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Xu J, Zhang X, E Y, Wang W, Zhou J, Shi Y, Chen S. Relationship Between Liver Fibrosis and Increased Risk of Symptomatic Intracranial Hemorrhage in Ischemic Stroke Patients Undergoing Mechanical Thrombectomy. Neuropsychiatr Dis Treat 2024; 20:101-108. [PMID: 38260047 PMCID: PMC10802170 DOI: 10.2147/ndt.s450061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Background Liver fibrosis has been reported to be associated with hematoma expansion and mortality in patients with intracerebral hemorrhage. This study aimed to detect the association between liver fibrosis and symptomatic intracranial hemorrhage (sICH) in ischemic stroke after mechanical thrombectomy (MT). Methods We retrospectively included patients with large artery occlusion in the anterior circulation and treated with MT at a single stroke center. The fibrosis-4 index (FIB-4) was used to assess the severity of liver fibrosis. sICH was diagnosed according to the Heidelberg Bleeding Classification criteria. Multivariate logistic regression and restricted cubic spline analysis were conducted to examine the relationship between liver fibrosis and sICH. Results Among the 578 patients (mean age, 70.1 years; 58.5% male) included in the study, 65 (11.2%) individuals were diagnosed with sICH. After adjusting for demographic characteristics and other potential confounders, a higher FIB-4 index was found to be independently associated with an increased risk of sICH (odds ratio: 1.306, 95% confidence interval: 1.127-1.512, P=0.001). Similar results were obtained when analyzing FIB-4 as a categorical variable. Conclusion This study demonstrated that there is a significant association between FIB-4 and the risk of sICH in patients with acute ischemic stroke who underwent MT. Therefore, liver fibrosis could serve as a valuable parameter in monitoring the risk of sICH following MT.
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Affiliation(s)
- Jing Xu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, People’s Republic of China
| | - Xiaohao Zhang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, People’s Republic of China
| | - Yan E
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, People’s Republic of China
| | - Wei Wang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, People’s Republic of China
| | - Junshan Zhou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, People’s Republic of China
| | - Yanyan Shi
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, People’s Republic of China
| | - Shuaiyu Chen
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, People’s Republic of China
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Abosheaishaa H, Hussein M, Ghallab M, Abdelhamid M, Balassiano N, Ahammed MR, Baig MA, Khan J, Elshair M, Soliman MY, Abdelwahed M, Ali A, Alzamzamy A, Nassar M. Association between non-alcoholic fatty liver disease and coronary artery disease outcomes: A systematic review and meta-analysis. Diabetes Metab Syndr 2024; 18:102938. [PMID: 38194827 DOI: 10.1016/j.dsx.2023.102938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/07/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES To evaluate the association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular outcomes, including angina, coronary artery disease (CAD), coronary artery calcification (CAC), myocardial infarction (MI), and calcified coronary plaques. METHODS A comprehensive search of databases, including PubMed, EMBASE, and Cochrane Library, was conducted up to January 2023. Studies were included investigating the relationship between NAFLD and cardiovascular outcomes in adult populations. Exclusion criteria were studies on animals, pediatric populations, and those not published in English. Two reviewers assessed the risk of bias in the included studies using the Newcastle-Ottawa Scale. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. RESULTS The meta-analysis included 32 studies with a total of 5,610,990 participants. NAFLD demonstrated significant associations with increased risks of angina (Relative Risk (RR): 1.45, 95% CI: 1.17, 1.79), CAD (RR: 1.21, 95% CI: 1.07, 1.38), CAC >0 (RR: 1.39, 95% CI: 1.15, 1.69), and calcified coronary plaques (RR: 1.55, 95% CI: 1.05, 2.27). However, no significant association was found between NAFLD and CAC >100 (RR: 1.16, 95% CI: 0.97, 1.38) or MI (RR: 1.70, 95% CI: 0.16, 18.32). CONCLUSION The meta-analysis demonstrated a significant association between NAFLD and cardiovascular outcomes independent of conventional cardiovascular disease (CVD) risk factors. These findings emphasize the importance of prevention, early detection, and proper management of NAFLD.
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Affiliation(s)
- Hazem Abosheaishaa
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria, Egypt
| | - Muhammad Ghallab
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Magdy Abdelhamid
- Department of Cardiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Natalie Balassiano
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Md Ripon Ahammed
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Muhammad Almas Baig
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Jawad Khan
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Moaz Elshair
- Hepatology, Gastroenterology, and Infectious Disease Department, Al-Azhar University, Cairo, Egypt
| | - Moataz Yousry Soliman
- Hepatology, Gastroenterology, and Infectious Disease Department, Al-Azhar University, Cairo, Egypt
| | - Mohammed Abdelwahed
- Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, NY, USA
| | - Amr Ali
- Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, NY, USA
| | - Ahmed Alzamzamy
- Department of Gastroenterology and Hepatology, Maadi Armed Forces Medical Complex, Military Medical Academy, Cairo, Egypt
| | - Mahmoud Nassar
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, New York, USA.
