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Gradel KO. Interpretations of the Role of Plasma Albumin in Prognostic Indices: A Literature Review. J Clin Med 2023; 12:6132. [PMID: 37834777 PMCID: PMC10573484 DOI: 10.3390/jcm12196132] [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: 07/07/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
This review assesses how publications interpret factors that influence the serum or plasma albumin (PA) level in prognostic indices, focusing on inflammation and nutrition. On PubMed, a search for "albumin AND prognosis" yielded 23,919 results. From these records, prognostic indices were retrieved, and their names were used as search strings on PubMed. Indices found in 10 or more original research articles were included. The same search strings, restricted to "Review" or "Systematic review", retrieved yielded on the indices. The data comprised the 10 latest original research articles and up to 10 of the latest reviews. Thirty indices had 294 original research articles (6 covering two indices) and 131 reviews, most of which were from recent years. A total of 106 articles related the PA level to inflammation, and 136 related the PA level to nutrition. For the reviews, the equivalent numbers were 54 and 65. In conclusion, more publications mention the PA level as a marker of nutrition rather than inflammation. This is in contrast to several general reviews on albumin and nutritional guidelines, which state that the PA level is a marker of inflammation but not nutrition. Hypoalbuminemia should prompt clinicians to focus on the inflammatory aspects in their patients.
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Affiliation(s)
- Kim Oren Gradel
- Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense, Denmark; ; Tel.: +45-21-15-80-85
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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Hegazi OE, Alalalmeh SO, Alnuaimi GRH, Shahwan M, Jairoun AA, Alorfi NM, Majrashi SA, Alkhanani MF, Alkhattabi A, Alourfi MM, Alsolami FA, Alsharif S, Alshahrani H. NAFLD and nutraceuticals: a review of completed phase III and IV clinical trials. Front Med (Lausanne) 2023; 10:1227046. [PMID: 37601777 PMCID: PMC10433184 DOI: 10.3389/fmed.2023.1227046] [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: 05/22/2023] [Accepted: 06/29/2023] [Indexed: 08/22/2023] Open
Abstract
Background Nonalcoholic Fatty Liver Disease (NAFLD) has become a significant public health concern, affecting approximately one-fourth of the population. Despite its prevalence, no FDA-approved drug treatments specifically target NAFLD. Aim To provide a review of clinical trials investigating the use of herbal remedies and dietary supplements in NAFLD management, utilizing the ClinicalTrials.gov database. Methods This review evaluates the current evidence by examining completed phase III and IV clinical trials registered on ClinicalTrials.gov. An exhaustive search was performed on April 17, 2023, using the terms "Nonalcoholic Fatty Liver Disease" and "NAFLD." Two independent reviewers appraised eligible trials based on pre-defined inclusion and exclusion criteria. Results An initial search yielded 1,226 clinical trials, with 12 meeting the inclusion criteria after filtration. The majority of trials focused on Omega-3 fatty acids (20.0%) and vitamin D (26.7%), followed by caffeine, chlorogenic acid, ginger, phosphatidylcholine, Trigonella Foenum-graecum seed extract, vitamin C, and vitamin E (each 6.7%). Most studies were Phase 3 (75.0%) and used a parallel assignment model (91.7%). Quadruple masking was the most prevalent technique (58.3%), and Iran was the leading country in terms of trial locations (25.0%). These interventions constitute two herbal interventions and nine supplement interventions. Conclusion This reveals a diverse range of nutraceuticals, with Omega-3 fatty acids and vitamin D being predominant in the management of NAFLD. The global distribution of trials highlights the widespread interest in these therapeutics. However, more rigorous, large-scale trials are needed to establish safety, efficacy, and optimal dosages.
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Affiliation(s)
- Omar E. Hegazi
- Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Samer O. Alalalmeh
- Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Ghala Rashid Humaid Alnuaimi
- Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Moyad Shahwan
- Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Ammar Abdulrahman Jairoun
- Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates
- School of Pharmaceutical Sciences, University Sains Malaysia (USM), Pulau Pinang, Malaysia
| | - Nasser M. Alorfi
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Shaker A. Majrashi
- Department of Laparoscopic Surgery, King Fahad Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Mustfa Faisal Alkhanani
- Biology Department, College of Sciences, University of Hafr Al Batin, Hafr Al Batin, Saudi Arabia
| | | | - Mansour M. Alourfi
- Department of Gastroenterology, East Jeddah Hospital, Jeddah, Saudi Arabia
- Internal Medicine Department, King Faisal Medical City for Southern Region, Abha, Saudi Arabia
| | - Faris A. Alsolami
- Khulais General Hospital, Makkah cluster, Ministry of Health, Makkah, Saudi Arabia
| | - Saeed Alsharif
- Gastroenterology Department, Armed force hospital of Southern region, Khamis Mushait, Saudi Arabia
| | - Hatim Alshahrani
- Internal medicine Department, Khamis Mushait General hospital, Khamis Mushait, Saudi Arabia
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Boonchai P, Kositamongkol C, Jitrukthai S, Phothirat S, Mepramoon E, Nimitpunya P, Srivanichakorn W, Chaisathaphol T, Washirasaksiri C, Auesomwang C, Sitasuwan T, Tinmanee R, Sayabovorn N, Charatcharoenwitthaya P, Phisalprapa P. Clinical Differences and Non-Alcoholic Fatty Liver Disease-Related Factors of Lean and Non-Lean Patients with Metabolic Syndrome. J Clin Med 2022; 11:jcm11092445. [PMID: 35566571 PMCID: PMC9103281 DOI: 10.3390/jcm11092445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 12/10/2022] Open
Abstract
This study investigated differences in the clinical data and prevalence of lean and non-lean patients with non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS). Data on patients with MetS who had results of ultrasonography or transient elastography were collected from a Thai university hospital database. Patients with exclusion criteria for NAFLD diagnosis were excluded. Patients’ clinical characteristic and the performances of three non-invasive scoring systems (fatty liver index [FLI], fibrosis-4 [FIB-4] index, and NAFLD fibrosis score [NFS]) were evaluated. The 743 subjects were classified into two groups: lean MetS (131 patients) and non-lean MetS (612 patients). The NAFLD prevalence in the non-lean group (62.6%) was higher than that in the lean group (31.3%). The age-adjusted odds ratio was 3.43. Advanced fibrosis was detected in 7.6% of lean patients and 10.8% of non-lean patients. FLI was not sensitive enough to detect NAFLD in the lean group at a high cutoff, but it performed acceptably at a low cutoff. FIB-4 performed better than NFS in determining advanced fibrosis. NAFLD was more common in non-lean than lean patients. Lean patients with MetS had a relatively higher risk of NAFLD than the general population. FLI and FIB-4 index performed acceptably in both groups.
