1
|
Pochopien M, Dziedzic JW, Aballea S, Clay E, Zerda I, Toumi M, Borissov B. Cost-Effectiveness Analysis of Innovative Therapies for Patients with Non-Alcoholic Fatty Liver Disease. J Mark Access Health Policy 2024; 12:35-57. [PMID: 38660414 PMCID: PMC11036255 DOI: 10.3390/jmahp12020005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/23/2024] [Accepted: 03/13/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Currently there are no disease-specific approved therapies for non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH); however, several treatments are under development. This study aimed to estimate the cost-effectiveness of hypothetical innovative therapies compared with lifestyle intervention alone and combined with pioglitazone, and assess the health economic consequences of their future availability for patients. METHODS A Markov cohort model was developed, considering fourteen disease health states and one absorbing state representing death. Transition probabilities, costs, utilities, and treatment efficacy were based on published data and assumptions. Four treatment strategies were considered, including two existing therapies (lifestyle intervention, small molecule treatment) and two hypothetical interventions (biological and curative therapy). The analysis was performed from the US third-party payer perspective. RESULTS The curative treatment with the assumed efficacy of 70% of patients cured and assumed price of $500,000 was the only cost-effective option. Although it incurred higher costs (a difference of $188,771 vs. lifestyle intervention and $197,702 vs. small molecule), it generated more QALYs (a difference of 1.58 and 1.38 QALYs, respectively), resulting in an ICER below the willingness-to-pay threshold of $150,000 per QALY. The sensitivity analyses showed that the results were robust to variations in model parameters. CONCLUSIONS This study highlighted the potential benefits of therapies aimed at curing a disease rather than stopping its progression. Nonetheless, each of the analyzed therapies could be cost-effective compared with lifestyle intervention at a relatively high price.
Collapse
Affiliation(s)
| | | | - Samuel Aballea
- InovIntell, 3023GJ Rotterdam, Zuid-Holland, The Netherlands
| | - Emilie Clay
- Clever-Access, 53 Avenue Montaigne, 75008 Paris, France
| | - Iwona Zerda
- Assignity, Wadowicka 8a, 30-415 Krakow, Poland
| | - Mondher Toumi
- InovIntell, 215 rue du Faubourg St Honoré, 75008 Paris, France
| | | |
Collapse
|
2
|
Fu K, Zhu B, Sun Y, Zhou Y, Pang H, Ren X, Guo Y, Shi X, Han J, Yang L, Zhou B. Bis(2-ethylhexyl)-tetrabromophthalate Poses a Higher Exposure Risk and Induces Gender-Specific Metabolic Disruptions in Zebrafish Liver. Environ Sci Technol 2024; 58:4937-4947. [PMID: 38446036 DOI: 10.1021/acs.est.4c00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Bis(2-ethylhexyl)-tetrabromophthalate (TBPH), a typical novel brominated flame retardant, has been ubiquitously identified in various environmental and biotic media. Consequently, there is an urgent need for precise risk assessment based on a comprehensive understanding of internal exposure and the corresponding toxic effects on specific tissues. In this study, we first investigated the toxicokinetic characteristics of TBPH in different tissues using the classical pseudo-first-order toxicokinetic model. We found that TBPH was prone to accumulate in the liver rather than in the gonad, brain, and muscle of both female and male zebrafish, highlighting a higher internal exposure risk for the liver. Furthermore, long-term exposure to TBPH at environmentally relevant concentrations led to increased visceral fat accumulation, signaling potential abnormal liver function. Hepatic transcriptome analysis predominantly implicated glycolipid metabolism pathways. However, alterations in the profile of associated genes and biochemical indicators revealed gender-specific responses following TBPH exposure. Besides, histopathological observations as well as the inflammatory response in the liver confirmed the development of nonalcoholic fatty liver disease, particularly in male zebrafish. Altogether, our findings highlight a higher internal exposure risk for the liver, enhancing our understanding of the gender-specific metabolic-disrupting potential associated with TBPH exposure.
Collapse
Affiliation(s)
- Kaiyu Fu
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Biran Zhu
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
- School of Basic Medical Sciences, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Yumiao Sun
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Yuxi Zhou
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hao Pang
- School of Chemistry and Environmental Engineering, Wuhan Institute of Technology, Wuhan 430074, China
| | - Xinxin Ren
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yongyong Guo
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Xiongjie Shi
- College of Life Sciences, the Institute for Advanced Studies, Wuhan University, Wuhan 430072, China
| | - Jian Han
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Lihua Yang
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Bingsheng Zhou
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| |
Collapse
|
3
|
Lee HS, Han SH, Swerdloff R, Pak Y, Budoff M, Wang C. The Effect of Testosterone Replacement Therapy on Nonalcoholic Fatty Liver Disease in Older Hypogonadal Men. J Clin Endocrinol Metab 2024; 109:e757-e764. [PMID: 37656011 DOI: 10.1210/clinem/dgad511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
CONTEXT Male hypogonadism is associated with visceral obesity and the metabolic syndrome: factors important for the development of nonalcoholic fatty liver disease (NAFLD). The Testosterone Trials (The T Trials) showed testosterone (T) treatment compared with placebo in older hypogonadal men was associated with decreases in cholesterol and insulin levels suggesting that T treatment may improve NAFLD. OBJECTIVE Compare effects of T vs placebo treatment on NAFLD scores and liver scans in elderly hypogonadal men. METHODS Secondary data analyses from 479 older hypogonadal men with total T < 275 ng/dL from The T Trials were performed. Three clinical liver fat scores-lipid accumulation product index, hepatic steatosis index, nonalcoholic fatty liver disease-metabolic syndrome score-and liver computed tomography (CT) Hounsfield units and liver to spleen ratio were evaluated at baseline and 12 months after treatment. RESULTS There were no statistically significant differences of change in lipid accumulation product index (P = .98), hepatic steatosis index (P = .67), and nonalcoholic fatty liver disease-metabolic syndrome (P = .52) in 246 men treated with T compared with 233 treated with placebo for 12 months. Liver CT showed no statistically significant difference of change in Hounsfield units (P = .24; n = 71 for T, n = 69 for placebo) and liver to spleen ratio (P = .74; n = 55 for T, n = 62 for placebo) between the 2 groups. CONCLUSIONS Our study did not show improvement of NAFLD in older hypogonadal men after 12 months of T vs placebo treatment, as assessed by 3 clinical scores and liver CT for hepatic steatosis. Future studies with longer treatment duration and additional NAFLD diagnostic modalities as primary outcome are warranted.
Collapse
Affiliation(s)
- Hae Seung Lee
- Division of Endocrinology, Department of Medicine, The Lundquist Institute and Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Sang Hun Han
- Division of Endocrinology, Department of Medicine, The Lundquist Institute and Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Ronald Swerdloff
- Division of Endocrinology, Department of Medicine, The Lundquist Institute and Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Youngju Pak
- Division of Endocrinology, Department of Medicine, The Lundquist Institute and Harbor-UCLA Medical Center, Torrance, CA 90502, USA
- The Clinical and Translational Research Center, The Lundquist Institute and Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Matthew Budoff
- Division of Cardiology, The Lundquist Institute and Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Christina Wang
- Division of Endocrinology, Department of Medicine, The Lundquist Institute and Harbor-UCLA Medical Center, Torrance, CA 90502, USA
- The Clinical and Translational Research Center, The Lundquist Institute and Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| |
Collapse
|
4
|
Parsa AA, Azama KA, Vawer M, Ona MA, Seto TB. Prevalence Study of MASLD in Adolescent and Young Adult Pacific Islanders and Asians Living in Hawai'i. J Endocr Soc 2024; 8:bvad165. [PMID: 38249431 PMCID: PMC10797323 DOI: 10.1210/jendso/bvad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Indexed: 01/23/2024] Open
Abstract
Context Nonalcoholic fatty liver disease, renamed metabolic dysfunction-associated steatotic liver disease (MASLD), is the most common cause of chronic liver disease with an estimated worldwide prevalence of 30.1% while clinical practice observations reflect a disproportionately lower prevalence of 1.9%, indicating a condition that is underrecognized in clinical care settings. Screening for MASLD is rarely performed, and little is known about the prevalence in Hawai'i. Objective This pilot aims to develop an understanding of the prevalence and factors associated with MASLD in Hawai'i's adolescent and young adult (AYA) population. Design/Methods Cross-sectional observational pilot study: We used Fibroscan®-liver ultrasonographic vibration-controlled transient elastography (VCTE) to identify MASLD based on controlled attenuation parameter (CAP) scores ≥238 (dB/m) and collected biometric, anthropometric, and Beverage Intake Questionnaire (sugar-sweetened beverage) survey data. Setting The study took place at community clinics in Hawai'i on the island of O'ahu. Participants One hundred individuals were evaluated, age 14 to 34 years. Main Outcome Measures We used VCTE Fibroscan® with CAP scoring to identify the presence of hepatocyte steatosis (fatty liver). Results Overall MASLD prevalence in the sample was 44% (95% confidence interval: 34.1%-54.3%). In participants with MASLD, obese Native Hawaiian and other Pacific Islanders (62%) and nonobese Asians (43%) had the highest rates of MASLD. Conclusion This pilot evaluation of the AYA NHOPI and Asian MASLD population in Hawai'i shows a higher rate of MASLD than those reported in other parts of the United States. Larger population health studies are indicated to expand our knowledge of MASLD in the Hawaiian Islands.
Collapse
Affiliation(s)
- Alan A Parsa
- John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
- Diabetes Research and Education Center of the Pacific, Honolulu, HI 96813, USA
- Department of Medicine, The Queen's Medical Center, Honolulu, HI 96813, USA
| | - Katie A Azama
- Department of Medicine, The Queen's Medical Center, Honolulu, HI 96813, USA
- Nancy Atmospera-Walch School of Nursing, University of Hawai’i, Honolulu, HI 96822, USA
| | - May Vawer
- Diabetes Research and Education Center of the Pacific, Honolulu, HI 96813, USA
- Department of Medicine, The Queen's Medical Center, Honolulu, HI 96813, USA
| | - Mel A Ona
- John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
| | - Todd B Seto
- John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
- Department of Medicine, The Queen's Medical Center, Honolulu, HI 96813, USA
| |
Collapse
|
5
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
6
|
Kim K, Baek S, Ko S, Moon S, Lee KP, Ahn S. A sport supplement candidate of Erigeron breviscapus extract regulates lipogenesis in vitro and in vivo. Phys Act Nutr 2023; 27:60-66. [PMID: 38297478 PMCID: PMC10844721 DOI: 10.20463/pan.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 02/02/2024] Open
Abstract
PURPOSE One of the urgent research projects in exercise science should focus on sports supplements for obese people who lack exercise and physical activity. In this study, we explored the efficacy in non-alcoholic fatty liver disease (NAFLD) mice models using a Korean herbal medicine Erigeron breviscapus (EB). METHODS Gene ontology analyses of active compounds in EB were performed using the Traditional Chinese Medicine Database and Analysis Platform (TCMSP) and Cytoscape program, respectively. PA-induced acid (PA) induced-lipid droplets in HepG2 cells were analyzed using a 3D-hologram. To analyze the fat-suppressing efficacy of EB in animal experiments, NAFLD was induced through a 24-week high-fat diet. Subsequently, the same diet was continued for an additional 8 weeks, with concurrent co-administration of drugs for efficacy analysis. In the 8-week experiment, mice were administered saline alone, metformin (17 mg/kg/day), or EB (26 mg/kg/day). The mice were sacrificed and the liver tissue was isolated. The liver tissues were stained with H&E and specific antibodies such as sterol regulatory element binding protein 1 (SREBP-1) and peroxisome proliferator-activated receptor- γ (PPAR-γ). RESULTS Seventeen EB-active compounds were identified by whole-body analysis. EB downregulated lipid droplets in PA-treated HepG2 cells. EB regulates lipid accumulation in liver tissue of HFD-fed NAFLD mice Metformin and EB significantly reduced the expression of SREBP-1 and PPAR-γ in liver tissue. CONCLUSION We suggest that EB is a candidate for the management of NAFLD and is an effective exercise supplement owing to its ability to inhibit lipid accumulation.
Collapse
Affiliation(s)
- Kibong Kim
- Second Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea
| | - Suji Baek
- Research & Development Center, UMUST R&D corporation, Seoul, Republic of Korea
| | - Solomon Ko
- Research & Development Center, UMUST R&D corporation, Los Angeles, USA
| | - Seungjae Moon
- Department of Korean Medicine, College of Korean Medicine, Semyung University, Chungchengbuk-do, Republic of Korea
| | - Kang Pa Lee
- Research & Development Center, UMUST R&D corporation, Seoul, Republic of Korea
| | - Sanghyun Ahn
- Department of Anatomy, College of Korean Medicine, Semyung University, Chungchengbuk-do, Republic of Korea
| |
Collapse
|
7
|
Chen X, Zhao Y, Zhang R, Zhao Y, Dai L. The effect of vitamin D supplementation on some metabolic parameters in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis of 8 RCTs. Medicine (Baltimore) 2023; 102:e35717. [PMID: 37861495 PMCID: PMC10589544 DOI: 10.1097/md.0000000000035717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/28/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND To systematically evaluate the effects of vitamin D supplementation in patients with nonalcoholic fatty liver disease (NAFLD). METHODS National Library of Medicine, Cochrane Library, Elsevier, China National Knowledge Infrastructure, Web of Science, WANFANG databases, and Google Scholar were retrieved to collect relevant randomized controlled trials, which are published from the earliest records the time the database was created to April 2023. Meta-analysis was conducted by using Review Manager 5.4 software after evaluating in terms of inclusion and exclusion criteria. The outcome indicators include 25-hydroxyvitamin D [25(OH)D] levels, insulin resistance index (homeostasis model assessment of insulin resistance), fasting blood glucose, and fasting insulin levels (FINS). RESULTS Eight randomized controlled trials with a total of 657 patients are included. Vitamin D supplementation increased 25(OH)D levels significantly (mean difference [MD] = 2.01, 95% confidence intervals [CI]: 0.94 to 3.08, P < .05) and vitamin D supplementation had a significant effect on insulin resistance index (MD = -0.54, 95% CI: -1.28 to 0.20, P = .16), fasting glucose (MD = -0.59, 95% CI: -1.50 to 0.32, P = .20), and FINS levels (MD = -0.30, 95% CI: -0.77 to 0.17, P = .21) had no significant effect. CONCLUSION Vitamin D supplementation improves 25(OH)D levels in patients with nonalcoholic fatty liver disease, but there is no effect on homeostasis model assessment of insulin resistance, fasting blood glucose, or FINS.