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3
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Duan W, Shi R, Yang F, Zhou Z, Wang L, Huang Z, Zang S. FSTL3 partially mediates the association of increased nonalcoholic fatty liver disease fibrosis risk with acute myocardial infarction in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2023; 22:297. [PMID: 37904173 PMCID: PMC10617048 DOI: 10.1186/s12933-023-02024-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/11/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The study aimed to investigate an association of increased liver fibrosis with acute myocardial infarction (AMI), and to investigate the mediating effect of serum follistatin-like protein 3 (FSTL3) on the association in patients with type 2 diabetes mellitus (T2DM). METHOD A total of 1424 participants were included in this study, and were firstly divided into two groups: 429 T2DM patients and 995 T2DM patients with NAFLD to assess the association of NAFLD and AMI. Then 995 T2DM co-existent NAFLD patients were categorized by NAFLD fibrosis risk to explore the association between NAFLD fibrosis risk and AMI. Immunohistochemistry staining and semi-quantitative analysis of liver FSTL3 were performed in 60 patients with NAFLD. There were 323 individuals (191 without AMI and 132 with AMI) in T2DM co-existent NAFLD patients who had serum samples, and serum FSTL3 was tested and mediation effect of FSTL3 in association of NAFLD fibrosis and AMI was performed. RESULTS First, increased NAFLD fibrosis risk was an independent risk factor for AMI in patients with T2DM and co-existent NAFLD. In addition, analysis of Gene Expression Omnibus (GEO) database and immunohistochemical staining confirmed the increased expression of FSTL3 in the liver of NAFLD patients with fibrosis. Serum FSTL3 significantly increased in patients with high NAFLD fibrosis risk and AMI, and closely associated with NAFLD fibrosis and AMI severity in T2DM patients with co-existent NAFLD. Most importantly, analysis of the level of mediation revealed that increased serum FSTL3 partially mediated the association of increased NAFLD fibrosis risk with AMI in T2DM patients with co-existent NAFLD. CONCLUSIONS NAFLD fibrosis was closely associated with AMI in T2DM patients. FSTL3 expression was enriched in the liver of NAFLD patients with significant and advanced fibrosis, and serum FSTL3 partially mediated the association of increased liver fibrosis risk with AMI in T2DM patients.
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Affiliation(s)
- Wenfei Duan
- Department of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai, 200240, China
| | - Ruixiao Shi
- Department of Traditional Chinese Medicine, Maqiao Community Health Service Center, Minhang District, Shanghai, 20111, China
- Center of Community-Based Health Research, Fudan University, Shanghai, China
| | - Fang Yang
- Department of Genetics and Developmental Science, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China
| | - Zhoujunhao Zhou
- Department of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai, 200240, China
| | - Lihong Wang
- Department of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai, 200240, China
| | - Zhe Huang
- Department of Genetics and Developmental Science, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China.
| | - Shufei Zang
- Department of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, 801 Heqing Road, Minhang District, Shanghai, 200240, China.
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4
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Hung WC, Tang WH, Yu TH, Wu CC, Wang CP, Lu YC, Wei CT, Chung FM, Lee YJ, Hsu CC. Low plasma growth/differentiation factor 1 levels are associated with liver fibrosis in patients with stable angina. J Clin Lab Anal 2022; 36:e24745. [PMID: 36268984 DOI: 10.1002/jcla.24745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/28/2022] [Accepted: 10/09/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Growth differentiation factor 1 (GDF1) is a member of the transforming growth factor-β (TGF-β) superfamily and a protective mediator against the development of post-infarction cardiac remodeling by negatively regulating MEK-ERK1/2 and Smad signaling pathways in the heart. The TGF-β/SMAD pathway has been shown to play a key role in the development of hepatic fibrosis. In addition, fatty liver disease has been associated with reduced MEK/ERK1/2 signaling. However, no previous study has investigated the association between GDF1 and liver fibrosis. Therefore, the aim of this study was to investigate the association between plasma GDF1 and liver fibrosis in patients with stable angina. METHODS We included 327 consecutive patients with stable angina. ELISA was used to measure circulating levels of GDF1, and the fibrosis-4 index was used to assess liver fibrosis. RESULTS The advanced liver fibrosis group had lower median plasma GDF1 levels than those with minimal liver fibrosis. There was a significant negative association between GDF1 plasma level and fibrosis-4 index (r = -0.135, p = 0.019). A lower concentration of GDF1 was significantly and independently associated with an increased risk of liver fibrosis when concentration was analyzed as a continuous variable and by tertile. In addition, fibrosis-4 index, aspartate aminotransferase (AST)-to-platelet ratio index, and AST/alanine aminotransferase ratio were significantly associated with GDF1 concentration. CONCLUSIONS Our results indicated an association between low plasma GDF1 and liver fibrosis in the enrolled patients. Further investigations into the role of plasma GDF1 in the pathogenesis of liver fibrosis are warranted.