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Affiliation(s)
- Punyisa Boonchai
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Chayanis Kositamongkol
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Suchanart Jitrukthai
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Sukumal Phothirat
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Euarat Mepramoon
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Pongpol Nimitpunya
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Weerachai Srivanichakorn
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Thanet Chaisathaphol
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Chaiwat Washirasaksiri
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Chonticha Auesomwang
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Tullaya Sitasuwan
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Rungsima Tinmanee
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Naruemit Sayabovorn
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
| | - Phunchai Charatcharoenwitthaya
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Pochamana Phisalprapa
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.B.); (C.K.); (S.J.); (S.P.); (E.M.); (P.N.); (W.S.); (T.C.); (C.W.); (C.A.); (T.S.); (R.T.); (N.S.)
- Correspondence: ; Tel./Fax: +66-2-419-7190
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Trifan A, Rotaru A, Stafie R, Stratina E, Zenovia S, Nastasa R, Huiban L, Cuciureanu T, Muzîca C, Chiriac S, Gîrleanu I, Sîngeap AM, Sfarti C, Cojocariu C, Stanciu C. Clinical and Laboratory Characteristics of Normal Weight and Obese Individuals with Non-Alcoholic Fatty Liver Disease. Diagnostics (Basel) 2022; 12:diagnostics12040801. [PMID: 35453849 PMCID: PMC9028454 DOI: 10.3390/diagnostics12040801] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 02/05/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) has had, over the past few decades, a progressively growing prevalence among the general population all over the world, in parallel with metabolic conditions such as type 2 diabetes mellitus (T2DM), dyslipidemia, and obesity. However, NAFLD is also detected in 10−13% of subjects with a body mass index (BMI) ≤ 25 kg/m² (lean-NAFLD), whose major risk factors remain unknown. In this study, we aimed to characterize the clinical features and associated risk factors of lean-NAFLD in comparison with obese-NAFLD patients. Consecutive patients diagnosed with NAFLD by vibration-controlled transient elastography and controlled attenuation parameter were prospectively enrolled. Biological and clinical data obtained from the participants were stratified according to their BMI in two groups: lean-NAFLD and obese-NAFLD. In total, 331 patients (56.8% males) were included in the final analysis. Most of the subjects were obese-NAFLD (n = 258, 77.9%) and had a higher prevalence of T2DM, dyslipidemia, and components of the metabolic syndrome, together with abnormal biological parameters. Regarding liver stiffness measurements, the proportion of subjects with at least significant fibrosis (≥F2) was approximately twofold higher among obese-NAFLD (43.81%) in comparison with lean-NAFLD patients (23.29%). Moreover, obese individuals had a higher risk for liver fibrosis (OR = 2.6, 95%, CI 1.5−4.42, p < 0.001) than lean individuals. Although associated metabolic conditions and at least significant liver fibrosis were present in approximately one-quarter of the patients, these were more frequent among obese-NAFLD patients. Therefore, individualized screening strategies for NAFLD should be established according to BMI.
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Affiliation(s)
- Anca Trifan
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Adrian Rotaru
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
- Correspondence: (A.R.); (R.S.)
| | - Remus Stafie
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
- Correspondence: (A.R.); (R.S.)
| | - Ermina Stratina
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Sebastian Zenovia
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Robert Nastasa
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Laura Huiban
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Tudor Cuciureanu
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Cristina Muzîca
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Stefan Chiriac
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Irina Gîrleanu
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Ana-Maria Sîngeap
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Catalin Sfarti
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Camelia Cojocariu
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Carol Stanciu
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.T.); (E.S.); (S.Z.); (R.N.); (L.H.); (T.C.); (C.M.); (S.C.); (I.G.); (A.-M.S.); (C.S.); (C.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” University Hospital, 700111 Iasi, Romania
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