Collapse
Affiliation(s)
- Xuemeng Chen
- Department of Public Health, International College, Krirk University, Bangkok, Thailand
| | - Ye Zhao
- Department of Public Health, International College, Krirk University, Bangkok, Thailand
| | - Ran Zhang
- School of Architecture & Art Design, Hebei University of Technology, Tianjin, China
| | - Yan Zhao
- Department of Public Health, International College, Krirk University, Bangkok, Thailand
| | - Liheng Dai
- Department of Internal Medicine, Tianjin Beichen Traditional Chinese Medicine Hospital, Tianjin, China
| |
Collapse
|
8
|
Darbhanga J, Krulikowski K, Riskin SI. Emerging Diagnostics and Therapeutics for Non-alcoholic Fatty Liver Disease. Cureus 2023; 15:e47821. [PMID: 38021846 PMCID: PMC10676744 DOI: 10.7759/cureus.47821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
The obesity epidemic has pushed fatty liver disease, which consists of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, to the forefront of the 21st century. Disease identification can be done invasively with a liver biopsy or noninvasively through elastography and measurements of biomarkers, such as the alanine aminotransferase (ALT) and aspartate aminotransferase (AST) liver enzymes. Presently, there are no FDA-approved drugs on the market to treat the disease. Alternative medicinal treatments have been investigated, which include altering the intestinal microbiota and consuming anti-inflammatory, herbal-based, vitamin-based, and plant-based medications, in addition to following a healthy lifestyle. In this study, multiple databases were used to identify articles pertaining to fatty liver disease (FLD). Databases included Biomedical Reference Collection: Comprehensive, Cumulative Index of Nursing and Allied Health (CINAHL), Google Scholar, and PubMed. All articles gathered from the databases were peer-reviewed and less than 10 years old to ensure the credibility of the work and recent information regarding the disease. A total of 13 articles were used to gather information for this review. All articles were confirmed to be peer-reviewed by checking them with Ulrich's web. In all 13 peer-reviewed articles, the diagnosis of FLD was most commonly done by analyzing ALT and AST liver enzymes and lipid profiles. Liver ultrasound, liver FibroScan, and liver biopsy served as other tools used for detecting the presence of FLD. It was observed that anti-inflammatory, herbal-based, vitamin-based, and plant-based medications and healthy gut microbiota had beneficial and therapeutic effects in treating FLD when coupled with healthy lifestyle changes. All medicinal treatments were found to lower the ALT and AST liver enzymes, lipid profiles (total cholesterol, triglycerides, low-density lipoprotein), and liver steatosis scores in studies where ultrasound was used before and after treatment. Further investigation is needed to fully understand the mechanisms behind the therapeutic effects of treating FLD; however, the medicinal treatments discussed in this review show promising prospects for treating the disease. The therapeutic effects of anti-inflammatory, herbal-based, vitamin-based, and plant-based medications and living a healthy lifestyle were seen in lower levels of liver enzymes, improved lipid profiles, and lower steatosis scores, with no reported side effects on subjects. The treatment options studied may have beneficial impacts in treating FLD patients and may be used in the development of future medications to combat the disease.
Collapse
Affiliation(s)
- Jake Darbhanga
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Kiarra Krulikowski
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Suzanne I Riskin
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| |
Collapse
|
9
|
Fateh HL, Rashid SA, Muhammad SS, Al-Jaf SH, Ali AM. Comparing effects of beetroot juice and Mediterranean diet on liver enzymes and sonographic appearance in patients with non-alcoholic fatty liver disease: a randomized control trials. Front Nutr 2023; 10:1181706. [PMID: 37662597 PMCID: PMC10469647 DOI: 10.3389/fnut.2023.1181706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background In both developed and developing countries, non-alcoholic fatty liver disease (NAFLD) has lately risen to the top of the list of chronic liver illnesses. Although there is no permanent cure, early management, diagnosis, and treatment might lessen its effects. The purpose of conducting the current study is to compare the effects of beetroot juice and the Mediterranean diet on the lipid profile, level of liver enzymes, and liver sonography in patients with NAFLD. Methods In this randomized controlled trial, 180 people with a mean age of (45.19 ± 14.94) years participated. Participants ranged in age from 19 to 73. The mean weight before intervention was (82.46 ± 5.97) kg, while the mean weight after intervention was roughly (77.88 ± 6.26) kg. The trial lasted for 12 weeks. The participants were split into four groups: control, a Mediterranean diet with beet juice (BJ + MeD), Mediterranean diet alone (MeD), and beetroot juice (BJ). The Mediterranean diet included fruits, vegetables, fish, poultry, and other lean meats (without skin), sources of omega-3 fatty acids, nuts, and legumes. Beetroot juice had 250 mg of beetroot. Data analysis was done using SPSS software (version 26.0). p < 0.05 is the statistical significance level. Results Following the intervention, Serum Bilirubin, alkaline phosphatase (ALP), alanine transaminase (ALT), serum cholesterol (CHOL), triglyceride (TG), and low-density lipoprotein (LDL) levels were significantly decreased in the BJ + MeD, BJ, and MeD groups (p = 0.001). Also, high-density lipoprotein (HDL) significantly increased in the BJ + MeD, BJ, and MeD groups (p = 0.001), while decreasing in the Control group (p = 0.001). Conclusion The research findings indicate a significant reduction in hepatic steatosis among the groups receiving beetroot juice (BJ) and beetroot juice combined with the Mediterranean diet (BJ + MeD). This suggests that beetroot juice holds potential as an effective treatment for non-alcoholic fatty liver disease (NAFLD) in adults. Furthermore, the combination of beetroot juice with the Mediterranean diet showed enhanced efficacy in addressing NAFLD.Clinical trial registration: ClinicalTrials.gov, identifier NCT05909631.
Collapse
Affiliation(s)
- Hawal Lateef Fateh
- Nursing Department, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
- Nursing Department, Kalar Technical College, Garmian Polytechnic University, Kalar, Iraq
| | | | - Sarmad S. Muhammad
- Medical Laboratory Technology Department, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
- Medical Laboratory Technology Department, Kalar Technical College, Garmian Polytechnic University, Kalar, Iraq
| | - Sabah H. Al-Jaf
- Department of Chemistry, College of Science, University of Garmian, Sulaimani, Iraq
| | - Ayad M. Ali
- Department of Chemistry, College of Science, University of Garmian, Sulaimani, Iraq
| |
Collapse
|
10
|
Muhamad NA, Maamor NH, Leman FN, Mohamad ZA, Bakon SK, Abdul Mutalip MH, Rosli IA, Aris T, Lai NM, Abu Hassan MR. The Global Prevalence of Nonalcoholic Fatty Liver Disease and its Association With Cancers: Systematic Review and Meta-Analysis. Interact J Med Res 2023; 12:e40653. [PMID: 37467012 PMCID: PMC10398554 DOI: 10.2196/40653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/22/2023] [Accepted: 04/19/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is one of the common causes of chronic liver disease globally. Obesity, metabolic diseases, and exposure to some environmental agents contribute to NAFLD. NAFLD is commonly considered a precursor for some types of cancers. Since the leading causes of death in people with NAFLD are cardiovascular disease and extrahepatic cancers, it is important to understand the mechanisms of the progression of NAFLD to control its progression and identify its association with extrahepatic cancers. Thus, this review aims to estimate the global prevalence of NAFLD in association with the risk of extrahepatic cancers. OBJECTIVE We aimed to determine the prevalence of various cancers in NAFLD patients and the association between NAFLD and cancer. METHODS We searched PubMed, ProQuest, Scopus, and Web of Science from database inception to March 2022 to identify eligible studies reporting the prevalence of NAFLD and the risk of incident cancers among adult individuals (aged ≥18 years). Data from selected studies were extracted, and meta-analysis was performed using random effects models to obtain the pooled prevalence with the 95% CI. The quality of the evidence was assessed with the Newcastle-Ottawa Scale. RESULTS We identified 11 studies that met our inclusion criteria, involving 222,523 adults and 3 types of cancer: hepatocellular carcinoma (HCC), breast cancer, and other types of extrahepatic cancer. The overall pooled prevalence of NAFLD and cancer was 26% (95% CI 16%-35%), while 25% of people had NAFLD and HCC (95% CI 7%-42%). NAFLD and breast cancer had the highest prevalence out of the 3 forms of cancer at 30% (95% CI 14%-45%), while the pooled prevalence for NAFLD and other cancers was 21% (95% CI 12%-31%). CONCLUSIONS The review suggests that people with NAFLD may be at an increased risk of cancer that might not affect not only the liver but also other organs, such as the breast and bile duct. The findings serve as important evidence for policymakers to evaluate and recommend measures to reduce the prevalence of NAFLD through lifestyle and environmental preventive approaches. TRIAL REGISTRATION PROSPERO CRD42022321946; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=321946.
Collapse
Affiliation(s)
- Nor Asiah Muhamad
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Nur Hasnah Maamor
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Fatin Norhasny Leman
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Zuraifah Asrah Mohamad
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Sophia Karen Bakon
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Mohd Hatta Abdul Mutalip
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Izzah Athirah Rosli
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Tahir Aris
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia
| | | |
Collapse
|
11
|
Lifante J, de la Fuente-Fernández M, Román-Carmena M, Fernandez N, Jaque García D, Granado M, Ximendes E. In vivo grading of lipids in fatty liver by near-infrared autofluorescence and reflectance. J Biophotonics 2023; 16:e202200208. [PMID: 36377726 DOI: 10.1002/jbio.202200208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/16/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
The prevalence of nonalcoholic fatty liver (NAFLD) is rapidly increasing worldwide. When untreated, it may lead to complications such as liver cirrhosis or hepatocarcinoma. The diagnosis of NAFLD is usually obtained by ultrasonography, a technique that can underestimate its prevalence. For this reason, physicians aspire for an accurate, cost-effective, and noninvasive method to determine both the presence and the specific stage of the NAFLD. In this paper, we report an integrated approach for the quantitative estimation of the density of triglycerides in the liver based on the use of autofluorescence and reflectance signals generated by the abdomen of obese C57BL6/J mice. Singular value decomposition is applied to the generated spectra and its corresponding regression model provided a determination coefficient of 0.99 and a root mean square error of 240 mg/dl. This, in turn, enabled the quantitative imaging of triglycerides density in the livers of mice under in vivo conditions.
Collapse
Affiliation(s)
- José Lifante
- Nanomaterials for Bioimaging Group (nanoBIG), Universidad Autónoma de Madrid, Madrid, Spain
- IRYCIS, Madrid, Spain
| | | | | | - Nuria Fernandez
- Nanomaterials for Bioimaging Group (nanoBIG), Universidad Autónoma de Madrid, Madrid, Spain
| | - Daniel Jaque García
- Nanomaterials for Bioimaging Group (nanoBIG), Universidad Autónoma de Madrid, Madrid, Spain
- IRYCIS, Madrid, Spain
| | - Miriam Granado
- Nanomaterials for Bioimaging Group (nanoBIG), Universidad Autónoma de Madrid, Madrid, Spain
| | - Erving Ximendes
- Nanomaterials for Bioimaging Group (nanoBIG), Universidad Autónoma de Madrid, Madrid, Spain
- IRYCIS, Madrid, Spain
| |
Collapse
|
12
|
Wang J, Li Y, Jiang C, Li J. [Effect of aerobic exercise on AKT/GSK3β mediated hepatocyte apoptosis in nonalcoholic fatty liver disease]. Wei Sheng Yan Jiu 2023; 52:246-252. [PMID: 37062687 DOI: 10.19813/j.cnki.weishengyanjiu.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
OBJECTIVE To investigate the effect of aerobic exercise on AKT/GSK3β pathway-mediated hepatocyte apoptosis in non-alcoholic fatty liver diseases(NAFLD). METHODS A total of 30 6-week-old male C57BL/6J mice, and mice were fed adaptively for one week. The control group was fed with ordinary diet, and the model group and model exercise group were fed with high-fat diet until 18 weeks. At the 10th week of the experiment, the model exercise group received aerobic exercise intervention for 8 consecutive weeks until the end of the experiment at the 18th week. Automatic biochemical analyzer to detect serum total cholesterol(TC), triglycerides(TG), alanine aminotransferase(ALT), aspartate aminotransferase(AST), low-density lipoprotein(LDL-C) and high-density lipoprotein(HDL-C) levels. Liver pathological morphology was observed by staining with oil red O and HE. The expression changes of AKT, P-AKT~( Ser473), GSK3β, P-GSK3β~(Ser9) and Caspase-3 proteins were detected by western blot, and the apoptosis of hepatocytes was detected by in situ terminal transferase labeling(TUNEL). RESULTS (1) After intervention, compared with control group, body weight, liver index, serum TC, TG, ALT, AST and LDL-C levels in model group were significantly increased(P<0.01 or P<0.05), while HDL-C level was significantly decreased(P<0.01). Compared with model group, body weight, liver index, serum TC, TG, ALT, AST and LDL-C levels in model exercise group were significantly decreased(P<0.01 or P<0.05), while HDL-C level was significantly increased(P<0.01). (2) Compared with the control group, hepatocyte steatosis and the number of lipid droplets in model group were significantly increased. Compared with the model group, the degree of hepatic adipose degeneration was significantly improved and the number of hepatic lipid droplets was significantly decreased in the model exercise group. (3) Compared with control group, the protein expression levels of P-AKT~(Ser473) and P-GSK3β~(Ser9) in model group were significantly decreased(P<0.01 or P<0.05), the protein expression levels of Caspase-3 were significantly increased(P<0.05), and the number of hepatocyte apoptosis was significantly increased(P<0.05). Compared with model group, the expression of P-AKT~(Ser473) and P-GSK3β~(Ser9) protein in model exercise group was significantly increased(P<0.01 or P<0.05), the expression of Caspase-3 protein was significantly decreased(P<0.05), and the number of hepatocyte apoptosis was significantly decreased(P<0.01). CONCLUSION Aerobic exercise can effectively improve NAFLD, by activating AKT/GSK3β pathway and increasing the expression of AKT/GSK3β pathway related molecules, thereby reducing caspase-3 expression and hepatocyte apoptosis.
