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Elmansoury N, Megahed AA, Kamal A, El-Nikhely N, Labane M, Abdelmageed M, Daly AK, Wahid A. Relevance of PNPLA3, TM6SF2, HSD17B13, and GCKR Variants to MASLD Severity in an Egyptian Population. Genes (Basel) 2024; 15:455. [PMID: 38674389 PMCID: PMC11049340 DOI: 10.3390/genes15040455] [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: 03/09/2024] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is a frequent clinical condition globally. Single nucleotide polymorphisms (SNPs) associated with NAFLD have been proposed in the literature and based on bioinformatic screening. The association between NAFLD and genetic variants in Egyptians is still unclear. Hence, we sought to investigate the association of some genetic variants with NAFLD in Egyptians. Egyptians have been categorized into either the MASLD group (n = 205) or the healthy control group (n = 187). The severity of hepatic steatosis and liver fibrosis was assessed by a Fibroscan device. TaqMan-based genotyping assays were employed to explore the association of selected SNPs with MASLD. PNPLA3 rs738409 C>G variant is associated with the presence of MASLD with liver fibrosis, the severity of both hepatic steatosis and liver fibrosis, increased systolic and diastolic blood pressure and increased alanine aminotransferase (all p < 0.05), while the TM6SF2 rs58542926 C>T, HSD17B13 rs9992651 G>A, and GCKR rs1260326 T>C variants were not (all p > 0.05). The TM6SF2 rs58542926 T allele is associated with increased fasting blood glucose and a decreased waist circumference. The GCKR rs1260326 C allele is associated with decreased aspartate transaminase and diastolic blood pressure (all p < 0.05). Only after adjusting for the risk factors (age, sex, BMI, WC, HDL, TG, diabetes mellitus, and hypertension) F2 liver fibrosis score is negatively correlated with the HSD17B13 rs9992651 GA genotype. This study offers evidence for the association of the PNPLA3 rs738409 C>G variant with MASLD among Egyptians and for the association of the PNPLA3 rs738409 G allele, the TM6SF2 rs58542926 T allele, and the GCKR rs1260326 C allele with some parameters of cardiometabolic criteria.
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Affiliation(s)
- Nehal Elmansoury
- Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt;
| | - Ahmed A. Megahed
- Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt; (A.A.M.); (M.L.)
| | - Ahmed Kamal
- Department of Internal Medicine and Hepatology, Faculty of Medicine, Alexandria University, Alexandria 21131, Egypt;
| | - Nefertiti El-Nikhely
- Institute of Graduate Studies and Research, Alexandria University, Alexandria 21526, Egypt;
| | - Marina Labane
- Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt; (A.A.M.); (M.L.)
| | - Manal Abdelmageed
- Department of Experimental and Clinical Internal Medicine, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt;
| | - Ann K. Daly
- Translational and Clinical Research Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK;
| | - Ahmed Wahid
- Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt;
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Liao YC, Wu JS, Chou HW, Kuo HY, Lee CT, Wu HT, Li CH, Ou HY. Serum Cardiotrophin-1 Concentration Is Negatively Associated with Controlled Attenuation Parameters in Subjects with Non-Alcoholic Fatty Liver Disease. J Clin Med 2023; 12:jcm12072741. [PMID: 37048824 PMCID: PMC10095180 DOI: 10.3390/jcm12072741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/09/2023] Open
Abstract
Background: Since non-alcoholic fatty liver disease (NAFLD) is highly associated with obesity, cardiovascular disease, and diabetes, biomarkers for the diagnosis of NAFLD have become an important issue. Although cardiotrophin-1 (CT-1) has a protective effect on the liver in NAFLD animal models, the serum levels of CT-1 in human subjects with NAFLD were still unknown. Objective: The present study aimed to investigate the relationship between the circulating concentration of CT-1 and the severity of hepatic steatosis graded by the value of the controlled attenuation parameter (CAP) in humans. Design and Methods: The study was designed as a cross-sectional study, and a total of 182 subjects were enrolled. Hepatic steatosis measurement was carried out with a Firoscan® device and recorded by CAP. The enrolled study subjects were