 32440840 DOI: 10.1007/s40620-020-00751-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023]
Abstract
The most common cause of liver disease worldwide is now non-alcoholic fatty liver disease (NAFLD). NAFLD refers to a spectrum of disease ranging from steatosis to non-alcoholic steatohepatitis, causing cirrhosis, and ultimately hepatocellular carcinoma. However, the impact of NAFLD is not limited to the liver. NAFLD has extra-hepatic consequences, most notably, cardiovascular and renal disease. NAFLD and chronic kidney disease share pathogenic mechanisms including insulin resistance, lipotoxicity, inflammation and oxidative stress. Not surprisingly, there has been a recent surge in efforts to manage NAFLD in an integrated way that not only protects the liver but also delays comorbidities such as chronic kidney disease. This concept of simultaneously addressing the main disease target and comorbidities is key to improve outcomes, as recently demonstrated by clinical trials of SGLT2 inhibitors and GLP1 receptor agonists in diabetes. HIF activators, already marketed in China, also have the potential to protect both liver and kidney, as suggested by preclinical data. This review concisely discusses efforts at identifying common pathogenic pathways between NAFLD and chronic kidney disease with an emphasis on potential paradigm shifts in diagnostic workup and therapeutic management.
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Musolino V, Gliozzi M, Bombardelli E, Nucera S, Carresi C, Maiuolo J, Mollace R, Paone S, Bosco F, Scarano F, Scicchitano M, Macrì R, Ruga S, Zito MC, Palma E, Gratteri S, Ragusa M, Volterrani M, Fini M, Mollace V. The synergistic effect of Citrus bergamia and Cynara cardunculus extracts on vascular inflammation and oxidative stress in non-alcoholic fatty liver disease. J Tradit Complement Med 2020; 10:268-274. [PMID: 32670822 PMCID: PMC7340872 DOI: 10.1016/j.jtcme.2020.02.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND AIM Non-Alcoholic Fatty Liver Disease (NAFLD) represents a risk factor for cardiovascular diseases. NAFLD is worsened by the simultaneous occurrence of type 2 diabetes mellitus (T2DM) causing an enhancement of inflammatory and fibrotic processes. Although insulin resistance appears the link between NAFLD and T2DM, current pharmacological treatments of T2DM failed to produce relevant benefits in preventing T2DM-related liver dysfunction. In this randomized, double blind, placebo-controlled clinical study, we evaluated the effect of Bergacyn, an innovative formulation originating from the combination of Bergamot Polyphenolic Fraction (BPF) and Cynara cardunculus (CyC). EXPERIMENTAL PROCEDURE 80 adult patients with a history of at least 12 months of T2DM and NAFLD received orally BPF (300 mg/daily) Cyc (300 mg/daily), separately or formulated in combination 50/50% (Bergacyn; 300 mg/daily), or placebo all containing 300 mg of bergamot albedo fibers micronized and co-grinded as excipients. RESULTS AND CONCLUSION Serum measurements and liver ultrasound analyses showed that concomitant administration of BPF and CyC produced significant improvement of NAFLD biomarkers in patients with T2DM. This effect was associated with a substantial reduction of oxidative stress/inflammatory biomarkers, thus contributing to a significant improvement of NO-mediated reactive vasodilation. Furthermore, the effect of Bergacyn showed a synergistic effect of both extracts, thus suggesting that this peculiar formulation represents a novel therapeutic strategy to counteract vascular inflammation and endothelial dysfunction in patients suffering from T2DM and NAFLD. Further studies in larger cohort of diabetic patients are required to better identify the potential of Bergacyn on metabolic disorders accompanying T2DM and NAFLD.
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Affiliation(s)
- Vincenzo Musolino
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Micaela Gliozzi
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Ezio Bombardelli
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Saverio Nucera
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Cristina Carresi
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Jessica Maiuolo
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Rocco Mollace
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Sara Paone
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Francesca Bosco
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Federica Scarano
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Miriam Scicchitano
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Roberta Macrì
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Stefano Ruga
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Maria Caterina Zito
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Ernesto Palma
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Santo Gratteri
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | - Monica Ragusa
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
| | | | | | - Vincenzo Mollace
- Institute of Research for Food Safety & Health, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Nutramed Scarl and, Italy
- San Raffaele IRCCS, Rome, Italy
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The Emerging Role of MicroRNAs in NAFLD: Highlight of MicroRNA-29a in Modulating Oxidative Stress, Inflammation, and Beyond. Cells 2020; 9:cells9041041. [PMID: 32331364 PMCID: PMC7226429 DOI: 10.3390/cells9041041] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease and ranges from steatosis to steatohepatitis and to liver fibrosis. Lipotoxicity in hepatocytes, elevated oxidative stress and the activation of proinflammatory mediators of Kupffer cells, and fibrogenic pathways of activated hepatic stellate cells can contribute to the development of NAFLD. MicroRNAs (miRs) play a crucial role in the dysregulated metabolism and inflammatory signaling connected with NAFLD and its progression towards more severe stages. Of note, the protective effect of non-coding miR-29a on liver damage and its versatile action on epigenetic activity, mitochondrial homeostasis and immunomodulation may improve our perception of the pathogenesis of NAFLD. Herein, we review the biological functions of critical miRs in NAFLD, as well as highlight the emerging role of miR-29a in therapeutic application and the recent advances in molecular mechanisms underlying its liver protective effect.