Collapse
Affiliation(s)
- Jiaqian Wang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Yalong Li
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Changjun Jiang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Junhan Li
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| |
Collapse
|
13
|
Helal KM, Cahyadi H, Taylor JN, Okajima A, Tabata K, Kumamoto Y, Mochizuki K, Itoh Y, Takamatsu T, Tanaka H, Fujita K, Komatsuzaki T, Harada Y. Raman imaging of rat nonalcoholic fatty liver tissues reveals distinct biomolecular states. FEBS Lett 2023. [PMID: 36807196 DOI: 10.1002/1873-3468.14600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/24/2022] [Accepted: 01/08/2023] [Indexed: 02/20/2023]
Abstract
An essential challenge in diagnosing states of nonalcoholic fatty liver disease (NAFLD) is the early prediction of progression from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) before the disease progresses. Histological diagnoses of NAFLD rely on the appearance of anomalous tissue morphologies, and it is difficult to segment the biomolecular environment of the tissue through a conventional histopathological approach. Here, we show that hyperspectral Raman imaging provides diagnostic information on NAFLD in rats, as spectral changes among disease states can be detected before histological characteristics emerge. Our results demonstrate that Raman imaging of NAFLD can be a useful tool for histopathologists, offering biomolecular distinctions among tissue states that cannot be observed through standard histopathological means.
Collapse
Affiliation(s)
- Khalifa Mohammad Helal
- Graduate School of Life Science, Transdisciplinary Life Science Course, Hokkaido University, Sapporo, Japan.,Department of Mathematics, Comilla University, Cumilla, Bangladesh
| | - Harsono Cahyadi
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine, Japan
| | - J Nicholas Taylor
- Research Institute for Electronic Science, Hokkaido University, Sapporo, Japan
| | - Akira Okajima
- Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Japan
| | - Koji Tabata
- Research Institute for Electronic Science, Hokkaido University, Sapporo, Japan
| | - Yasuaki Kumamoto
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine, Japan
| | - Kentaro Mochizuki
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Japan
| | - Tetsuro Takamatsu
- Department of Medical Photonics, Kyoto Prefectural University of Medicine, Japan
| | - Hideo Tanaka
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine, Japan
| | - Katsumasa Fujita
- Department of Applied Physics, Osaka University, Japan.,Transdimensional Life Imaging Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Japan.,Advanced Photonics and Biosensing Open Innovation Laboratory, AIST-Osaka University, Japan
| | - Tamiki Komatsuzaki
- Graduate School of Life Science, Transdisciplinary Life Science Course, Hokkaido University, Sapporo, Japan.,Research Institute for Electronic Science, Hokkaido University, Sapporo, Japan.,Laboratoire Interdisciplinaire Carnot de Bourgogne, UMR 6303 CNRS-Univ. Bourgogne Franche-Comté, Dijon Cedex, France
| | - Yoshinori Harada
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine, Japan
| |
Collapse
|
14
|
Shen W, Yang L, Yang Y, Wang P, Tao X, Shen Y, Wang S, Shen Y. PRDX6 Promotes Fatty Acid Oxidation via PLA2-Dependent PPARα Activation in Rats Fed High-Fat Diet. Antioxid Redox Signal 2023; 38:1184-1200. [PMID: 36401357 DOI: 10.1089/ars.2022.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aims: Nonalcoholic fatty liver disease (NAFLD) is becoming the most common chronic liver disease globally, which is defined as an excess accumulation of fat caused by the imbalance of lipogenesis and lipid catabolism. Recently, increasing evidence suggests that peroxiredoxin 6 (PRDX6) is involved in the pathogenesis and progression of NAFLD. However, little is known regarding its role in liver lipid catabolism. Results: We found that PRDX6 level was significantly increased in liver tissues after high-fat diet (HFD) treatment. PRDX6 knockout (KO) exacerbated HFD-induced hepatic steatosis. PRDX6 KO did not affect messenger RNA (mRNA) and protein levels of peroxisome proliferator-activated receptor alpha (PPARα). However, PRDX6 KO decreased the mRNA and protein levels of carnitine palmitoyltransferase-1alpha (CPT-1α) and acyl-CoA oxidase 1 (ACOX1), the target genes of PPARα. PRDX6 KO also did not activate AMP-activated protein kinase (AMPK)α/proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α), the upstream signal of PPARα. However, PRDX6 KO reduces the levels of PPARα activators, the oxidized fatty acids (9- and 13-hydroxyoctadecadienoic acid) in HFD rats. More interestingly, PRDX6 promoted the production of oxidized fatty acids by hydrolyzing oxidized low-density lipoprotein (Ox-LDL), which depends on its phospholipase A2 (PLA2) activity. PRDX6 mutation on its PLA2 and its competitive phospholipase inhibitor inhibited the production of the oxidized fatty acids as well as the activation of PPARα. Furthermore, PRDX6 overexpression enhanced the transcriptional activation of PPARα. Innovation and Conclusion: This study elucidates for the first time the role of PLA2 enzyme activity of PRDX6 in fatty acid oxidation and reveals a novel mechanism of PRDX6 involved in liver steatosis.
Collapse
Affiliation(s)
- Wenwen Shen
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.,Biopharmaceutical Research Institute, Anhui Medical University, Hefei, China
| | - Lin Yang
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.,Biopharmaceutical Research Institute, Anhui Medical University, Hefei, China
| | - Yi Yang
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.,Biopharmaceutical Research Institute, Anhui Medical University, Hefei, China
| | - Peng Wang
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.,Biopharmaceutical Research Institute, Anhui Medical University, Hefei, China
| | - Xiaofang Tao
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.,Biopharmaceutical Research Institute, Anhui Medical University, Hefei, China
| | - Yujun Shen
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.,Biopharmaceutical Research Institute, Anhui Medical University, Hefei, China
| | - Sheng Wang
- Anhui Medical University, Center for Scientific Research of Anhui Medical University, Hefei, China
| | - Yuxian Shen
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.,Biopharmaceutical Research Institute, Anhui Medical University, Hefei, China
| |
Collapse
|
15
|
Fei N, Miyoshi S, Hermanson JB, Miyoshi J, Xie B, DeLeon O, Hawkins M, Charlton W, D’Souza M, Hart J, Sulakhe D, Martinez-Guryn KB, Chang EB, Charlton MR, Leone VA. Imbalanced gut microbiota predicts and drives the progression of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in a fast-food diet mouse model. bioRxiv 2023:2023.01.09.523249. [PMID: 36712061 PMCID: PMC9882021 DOI: 10.1101/2023.01.09.523249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is multifactorial in nature, affecting over a billion people worldwide. The gut microbiome has emerged as an associative factor in NAFLD, yet mechanistic contributions are unclear. Here, we show fast food (FF) diets containing high fat, added cholesterol, and fructose/glucose drinking water differentially impact short- vs. long-term NAFLD severity and progression in conventionally-raised, but not germ-free mice. Correlation and machine learning analyses independently demonstrate FF diets induce early and specific gut microbiota changes that are predictive of NAFLD indicators, with corresponding microbial community instability relative to control-fed mice. Shotgun metagenomics showed FF diets containing high cholesterol elevate fecal pro-inflammatory effectors over time, relating to a reshaping of host hepatic metabolic and inflammatory transcriptomes. FF diet-induced gut dysbiosis precedes onset and is highly predictive of NAFLD outcomes, providing potential insights into microbially-based pathogenesis and therapeutics.
Collapse
Affiliation(s)
- Na Fei
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Sawako Miyoshi
- Department of General Medicine, Kyorin University School of Medicine, Tokyo 1818611, Japan
| | - Jake B. Hermanson
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Jun Miyoshi
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo 1818611, Japan
| | - Bingqing Xie
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Orlando DeLeon
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Maximilian Hawkins
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - William Charlton
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Mark D’Souza
- Duchossois Family Institute, University of Chicago, Chicago, IL, 60637, USA
| | - John Hart
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Dinanath Sulakhe
- Duchossois Family Institute, University of Chicago, Chicago, IL, 60637, USA
| | | | - Eugene B. Chang
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Michael R. Charlton
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Vanessa A. Leone
- Department of Animal & Dairy Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| |
Collapse
|
16
|
Yoon EL, Jun DW. Precision medicine in the era of potent antiviral therapy for chronic hepatitis B. J Gastroenterol Hepatol 2022; 37:1191-1196. [PMID: 35430754 DOI: 10.1111/jgh.15856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/04/2022] [Indexed: 12/09/2022]
Abstract
With the wide use of potent and safe nucloes(t-)ide analogues (NAs) treatment, patient-centered care is getting important. Intensive care for comorbidity has gain utmost importance in care of aging chronic hepatitis B (CHB) patients with life-long antiviral treatment. Linkage to care of patients with CHB is essential for the goal of hepatitis B virus (HBV) eradication. As long-term suppression of HBV DNA replication does not prevent hepatocellular carcinoma (HCC), prevention of HCC is another challenge for NAs treatment. There is a possibility of hepatocarcinogenesis in the immune-tolerant phase and risk of loss of patients during active monitoring seeking the time point for antiviral treatment initiation. Initiation of NAs treatment from the immune-tolerant phase would improve the linkage to care. However, universal recommendation is premature and evidence for cost-effectiveness needs to be accumulated. Early initiation of NAs in the evidence of significant disease progression, either HBV associated or comorbidity associated, would be a better strategy to reduce the risk of HCC in patients located in the gray zone.
Collapse
Affiliation(s)
- Eileen L Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| |
Collapse
|
17
|
Kamel AM, Farag MA. Therapeutic Potential of Artichoke in the Treatment of Fatty Liver: A Systematic Review and Meta-Analysis. J Med Food 2022; 25:931-942. [PMID: 35763310 DOI: 10.1089/jmf.2022.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a major chronic liver disease that can lead to liver cirrhosis, liver cancer, and death. Artichoke leaf extract (ALE) is well known in folk medicine for its hepatoprotective effect. Till recent times, no sufficient data from randomized clinical trials (RCTs) exist to support such use. This meta-analysis summarizes evidence from recent RCTs that evaluated ALE in NAFLD patients. Electronic databases were searched for RCTs that used ALE in NAFLD patients. The random-effects model was used to pool effect sizes (standardized change score). Data synthesis from five RCTs (333 patients) showed that ALE resulted in a significant reduction in alanine aminotransferase (standardized mean difference [SMD]: 1.1; 95% confidence interval [CI], 0.79-1.73; P < .001) and aspartate aminotransferase levels (SMD: 1.01; 95% CI, 0.52-1.51; P < .001) compared with the control group. ALE also resulted in a significant reduction in total cholesterol (SMD: 0.98; 95% CI, 0.53-1.43; P = .004), low-density lipoprotein (SMD: 0.96; 95% CI, 0.3-1.62; P < .001) and triglycerides (SMD: 0.95; 95% CI, 0.58-1.32; P < .001). The current review provides evidence from RCTs to support the use of ALE as a hepatoprotective agent in NAFLD patients. The study was registered on the PROSPERO database with the Registration No. CRD42020182502 (https://www.crd.york.ac.uk/prospero).
Collapse
Affiliation(s)
- Ahmed Mohamed Kamel
- Department of Clinical Pharmacy, and Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Mohamed Ali Farag
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| |
Collapse
|
18
|
Shin J, Choi SJ, Lee HR, Han K, Chang J, Jeong SM, Choi YS, Lee D, Shin DW. Non-Alcoholic Fatty Liver Disease and the Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study. J Pers Med 2022; 12. [PMID: 35455663 DOI: 10.3390/jpm12040546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/17/2022] [Accepted: 03/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is regarded as a risk factor for type 2 diabetes mellitus (DM). Menopausal status also influences T2DM risk, where estrogen is presumed to play a protective role by decreasing insulin resistance. As such, we investigated the association between NAFLD and DM risk according to menopausal status. Objectives: We sought to examine the association between NAFLD and DM incidence in pre- and post-menopausal women. Methods: A total of 842,772 pre-menopausal and 1,074,767 post-menopausal women who underwent health examinations between 2009 and 2014 were included from the Korean National Health Insurance Service database. Multivariate Cox proportional hazard analyses were performed to evaluate the association between the risk of DM according to menopausal status and NAFLD, defined by a fatty liver index >60. Results: During the mean follow-up period (7.8 years), DM was diagnosed in 33,461 (4.0%) of pre-menopausal women and 121,102 (9.4%) post-menopausal women. A stronger association between NAFLD and the risk of DM was found in pre-menopausal women (multivariable-adjusted hazard ratio [aHR], 3.60; 95% confidence interval [CI], 3.48−3.71) than in post-menopausal women (aHR, 2.24; 95% CI, 2.21−2.28) (P-interaction < 0.01). Subgroup analyses among women aged 45 to 55 years also showed a stronger association in pre-menopausal (aHR, 3.35; 95% CI, 3.21−3.49) than in post-menopausal women (aHR, 2.83; 95% CI, 2.68−2.98) (P-interaction < 0.01). Conclusions: The association between NAFLD and DM was stronger in pre-menopausal women than in post-menopausal women. This might be due to the protective effect of estrogen, which is possibly in higher production in the peripheral fat tissue of post-menopausal women with NAFLD.
Collapse
|
19
|
Natarajan Y, Loomba R. Magnetic Resonance Elastography for the Clinical Risk Assessment of Fibrosis, Cirrhosis, and Portal Hypertension in Patients With NAFLD. J Clin Exp Hepatol 2022; 12:174-179. [PMID: 35068797 PMCID: PMC8766685 DOI: 10.1016/j.jceh.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/01/2021] [Indexed: 01/03/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is rapidly becoming one of the most common causes of liver disease. The progressive subtype of NAFLD, nonalcoholic steatohepatitis (NASH), leads to cirrhosis, hepatocellular carcinoma, and mortality. Fibrosis is the strongest predictor for complications. Due to the invasive nature of liver biopsy, noninvasive testing methods have emerged to detect fibrosis and predict outcomes. Of these modalities, magnetic resonance elastography (MRE) has demonstrated the highest accuracy to detect fibrosis. In this review, we will focus on the emerging data regarding MRE and liver fibrosis, cirrhosis, and portal hypertension in NAFLD.