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Affiliation(s)
- Wei-Chin Hung
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Wei-Hua Tang
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualien, Taiwan.,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Teng-Hung Yu
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Cheng-Ching Wu
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Ping Wang
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yung-Chuan Lu
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Ching-Ting Wei
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Division of General Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan.,Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan.,Department of Electrical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Fu-Mei Chung
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | | | - Chia-Chang Hsu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,Health Examination Center, E-Da Dachang Hospital, Kaohsiung, Taiwan.,The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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5
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Taylan G, Ebik M, Solak S, Kaya Ç, Yalta K. Risk of premature coronary atherosclerosis in patients with nonalcoholic fatty liver disease. Rev Assoc Med Bras (1992) 2022; 68:1428-1433. [DOI: 10.1590/1806-9282.20220514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 07/12/2022] [Indexed: 11/23/2022] Open
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6
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Ismaiel A, Ciobanu OS, Ismaiel M, Leucuta DC, Popa SL, David L, Ensar D, Al Srouji N, Dumitrascu DL. Atherogenic Index of Plasma in Non-Alcoholic Fatty Liver Disease: Systematic Review and Meta-Analysis. Biomedicines 2022; 10:biomedicines10092101. [PMID: 36140201 PMCID: PMC9495578 DOI: 10.3390/biomedicines10092101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Approximately a billion people worldwide are affected by NAFLD, which places a high clinical burden and financial cost on society. Liver biopsy is the gold standard for diagnosing NAFLD, but its invasivity limits the early diagnosis of NAFLD. Hence, it is important to look for alternate techniques in detecting and diagnosing NAFLD. NAFLD is associated with atherosclerosis. The purpose of this study was to assess the effectiveness of the atherogenic index of plasma (AIP) as a non-invasive modality for predicting NAFLD. (2) Methods: A search using electronic databases PubMed, EMBASE, and Scopus was carried out to find observational studies, looking at research that had been published up until the date of 11 May 2022. The included studies’ quality, risk of bias, and internal validity were evaluated using the QUADAS-2 quality assessment tool. The key summary outcomes were the mean difference (MD) and area under the curve (AUC). (3) Results: A total of eight studies (81,178 participants) were included in our review, while 17% of the included participants had NAFLD. A sex distribution of 57.8% men and 42.2% women was observed. The AIP between NAFLD and the controls was not significant (MD 0.212 [95% CI 0.231–0.655]). A significant MD in AIP between the males and females with NAFLD was observed (MD 0.246 [95% CI 0.098–0.395]). The AIP predicted NAFLD with an AUC of 0.764 as well as in males (AUC 0.761) and females (AUC 0.733). (4) Conclusions: There was a substantial MD in the AIP between both sexes, but there was no significant difference in the AIP values between patients with NAFLD and the controls. The AIP is a reliable biomarker for the diagnosis of NAFLD since its ability to predict the development of NAFLD was comparable to that of the other biomarkers.