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El Hadi H, Di Vincenzo A, Vettor R, Rossato M. Relationship between Heart Disease and Liver Disease: A Two-Way Street. Cells 2020; 9:cells9030567. [PMID: 32121065 PMCID: PMC7140474 DOI: 10.3390/cells9030567] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 12/18/2022] Open
Abstract
In clinical practice, combined heart and liver dysfunctions coexist in the setting of the main heart and liver diseases because of complex cardiohepatic interactions. It is becoming increasingly crucial to identify these interactions between heart and liver in order to ensure an effective management of patients with heart or liver disease to provide an improvement in overall prognosis and therapy. In this review, we aim to summarize the cross-talk between heart and liver in the setting of the main pathologic conditions affecting these organs. Accordingly, we present the clinical manifestation, biochemical profiles, and histological findings of cardiogenic ischemic hepatitis and congestive hepatopathy due to acute and chronic heart failure, respectively. In addition, we discuss the main features of cardiac dysfunction in the setting of liver cirrhosis, nonalcoholic fatty liver disease, and those following liver transplantation.
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Affiliation(s)
- Hamza El Hadi
- Internal Medicine 3, Department of Medicine—DIMED, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; (H.E.H.); (A.D.V.); (R.V.)
- Department of Medicine, Klinikum Rheine, 48431 Rheine, Germany
| | - Angelo Di Vincenzo
- Internal Medicine 3, Department of Medicine—DIMED, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; (H.E.H.); (A.D.V.); (R.V.)
| | - Roberto Vettor
- Internal Medicine 3, Department of Medicine—DIMED, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; (H.E.H.); (A.D.V.); (R.V.)
| | - Marco Rossato
- Internal Medicine 3, Department of Medicine—DIMED, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; (H.E.H.); (A.D.V.); (R.V.)
- Correspondence: ; Tel.: +39-049-8218747; Fax: +39049-8213332
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Sinclair AJ, Abdelhafiz AH. Cardiometabolic disease in the older person: prediction and prevention for the generalist physician. Cardiovasc Endocrinol Metab 2020; 9:90-95. [PMID: 32803140 DOI: 10.1097/xce.0000000000000193] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/13/2020] [Indexed: 12/17/2022]
Abstract
Ageing is associated with chronic inflammation and oxidative stress that increase the risk of cardiovascular disease. Frailty and sarcopenia, which are associated with increased visceral obesity and muscle mass loss, are now emerging as new potential risk factors for cardiovascular disease. Increased muscle visceral fat leads to increased secretion of harmful proinflammatory adipokines and reduced muscle mass leads to reduced secretion of the protective myokines creating an abnormal cardiometabolic state increasing the risk of cardiovascular disease. This review: (1) explore traditional and newly emerging cardiometabolic risk factors in older people; (2) investigate methods of prediction and prevention of cardiovascular disease in those with diabetes; and (3) concludes that the development of a subspeciality of Cardiometabolic Medicine should be considered.
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Affiliation(s)
- Alan J Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd.,Kings College, London
| | - Ahmed H Abdelhafiz
- Department of Geriatric Medicine, Rotherham General Hospital, Rotherham, UK
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Robert C, Couëdelo L, Vaysse C, Michalski MC. Vegetable lecithins: A review of their compositional diversity, impact on lipid metabolism and potential in cardiometabolic disease prevention. Biochimie 2019; 169:121-132. [PMID: 31786232 DOI: 10.1016/j.biochi.2019.11.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022]
Abstract
Vegetable lecithins, widely used in the food industry as emulsifiers, are a mixture of naturally occurring lipids containing more than 50% of phospholipids (PL). PL exert numerous important physiological effects. Their amphiphilic nature notably enables them to stabilise endogenous lipid droplets, conferring them an important role in lipoprotein transport, functionality and metabolism. In addition, beneficial effects of dietary lecithin on metabolic disorders have been reported since the 1990s. This review attempts to summarize the effects of various vegetable lecithins on lipid and lipoprotein metabolism, as well as their potential application in the treatment of dyslipidemia associated with metabolic disorders. Despite controversial data concerning the impact of vegetable lecithins on lipid digestion and intestinal absorption, the beneficial effect of lecithin supplementation on plasma and hepatic lipoprotein and cholesterol levels is unequivocal. This is especially true in hyperlipidemic patients. Furthermore, the immense compositional diversity of vegetable lecithins endows them with a vast range of biochemical and biological properties, which remain to be explored in detail. Data on the effects of vegetable lecithins alternative to soybean, both as supplements and as ingredients in different foods, is undoubtedly lacking. Given the exponential demand for vegetable products alternative to those of animal origin, it is of primordial importance that future research is undertaken in order to elucidate the mechanisms by which individual fatty acids and PL from various vegetable lecithins modulate lipid metabolism. The extent to which they may influence parameters associated with metabolic disorders, such as intestinal integrity, low-grade inflammation and gut microbiota must also be assessed.
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Affiliation(s)
- Chloé Robert
- Univ Lyon, CarMeN Laboratory, Inserm, INRAE, INSA Lyon, Université Claude Bernard Lyon 1, Lyon-Sud Medical School, Pierre-Bénite, FR-69310, France; ITERG, Equipe Nutrition, Santé et Biochimie des Lipides, Canéjan, FR-33610, Canéjan, France
| | - Leslie Couëdelo
- ITERG, Equipe Nutrition, Santé et Biochimie des Lipides, Canéjan, FR-33610, Canéjan, France
| | - Carole Vaysse
- ITERG, Equipe Nutrition, Santé et Biochimie des Lipides, Canéjan, FR-33610, Canéjan, France
| | - Marie-Caroline Michalski
- Univ Lyon, CarMeN Laboratory, Inserm, INRAE, INSA Lyon, Université Claude Bernard Lyon 1, Lyon-Sud Medical School, Pierre-Bénite, FR-69310, France.
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