categorized into CAP < 238 dB/m, 238 ≤ CAP ≤ 259 dB/m, 260 ≤ CAP ≤ 290 dB/m, and CAP > 290 dB/m. Serum CT-1 concentrations were determined by enzyme-linked immunosorbent assay. The association between the serum CT-1 concentration and NAFLD was examined by multivariate linear regression analysis. Results: Body mass index, percentage of body fat, systolic and diastolic blood pressure, alanine aminotransferase (ALT), cholesterol, triglyceride, hemoglobin A1c and homeostatic model assessment for insulin resistance (HOMA-IR) were significantly increased in groups with higher CAP value, whereas high-density lipoprotein cholesterol was significantly decreased. In addition, serum CT-1 concentrations were significantly decreased in subjects with higher CAP values. In multivariate linear regression models, including age, sex, body fat percentage, CAP, high sensitivity- C reactive protein, uric acid, creatinine, ALT, total cholesterol, and HOMA-IR, only age, CAP and uric acid independently associated with CT-1 levels. Moreover, having NAFLD was independently associated with CT-1 after adjustment for sex, obesity and type 2 diabetes. Conclusions: Serum CT-1 concentrations are decreased in subjects with NAFLD and negatively associated with CAP.
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Affiliation(s)
- Yi-Chun Liao
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Juei-Seng Wu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 703, Taiwan
| | - Hsuan-Wen Chou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 703, Taiwan
| | - Hsin-Yu Kuo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 703, Taiwan
| | - Chun-Te Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 703, Taiwan
| | - Hung-Tsung Wu
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Chung-Hao Li
- Department of Family Medicine, An Nan Hospital, China Medical University, Tainan 709, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Horng-Yih Ou
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 703, Taiwan
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Silymarin for treatment of adults with nonalcoholic fatty liver disease. Cochrane Database Syst Rev 2023; 2023:CD015524. [PMCID: PMC10074766 DOI: 10.1002/14651858.cd015524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of silymarin in adults with nonalcoholic fatty liver disease (NAFLD).
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Yan H, Liu J, Jin S, Du L, Wang Q, Luo Y. A novel prediction tool based on shear wave elastography, gallbladder ultrasound, and serum biomarkers for the early diagnosis of biliary atresia in infants younger than 60 days old. Quant Imaging Med Surg 2023; 13:259-270. [PMID: 36620159 PMCID: PMC9816742 DOI: 10.21037/qims-22-324] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/20/2022] [Indexed: 11/07/2022]
Abstract
Background Early Kasai surgery before 60 days of life results in better clinical outcomes in patients with biliary atresia (BA). We aimed to develop and validate a prediction tool for the early diagnosis of BA in infants younger than 60 days old. Methods This prospective study recruited consecutive infants younger than 60 days old with conjugated hyperbilirubinemia who were evaluated with an ultrasound (US) scan, including B-mode US with color Doppler flow imaging (CDFI) features and liver two-dimensional shear wave elastography (2D SWE), from March 2017 to July 2021. The reference standard for diagnosis was intraoperative cholangiography, liver biopsy, or the resolution of jaundice. Area under the receiver operating characteristic curve (AUC) analysis, logistic regression analysis, and establishment of a nomogram were performed. Results A total of 174 patients (mean age, 46 days), including 87 infants with BA and 87 non-BA cholestatic infants, were included in the study. The established nomogram based on gallbladder (GB) abnormality, liver 2D SWE, and serum γ-glutamyl transferase (GGT) and alanine aminotransferase (ALT) had an AUC of 0.99 [95% confidence interval (CI): 0.94-1.00], a sensitivity of 92%, and a specificity of 100%. The nomogram in the validation cohort also had good diagnostic performance in the diagnosis of BA, with an AUC of 0.98 (95% CI: 0.95-1.00). Conclusions The new prediction tool had a good diagnostic performance in the early prediction of BA in infants younger than 60 days old and will facilitate timely Kasai surgery.
