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van Son K, te Nijenhuis-Noort L, Boone S, Mook-Kanamori D, Holleboom A, Roos P, Lamb H, Alblas G, Coenraad M, Rosendaal F, de Mutsert R, Tushuizen M. Prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in a middle-aged population with overweight and normal liver enzymes, and diagnostic accuracy of noninvasive proxies. Medicine (Baltimore) 2024; 103:e34934. [PMID: 38181294 PMCID: PMC10766322 DOI: 10.1097/md.0000000000034934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/04/2023] [Indexed: 01/07/2024] Open
Abstract
The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing at an alarming rate. Elevated liver enzymes are a primary reason to refer patients for further testing. However, liver enzymes within the normal range do not exclude the presence of MASLD. We examined the prevalence of MASLD in a middle-aged population with overweight and normal liver enzymes. In addition, we examined the accuracy of 4 sets of noninvasive proxies for MASLD. We included 1017 participants from the Netherlands epidemiology of obesity cohort study with body mass index ≥25 kg/m2 and liver enzymes (asparate aminotransferase, alanine aminotransferase, gamma-glutamyltranspeptidase) within normal range. The diagnostic accuracy of biomarker scores (fatty liver index, liver fat score [LFS], STEATO-ELSA, and hepatic steatosis index) was determined against elevated hepatic triglyceride content measured by 1proton magnetic resonance spectroscopy. Participants (mean age 56 years, 49% women), had a median body mass index of 29.6 kg/m2 and a median hepatic triglyceride content of 4.4%. MASLD was present in 42% of participants and was more common in men than women, with respectively 47% and 36% being affected. The LFS showed the highest accuracy with an area under the curve of 0.72. We identified metabolic syndrome as the prime predictor for MASLD with an odds ratio of 2.95 (95% confidence interval 2.20-3.98). The prevalence of MASLD in middle-aged men and women with overweight and liver enzymes within the normal range is over 40%. LFS showed the highest accuracy to detect MASLD, but, overall, biomarker scores performed relatively poor. The presence of metabolic syndrome was the prime predictor of MASLD.
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Affiliation(s)
- K.C. van Son
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Vascular Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | | | - S.C. Boone
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - D.O. Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - A.G. Holleboom
- Department of Vascular Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - P.R. Roos
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - H.J. Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - G. Alblas
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - M.J. Coenraad
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - F.R. Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - R. de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - M.E. Tushuizen
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
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Aguirre L, Palacios-Ortega S, Fernández-Quintela A, Hijona E, Bujanda L, Portillo MP. Pterostilbene Reduces Liver Steatosis and Modifies Hepatic Fatty Acid Profile in Obese Rats. Nutrients 2019; 11:nu11050961. [PMID: 31035507 PMCID: PMC6566509 DOI: 10.3390/nu11050961] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/18/2019] [Accepted: 04/24/2019] [Indexed: 01/04/2023] Open
Abstract
Excessive fat accumulation within the liver is known as “simple hepatic steatosis”, which is the most benign form of non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to determine whether pterostilbene improves this hepatic alteration in Zucker (fa/fa) rats. Animals were distributed in two experimental groups (n = 10) and fed a standard laboratory diet. Rats in the pterostilbene group were given a dose of 30 mg/kg body weight/d for six weeks. After sacrifice, serum glucose, transaminase, and insulin concentrations were quantified and the liver triacylglycerol content and fatty acid profile was analyzed. Different pathways of triacylglycerol metabolism in liver were studied, including fatty acid synthesis and oxidation, triglyceride assembly, fatty acid uptake, and glucose uptake. With pterostilbene administration, a reduction in insulin concentrations (consequently in the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)) and hepatic triacylglycerol content were observed. No effects were observed in pterostilbene-treated rats in the activity of de novo lipogenesis enzymes. An improvement in the fatty acid profile was observed in pterostilbene-treated rats. In conclusion, pterostilbene is a useful molecule to reduce liver steatosis. Its delipidating effect is due, at least in part, to reduced fatty acid availability and triacylglycerol synthesis, as well as to an increased very low-density lipoprotein assembly and fatty acid oxidation.
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Affiliation(s)
- Leixuri Aguirre
- Nutrition and Obesity Group, Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of the Basque Country (UPV/EHU) 01006 Vitoria, Spain.