Collapse
Affiliation(s)
- Yamini Natarajan
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, USA,Clinical Epidemiology and Comparative Effectiveness Program, Section of Health Services Research (IQuESt), Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA,Address for correspondence. Yamini Natarajan, MD, 2002 Holcombe Blvd (111-D), Houston, TX, 77030, USA.
| | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA, USA,Address for correspondence. Rohit Loomba, MD, MHSc, 9500 Gilman Drive, ACTRI Building, 2W202, La Jolla, CA, 92093-0887, USA. http://fattyliver.ucsd.edu
| |
Collapse
|
20
|
Yang Q, Wang Z, Huang Z, Zhang S, Xie Y, Wang X. Evaluation of Aortic Distensibility in Patients with Nonalcoholic Fatty Liver using CT. Curr Med Imaging 2021; 18:883-887. [PMID: 34789138 DOI: 10.2174/1573405617666211117141640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/27/2021] [Accepted: 10/07/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Nonalcoholic fatty liver disease has attracted considerable attention with continuously increasing morbidity. OBJECTIVE To evaluate the aortic distensibility in patients with non-diabetes and hypertension-type nonalcoholic fatty liver disease(NAFLD) through dual-source computed tomography(DSCT). METHOD 120 patients with NAFLD (experimental group) and 30 healthy subjects (control group) were consecutively enrolled in the study. In the two groups, aortic distensibility was calculated as follows: D = △A/(A0 ×△p). Record fasting insulin, fasting blood glucose, fasting lipid status, age, heart rate, waist circumference, systolic blood pressure, and diastolic blood pressure. Calculate homeostasis model assessment of insulin resistance (HOMA-IR) and body mass index (BMI). A comparative analysis between the two groups was carried out, followed by correlation analysis between D value and risk factors. RESULTS D value and liver attenuation of the patients in the NAFLD group were significantly reduced relative to those in the control group (2.24±0.63×10-3mmHg-1 vs. 3.19±0.86×10-3mmHg-1, P<0.001 and 41±6HU vs. 53±5HU, P<0.001, respectively) and their fasting blood glucose, fasting insulin, triglyceride, low-density lipoprotein, aspartate aminotransferase, alanine transaminase, HOMA-IR, and BMI were higher than those in the control group. Liver attenuation, HOMA-IR, age, and BMI were significantly correlated with D value in the NAFLD group. The stepwise multiple linear regression analysis indicates that Liver attenuation and HOMA-IR were the significant risk factors for D value (β coefficient =0.43, P =0.001, and β coefficient =-0.33, P =0.02, respectively). CONCLUSION Patients with NAFLD suffer from a reduction in aortic distensibility, and insulin resistance may play a significant role in the early atherosclerosis stage.
Collapse
Affiliation(s)
- Qianqian Yang
- Department of Radiology, Wuhan Hospital of Traditional Chinese Medicine, Wuhan. China
| | - Zheng Wang
- Department of Radiology, Tongji Medical College, Huazhong University of Science and Technology, The Central Hospital of Wuhan, Wuhan. China
| | - Zengfa Huang
- Department of Radiology, Tongji Medical College, Huazhong University of Science and Technology, The Central Hospital of Wuhan, Wuhan. China
| | - Shutong Zhang
- Department of Radiology, Tongji Medical College, Huazhong University of Science and Technology, The Central Hospital of Wuhan, Wuhan. China
| | - Yuanliang Xie
- Department of Radiology, Tongji Medical College, Huazhong University of Science and Technology, The Central Hospital of Wuhan, Wuhan. China
| | - Xiang Wang
- Department of Radiology, Tongji Medical College, Huazhong University of Science and Technology, The Central Hospital of Wuhan, Wuhan. China
| |
Collapse
|
21
|
Sharpton SR, Tamaki N, Bettencourt R, Madamba E, Jung J, Liu A, Behling C, Valasek MA, Loomba R. Diagnostic accuracy of two-dimensional shear wave elastography and transient elastography in nonalcoholic fatty liver disease. Therap Adv Gastroenterol 2021; 14:17562848211050436. [PMID: 34646360 PMCID: PMC8504217 DOI: 10.1177/17562848211050436] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/09/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Two-dimensional shear wave elastography (2D-SWE) and vibration-controlled transient elastography (VCTE) provide noninvasive assessment of hepatic fibrosis. We compared performance of 2D-SWE and VCTE for fibrosis detection in nonalcoholic fatty liver disease (NAFLD). METHODS We performed a prospective study of adults with NAFLD who underwent 2D-SWE, VCTE, and liver biopsy analysis (using Nonalcoholic Steatohepatitis Clinical Research Network scoring system). The primary outcome was hepatic fibrosis (stage ⩾ 1); secondary outcomes included dichotomized fibrosis stages. Area under receiver operating characteristic curve (AUROC) analyses were used to compare 2D-SWE and VCTE performance. RESULTS A total of 114 adults with a median BMI of 31.2 kg/m2 were included. The VCTE was better than 2D-SWE for the detection of fibrosis (AUROC: 0.81 versus 0.72, p = 0.03). The VCTE detected fibrosis stage 2, 3, or 4 with AUROCs of 0.86 (95% CI, 0.80-0.93), 0.91 (95% CI, 0.82-0.99), and 0.96 (95% CI, 0.91-1.00). The 2D-SWE detected fibrosis stage 2, 3, or 4 with AUROCs of 0.84 (95% CI, 0.76-0.92), 0.88 (95% CI, 0.81-0.96), and 0.93 (95% CI, 0.86-0.99). CONCLUSION In a prospective study including more than 100 adults with NAFLD, we found VCTE to be more accurate than 2D-SWE in detecting fibrosis; these modalities, however, are comparable in assessing for higher stages of fibrosis.
Collapse
Affiliation(s)
- Suzanne R. Sharpton
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA,NAFLD Research Center, University of California San Diego, La Jolla, CA, USA
| | - Nobuharu Tamaki
- NAFLD Research Center, University of California San Diego, La Jolla, CA, USA,Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Ricki Bettencourt
- NAFLD Research Center, University of California San Diego, La Jolla, CA, USA
| | - Egbert Madamba
- NAFLD Research Center, University of California San Diego, La Jolla, CA, USA
| | - Jinho Jung
- NAFLD Research Center, University of California San Diego, La Jolla, CA, USA
| | - Amy Liu
- NAFLD Research Center, University of California San Diego, La Jolla, CA, USA
| | - Cynthia Behling
- Department of Pathology, Sharp Health System, San Diego, CA, USA
| | - Mark A. Valasek
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | | |
Collapse
|
22
|
Majnooni MB, Ataee M, Bahrami G, Heydarpour F, Aneva IY, Farzaei MH, Ahmadi-Juoibari T. The effects of co-administration of artichoke leaf extract supplementation with metformin and vitamin E in patients with nonalcoholic fatty liver disease: A randomized clinical trial. Phytother Res 2021; 35:6324-6334. [PMID: 34533249 DOI: 10.1002/ptr.7279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 06/29/2021] [Accepted: 08/28/2021] [Indexed: 01/20/2023]
Abstract
Medicinal plants are widely used as a complementary therapy to treat complex diseases, such as nonalcoholic fatty liver disease (NAFLD). Therefore, this study was done to investigate the effect of co-administration of artichoke leaf extract supplement (ALES) with conventional medicines on patients with NAFLD. The clinical trial was based on patients randomly divided into three groups involving metformin-vitamin E (ME), metformin-ALES (MA), and vitamin E-ALES (EA). The effectiveness of treatment in the treated groups was evaluated using liver ultrasonography and biochemical markers. After 12 weeks of treatment, the results showed that the rate of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was significantly reduced within all the study groups (p < .05). Liver ultrasonographic findings revealed that the rate of fat accumulation in liver of patients was decreased significantly within all the study groups and it was increased in the subjects with grade 0 fatty liver (without fat accumulation) in the MA and EA groups by 23.3 and 17.2%, respectively. In summary, the results of the present study showed that the concomitant use of ALES with metformin and vitamin E can have beneficial effects on amelioration of complications in patients with NAFLD. However, larger-scale clinical trial studies are required in this regard.
Collapse
Affiliation(s)
| | - Mari Ataee
- Clinical Research Development Center, Imam Khomeini and Dr Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Gholamreza Bahrami
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Heydarpour
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ina Yosifova Aneva
- Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Touraj Ahmadi-Juoibari
- Clinical Research Development Center, Imam Khomeini and Dr Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
23
|
Goodarzi R, Jafarirad S, Mohammadtaghvaei N, Dastoorpoor M, Alavinejad P. The effect of pomegranate extract on anthropometric indices, serum lipids, glycemic indicators, and blood pressure in patients with nonalcoholic fatty liver disease: A randomized double-blind clinical trial. Phytother Res 2021; 35:5871-5882. [PMID: 34498307 DOI: 10.1002/ptr.7249] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/25/2021] [Accepted: 08/06/2021] [Indexed: 12/16/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. The beneficial effects of pomegranate have been shown on insulin resistance and obesity, which are linked to NAFLD pathogenesis. The aim of this study was to investigate the efficacy of pomegranate extract in patients with NAFLD. Forty-four NAFLD patients were randomly assigned to receive two pomegranate extract tablets or placebo for 12 weeks. Anthropometric measurements, serum lipids, glycemic indicators, and blood pressure were assessed at baseline and the end of the study. Pomegranate was associated with a reduction in the total cholesterol (p ˂ .001), triglyceride (p ˂ .001), low-density lipoprotein cholesterol (LDL-C)-to-high-density lipoprotein cholesterol (HDL-C) ratio (p ˂ .003), fasting blood sugar (p ˂ .001), homeostatic model assessment of insulin resistance (p = .02), diastolic blood pressure (p = .04), weight (p ˂ .001), body mass index (p ˂ .001), and waist circumference (p = .002), as compared to placebo. A significant increase was observed in serum HDL-C (p ˂ .001) after intervention with the pomegranate extract. However, no significant difference was shown between the two groups in serum insulin and LDL-C. The pomegranate extract supplement could be used as a complementary therapy along with existing therapies to improve glycemic indicators, serum lipids, anthropometric indices, and blood pressure in patients with nonalcoholic fatty liver.
Collapse
Affiliation(s)
- Reza Goodarzi
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sima Jafarirad
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Mohammadtaghvaei
- Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Pejman Alavinejad
- Research Institute for Infectious Disease of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
24
|
Sangsefidi ZS, Yarhosseini F, Hosseinzadeh M, Ranjbar A, Akhondi-Meybodi M, Fallahzadeh H, Mozaffari-Khosravi H. The effect of (Cornus mas L.) fruit extract on liver function among patients with nonalcoholic fatty liver: A double-blind randomized clinical trial. Phytother Res 2021; 35:5259-5268. [PMID: 34254372 DOI: 10.1002/ptr.7199] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/23/2021] [Accepted: 06/11/2021] [Indexed: 01/06/2023]
Abstract
This double-blind randomized clinical trial aimed to investigate impact of Cornus mas L. fruit extract (CMFE) on liver function in nonalcoholic fatty liver disease (NAFLD). Fifty patients were randomly assigned into the CMFE and placebo groups to receive 20 ml of the extract or placebo for 12 weeks, respectively. Serum alanine aminotransferase, aspartate aminotransferase, cytokeratin 18 (CK-18) levels, and steatosis and fibrosis scores were examined before and after the intervention. Although, a significant decrease was observed in CK-18 levels among the CMFE group (288.80 ± 85.40 vs. 235.66 ± 60.38; p = .001) after 12 weeks, no significant difference was found between the two groups. Moreover, a significant increase in fibrosis score in the placebo group (8.20 (6.35-9.40) vs. 8.40 (7.70-13.00); p = .03) as well as a significant difference in this marker (CMEF: 7.64 (6.30-8.25); placebo: 8.40 (7.70-13.00); p = .02) and its changes (CMEF: 0.60 (-1.00-1.07); placebo: 0.80 (-0.25-3.95); p = .02) were found between the groups after 12 weeks. No significant effect was noted on other variables. Therefore, consuming CMFE might have some beneficial effects on liver function markers in NAFLD. However, more studies are required in this area.
Collapse
Affiliation(s)
- Zohreh Sadat Sangsefidi
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Faezeh Yarhosseini
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdieh Hosseinzadeh
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alimohammad Ranjbar
- Department of Pharmacognosy, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Akhondi-Meybodi
- Gastroentrology Department, Shahid Sadoughi Hospital, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hassan Mozaffari-Khosravi
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
25
|
Hernández-Aguilar AI, Luciano-Villa CA, Tello-Flores VA, Beltrán-Anaya FO, Zubillaga-Guerrero MI, Flores-Alfaro E. Dysregulation of lncRNA-H19 in cardiometabolic diseases and the molecular mechanism involved : a systematic review. Expert Rev Mol Diagn 2021; 21:809-821. [PMID: 34133256 DOI: 10.1080/14737159.2021.1944808] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Cardiometabolic diseases are a global public health problem, with significant increases in their prevalence. Different epigenetic factors involved in the progression of metabolic alterations have been described, such as long non-coding RNAs (lncRNAs). H19 is a multifunctional lncRNA expressed from the maternal allele, with low expression after birth, except in the skeletal muscle and heart. Recent studies have linked its dysregulation to alterations in cell metabolism.Areas covered: H19 plays a role in the pathogenesis of coronary artery disease, nonalcoholic fatty liver disease, hepatic and renal fibrosis, insulin resistance, type 2 diabetes, and inflammation. H19 acts mainly as a competitive endogenous RNA of molecules involved in pathways that regulate cell metabolism. In this review, we analyzed the dysregulation of H19 in cardiometabolic diseases and its relationship with molecular alterations in different signaling pathways.Expert opinion: The association of H19 with the development of cardiometabolic diseases, indicates that H19 could be a therapeutic target and prognostic biomarker for these diseases. Controversies have been reported regarding the expression of H19 in some metabolic diseases, therefore, it is necessary to continue research to clarify its pathogenic effect in different organs.
Collapse
Affiliation(s)
- Ana Iris Hernández-Aguilar
- Faculty of Chemical‑Biological Sciences, Autonomous University of Guerrero, Chilpancingo, Guerrero, Mexico
| | | | | | - Fredy Omar Beltrán-Anaya
- Faculty of Chemical‑Biological Sciences, Autonomous University of Guerrero, Chilpancingo, Guerrero, Mexico
| | | | - Eugenia Flores-Alfaro
- Faculty of Chemical‑Biological Sciences, Autonomous University of Guerrero, Chilpancingo, Guerrero, Mexico
| |
Collapse
|
26
|
Gui W, Zhu Y, Sun S, Zhu W, Tan B, Zhao H, Shang C, Zheng F, Lin X, Li H. Knockdown of insulin-like growth factor 2 gene disrupts mitochondrial functions in the liver. J Mol Cell Biol 2021; 13:mjab030. [PMID: 33988719 PMCID: PMC8697341 DOI: 10.1093/jmcb/mjab030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 11/14/2022] Open
Abstract
Even though insulin-like growth factor 2 (IGF2) has been reported to be overexpressed in nonalcoholic fatty liver disease (NAFLD), its role in the progression of NAFLD and the potential mechanism remain largely unclear. Using in vitro models, we found that IGF2 was the key overexpressed gene in steatosis, suggesting a possible association between IGF2 and NAFLD. Interestingly, loss-of-function experiments revealed that inhibition of IGF2 protein impaired mitochondrial biogenesis and respiration. It additionally disrupted the expression changes of mitochondrial fusion and fission-related proteins necessary in maintaining mitochondrial homeostasis. Consistently, IGF2 knockdown reduced the mitochondrial membrane potential and increased the production of reactive oxygen species. Mechanistically, IGF2 regulates mitochondrial functions by modulating the expression of SIRT1 and its downstream gene PGC1α. This research opens a new frontier on the role of IGF2 in energy metabolism, which potentially participates in the development of NAFLD. As such, IGF2 is a potential therapeutic target against NAFLD.