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Affiliation(s)
- Abdulrahman Ismaiel
- 2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Oana Sabina Ciobanu
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Mohamed Ismaiel
- Department of Surgery, St Michael’s Hospital, A96 D628 Dublin, Ireland
| | - Daniel-Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-26-459-7256 (ext. 2502)
| | - Stefan-Lucian Popa
- 2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Liliana David
- 2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Dilara Ensar
- Department of Medicine, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Nahlah Al Srouji
- 2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Dan L. Dumitrascu
- 2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
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Celecoxib-mediated attenuation of non-alcoholic steatohepatitis is potentially relevant to redistributing the expression of adiponectin receptors in rats. Heliyon 2022; 8:e09872. [PMID: 35832345 PMCID: PMC9272346 DOI: 10.1016/j.heliyon.2022.e09872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/20/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Pharmacological inhibition of cyclooxygenase-2 (COX-2) activity ameliorated the severity of non-alcoholic steatohepatitis (NASH) rats. It is not completely understood that the role of COX-2 inhibitor celecoxib on adiponectin receptors (Adipo-R1/R2) expression in different tissues in NASH rats. Sprague-Dawley male NASH rats induced by a high-fat diet (HFD) were administrated with or without celecoxib for 8 weeks. Biochemical parameters of liver function, glucose, and lipid metabolism, and the levels of adiponectin, tumor necrosis factor-alpha (TNF-α), prostaglandin E2 (PGE2) in the serum or liver were collected according to the standard protocols. The mRNA and protein levels of Adipo-R1, Adipo-R2, and COX-2 in the liver, muscle, and visceral fat were performed by quantitative real-time polymerase chain reaction (q-PCR) and Western blot analysis, respectively. The results showed that celecoxib ameliorated the various clinical indicators and pathological characteristics in the NASH rats, including body weight, liver function, liver index, and redox activities in serum and hepatic samples. The serum concentrations of adiponectin and TNF-α and PGE2 were negatively correlated. As expected, these ameliorative effects of celecoxib were associated with the gene and protein levels up-regulation of Adipo-R1, Adipo-R2 in the liver and visceral fat tissues, and seeming to be compensatory down-regulation expression in muscle tissues (P <0.05). Additionally, COX-2 protein expression was negatively correlated with serum adiponectin levels, protein expression of adiponectin receptors from the liver and visceral fat, conversely, positively correlated with those from the muscle. Our current study demonstrate that celecoxib might effectively alleviate NASH rats in a unique manner closely relevant to redistributing the expression of adiponectin receptors in the liver, visceral fat, and muscle. However, the precise molecular mechanism needs further study. NASH is a watershed in the progression of NAFLD. Finding a therapy for NASH is in urgent need. Pharmacological inhibition of COX-2 activity ameliorated the severity of NASH. Low-dose celecoxib, a COX-2 inhibitor, can improve NASH by redistributing the expression of adiponectin receptors.
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8
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Comprehensive Review and Updates on Holistic Approach Towards Non-Alcoholic Fatty Liver Disease Management with Cardiovascular Disease. Curr Atheroscler Rep 2022; 24:515-532. [PMID: 35507280 DOI: 10.1007/s11883-022-01027-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The global prevalence of non-alcoholic fatty liver disease (NAFLD) presents an unmet need in treating these, often asymptomatic, individuals. In this review, we summarised NAFLD management and described recent developments in non-alcoholic steatohepatitis (NASH) therapeutics that can shape the future of NAFLD. RECENT FINDINGS A multi-disciplinary effort in promoting sustainable lifestyle measures is paramount, with the goal of either limiting energy surplus alone or in combination with targeting downstream pathways of inflammation and fibrosis. Several antidiabetic medications like PPAR-γ agonist and glucagon-like peptide receptor agonists have beneficial effects on the metabolic profile as well as NASH histology. Vitamin E has shown promise in specific groups of patients with the haptoglobin2 allele protein. Newer drugs have demonstrated promising results in NASH resolution and fibrosis improvement such as obeticholic acid, resmetirom, aramchol, efruxifermin, aldafermin and lanifibranor. Apart from discussing the results of late stage clinical trials and the possible challenges in managing these patients with limited approved therapies, we also discussed the specific management of comorbidities (diabetes, hypertension, hyperlipidaemia, cardiovascular diseases) in NAFLD patients. Treatment strategy needs to target improvements in liver-related outcomes and cardiometabolic profile.
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9
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Haidara MA, Al-Ani B, Bin-Jaliah I, Shams Eldeen AM, Morsy MD. Vanadyl sulphate ameliorates biomarkers of endothelial injury and coagulation and thrombosis in a rat model of hyperglycaemia. Arch Physiol Biochem 2022; 128:447-454. [PMID: 31774317 DOI: 10.1080/13813455.2019.1691602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND We sought to determine whether the insulin mimicking agent, vanadyl sulphate (Van) can inhibit biomarkers of endothelial injury and coagulation and thrombosis induced by a moderate level of hyperglycaemia. MATERIAL AND METHODS Hyperglycaemia was induced in rats by a single injection of streptozotocin (STZ, 50 mg/kg) two weeks after being fed on a high-fat diet (model group). The treatment group started Van (20 mg/kg/day) treatment one-week post STZ injection and continued on Van until being sacrificed at week 10. RESULTS Administration of Van to the model group significantly (p < .05) ameliorated dyslipidemia and biomarkers of inflammation (TNF-α, IL-6, and hsCRP) and endothelial injury (E-selectin, P-selectin, sICAM-1, sVCAM-1, and ET-1). Van also significantly inhibited hyperglycaemia-induced blood levels of coagulation (vWF) and thrombosis (PAI-1 and fibrinogen) biomarkers. CONCLUSIONS Vanadyl sulphate effectively suppresses hyperglycaemia-induced endothelial injury, coagulation and thrombosis, which is associated with the inhibition of inflammation and dyslipidemia.