- Lucio Lascaray Research Centre, 01006 Vitoria, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, 01006 Vitoria, Spain.
| | - Sara Palacios-Ortega
- Doisy Research Center, Biochemistry and Molecular Biology Department, Saint Louis University, St. Louis, MO 63104, USA.
| | - Alfredo Fernández-Quintela
- Nutrition and Obesity Group, Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of the Basque Country (UPV/EHU) 01006 Vitoria, Spain.
- Lucio Lascaray Research Centre, 01006 Vitoria, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, 01006 Vitoria, Spain.
| | - Elizabeth Hijona
- Department of Gastroenterology, University of the Basque Country (UPV/EHU), Donostia Hospital, 20014 San Sebastián, Spain.
- Biodonostia Institute, 20014 San Sebastián, Spain.
- CIBER Hepatic and Digestive Pathologies (CIBERehd), Institute of Health Carlos III, 20014 San Sebastián, Spain.
| | - Luis Bujanda
- Department of Gastroenterology, University of the Basque Country (UPV/EHU), Donostia Hospital, 20014 San Sebastián, Spain.
- Biodonostia Institute, 20014 San Sebastián, Spain.
- CIBER Hepatic and Digestive Pathologies (CIBERehd), Institute of Health Carlos III, 20014 San Sebastián, Spain.
| | - María P Portillo
- Nutrition and Obesity Group, Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of the Basque Country (UPV/EHU) 01006 Vitoria, Spain.
- Lucio Lascaray Research Centre, 01006 Vitoria, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, 01006 Vitoria, Spain.
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Rico D, Martin-Diana AB, Lasa A, Aguirre L, Milton-Laskibar I, de Luis DA, Miranda J. Effect of Wakame and Carob Pod Snacks on Non-Alcoholic Fatty Liver Disease. Nutrients 2019; 11:E86. [PMID: 30621142 PMCID: PMC6356417 DOI: 10.3390/nu11010086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 12/16/2018] [Accepted: 12/28/2018] [Indexed: 02/06/2023] Open
Abstract
Snacks combining different functional ingredients could represent a useful therapeutic strategy against NAFLD. The present study aimed to analyze the effect of two snack formulations based on carob and wakame flour in the treatment for NAFLD in rats. For this purpose, metabolic syndrome was induced in 50 adult rats by a high-fat high-fructose diet over eight weeks. After this period, rats were fed either normal calorie diets supplemented or not with snack A (1/50 wakame/carob pod) and snack B (1/5 wakame/carob pod) for four additional weeks. After sacrifice, liver composition and serum parameters were analyzed. Different pathways of triacylglycerol metabolism in liver were studied including fatty acid oxidation, fatty acid synthesis, triglyceride assembly and release, fatty acid uptake and glucose uptake. Oxidative stress was also measured. Snack treatment, and mainly B snack, reduced liver triacylglycerol levels by increasing fat oxidation. Moreover, this snack reduced oxidative stress. Therefore, this snack formulation could represent an interesting tool useful for fatty liver treatment.
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Affiliation(s)
- Daniel Rico
- Department of Research and Technology, Agrarian Technological Institute of Castilla and Leon (ITACyL), Government of Castilla and Leon, Ctra. de Burgos Km. 119, 47071 Valladolid, Spain.
| | - Ana Belén Martin-Diana
- Department of Research and Technology, Agrarian Technological Institute of Castilla and Leon (ITACyL), Government of Castilla and Leon, Ctra. de Burgos Km. 119, 47071 Valladolid, Spain.
| | - Arrate Lasa
- Nutrition and Obesity Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of Basque Country (UPV/EHU) and Lucio Lascaray Research Center, 01006 Vitoria, Spain.
- CIBEROBN Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 01006 Vitoria-Gasteiz, Spain.
| | - Leixuri Aguirre
- Nutrition and Obesity Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of Basque Country (UPV/EHU) and Lucio Lascaray Research Center, 01006 Vitoria, Spain.
- CIBEROBN Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 01006 Vitoria-Gasteiz, Spain.
| | - Iñaki Milton-Laskibar
- Nutrition and Obesity Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of Basque Country (UPV/EHU) and Lucio Lascaray Research Center, 01006 Vitoria, Spain.