Collapse
Affiliation(s)
- Weiwei Gui
- Department of Endocrinology, The Affiliated Sir Run Run Shaw Hospital, School
of Medicine, Zhejiang University, Hangzhou, China
| | - Yiyi Zhu
- Department of Endocrinology, Peking Union Medical College Hospital, Peking
Union Medical College, Chinese Academy of Medical Sciences, Beijing,
China
| | - Shuiya Sun
- Department of Endocrinology, The Affiliated Sir Run Run Shaw Hospital, School
of Medicine, Zhejiang University, Hangzhou, China
| | - Weifen Zhu
- Department of Endocrinology, The Affiliated Sir Run Run Shaw Hospital, School
of Medicine, Zhejiang University, Hangzhou, China
| | - Bowen Tan
- College of Medicine, Zhejiang University, Hangzhou, China
| | - Hanxin Zhao
- Department of Endocrinology, The Affiliated Sir Run Run Shaw Hospital, School
of Medicine, Zhejiang University, Hangzhou, China
| | - Chengxin Shang
- Department of Endocrinology, The Affiliated Sir Run Run Shaw Hospital, School
of Medicine, Zhejiang University, Hangzhou, China
| | - Fenping Zheng
- Department of Endocrinology, The Affiliated Sir Run Run Shaw Hospital, School
of Medicine, Zhejiang University, Hangzhou, China
| | - Xihua Lin
- Department of Endocrinology, The Affiliated Sir Run Run Shaw Hospital, School
of Medicine, Zhejiang University, Hangzhou, China
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang
Province, The Affiliated Sir Run Run Shaw Hospital, Zhejiang University,
Hangzhou, China
| | - Hong Li
- Department of Endocrinology, The Affiliated Sir Run Run Shaw Hospital, School
of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
27
|
Tang G, Zhang L, Tao J, Wei Z. Effect of Nigella sativa in the treatment of nonalcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2021; 35:4183-4193. [PMID: 33728708 DOI: 10.1002/ptr.7080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 11/06/2022]
Abstract
The effectiveness of Nigella sativa (NS) treatment for nonalcoholic fatty liver disease (NAFLD) remains controversial. This systematic review, and meta-analysis, was conducted to evaluate potential benefits of NS for NAFLD. Up to June 11, 2020, randomized controlled trials (RCTs) evaluating NS for the treatment of NAFLD were searched and included from PubMed, Embase, Cochrane Library, and Web of science. Mean differences (MD) or risk ratio (RR) and 95% confidence intervals (CI) were calculated. Six articles from five trails with a total of 358 participants were included. Although NS has no beneficial effect on the levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL), triglyceride (TG), insulin, and tumor necrosis factor α (TNF-α), its supplementation did improve the levels of alanine transaminase (ALT), aspartate transaminase (AST), fasting blood sugar (FBS), high-density lipoprotein cholesterol (HDL), high-sensitivity C reactive protein (hs-CRP), and grade of fatty liver compared with placebo. In summary, this study showed that NS supplementation was effective in the treatment of NAFLD and could improve the levels of ALT, AST, FBS, HDL, and hs-CRP in patients with NAFLD, as well as the severity of NAFLD. High-quality large sample RCTs are necessary to confirm the benefit of NS supplementation for NAFLD.
Collapse
Affiliation(s)
- Gang Tang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linyu Zhang
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Jie Tao
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Zhengqiang Wei
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
28
|
Huang HC, Chen CJ, Lai YH, Lin YC, Chiou WC, Lu HF, Chen YF, Chen YH, Huang C. Momordica cochinchinensis Aril Ameliorates Diet-Induced Metabolic Dysfunction and Non-Alcoholic Fatty Liver by Modulating Gut Microbiota. Int J Mol Sci 2021; 22:2640. [PMID: 33808007 DOI: 10.3390/ijms22052640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 01/04/2023] Open
Abstract
Obesity and its associated conditions, such as type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD), are a particular worldwide health problem at present. Momordica cochinchinensis (MC) is consumed widely in Southeast Asia. However, whether it has functional effects on fat-induced metabolic syndrome remains unclear. This study was conducted to examine the prevention effect of Momordica cochinchinensis aril (MCA) on obesity, non-alcoholic fatty liver and insulin resistance in mice. MCA protected the mice against high-fat diet (HFD)-induced body weight gain, hyperlipidemia and hyperglycemia, compared with mice that were not treated. MCA inhibited the expansion of adipose tissue and adipocyte hypertrophy. In addition, the insulin sensitivity-associated index that evaluates insulin function was also significantly restored. MCA also regulated the secretion of adipokines in HFD-induced obese mice. Moreover, hepatic fat accumulation and liver damage were reduced, which suggested that fatty liver was prevented by MCA. Furthermore, MCA supplementation suppressed hepatic lipid accumulation by activation of the AMP-activated protein kinase (AMPK) and peroxisome proliferator-activated receptor-alpha (PPAR-alpha) signaling pathway in the human fatty liver HuS-E/2 cell model. Our data indicate that MCA altered the microbial contents of the gut and modulated microbial dysbiosis in the host, and consequently is involved in the prevention of HFD-induced adiposity, insulin resistance and non-alcoholic fatty liver disease.
Collapse
|
29
|
Abstract
PURPOSE OF REVIEW Nonalcoholic fatty liver is the result of an imbalance between lipid storage [from meal, de novo lipogenesis (DNL) and fatty acid (FA) uptake] and disposal (oxidation and VLDL output). Knowledge on the contribution of each of these pathways to liver fat content in humans is essential to develop tailored strategies to prevent and treat nonalcoholic fatty liver. Here, we review the techniques available to study the different storage pathways and review dietary modulation of these pathways. RECENT FINDINGS The type of carbohydrate and fat could be of importance in modulating DNL, as complex carbohydrates and omega-3 FAs have been shown to reduce DNL. No effects were found on the other pathways, however studies investigating this are scarce. SUMMARY Techniques used to assess storage pathways are predominantly stable isotope techniques, which require specific expertise and are costly. Validated biomarkers are often lacking. These methodological limitations also translate into a limited number of studies investigating to what extent storage pathways can be modulated by diet. Further research is needed to elucidate in more detail the impact that fat and carbohydrate type can have on liver fat storage pathways and content.
Collapse
Affiliation(s)
- Kay H.M. Roumans
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht
| | | | | | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht
| | - Vera B. Schrauwen-Hinderling
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| |
Collapse
|
30
|
Huang XJ, He CJ, Liang S, Wang J, Li J, Yang GZ, Zhao Z. Veratrilla baillonii Franch Could Alleviate Lipid Accumulation in LO2 Cells by Regulating Oxidative, Inflammatory, and Lipid Metabolic Signaling Pathways. Front Pharmacol 2020; 11:575772. [PMID: 33071788 PMCID: PMC7538785 DOI: 10.3389/fphar.2020.575772] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/03/2020] [Indexed: 11/13/2022] Open
Abstract
Based on the pathological theory of lipid metabolism and using network pharmacology, this study was designed to investigate the protective effect of water extract of Veratrilla baillonii (WVBF) on non-alcoholic fatty liver disease (NAFLD) model using LO2 cells and to identify the potential mechanism underlying the effect. The components of V. baillonii were identified from the public database of traditional Chinese medicine systems pharmacology database (TCMSP). Cytoscape software was used to construct the related composite target network. Then, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were carried out for critical nodes. The BioGPS database was used to determine the distribution of the target in tissues and organs. Moreover, the inhibitory effect of V. baillonii was further investigated using an in vitro hepatocyte NAFLD model. Fourteen active components were then selected from the 27 known compounds of V. baillonii. The targets of gene enrichment analysis were mainly distributed in the lipid catabolism-related signaling pathway. Network analysis revealed that five target genes of TNF, MAPK8, mTOR, NF-ĸB, and SREBP-1c were key nodes and played important roles in this process. Organ localization analysis indicated that one of the core target site of V. baillonii was liver tissue. The results of the in vitro study revealed that WVBF can alleviate the inflammatory response and lipid accumulation in LO2 hepatocytes by inhibiting oxidative stress and the adipocytokine signaling pathway. Genes and proteins related to the lipid synthesis, such as SREBP-1C, acetyl-CoA carboxylase (ACC), and fatty acid synthase (FASN), were significantly decreased, and PPARα expression is significantly increased with WVBF administration. In conclusion, V. baillonii may regulate local lipid metabolism and attenuate oxidative stress and inflammatory factors through the PPARα/SREBP-1c signaling pathway. The present study also indicates that multiple components of V. baillonii regulate multiple targets and pathways in NAFLD. The findings highlight the potential of V. baillonii as a promising treatment strategy for nonalcoholic fatty liver injury.
Collapse
Affiliation(s)
- Xian-Ju Huang
- School of Pharmacy, South-Central University for Nationalities, Wuhan, China
| | - Cai-Jing He
- School of Pharmacy, South-Central University for Nationalities, Wuhan, China
| | - Shuai Liang
- School of Pharmacy, South-Central University for Nationalities, Wuhan, China
| | - Jing Wang
- School of Pharmacy, South-Central University for Nationalities, Wuhan, China
| | - Jun Li
- School of Pharmacy, South-Central University for Nationalities, Wuhan, China
| | - Guang-Zhong Yang
- School of Pharmacy, South-Central University for Nationalities, Wuhan, China
| | - Zhang Zhao
- Department of Anesthesiology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
31
|
Kakiyama G, Marques D, Martin R, Takei H, Rodriguez-Agudo D, LaSalle SA, Hashiguchi T, Liu X, Green R, Erickson S, Gil G, Fuchs M, Suzuki M, Murai T, Nittono H, Hylemon PB, Zhou H, Pandak WM. Insulin resistance dysregulates CYP7B1 leading to oxysterol accumulation: a pathway for NAFL to NASH transition. J Lipid Res 2020; 61:1629-1644. [PMID: 33008924 DOI: 10.1194/jlr.ra120000924] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
NAFLD is an important public health issue closely associated with the pervasive epidemics of diabetes and obesity. Yet, despite NAFLD being among the most common of chronic liver diseases, the biological factors responsible for its transition from benign nonalcoholic fatty liver (NAFL) to NASH remain unclear. This lack of knowledge leads to a decreased ability to find relevant animal models, predict disease progression, or develop clinical treatments. In the current study, we used multiple mouse models of NAFLD, human correlation data, and selective gene overexpression of steroidogenic acute regulatory protein (StarD1) in mice to elucidate a plausible mechanistic pathway for promoting the transition from NAFL to NASH. We show that oxysterol 7α-hydroxylase (CYP7B1) controls the levels of intracellular regulatory oxysterols generated by the "acidic/alternative" pathway of cholesterol metabolism. Specifically, we report data showing that an inability to upregulate CYP7B1, in the setting of insulin resistance, results in the accumulation of toxic intracellular cholesterol metabolites that promote inflammation and hepatocyte injury. This metabolic pathway, initiated and exacerbated by insulin resistance, offers insight into approaches for the treatment of NAFLD.
Collapse
Affiliation(s)
- Genta Kakiyama
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA; Department of Veterans Affairs, McGuire Veterans Administration Medical Center, Richmond, VA, USA.
| | - Dalila Marques
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA; Department of Veterans Affairs, McGuire Veterans Administration Medical Center, Richmond, VA, USA
| | - Rebecca Martin
- Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, VA, USA
| | - Hajime Takei
- Junshin Clinic Bile Acid Institute, Tokyo, Japan
| | - Daniel Rodriguez-Agudo
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA; Department of Veterans Affairs, McGuire Veterans Administration Medical Center, Richmond, VA, USA
| | - Sandra A LaSalle
- Department of Veterans Affairs, McGuire Veterans Administration Medical Center, Richmond, VA, USA
| | | | - Xiaoying Liu
- Department of Medicine, Northwestern University, Chicago, IL, USA
| | - Richard Green
- Department of Medicine, Northwestern University, Chicago, IL, USA
| | - Sandra Erickson
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Gregorio Gil
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University, Richmond, VA, USA; Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael Fuchs
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA; Department of Veterans Affairs, McGuire Veterans Administration Medical Center, Richmond, VA, USA
| | - Mitsuyoshi Suzuki
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Tsuyoshi Murai
- School of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Hokkaido, Japan
| | | | - Phillip B Hylemon
- Department of Veterans Affairs, McGuire Veterans Administration Medical Center, Richmond, VA, USA; Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, VA, USA; Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Huiping Zhou
- Department of Veterans Affairs, McGuire Veterans Administration Medical Center, Richmond, VA, USA; Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, VA, USA; Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - William M Pandak
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA; Department of Veterans Affairs, McGuire Veterans Administration Medical Center, Richmond, VA, USA; Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
32
|
Gupta N, Jindal G, Nadda A, Bansal S, Gahukar S, Kumar A. Prevalence and risk factors for nonalcoholic fatty liver disease in obese children in rural Punjab, India. J Family Community Med 2020; 27:103-108. [PMID: 32831555 PMCID: PMC7415271 DOI: 10.4103/jfcm.jfcm_287_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/20/2020] [Accepted: 03/30/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Pediatric nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, hypertension, metabolic syndrome, cardiovascular problems, and increased risk of chronic liver disease and Type II diabetes mellitus. The aim of the study was to assess the metabolic profiles and associated risk factors of NAFLD in obese children. MATERIALS AND METHODS Children with a body mass index (BMI) of >27 kg/m2 an adult equivalent cutoff (Indian Academy of Paediatrics, 2015 guidelines) aged 5-18 years presenting to the pediatric outpatient unit of PGIMER Satellite Centre, Sangrur, India, were retrospectively recruited over a 1-year period. Anthropometry, lipid profile, thyroid levels, liver function test, fasting blood sugar, and blood pressure were measured. Ultrasonography was used to diagnose NAFLD. Logistic regression was used to assess the risk factors. RESULTS A total of 100 children participated in the study. The mean age was 10.6 ± 2.6 years and the mean BMI-Z score was 2.6 ± 0.5. The prevalence of NAFLD was 62%. Alanine transaminase (ALT) was significantly elevated in all the children with NAFLD. Lipid levels and BMI Z-score were similar in both groups. Unadjusted odds ratio shows statistically significant association of ALT (2.058 [1.11-1.01]) and waist circumference (1.089 [1.19-0.99]) with NAFLD. With adjusted odds ratio only, ALT (1.12 [1.24-1.01]) was found to be significantly associated with NAFLD. CONCLUSION There is quite a high prevalence of nonalcoholic fatty liver in obese Indian children. All children with raised liver enzymes should undergo sonography to rule out NAFLD.