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Affiliation(s)
- Mohamed A Haidara
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Department of Physiology, Kasr Al-Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Bahjat Al-Ani
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ismaeel Bin-Jaliah
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Asmaa M Shams Eldeen
- Department of Physiology, Kasr Al-Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M D Morsy
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Department of Physiology, College of Medicine, Menoufia University, Shibin el Kom, Egypt
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10
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Istanbuly S, Matetic A, Mohamed MO, Panaich S, Velagapudi P, Elgendy IY, Paul TK, Alkhouli M, Mamas MA. Comparison of Outcomes of Patients With Versus Without Chronic Liver Disease Undergoing Percutaneous Coronary Intervention. Am J Cardiol 2021; 156:32-38. [PMID: 34348842 DOI: 10.1016/j.amjcard.2021.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/12/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023]
Abstract
There are limited data on the outcomes of chronic liver disease (CLD) patients admitted for percutaneous coronary intervention (PCI). All PCI hospitalizations from the Nationwide Inpatient Sample (2004 to 2015) were analyzed and stratified by the presence, cause and severity of CLD, as well as the indication for PCI. Multivariable logistic regression analysis was performed to determine the adjusted odds ratios (aOR) of in-hospital adverse outcomes in patients with CLD compared with those without CLD. Among 7,296,679 PCI admissions, 54,368 (0.7%) had a CLD diagnosis. Among patients with CLD, 36,853 (67.8%) had severe CLD. Patients with CLD had higher likelihood of adverse outcomes including major adverse cardiovascular and cerebrovascular events (MACCE) (aOR 1.25, 95%CI 1.20 to 1.30), mortality (aOR 1.43, 95%CI 1.35 to 1.51), major bleeding (aOR 2.22, 95%CI 2.12 to 2.32). When accounting for severity, only severe CLD subgroup was more likely to have MACCE and all-cause mortality compared to no-CLD patients (p <0.001). Among CLD etiologic subgroups, those with 'alcohol-related liver disease' and 'other CLD' were consistently more likely to develop MACCE, all-cause mortality and major bleeding in comparison to no-CLD patients, while 'chronic viral hepatitis' subgroup had only increased odds of major bleeding (p <0.001). In conclusion, CLD patients admitted for PCI are more likely to have worse in-hospital outcomes, particularly in the severe CLD subgroup and 'alcohol-related liver disease' and 'other CLD' etiologic subgroups.
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11
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Huang H, Wang J, Xu L, Miao M, Xu C. Association between High-Density Lipoprotein Cholesterol to Apolipoprotein A-I Ratio and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study. Int J Endocrinol 2021; 2021:6676526. [PMID: 34194492 PMCID: PMC8203372 DOI: 10.1155/2021/6676526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/22/2021] [Accepted: 05/29/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This study aimed to explore the association between high-density lipoprotein cholesterol to apolipoprotein A-I ratio (HDL-C/apo A-I) and nonalcoholic fatty liver disease (NAFLD). METHODS A total of 9025 Chinese adults were enrolled in this cross-sectional study, who presented their annual health checkups at Zhenhai Lianhua Hospital, Ningbo, during 2017. RESULTS The NAFLD prevalence was 33.7%, and HDL-C/apo A-I was significantly decreased in NAFLD patients, as well as in lean NAFLD and in patients with NAFLD-related advanced fibrosis (all P < 0.001). The prevalence of NAFLD and components of metabolic syndrome are inversely associated with HDL-C/apo A-I (P < 0.001). Multivariate logistic regression analysis show that HDL-C/apo A-I is inversely associated with the risk of NAFLD (odds ratio: 0.353, 95% confidence interval: 0.257-0.486; P < 0.001). CONCLUSIONS Our results suggested that increased HDL-C/apo A-I is significantly associated with a decreased risk of NAFLD.