- CIBEROBN Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 01006 Vitoria-Gasteiz, Spain.
| | - Daniel Antonio de Luis
- Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid-IEN, Facultad de Medicina, Universidad de Valladolid, 47005 Valladolid, Spain.
| | - Jonatan Miranda
- Nutrition and Obesity Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of Basque Country (UPV/EHU) and Lucio Lascaray Research Center, 01006 Vitoria, Spain.
- CIBEROBN Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 01006 Vitoria-Gasteiz, Spain.
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Harrison SA, Dennis A, Fiore MM, Kelly MD, Kelly CJ, Paredes AH, Whitehead JM, Neubauer S, Traber PG, Banerjee R. Utility and variability of three non-invasive liver fibrosis imaging modalities to evaluate efficacy of GR-MD-02 in subjects with NASH and bridging fibrosis during a phase-2 randomized clinical trial. PLoS One 2018; 13:e0203054. [PMID: 30192782 PMCID: PMC6128474 DOI: 10.1371/journal.pone.0203054] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/12/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Given the worldwide prevalence of NAFLD and NASH, there is a need to develop treatments to slow or reverse disease progression. GR-MD-02 (galactoarabino-rhamnogalaturonate) has been shown to reduce hepatic fibrosis in animal studies, and lower serum biomarkers of NASH fibrogenesis in humans. The primary aim of this study was to determine the difference between four-months of treatment with GR-MD-02 or placebo in liver inflammation and fibrosis as measured by iron-corrected T1 (cT1) mapping, a non-invasive magnetic resonance imaging (MRI) biomarker that correlates with the extent of hepatic fibro-inflammatory disease. The secondary aims were to determine change in liver stiffness as measured by magnetic resonance elastography (MRE) and shear-wave ultrasonic elastography (LSM), and to explore test-retest repeatability of the three biomarkers. MATERIALS AND METHODS Thirty subjects (13 females, 46-71 years) with NASH and advanced fibrosis were recruited. Subjects were randomized to receive 8 mg.kg-1 GR-MD-02 (via IV infusion) or placebo, administered biweekly over a 16-week period. Therapeutic efficacy was examined using cT1, MRE, and LSM. Statistical analyses on group differences in the biomarkers were performed using robust ANCOVA models adjusting for baseline measurement and additional covariates. RESULTS There was no significant difference in cT1 (p = 0.16) between GR-MD-02 and placebo groups following a 16-week intervention. There was also no significant difference in liver stiffness, measured by MRE (p = 0.80) or LSM (p = 0.63), between groups. Examination of repeatability of the cT1, MRE and LSM revealed coefficient of variations of 3.1%, 11% and 40% respectively. CONCLUSIONS 8 mg.kg-1 of GR-MD-02 had no significant effect on non-invasive biomarkers of liver inflammation or fibrosis over a 4-month period. Histological confirmation was not available in this study. The high reproducibility of the primary outcome measure suggests that cT1 could be utilized for monitoring longitudinal change in patients with NASH.
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Affiliation(s)
- Stephen A. Harrison
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Andrea Dennis
- Perspectum Diagnostics, Oxford, United Kingdom
- * E-mail:
| | | | | | | | - Angelo H. Paredes
- San Antonio Military Medical Center, San Antonio, Texas, United States of America
| | | | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Perspectum Diagnostics, Oxford, United Kingdom
| | - Peter G. Traber
- Galectin Therapeutics Incorporated, Norcross, Georgia, United States of America
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Evans WN, Acherman RJ, Ciccolo ML, Carrillo SA, Galindo A, Rothman A, Mayman GA, Adams EA, Reardon LC, Winn BJ, Yumiaco NS, Shimuizu L, Inanaga Y, Deleon RJ, Restrepo H. A composite noninvasive index correlates with liver fibrosis scores in post-Fontan patients: Preliminary findings. CONGENIT HEART DIS 2017; 13:38-45. [DOI: 10.1111/chd.12558] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/03/2017] [Accepted: 10/15/2017] [Indexed: 12/16/2022]
Affiliation(s)
- William N. Evans
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- Division of Pediatric Cardiology, Department of Pediatrics; University of Nevada School of Medicine; Las Vegas Nevada USA
| | - Ruben J. Acherman
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- Division of Pediatric Cardiology, Department of Pediatrics; University of Nevada School of Medicine; Las Vegas Nevada USA
| | - Michael L. Ciccolo
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- Department of Surgery; University of Nevada School of Medicine; Las Vegas Nevada USA
| | - Sergio A. Carrillo