Collapse
Affiliation(s)
- Nishu Gupta
- Department of Pediatrics, PGIMER Satellite Centre Sangrur, Patiala, Punjab, India
| | - Gunjan Jindal
- Department of Radiodiagnosis, PGIMER Satellite Centre Sangrur, Patiala, Punjab, India
| | - Anuradha Nadda
- Department of Community Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India
| | - Saloni Bansal
- Department of Biochemistry, PGIMER Satellite Centre Sangrur, Patiala, Punjab, India
| | - Shailesh Gahukar
- Department of Hospital Administration, PGIMER Satellite Centre Sangrur, Patiala, Punjab, India
| | - Ashok Kumar
- Department of Hospital Administration, PGIMER, Chandigarh, India
| |
Collapse
|
33
|
Lu K, Wang J, Yu Y, Wu Y, He Z. Lycium ruthenicum Murr. alleviates nonalcoholic fatty liver in mice. Food Sci Nutr 2020; 8:2588-2597. [PMID: 32566176 PMCID: PMC7300084 DOI: 10.1002/fsn3.1445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/19/2019] [Accepted: 01/10/2020] [Indexed: 12/15/2022] Open
Abstract
Oxidative stress and inflammation contribute to hypertriglyceridemia-induced nonalcoholic fatty liver disease (NAFLD). Cholesterol-enriched diets increase the risk of NAFLD. Lycium ruthenium Murr. (LRM) contains water-soluble antioxidant proanthocyanidins. Whether Lycium ruthenium Murr. improves NAFLD remains elusive. In this study, we established a model of NAFLD-induced by cholesterol-enriched high-fat diet (western diet) in ApoE -/- mice; oxidative stress and inflammation were examined and intervened by supplement of Lycium ruthenium Murr. (LRM) extracts. LRM supplement did not influence body weight gain, food intake, and lipotoxicity of mice. LRM supplement significantly alleviated triglyceride accumulation in liver, with reduced inflammation, elevated GSH-Px activity, and reduced MDA levels. The expression of fatty acids oxidative gene Scd1 was significantly increased, and fatty acids synthesis-related gene Pparγ was dramatically downregulated on mRNA level in liver of mice with LRM supplement. These data demonstrated that LRM supplement decreased ROS production and inflammation, increased fatty acids oxidation, and reduced fatty acids synthesis in liver, leading to ameliorate the development of NAFLD induced by high western diet. Thus, oxidative stress and inflammation also are involved in the pathogenesis of western diet-induced NAFLD, which is independent of obesity.
Collapse
Affiliation(s)
- Keke Lu
- Shandong Provincial Hospital and School of MedicineShandong UniversityJinanChina
| | - Jing Wang
- Shandong Provincial Hospital and School of MedicineShandong UniversityJinanChina
| | - Yueyuan Yu
- State Key Laboratory of Food Science and TechnologySchool of Food Science and TechnologyJiangnan UniversityWuxiChina
| | - Yikuan Wu
- State Key Laboratory of Food Science and TechnologySchool of Food Science and TechnologyJiangnan UniversityWuxiChina
| | - Zhao He
- Shandong Provincial Hospital and School of MedicineShandong UniversityJinanChina
- State Key Laboratory of Food Science and TechnologySchool of Food Science and TechnologyJiangnan UniversityWuxiChina
- Shandong Key Laboratory of Endocrinology and Lipid MetabolismShandong Provincial HospitalJinanChina
- Institute of Endocrinology and metabolismShandong Academy of Clinical MedicineJinanChina
| |
Collapse
|
34
|
Leitão J, Carvalhana S, Cochicho J, Silva AP, Velasco F, Medeiros I, Alves AC, Bourbon M, Oliveiros B, Rodrigues V, Sousa R, Sampaio F, Carvalho A, Cortez-Pinto H. Prevalence and risk factors of fatty liver in Portuguese adults. Eur J Clin Invest 2020; 50:e13235. [PMID: 32289180 DOI: 10.1111/eci.13235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/17/2020] [Accepted: 03/29/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prevalence of fatty liver (FL) and nonalcoholic fatty liver disease (NAFLD) depends mainly on obesity, diabetes and genetic factors. FL and NAFLD prevalence was evaluated in Portuguese adult population and correlated with several risk factors and related mortality data, within the same period. MATERIALS AND METHODS A cross-sectional, population-based multicenter study, voluntary and randomly selected in 834 Portuguese adults (18-79 years). Participants were evaluated after 12-hour fasting. Anthropometric data, past history including alcohol consumption, and associated diseases were registered. Blood samples were collected for biochemical testing. Dietary intake was evaluated using a semi-quantitative food frequency questionnaire. Presence of FL was evaluated using ultrasound, and NAFLD was diagnosed after exclusion of other causes for liver disease. RESULTS Adjusted prevalence of FL and NAFLD was 37.8% and 17.0%, respectively. FL individuals were older, more frequently males, with increased probability of having obesity, diabetes or harmful alcohol consumption (HAC). NAFLD individuals were also older, but had a similar sex distribution and an increased probability of obesity and diabetes. In both groups, no differences were found regarding dietary pattern or physical activity. During the same time period, nonalcoholic steatohepatitis (NASH) liver-related deaths in Portugal were 0.105/100 000, while alcohol-related liver disease mortality was 6.790/100 000. CONCLUSION The large spectrum of FL was present in more than one third of the population, although only less than half could be classified as NAFLD. Other significant risk factors, such as HAC, are probably implicated in FL, explaining the low NASH-related mortality compared with the high alcohol-related mortality during the same time period.
Collapse
Affiliation(s)
- Jorge Leitão
- Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sofia Carvalhana
- Department of Gastroenterology, Centro Hospitalar e Universitário Lisboa Norte, Lisboa, Portugal
| | - Joana Cochicho
- Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ana Paula Silva
- Department of Gastroenterology, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Francisco Velasco
- Department of Gastroenterology, Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal
| | - Isabel Medeiros
- Department of Gastroenterology, Hospital Espírito Santo, Évora, Portugal
| | - Ana Catarina Alves
- Biosystems and Integrative Science Institute (BioISI), Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
| | - Mafalda Bourbon
- Biosystems and Integrative Science Institute (BioISI), Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
| | - Bárbara Oliveiros
- Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Vitor Rodrigues
- Instituto de Higiene e Medicina Social, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rita Sousa
- Centro de Estudos de Medicina Baseada na Evidência, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Filipa Sampaio
- Centro de Estudos de Medicina Baseada na Evidência, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Armando Carvalho
- Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Helena Cortez-Pinto
- Department of Gastroenterology, Centro Hospitalar e Universitário Lisboa Norte, Lisboa, Portugal.,Clínica Universitária de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| |
Collapse
|
35
|
Wang F, Zhang HF. [Effects of liraglutide combined with vitamin D on non-alcoholic fatty liver induced by high fat in mice and its mechanism]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2020; 36:261-264. [PMID: 32981283 DOI: 10.12047/j.cjap.5911.2020.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Objective: To investigate the effects of liraglutide combined with vitamin D on high-fat-induced non-alcoholic fatty liver disease (NAFLD) mice and its potential mechanism. Methods: C57BL/6 mice were divided into control group, NAFLD model group, liraglutide group, vitamin D group and liraglutide combined with vitamin D group. Each group consisted of 10 mice. The control group was fed with normal diet for 12 weeks; the model group was fed with high-fat diet for 12 weeks; the liraglutide group, vitamin D group and combined group were fed with high-fat diet for 12 weeks, From the 9th week, the three groups of mice were intraperitoneally injected with liraglutide (0.6 mg/kg), vitamin D(250 mg/(kg·d) ) by gavage, and combination. After 12 weeks of feeding, the blood and liver tissues of mice in each group were collected for biochemical and pathological examination, and the phosphorylation level of AMP-activated protein kinase (AMPK) in liver tissues of mice in each group was detected by immunoblotting. Results: Liraglutide or vitamin D alone or in combination could improve liver lipid accumulation (triglycerides: 6.0±0.7 vs 3.8±0.3, 3.9±0.3 and 2.1±0.2, all P<0.05; cholesterol: 1.4±0.5 vs 0.9±0.2, 0.8±0.2 and 0.5±0.1, all P<0.05) and steatosis (NAFLD activity score: 2.4±0.3 vs 1.0±0.2, 0.9±0.1 and 0.6±0.1, all P<0.05) in NAFLD mice. In addition, compared with liraglutide or vitamin D group, liraglutide combined with vitamin D treatment was more effective, and might be related to the regulation of insulin resistance and AMPK phosphorylation. Conclusion: The results showed that vitamin D could enhance the therapeutic effect of liraglutide on NAFLD induced by high fat, and may be related to the regulation of insulin resistance and AMPK phosphorylation.
Collapse
Affiliation(s)
- Feng Wang
- Department of Physiology, Inner Mongolia Medical University, Hohhot 010110, China
| | - Hai Feng Zhang
- Department of Physiology, Inner Mongolia Medical University, Hohhot 010110, China
| |
Collapse
|
36
|
Ioannou GN, Nagana Gowda GA, Djukovic D, Raftery D. Distinguishing NASH Histological Severity Using a Multiplatform Metabolomics Approach. Metabolites 2020; 10:E168. [PMID: 32344559 DOI: 10.3390/metabo10040168] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 12/31/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is categorized based on histological severity into nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH). We used a multiplatform metabolomics approach to identify metabolite markers and metabolic pathways that distinguish NAFL from early NASH and advanced NASH. We analyzed fasting serum samples from 57 prospectively-recruited patients with histologically-proven NAFLD, including 12 with NAFL, 31 with early NASH and 14 with advanced NASH. Metabolite profiling was performed using a combination of liquid chromatography-mass spectrometry (LC-MS) and nuclear magnetic resonance (NMR) spectroscopy analyzed with multivariate statistical and pathway analysis tools. We targeted 237 metabolites of which 158 were quantified. Multivariate analysis uncovered metabolite profile clusters for patients with NAFL, early NASH, and advanced NASH. Also, multiple individual metabolites were associated with histological severity, most notably spermidine which was more than 2-fold lower in advanced fibrosis vs. early fibrosis, in advanced NASH vs. NAFL and in advanced NASH vs. early NASH, suggesting that spermidine exercises a protective effect against development of fibrosing NASH. Furthermore, the results also showed metabolic pathway perturbations between early-NASH and advanced-NASH. In conclusion, using a combination of two reliable analytical platforms (LC-MS and NMR spectroscopy) we identified individual metabolites, metabolite clusters and metabolic pathways that were significantly different between NAFL, early-NASH, and advanced-NASH. These differences provide mechanistic insights as well as potentially important metabolic biomarker candidates that may noninvasively distinguish patients with NAFL, early-NASH, and advanced-NASH. The associations of spermidine levels with less advanced histology merit further assessment of the potential protective effects of spermidine in NAFLD.
Collapse
|
37
|
Rampally V, Biri SK, Nair IK, Vadlakonda A. Determination of association between nonalcoholic fatty liver disease and carotid artery atherosclerosis among nondiabetic individuals. J Family Med Prim Care 2020; 9:1182-1186. [PMID: 32318489 PMCID: PMC7113986 DOI: 10.4103/jfmpc.jfmpc_957_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/10/2020] [Accepted: 01/22/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is a condition characterized by the infiltration of fat in the liver cells. High levels of fat in the liver associated with increased risk of diseases like diabetes, high blood pressure and kidney disease, high cholesterol, metabolic syndrome. Aim and Objective: To determine the association between NAFLD and carotid intima media thickness (CIMT) among nondiabetic individuals. Materials and Methods: A total of 90 in-patients and outpatients (45 NAFL subjects and 45 patients with the normal liver as controls) with NAFL on abdomen ultrasound scan from Bangalore Baptist Hospital were included in our study. All the participants were subjected to a doppler study for carotid intima thickness and a blood sample (4 ml) was collected from all the subjects. Results: In this study, there is an elevated level of BMI, weight, dyslipidemia in NAFLD compared with controls. The present study suggests that cardiovascular risk factors such as increased carotid intima-media thickness occur more frequently among NAFLD patients compared to healthy individuals. Conclusion: We can conclude that NAFL has a significant association with higher cardiovascular risk in terms of carotid intima-media thickness, dyslipidemia, and hypoalphalipidemia. Lifestyle changes include weight loss, dietary changes, reduction of sedentary habits and physical exercise are recommended in the NAFL disease subjects with higher BMI and weight.
Collapse
Affiliation(s)
- Vijay Rampally
- Department of General Medicine, ESI Medical College and Hospital, Sanath Nagar, Hyderabad, Telangana, India
| | - SaiRavi Kiran Biri
- Department of Biochemistry, Fakir Mohan Medical College and Hospital, Balasore, Odissa, India
| | - Indu K Nair
- Department of General Medicine, Bangalore Baptist Hospital, Bangalore, Karnataka, India
| | - Arvind Vadlakonda
- Department of General Medicine, ESI Medical College and Hospital, Sanath Nagar, Hyderabad, Telangana, India
| |
Collapse
|
38
|
Abstract
Nonalcoholic fatty liver disease is the most common liver disease worldwide. The patomechanism is unknown, but unhealthy diet, high caloric and carbohydrate intake, physical inactivity play important role in the pathomechanism. Lifestyle modification, physical activity are regarded as a foundation for the management of nonalcoholic fatty liver disease. Several tests have proved the beneficial effect of regular exercising on the histological differences of the liver tissue. Exercising also improves the sensitivity against insulin, increases lipogenesis and carbohydrate metabolism, at the same time the chance for steatosis and fibrosis decreases. Moreover, as a result of regular exercising the visceral fat tissue also decreases, which plays an important role in the inflammatory process and fibrogenesis of the liver. The alteration of the gut bacteria composition might also contribute to the positive changes in the liver. The lifestyle of everyday people nowadays, however, does not favour physical activity. Most people cannot or do not want to accept these facts. First and foremost, patients must be persuaded of the necessity of the change in their habits. Adequate physical activity in itself makes it possible that even without a diet liver disease can be prevented. Orv Hetil. 2020; 161(6): 203-207.