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Affiliation(s)
- Hangkai Huang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jinghua Wang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Lei Xu
- Department of Gastroenterology, Zhejiang University Ningbo Hospital, Ningbo 315010, China
| | - Min Miao
- Department of Internal Medicine, Zhenhai Lianhua Hospital, Ningbo 315207, China
| | - Chengfu Xu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Svop Jensen V, Fledelius C, Max Wulff E, Lykkesfeldt J, Hvid H. Temporal Development of Dyslipidemia and Nonalcoholic Fatty Liver Disease (NAFLD) in Syrian Hamsters Fed a High-Fat, High-Fructose, High-Cholesterol Diet. Nutrients 2021; 13:nu13020604. [PMID: 33673227 PMCID: PMC7917647 DOI: 10.3390/nu13020604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 02/06/2023] Open
Abstract
The use of translationally relevant animal models is essential, also within the field of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Compared to frequently used mouse and rat models, the hamster may provide a higher degree of physiological similarity to humans in terms of lipid profile and lipoprotein metabolism. However, the effects in hamsters after long-term exposure to a NASH diet are not known. Male Syrian hamsters were fed either a high-fat, high-fructose, high-cholesterol diet (NASH diet) or control diets for up to 12 months. Plasma parameters were assessed at two weeks, one, four, eight and 12 months and liver histopathology and biochemistry was characterized after four, eight and 12 months on the experimental diets. After two weeks, hamsters on NASH diet had developed marked dyslipidemia, which persisted for the remainder of the study. Hepatic steatosis was present in NASH-fed hamsters after four months, and hepatic stellate cell activation and fibrosis was observed within four to eight months, respectively, in agreement with progression towards NASH. In summary, we demonstrate that hamsters rapidly develop dyslipidemia when fed a high-fat, high-fructose, high-cholesterol diet. Moreover, within four to eight months, the NASH-diet induced hepatic changes with resemblance to human NAFLD.
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Affiliation(s)
- Victoria Svop Jensen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Ridebanevej 9, DK-1870 Frederiksberg, Denmark;
- Diabetes Pharmacology 1, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark;
- Correspondence:
| | - Christian Fledelius
- Diabetes Pharmacology 1, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark;
| | - Erik Max Wulff
- Gubra ApS, Hørsholm Kongevej 11B, DK-2970 Hørsholm, Denmark;
| | - Jens Lykkesfeldt
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Ridebanevej 9, DK-1870 Frederiksberg, Denmark;
| | - Henning Hvid
- Pathology & Imaging, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark;
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Xing J, Guan X, Zhang Q, Chen S, Wu S, Sun X. Triglycerides Mediate Body Mass Index and Nonalcoholic Fatty Liver Disease: A Population-Based Study. Obes Facts 2021; 14:190-196. [PMID: 33780962 PMCID: PMC8138251 DOI: 10.1159/000514848] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Nonalcoholic fatty liver disease (NAFLD) is defined by the accumulation of triglycerides (TG). The body mass index (BMI) is associated with NAFLD. This large-scale cohort study was performed to evaluate and quantify the mediating effect of TG on the association between BMI and NAFLD. METHODS In total, 15,943 participants in the Kailuan Group were recruited between 2010 and 2014. The impact of TG on the association between BMI and NAFLD was determined through a mediation analysis. RESULTS BMI was an independent risk factor for incident NAFLD, with OR of 1.416 (95% CI 1.338-1.499) and 1.187 (95% CI 1.137-1.240) in the low-BMI and high-BMI groups, respectively (p < 0.001). The TG level was a risk factor for NAFLD in the high-BMI group, with an OR of 2.775 (95% CI 1.488-5.177; p = 0.001). Positive associations between BMI and the TG level remained in the 2 above mentioned groups after adjusting for confounders (β = 0.072 and 0.032; p < 0.001). The mediation analysis revealed that TG contributed to 26.050% of incident NAFLD in the high-BMI group (p = 0.01). CONCLUSION A high BMI was an independent risk factor for incident NAFLD, and a high TG level was a risk factor in the high-BMI group (BMI ≥24). TG contributes about 25% to incident NAFLD in people with obesity.