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- Department of Surgery; University of Nevada School of Medicine; Las Vegas Nevada USA
| | - Alvaro Galindo
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- Division of Pediatric Cardiology, Department of Pediatrics; University of Nevada School of Medicine; Las Vegas Nevada USA
| | - Abraham Rothman
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- Division of Pediatric Cardiology, Department of Pediatrics; University of Nevada School of Medicine; Las Vegas Nevada USA
| | - Gary A. Mayman
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- Division of Pediatric Cardiology, Department of Pediatrics; University of Nevada School of Medicine; Las Vegas Nevada USA
| | - Elizabeth A. Adams
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- Division of Pediatric Cardiology, Department of Pediatrics; University of Nevada School of Medicine; Las Vegas Nevada USA
| | - Leigh C. Reardon
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- UCLA Division of Cardiology and Division of Pediatric Cardiology; Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California USA
| | - Brody J. Winn
- Laboratory Medicine Consultants; Las Vegas Nevada USA
| | | | - Lesley Shimuizu
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
| | - Yoko Inanaga
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
| | - Rowena J. Deleon
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
| | - Humberto Restrepo
- Department of Pediatric Cardiology, Children's Heart Center Nevada; Las Vegas Nevada USA
- Division of Pediatric Cardiology, Department of Pediatrics; University of Nevada School of Medicine; Las Vegas Nevada USA
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Zhou YJ, Zheng JN, Liu WY, Miele L, Vitale A, Van Poucke S, Zou TT, Fang DH, Shen S, Zhang DC, Zheng MH. The NAFL Risk Score: A simple scoring model to predict 4-y risk for non-alcoholic fatty liver. Clin Chim Acta 2017; 468:17-24. [PMID: 28111272 DOI: 10.1016/j.cca.2017.01.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/14/2017] [Accepted: 01/18/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although several risk factors for non-alcoholic fatty liver (NAFL) have been reported, there are few clinical scores that predict its incidence in the long term. We developed and validate a scoring model for individual prediction of 4-y risk for NAFL. METHODS Four-year follow-up data of 8226 initially NAFL-free subjects enrolled for an annual physical examination from Wenzhou Medical Center were analyzed. These subjects are randomly split into the training and the validation cohort. Univariate and multivariable logistic regression models were employed for model development. The selected variables were assigned an integer or half-integer risk score proportional to the estimated coefficient from the logistic model. Risk scores were tested in a validation cohort. We also compared the predictive performance of with that of the NAFLD Index by computing the area under the receiver operating characteristic curve (AUROC). RESULTS The NAFL Risk Score was developed as 0 to 18 points comprising of BMI, TG×GGT, ALT/AST, LDL-C/HDL-C and UA in both sexes. Comparison of the observed with the estimated incidence of NAFL at both cohorts showed satisfactory precision. In addition, the NAFL Risk Score showed relatively good discriminative power (AUROC=0.739 for males, 0.823 for females) compared with the NAFLD Index (AUROC=0.661 for males, 0.729 for females) in these Chinese subjects. CONCLUSIONS We developed and validated the NAFL Risk Score, a new scoring model to predict 4-y risk for NAFL. The NAFL Risk Score may be clinically simple and useful for assessing individual risk for NAFL.
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Affiliation(s)
- Yu-Jie Zhou
- Department of Hepatology, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Ji-Na Zheng
- Department of Hepatology, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Wen-Yue Liu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Luca Miele
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
| | | | - Sven Van Poucke
- Department of Anesthesiology, Critical Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Tian-Tian Zou
- Department of Hepatology, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; School of the Second Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Dan-Hong Fang
- Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Shengrong Shen
- Department of Food Science & Nutrition, Zhejiang University, Hangzhou, China
| | - Dong-Chu Zhang
- Wenzhou Medical Center, Wenzhou People's Hospital, Wenzhou, China
| | - Ming-Hua Zheng
- Department of Hepatology, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Institute of Hepatology, Wenzhou Medical University, Wenzhou, China.