Collapse
Affiliation(s)
- Klára Werling
- Általános Orvostudományi Kar, II. Belgyógyászati Klinika,Semmelweis EgyetemBudapest, Szentkirályi u. 46., 1088
| | | |
Collapse
|
39
|
Banaszczak M, Maciejewska D, Drozd A, Ryterska K, Milc DJ, Raszeja-Wyszomirska J, Wunsch E, González-Muniesa P, Stachowska E. 5-Lipooxygenase Derivatives as Serum Biomarkers of a Successful Dietary Intervention in Patients with NonAlcoholic Fatty Liver Disease. ACTA ACUST UNITED AC 2020; 56:medicina56020058. [PMID: 32028646 PMCID: PMC7073509 DOI: 10.3390/medicina56020058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 12/19/2022]
Abstract
Background: It was previously shown that a bodyweight reduction among patients with nonalcoholic fatty liver (NAFLD) was connected to the lower concentration of arachidonic and linoleic acid derivatives in their blood. We hypothesized that the concentration of these lipids was correlated with the extent of their body mass reduction and, thus, liver steatosis. Methods: We analyzed 68 individuals who completed the dietary intervention. Patients were divided into two groups depending on their body mass reduction (more or less than 7%). Before and after the dietary intervention, all patients had the following measurements recorded: body mass, waist circumference, stage of steatosis, fatty liver index, liver enzymes, lipid parameters, insulin and glucose. Concentrations of lipoxins A4 (LTX A4), hydroxyeicosatetraenoic fatty acids (5(S)-HETE, 12(S)-HETE and 16(S)-HETE), hydroxyoctadecaenoic acids (9(S)-HODE and 13(S)-HODE) and 5-oxo-eicosatetraenoic acid (5-oxo-ETE) were measured in serum samples collected before and after the dietetic intervention using high-performance liquid chromatography (HPLC). Results: Patients who reduced their body mass by more than 7% revealed a significant improvement in their steatosis stage, waist circumference, fatty liver index, triglycerides and cholesterol. Conclusion: A reduction in body mass by more than 7% but not by less than 7% revealed a significant improvement in steatosis stage; waist circumference; fatty liver index; and levels of triglycerides, cholesterol, 5-oxo-ETE and LTXA-4.
Collapse
Affiliation(s)
- Marcin Banaszczak
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland; (M.B.); (D.M.); (A.D.); (K.R.); (D.J.M.)
| | - Dominika Maciejewska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland; (M.B.); (D.M.); (A.D.); (K.R.); (D.J.M.)
| | - Arleta Drozd
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland; (M.B.); (D.M.); (A.D.); (K.R.); (D.J.M.)
| | - Karina Ryterska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland; (M.B.); (D.M.); (A.D.); (K.R.); (D.J.M.)
| | - Dominika Jamioł Milc
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland; (M.B.); (D.M.); (A.D.); (K.R.); (D.J.M.)
| | - Joanna Raszeja-Wyszomirska
- Liver and Internal Medicine Unit, Department of General. Transplant and Liver Surgery of the Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Ewa Wunsch
- Translational Medicine Group, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Pedro González-Muniesa
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain;
- Centre for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, 28029 Madrid, Spain
- IDISNA, Navarra’s Health Research Institute, 31008 Pamplona, Spain
| | - Ewa Stachowska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland; (M.B.); (D.M.); (A.D.); (K.R.); (D.J.M.)
- Correspondence: ; Tel.: +48-91-441-4806
| |
Collapse
|
40
|
Reddy YK, Marella HK, Jiang Y, Ganguli S, Snell P, Podila PS, Maliakkal B, Satapathy SK. Natural History of Non-Alcoholic Fatty Liver Disease: A Study With Paired Liver Biopsies. J Clin Exp Hepatol 2020; 10:245-254. [PMID: 32405181 PMCID: PMC7212293 DOI: 10.1016/j.jceh.2019.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although there is unequivocal evidence for progression of nonalcoholic steatohepatitis (NASH) to cirrhosis, there is uncertainty with regard to the progression to nonalcoholic fatty liver (NAFL) and NASH. AIMS We investigated the rate of progression to NASH and advanced fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) and assessed the factors associated with such progression. METHODS Histological assessment was performed in 36 patients with NAFLD with paired liver biopsies (≥1 year apart; median, 3.8 years; range, 1-10.33 years). NASH Clinical Research Network (NASH CRN) criteria were used to assess NAFLD Activity Score (NAS). RESULTS At baseline, 26 (72%) patients had NAFL and 10 (28%) patients had NASH. At follow-up, 27% NAFL progressed to NASH (NAS score ≥5), and 50% of patients with NASH no longer met the criteria of NASH. Fibrosis progressed in 15 (42%), regressed in 9 (25%), and remained stable in 12 (33%) patients overall. Thirty-five percent of patients with NAFL had fibrosis progression. The incidence of type 2 diabetes mellitus (T2DM) was higher in patients with NASH versus NAFL (40% vs. 27%). Both at the time of baseline and follow-up, liver biopsies, composite models of noninvasive scores such as Fibrosis-4 (FIB-4) score and NAFLD fibrosis score, and ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) were all significantly higher in progressors than in nonprogressors. CONCLUSIONS NAFLD is a dynamic liver disease with varying degrees of progression and regression. T2DM was strongly associated with fibrosis progression. Noninvasive fibrosis scores such as AST/ALT ratio, FIB-4 score, and NAFLD fibrosis score can identify those at risk of fibrosis progression.
Collapse
Affiliation(s)
- Yala K. Reddy
- Division of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN, 38104, USA
| | - Hemnishil K. Marella
- Division of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN, 38104, USA
| | - Yu Jiang
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN, 38152, USA
| | - Surosree Ganguli
- Department of Medicine, University of Louisville, Louisville, KY, 40202, USA
| | - Peter Snell
- Division of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN, 38104, USA
| | - Pradeep S.B. Podila
- Methodist University Hospital, Methodist Le Bonheur Healthcare, Memphis, TN, USA
| | - Benedict Maliakkal
- Division of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN, 38104, USA
| | - Sanjaya K. Satapathy
- Division of Hepatology and Sandra Atlas Bass Center for Liver Diseases, Donald and Barbara Zucker School of Medicine/Northwell Health, Manhasset, NY, 11030, USA
- Address for correspondence: Sanjaya K. Satapathy, Medical Director, Liver Transplantation, Division of Hepatology at Sandra Atlas Bass Center for Liver Diseases & Transplantation, Associate Professor of Medicine, Donald and Barbara Zucker School of Medicine/Northwell Health, 400 Community Drive, Manhasset, NY 11030, USA.
| |
Collapse
|
41
|
Mun J, Park J, Yoon HG, You Y, Choi KC, Lee YH, Kim K, Lee J, Kim OK, Jun W. Effects of Eriobotrya japonica Water Extract on Alcoholic and Nonalcoholic Fatty Liver Impairment. J Med Food 2019; 22:1262-1270. [PMID: 31834842 DOI: 10.1089/jmf.2019.4493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to investigate the potential protective effects of the hot water extract of Eriobotrya japonica (EJW) on EtOH- or free fatty acid (FFA)-induced fatty liver injury in vitro. HepG2/2E1 cells were exposed to EtOH and HepG2 cells were exposed to a mixture of FFAs (oleic acid:palmitic acid, 2:1) to stimulate oxidative stress and to induce lipid accumulation, respectively. Antioxidant activity was significantly increased and lipid accumulation was inhibited in cells pretreated with EJW compared to those in cells exposed to EtOH or FFA only. Also, 5'adenosine monophosphate (AMP)-activated protein kinase (AMPK) and acetyl-coenzyme A carboxylase (ACC) phosphorylations were considerably increased, indicating activation of AMPK. Furthermore, EJW reduced the messenger RNA (mRNA) expression of lipogenesis-associated factors such as ACC, sterol regulatory element binding protein-1c (SREBP-1c), and fatty acid synthase (FAS), and increased mRNA expression related to components of the fatty acid β-oxidation pathway, such as AMPK, carnitine palmitoyltransferase 1 (CPT-1), and peroxisome proliferator-activated receptor alpha (PPARα). These results suggest that EJW possessed potential preventive effects against both EtOH- and FFA-induced fatty liver disease by alleviation of oxidative stress and lipid accumulation in hepatocytes.
Collapse
Affiliation(s)
- Jeongeun Mun
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea
| | - Jeongjin Park
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea.,Research Institute for Human Ecology, Chonnam National University, Gwangju, Korea
| | - Ho-Geun Yoon
- Department of Biochemistry and Molecular Biology, Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea
| | - Yanghee You
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea
| | - Kyung-Chul Choi
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - Yoo-Hyun Lee
- Department of Food and Nutrition, University of Suwon, Suwon, Korea
| | - Kyungmi Kim
- Department of Biofood Analysis, Korea Bio Polytechnic, Ganggyung, Korea
| | - Jeongmin Lee
- Department of Medical Nutrition, Kyung Hee University, Yongin, Korea
| | - Ok-Kyung Kim
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea.,Research Institute for Human Ecology, Chonnam National University, Gwangju, Korea
| | - Woojin Jun
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea.,Research Institute for Human Ecology, Chonnam National University, Gwangju, Korea
| |
Collapse
|
42
|
Suvorov A, Naumov V, Shtratnikova V, Logacheva M, Shershebnev A, Wu H, Gerasimov E, Zheludkevich A, Pilsner JR, Sergeyev O. Rat liver epigenome programing by perinatal exposure to 2,2',4'4'-tetrabromodiphenyl ether. Epigenomics 2019; 12:235-249. [PMID: 31833787 DOI: 10.2217/epi-2019-0315] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Perinatal exposures to polybrominated diphenyl ethers permanently reprogram liver metabolism and induce a nonalcoholic fatty liver disease-like phenotype and insulin resistance in rodents. Aim: To test if these changes are associated with altered liver epigenome. Materials & methods: Expression of small RNA and changes in DNA methylation in livers of adult rats were analyzed following perinatal exposure to 2,2',4,4'-tetrabromodiphenyl ether, the polybrominated diphenyl ether congener most prevalent in human tissues. Results: We identified 33 differentially methylated DNA regions and 15 differentially expressed miRNAs. These changes were enriched for terms related to lipid and carbohydrate metabolism, insulin signaling, Type-2 diabetes and nonalcoholic fatty liver disease. Conclusion: Changes in the liver epigenome are a likely candidate mechanism of long-term maintenance of an aberrant metabolic phenotype.
Collapse
Affiliation(s)
- Alexander Suvorov
- Department of Environmental Health Sciences, School of Public Health & Health Sciences, University of Massachusetts 686 North Pleasant Street Amherst, MA 01003, USA.,A.N. Belozersky Research Institute of Physico-Chemical Biology, Moscow State University, Leninskye Gory, House 1, Building 40, 119992, Moscow, Russia
| | - Vladimir Naumov
- Kulakov National Medical Research Center of Obstetrics, Gynecology & Perinatology, Ministry of Health of the Russian Federation, Oparina 4, 117997, Moscow, Russia
| | - Victoria Shtratnikova
- A.N. Belozersky Research Institute of Physico-Chemical Biology, Moscow State University, Leninskye Gory, House 1, Building 40, 119992, Moscow, Russia.,Center for Data-Intensive Biomedicine & Biotechnology, Skolkovo Institute of Science & Technology, 143028, Moscow, Russia
| | - Maria Logacheva
- A.N. Belozersky Research Institute of Physico-Chemical Biology, Moscow State University, Leninskye Gory, House 1, Building 40, 119992, Moscow, Russia.,Center for Data-Intensive Biomedicine & Biotechnology, Skolkovo Institute of Science & Technology, 143028, Moscow, Russia
| | - Alex Shershebnev
- Department of Environmental Health Sciences, School of Public Health & Health Sciences, University of Massachusetts 686 North Pleasant Street Amherst, MA 01003, USA
| | - Haotian Wu
- Department of Environmental Health Sciences, School of Public Health & Health Sciences, University of Massachusetts 686 North Pleasant Street Amherst, MA 01003, USA.,Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, USA
| | - Evgeny Gerasimov
- E.I. Martsinovsky Institute of Medical Parasitology & Tropical Medicine, I.M. Sechenov First Moscow State Medical University, 20 Malaya Pirogovskaya, 119435, Moscow, Russia.,Faculty of Biology, Lomonosov Moscow State University, 119992, Moscow, Russia
| | | | - Jonathan R Pilsner
- Department of Environmental Health Sciences, School of Public Health & Health Sciences, University of Massachusetts 686 North Pleasant Street Amherst, MA 01003, USA
| | - Oleg Sergeyev
- A.N. Belozersky Research Institute of Physico-Chemical Biology, Moscow State University, Leninskye Gory, House 1, Building 40, 119992, Moscow, Russia.,Chapaevsk Medical Association, 3a Meditsinskaya St., Samara region, 446100, Chapaevsk, Russia
| |
Collapse
|
43
|
Huang J, Jing M, Wang C, Wang M, You S, Lin S, Zhu Y. The impact of hepatitis B virus infection status on the prevalence of nonalcoholic fatty liver disease: A population-based study. J Med Virol 2019; 92:1191-1197. [PMID: 31691993 DOI: 10.1002/jmv.25621] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 10/31/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND We aimed to explore the impact of hepatitis B virus (HBV) infection on the prevalence of nonalcoholic fatty liver disease (NAFLD) based on clinical big data. METHODS Data were collected from the health examination center of the First Affiliated Hospital of Fujian Medical University. Univariate and multivariate analysis were applied to investigate the relationship between HBV and NAFLD. RESULTS A total of 14 452 patients were included, with an average age of 43.84 ± 13.03 years. Cases of HBV current infection, past infection, and noninfection were 21 102 110 (14.6%), 90 039 003 (62.3%), and 33 393 339 (23.1%), respectively. The prevalence of NAFLD was significantly lower in the current infection group (29.9%) than in the past infection group (35.8%) and noninfection group (31.9%) (P < .001). After adjusting for age, the prevalence of NAFLD in the current infection group remained the lowest across all of the age groups. Multivariate analysis showed that current infection was at a lower risk of NAFLD (odds ratio [OR] = 0.717, 95% CI: 0.608-0.846), whereas past infection had no effect on NAFLD. CONCLUSIONS Current HBV infection may lower the risk of NAFLD. This effect becomes insignificant when the patient is no longer infected.