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Affiliation(s)
- Hualin Yan
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Juxian Liu
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Shuguang Jin
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Lanxin Du
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Qi Wang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Luo
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
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Brunnert L, Puasa ID, Garten A, Penke M, Gaul S, Grafe N, Karlas T, Kiess W, Flemming G, Vogel M. Pediatric percentiles for transient elastography measurements - effects of age, sex, weight status and pubertal stage. Front Endocrinol (Lausanne) 2022; 13:1030809. [PMID: 36237190 PMCID: PMC9551398 DOI: 10.3389/fendo.2022.1030809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIMS Transient Elastography is a non-invasive, cost-efficient, non-ionizing, observer-independent and reliable method to detect liver fibrosis using Liver Stiffness Measurement (LSM) and the degree of fat accumulation in the liver using Controlled Attenuation Parameter (CAP). This study aims to derive reference values for both measures from healthy children and adolescents. Further, we aim to assess the potential influence of age, sex, puberty, and BMI-SDS on CAP and LSM. METHODS Within the LIFE Child study, amongst others, anthropometric data and pubertal status were assessed. Transient Elastography (TE) was performed using the FibroScan® device in a population-based cohort at 982 study visits of 482 healthy children aged between 10 and 18 years. Percentiles for LSM and CAP were estimated, and the effects of age, sex, puberty and weight status were assessed through hierarchical regression models. RESULTS There was a strong age dependency for LSM with higher values for older children, most pronounced in the upper percentiles in boys. Contrarily, CAP was relatively stable across the age span without considerable difference between boys and girls. We found a significant positive correlation between BMI-SDS and both CAP and LSM for BMI-SDS >1.28. For BMI-SDS < 1.28, the association was also positive but reached statistical significance only for CAP. Further, the association between BMI-SDS and CAP was significantly stronger in younger than in older children. There was no association between pubertal status and CAP. For LSM, we found that children with a high BMI-SDS but not children with normal weight had significantly higher LSM values in Tanner stage 4. CONCLUSIONS Age, sex, pubertal status and weight status should be considered when interpreting LSM and CAP in pediatric patients to facilitate and improve early detection of abnormal liver function, which is associated with common pathologies, such as NAFLD.
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Affiliation(s)
- Lina Brunnert
- Center for Pediatric Research, University Hospital for Children and Adolescents, Leipzig, Germany
| | - Ika Damayanti Puasa
- Center for Pediatric Research, University Hospital for Children and Adolescents, Leipzig, Germany
| | - Antje Garten
- Center for Pediatric Research, University Hospital for Children and Adolescents, Leipzig, Germany
| | - Melanie Penke
- Center for Pediatric Research, University Hospital for Children and Adolescents, Leipzig, Germany
| | - Susanne Gaul
- Center for Pediatric Research, University Hospital for Children and Adolescents, Leipzig, Germany
- Clinic and Polyclinic for Cardiology, Leipzig University Medical Center, Leipzig, Germany
| | - Nico Grafe
- Leipzig Research Center for Civilization Diseases, LIFE Child, Leipzig, Germany
| | - Thomas Karlas
- Department of Medicine II, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany
| | - Wieland Kiess
- Center for Pediatric Research, University Hospital for Children and Adolescents, Leipzig, Germany
- Leipzig Research Center for Civilization Diseases, LIFE Child, Leipzig, Germany
| | - Gunter Flemming
- Center for Pediatric Research, University Hospital for Children and Adolescents, Leipzig, Germany
| | - Mandy Vogel
- Center for Pediatric Research, University Hospital for Children and Adolescents, Leipzig, Germany
- Leipzig Research Center for Civilization Diseases, LIFE Child, Leipzig, Germany
- *Correspondence: Mandy Vogel,
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