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miR33a/miR33b* and miR122 as Possible Contributors to Hepatic Lipid Metabolism in Obese Women with Nonalcoholic Fatty Liver Disease. Int J Mol Sci 2016; 17:ijms17101620. [PMID: 27669236 PMCID: PMC5085653 DOI: 10.3390/ijms17101620] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 02/06/2023] Open
Abstract
Specific miRNA expression profiles have been shown to be associated with nonalcoholic fatty liver disease (NAFLD). We examined the correlation between the circulating levels and hepatic expression of miR122 and miR33a/b*, the key lipid metabolism-related gene expression and the clinicopathological factors of obese women with NAFLD. We measured miR122 and miR33a/b* expression in liver samples from 62 morbidly obese (MO), 30 moderately obese (ModO), and eight normal-weight controls. MiR122 and miR33a/b* expression was analyzed by qRT-PCR. Additionally, miR122 and miR33b* circulating levels were analyzed in 122 women. Hepatic miR33b* expression was increased in MO compared to ModO and controls, whereas miR122 expression was decreased in the MO group compared to ModO. In obese cohorts, miR33b* expression was increased in nonalcoholic steatohepatitis (NASH). Regarding circulating levels, MO patients with NASH showed higher miR122 levels than MO with simple steatosis (SS). These circulating levels are good predictors of histological features associated with disease severity. MO is associated with altered hepatic miRNA expression. In obese women, higher miR33b* liver expression is associated with NASH. Moreover, multiple correlations between miRNAs and the expression of genes related to lipid metabolism were found, that would suggest a miRNA-host gene circuit. Finally, miR122 circulating levels could be included in a panel of different biomarkers to improve accuracy in the non-invasive diagnosis of NASH.
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Bedossa P, Patel K. Biopsy and Noninvasive Methods to Assess Progression of Nonalcoholic Fatty Liver Disease. Gastroenterology 2016; 150:1811-1822.e4. [PMID: 27003601 DOI: 10.1053/j.gastro.2016.03.008] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 02/24/2016] [Accepted: 03/09/2016] [Indexed: 02/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) comprises a spectrum of histopathologic features, ranging from isolated hepatic steatosis, to steatohepatitis with evidence of hepatocellular injury and fibrosis, to cirrhosis. The diagnosis and determination of NAFLD prognosis requires clinical and histopathologic assessments. Liver biopsy still is regarded as the reference for differentiating steatosis (NAFL) from nonalcoholic steatohepatitis, for staging hepatic fibrosis, and for identifying NAFLD in patients with other chronic liver disease. Standardized grading and staging histologic scoring systems, such as the NAFLD activity score and the steatosis, activity, and fibrosis score, can help guide clinical decisions and assess outcomes of clinical trials. Improved understanding of the pathophysiology of NAFLD and technologic advances have led to algorithms that can be used to assess serum biomarkers and imaging methods that are noninvasive alternatives to biopsy collection and analysis. We review the advantages and limitations of biopsy analysis and noninvasive tests as diagnostic and prognostic tools for patients with NAFLD. We also discuss techniques to improve dynamic histopathology assessment, and emerging blood and imaging biomarkers of fibrogenesis.
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Affiliation(s)
- Pierre Bedossa
- Department of Pathology, Physiology and Imaging, Hôpital Beaujon, Clichy, France
| | - Keyur Patel
- Division of Gastroenterology, University of Toronto Health Network, Toronto General Hospital, Toronto, Ontario, Canada.
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Chen P, Lv NH. Diagnostic and therapeutic value of Ghrelin in digestive diseases. Shijie Huaren Xiaohua Zazhi 2015; 23:3247-3253. [DOI: 10.11569/wcjd.v23.i20.3247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Ghrelin is a 28 amino-acid multi-functional peptide hormone, which was identified as a natural ligand of growth hormone secretagogue receptor (GHS-R). Ghrelin has been found in the stomach, intestine, pancreas and liver. In recent years, the application value of Ghrelin in digestive system diseases has attracted wide attention, especially in the protection of liver damage, assessment of the severity of pancreatitis, and evaluation of the activity and prognosis of peptic ulcer, gastritis and inflammatory bowel disease, and the occurrence and progression of gastrointestinal cancer. In this paper, we review the recent advance in understanding the role of Ghrelin in digestive diseases.
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