Collapse
Affiliation(s)
- Jiaofeng Huang
- Department of Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Mengli Jing
- Department of Physical Examination Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Ciyang Wang
- Department of Physical Examination Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Mingfang Wang
- Department of Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Shunjie You
- Department of Physical Examination Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Su Lin
- Department of Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yueyong Zhu
- Department of Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| |
Collapse
|
44
|
Liu R, Liu Q, He Y, Shi W, Xu Q, Yuan Q, Lin Q, Li B, Ye L, Min Y, Zhu P, Shao Y. Association between Helicobacter pylori infection and nonalcoholic fatty liver: A meta-analysis. Medicine (Baltimore) 2019; 98:e17781. [PMID: 31689846 PMCID: PMC6946209 DOI: 10.1097/md.0000000000017781] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Opinion regarding whether Helicobacter pylori infection can promote the occurrence and development of nonalcoholic fatty liver (NAFLD) is divided. Therefore, we aimed to assess the exact relationship between H pylori infection and NAFLD by integrating all available data. METHODS The articles about H pylori infection and NAFLD were collected by searching the databases of PubMed, Embase, Web of Science, Scopus, China National Knowledge Infrastructure, and WanFang. The random-effects model was used for data analysis, followed by subgroup analysis and meta-regression to explore sources of heterogeneity. RESULTS Twenty-one articles were included in the study. Pooled analysis showed that H pylori infection indeed promoted NAFLD. Subgroup analysis and regression analysis showed that case-control ratio may be one of the sources of heterogeneity. CONCLUSIONS H pylori infection is indeed one of the factors that promotes the progression of NAFLD for the Asian population. This provides new approaches for clinical prevention and treatment for NAFLD.
Collapse
Affiliation(s)
- Rongqiang Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangzhou Medical University
| | - Qiuli Liu
- Biological Therapy Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ying He
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| | - Wenqing Shi
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| | - Qianhui Xu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| | - Qing Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| | - Qi Lin
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| | - Biao Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| | - Lei Ye
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| | - Youlan Min
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| | - Peiwen Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi
| |
Collapse
|
45
|
Ghaffari A, Rafraf M, Navekar R, Sepehri B, Asghari-Jafarabadi M, Ghavami SM. Turmeric and chicory seed have beneficial effects on obesity markers and lipid profile in non-alcoholic fatty liver disease (NAFLD). INT J VITAM NUTR RES 2019; 89:293-302. [PMID: 31017556 DOI: 10.1024/0300-9831/a000568] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In an attempt to investigate new strategies aimed at reducing risk factors of non-alcoholic fatty liver disease (NAFLD), effects of turmeric (Curcuma longa L.) and chicory seed (Cichorium intybus L.) supplementation was evaluated in these patients. In this double-blind, randomized, controlled clinical trial, 92 patients with NAFLD aged 20-60 year with body mass index (BMI) ranged 24.9-40 kg/m2 was randomly assigned to 4 groups as follows. 1) Turmeric supplementation (3 g/d) (n = 23, TUR); 2) Chicory seed supplementation (infused 9 g/d (4.5 g /100mL)) (n = 23, CHI); 3) Turmeric and chicory seed supplementation (3 g/d turmeric + infused 9 g/d chicory seed (n = 23, TUR + CHI); 4) Placebo (n = 23, PLA). All intervention periods were 12 weeks. Fasting blood samples, anthropometric measurements, dietary records and physical activity were collected at baseline and at the end of the trial. Significant decreases were observed in BMI and waist circumference (WC) of subjects in CHI and TUR + CHI groups, compared with PLA group (p < 0.05). Combination of turmeric and chicory seed significantly decreased serum alkaline phosphatase level (p < 0.05). Serum levels of HDL-C increased considerably in TUR and TUR + CHI groups (p < 0.05 vs. placebo). Turmeric supplementation alone and plus chicory seed led to significant reduction in serum levels of TG/HDL-C and LDL-C/HDL-C ratio in TUR and TUR + CHI groups in comparison with placebo (p < 0.05). In conclusion, turmeric and chicory seed supplementation can be significantly useful in management of NAFLD risk factors.
Collapse
Affiliation(s)
- Aida Ghaffari
- Talented Students Center, Students Research Committee, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Rafraf
- Professor of Nutrition, Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roya Navekar
- Students Research Committee, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bita Sepehri
- Assistant professor, Department of Gastroenterology and Hepatology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Associate professor, Traffic Injury Prevention Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyyed-Mostafa Ghavami
- Associate professor of Radiology, Faculty of paramedical, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
46
|
Wenping S, Ying L, Yuzhong L, Hui L. Variations in laboratory parameters in prechronic disease to determine disease occurrence at the molecular level. Biomark Med 2019; 13:1227-1234. [PMID: 31580165 DOI: 10.2217/bmm-2018-0291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Aim: Change at a molecular level should occur before histopathological impairments. We refer to these changes as 'prechronic disease state.' Methods: Two blood samples were taken 1 day apart, 1 month apart and 2 years apart to determine the contribution of genetic and biological variations. Results: The 95% CI calculated quantitatively by the variability of genetic variation was very similar to the reference interval provided by the laboratory for most indicators, indicating that pathological variability had occurred without consideration of biological variation if an indicator's value lies outside of the reference interval. Conclusion: The physiological or predisease state can be distinguished directly using the laboratory reference interval.
Collapse
Affiliation(s)
- Sun Wenping
- College of Medical Laboratory, Dalian Medical University, Dalian, PR China
| | - Liu Ying
- Second Affiliated Hospital of Dalian Medical University, PR China
| | - Li Yuzhong
- College of Medical Laboratory, Dalian Medical University, Dalian, PR China.,Second Affiliated Hospital of Dalian Medical University, PR China
| | - Liu Hui
- College of Medical Laboratory, Dalian Medical University, Dalian, PR China
| |
Collapse
|
47
|
Yang H, Yang T, Heng C, Zhou Y, Jiang Z, Qian X, Du L, Mao S, Yin X, Lu Q. Quercetin improves nonalcoholic fatty liver by ameliorating inflammation, oxidative stress, and lipid metabolism in db/db mice. Phytother Res 2019; 33:3140-3152. [PMID: 31452288 DOI: 10.1002/ptr.6486] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/02/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022]
Abstract
Multiphase pathological processes involve in Type 2 diabetes (T2DM)-induced nonalcoholic fatty liver disease (NAFLD). However, the therapies are quite limited. In the present study, the hepatoprotective effects and underlying mechanisms of quercetin in T2DM-induced NAFLD were investigated. T2DM-induced NAFLD and quercetin treatment models were established in vivo and in vitro. The results revealed that quercetin alleviated serum transaminase levels and markedly reduced T2DM-induced histological alterations of livers. Additionally, quercetin restored superoxide dismutase, catalase, and glutathione content in livers. Not only that, quercetin markedly attenuated T2DM-induced production of interleukin 1 beta, interleukin 6, and TNF-α. Accompanied by the restoration of the increased serum total bile acid (p = .0001) and the decreased liver total bile acid (p = .0005), quercetin could reduce lipid accumulation in the liver of db/db mice. Further mechanism studies showed that farnesoid X receptor 1/Takeda G-protein-coupled receptor 5 signaling pathways was involved in quercetin regulation of lipid metabolism in T2DM-induced NAFLD. In high D-glucose and free fatty acid cocultured HepG2 cells model, quercetin eliminated lipid droplets and restored the upregulated total cholesterol and triglyceride levels. Similar to the findings in mice, quercetin could also activate farnesoid X receptor 1/Takeda G-protein-coupled receptor 5 signaling pathway. These findings suggested that quercetin might be a potentially effective drug for the treatment of T2DM-induced NAFLD.
Collapse
Affiliation(s)
- Hao Yang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Tingting Yang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Cai Heng
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Yi Zhou
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Zhenzhou Jiang
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Xuan Qian
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Lei Du
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Shiyu Mao
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Xiaoxing Yin
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Qian Lu
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| |
Collapse
|
48
|
Sharpton SR, Maraj B, Harding-Theobald E, Vittinghoff E, Terrault NA. Gut microbiome-targeted therapies in nonalcoholic fatty liver disease: a systematic review, meta-analysis, and meta-regression. Am J Clin Nutr 2019; 110:139-149. [PMID: 31124558 PMCID: PMC6599739 DOI: 10.1093/ajcn/nqz042] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Preclinical evidence suggests that modulation of the gut microbiome could represent a new therapeutic target in nonalcoholic fatty liver disease (NAFLD). OBJECTIVES The aim of this study was to evaluate the most current evidence for liver-specific and metabolic effects of microbiome-targeted therapies (MTTs) in persons with NAFLD. METHODS We searched multiple electronic databases for randomized controlled trials (RCTs) published from January 1, 2005 to December 1, 2018 that enrolled persons with NAFLD who received MTT rather than placebo or usual care. MTT was defined as antibiotics, probiotics, synbiotics, or fecal microbiota transplantation (FMT). Clinical outcomes were pooled with the use of random-effects models and heterogeneity was assessed with the I2 statistic. A random-effects meta-regression was performed to determine sources of heterogeneity in prevalence estimates between studies. RESULTS Twenty-one RCTs (1252 participants) were included; 9 evaluated probiotics and 12 evaluated synbiotics, with treatment duration ranging from 8 to 28 wk. No RCTs examined the efficacy of antibiotics or FMT. Probiotics/synbiotics were associated with a significant reduction in alanine aminotransferase activity [ALT, weighted mean difference (WMD): -11.23 IU/L; 95% CI: -15.02, -7.44 IU/L] and liver stiffness measurement (LSM) by elastography (reflecting inflammation and fibrosis) (WMD: -0.70 kPa; 95% CI: -1.00, -0.40 kPa), although analyses showed heterogeneity (I2 = 90.6% and I2 = 93.4%, respectively). Probiotics/synbiotics were also associated with increased odds of improvement in hepatic steatosis, as graded by ultrasound (OR: 2.40; 95% CI: 1.50, 3.84; I2 = 22.4%). No RCTs examined sequential liver biopsy findings. Probiotics (WMD: -1.84; 95% CI: -3.30, -0.38; I2 = 23.6%), but not synbiotics (WMD: -0.85; 95% CI: -2.17, 0.47; I2 = 96.6%), were associated with a significant reduction in body mass index. CONCLUSIONS The use of probiotics/synbiotics was associated with improvement in liver-specific markers of hepatic inflammation, LSM, and steatosis in persons with NAFLD. Although promising, given the heterogeneity in pooled analyses, additional well-designed RCTs are needed to define the efficacy of probiotics/synbiotics for treatment of NAFLD. This study was registered with PROSPERO as CRD42018091455.
Collapse
Affiliation(s)
| | | | | | - Eric Vittinghoff
- Biostatistics and Epidemiology, University of California San Francisco, San Francisco, CA
| | - Norah A Terrault
- Keck Medicine at University of Southern California, Los Angeles, CA,Address correspondence to NAT (e-mail: )
| |
Collapse
|
49
|
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a burgeoning health problem worldwide and an important risk factor for both hepatic and cardiometabolic mortality. The rapidly increasing prevalence of this disease and of its aggressive form nonalcoholic steatohepatitis (NASH) will require novel therapeutic approaches based on a profound understanding of its pathogenesis to halt disease progression to advanced fibrosis or cirrhosis and cancer. The pathogenesis of NAFLD involves a complex interaction among environmental factors (i.e., Western diet), obesity, changes in microbiota, and predisposing genetic variants resulting in a disturbed lipid homeostasis and an excessive accumulation of triglycerides and other lipid species in hepatocytes. Insulin resistance is a central mechanism that leads to lipotoxicity, endoplasmic reticulum stress, disturbed autophagy, and, ultimately, hepatocyte injury and death that triggers hepatic inflammation, hepatic stellate cell activation, and progressive fibrogenesis, thus driving disease progression. In the present review, we summarize the currently available data on the pathogenesis of NAFLD, emphasizing the most recent advances. A better understanding of NAFLD/NASH pathogenesis is crucial for the design of new and efficient therapeutic interventions.
Collapse
Affiliation(s)
- Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile.,Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Marco Arrese
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile.,Centro de Envejecimiento y Regeneración (CARE), Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna A-1090, Austria;
| |
Collapse
|
50
|
Khanal UP, Paudel B, Gurung G, Hu YS, Kuo CW. Correlational Study of Nonalcoholic Fatty Liver Disease Diagnosed by Ultrasonography with Lipid Profile and Body Mass Index in Adult Nepalese Population. J Med Ultrasound 2018; 27:19-25. [PMID: 31031531 PMCID: PMC6445041 DOI: 10.4103/jmu.jmu_53_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 04/23/2018] [Indexed: 12/13/2022] Open
Abstract
Objective: The purpose of this study was to categorize patients into different grades of nonalcoholic fatty liver disease (NAFLD) by ultrasonography and to compare the findings with their serum lipid profile. Materials and Methods: Descriptive, cross-sectional study design was used. One hundred and nine patients without a history of alcohol consumption of age more than 16 years attending general health checkup were selected at Tribhuvan University Teaching Hospital, Maharajganj, Kathmandu, as per the exclusion and inclusion criteria. Ultrasound scanning of the patients was done and their liver size, as well as grading of fatty liver, was done. Data were collected in predesigned pro forma and were analyzed using Statistical Package for the Social Sciences (SPSS) 16.0, IBM (SPSS Inc., Chicago, IL). Results: In this study, the mean age of fatty liver in males was found to be 44.3 years and in females was found to be 51.9 years. 22.9% of patients with NAFLD had increased liver size. Significant association with increasing grades of fatty liver was found with increasing levels of cholesterol (P = 0.028), low-density lipoprotein (LDL) (P = 0.017), liver size (P = 0.001), and body mass index (BMI) (P = 0.045) in patients diagnosed with NAFLD. No significant association with increasing grades of fatty liver was found with increasing levels of triglyceride (P = 0.32) and high-density lipoprotein (P = 0.25). Conclusion: Ultrasound is a safe and first-line modality for the evaluation of fatty liver and its grading. Increasing grades of fatty liver had significant association with increasing levels of cholesterol LDL, increasing liver size, and BMI of patients.
Collapse
Affiliation(s)
- Umesh P Khanal
- Department of Radiology and Imaging, T.U Teaching Hospital, Kathmandu, Nepal
| | - Bigyan Paudel
- Department of Radiology and Imaging, T.U Teaching Hospital, Kathmandu, Nepal
| | - Ghanshyam Gurung
- Department of Radiology and Imaging, T.U Teaching Hospital, Kathmandu, Nepal
| | - Yong-Sin Hu
- Department of Radiology, School of Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
| | - Chiung-Wen Kuo
- Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| |
Collapse
|