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Affiliation(s)
- Jie Xing
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xue Guan
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Xiujing Sun
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Yan X, Jin W, Zhang J, Wang M, Liu S, Xin Y. Association of TCF7L2 rs7903146 Gene Polymorphism with the Risk of NAFLD and CAD in the Chinese Han Population. J Clin Transl Hepatol 2020; 8:371-376. [PMID: 33447519 PMCID: PMC7782105 DOI: 10.14218/jcth.2020.00071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/25/2020] [Accepted: 09/24/2020] [Indexed: 12/13/2022] Open
Abstract
Background and Aims: Coronary artery disease (CAD) is a major cause of morbidity and mortality in patients with non-alcoholic fatty liver disease (NAFLD). Previous studies have suggested that TCF7L2 rs7903146 was related to the risk of developing NAFLD but the conclusions are not consistent and no related study has been conducted in Chinese populations. The aim of this study was to investigate the association between TCF7L2 rs7903146 and the risk of developing NAFLD and CAD in a Chinese Han population. Methods: TCF7L2 rs7903146 genotypes were measured by the MALDI-TOF-MS from 143 NAFLD patients, 159 CAD patients, 131 NAFLD + CAD patients, and 212 healthy controls. The demographic data and serum lipid profiles of all subjects were collected. The distributions of genotype and allele frequency in each group were also tested. Logistic regression was used to investigate the risk of TCF7L2 rs7903146 with NAFLD and CAD. All statistical analyses were conducted using SPSS 23.0. Results: There were no significant differences in the distributions of TCF7L2 rs7903146 genotype and allele frequency in each of the two groups, and the TCF7L2 rs7903146 CT + TT genotype did not increase the risk of developing NAFLD, CAD, and NAFLD + CAD. Except for body mass index in the control group, the differences of clinical parameters between the TCF7L2 rs7903146 T allele carriers and non-carriers in each group were not significant. In the non-obese group, the TCF7L2 rs7903146 CT + TT genotype was a protective factor for the development of NAFLD in the non-obese subjects (odds ratio=0.359, 95% confidence interval: 0.134-0.961, p = 0.041). Conclusions: TCF7L2 rs7903146 was not associated with the risk of developing NAFLD, CAD, and NAFLD + CAD in the Chinese Han population. In the non-obese population, the TCF7L2 rs7903146 CT + TT genotype was a protective factor against the development of NAFLD.
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Affiliation(s)
- Xin Yan
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao, Shandong, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Wenwen Jin
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Jie Zhang
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Mengke Wang
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Shousheng Liu
- Clinical Research Center, Qingdao Municipal Hospital, Qingdao, Shandong, China
- Digestive Disease Key Laboratory of Qingdao, Qingdao, Shandong, China
- Correspondence to: Yongning Xin, Department of Infectious Disease, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, Shandong 266011, China. Tel: +86-532-82789463, Fax: +86-532-85968434, E-mail: ; Shousheng Liu, Clinical Research Center, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, Shandong 266011, China. Tel: +86-532-88905831, Fax: +86-532-88905293, E-mail:
| | - Yongning Xin
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao, Shandong, China
- Clinical Research Center, Qingdao Municipal Hospital, Qingdao, Shandong, China
- Digestive Disease Key Laboratory of Qingdao, Qingdao, Shandong, China
- Correspondence to: Yongning Xin, Department of Infectious Disease, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, Shandong 266011, China. Tel: +86-532-82789463, Fax: +86-532-85968434, E-mail: ; Shousheng Liu, Clinical Research Center, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, Shandong 266011, China. Tel: +86-532-88905831, Fax: +86-532-88905293, E-mail:
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Xie W, Chen S. A nomogram for estimating the probability of nonalcoholic fatty liver disease in a Chinese population: A retrospective cohort study. Medicine (Baltimore) 2020; 99:e23049. [PMID: 33235066 PMCID: PMC7710235 DOI: 10.1097/md.0000000000023049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Studies have showed that dyslipidemia is closely related to nonalcoholic fatty liver disease (NAFLD). However, less attention has been paid to the relationship between early dyslipidemia and long-term risk of NAFLD. Therefore, we aimed to develop a simple-to-use nomogram to predict early dyslipidemia and long-term risk of NAFLD onset.A retrospective cohort study including 3621 employees (including retirees) from 7 companies was conducted between 2012 and 2019. Anthropometric, potential laboratory parameters and abdominal ultrasound were performed at baseline and after a 5-year follow-up. Cox proportional hazards model was used to determine predictors for NAFLD onset. The effects of lipids, age, body mass index (BMI), and serum uric acid (UA) on NAFLD were evaluated with the use of Kaplan-Meier curves (log-rank test). A nomogram was developed based on the Cox proportional hazard model and a 2-piecewise linear regression model. The accuracy of model was evaluated according to the area under the receiver operating characteristic curves.A total of 1545 subjects were included in the final analysis. The mean follow-up time was 52 ± 6.6 months. Of the total subjects, 77.61% were male and 22.39% were female. The mean age at the time of initial visit was 45.21 ± 11.20 years. Five hundred fifty-five subjects (35.92% of all subjects) were finally diagnosed with NAFLD. Variables in the nomogram included age, BMI, triglycerides, high-density lipoprotein, low-density lipoprotein, and UA. The accuracy of the nomogram for predicting 5-year cumulative occurrence of NAFLD was 0.8135 (95% confidence interval: 0.7921-0.8349), and the sensitivity and specificity were 0.8108 and 0.6960, respectively.The combination of age, BMI, triglycerides, high-density lipoprotein, low-density lipoprotein, and UA translated into a nomogram can reliably estimate the incidence of NAFLD within 5 years. It may serve as a decision support tool to determine whether to intervene at an early stage.
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Dallak MA, Al-Ani B, El Karib AO, Abd Ellatif M, Eid RA, Al-Ani R, Mahmoud HM, Haidara MA. Exercise augments the modulatory effects of vitamin E on pre-diabetes-induced aortopathy: a potential role of adiponectin. Arch Physiol Biochem 2020; 126:356-362. [PMID: 30465443 DOI: 10.1080/13813455.2018.1538250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: We tested the hypothesis that vitamin E may protect against pre-diabetes-induced aortic injury (aortopathy), and exercise can augment the action of vitamin E.Material and methods: Rats were either fed with a high fat and fructose diet (HFD) (model group) or a standard laboratory chow (control group) for 15 weeks before being sacrificed. The three protective groups were treated with vitamin E (HFD + Vit E), swimming exercises (HFD + Ex), and vitamin E plus swimming exercises (HFD + VitE + Ex), respectively.Results: Aortopathy was developed in the model group as demonstrated by substantial tissue ultrastructural alterations, which were partially protected by vitamin E and effectively protected with vitamin E plus swim exercise. Also, swimming exercises significantly (p < .05) increased the modulatory effects of vitamin E on dyslipidemia, insulin resistance, blood pressure, oxidative stress, inflammation, leptin, and adiponectin, except coagulation and thrombosis.Conclusions: Swim exercise augments the protective effects of vitamin E in a pre-diabetic animal model.
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Affiliation(s)
- Mohammad A Dallak
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Bahjat Al-Ani
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Abbas O El Karib
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Mohamed Abd Ellatif
- Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Department of Medical Biochemistry, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Refaat A Eid
- Department of Pathology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Rihab Al-Ani
- Department of Microbiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Hesham M Mahmoud
- Department of Medical Pharmacology, Kasr Al-Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed A Haidara
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Department of Physiology, Kasr Al-Aini Faculty of Medicine, Cairo University, Cairo, Egypt
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Louala S, Lamri-Senhadji M. Beneficial Effects of Low-Calorie-Carbohydrate/High-Agar Diet on Cardiometabolic Disorders Associated with Non-Alcoholic Fatty Liver Disease in Obese Rats. Prev Nutr Food Sci 2019; 24:400-409. [PMID: 31915635 PMCID: PMC6941718 DOI: 10.3746/pnf.2019.24.4.400] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022] Open
Abstract
Energy restriction and low carbohydrate diets are recommended as nutrition therapies to prevent becoming overweight or obese. However, their beneficial effects in non-alcoholic fatty liver disease (NAFLD) are less well investigated. In addition, the effects of the type of polysaccharides incorporated into these diets and their contents have been scarcely studied. Therefore, this study aimed to elucidate whether low-calorie-carbohydrate high-agar diets could improve liver metabolic dysfunction, membrane fluidity, oxidative damage, and endothelial dysfunction in obese rats. Obesity was induced by feeding rats a high-fat diet (HFD) for 10 weeks. The obese rats were then divided into two homogenous groups: the first group was fed low-calorie-carbohydrate/high-agar diet (LCC/HA) and the second continued to consume the HFD for 4 weeks [obese control (Ob-C)]. Normo-ponderal rats were fed a normal diet during the entire study, and were used as the control (N-C). Compared with the Ob-C group, body weight, hepatic lipids, low density lipoproteins cholesterol (C), the non esterified cholesterol/phospholipids ratio, serum transaminases activities, and lipid peroxidation markers (thiobarbituric acid reactive substances and lipid hydroperoxides) were reduced in LCC/HA group (P<0.05). However, the serum concentration of high density lipoproteins-C was enhanced (P<0.05). In addition, we observed improved antioxidant defence and endothelial dysfunction associated with antioxidant enzymes, such as superoxide dismutase, glutathione peroxidase, and catalase (P<0.05), and nitric oxide level (P<0.05). These findings suggest that hypocaloric diets low in energy and carbohydrates and rich in agar may be beneficial against HFD-induced hepatic steatosis damage, and may be a promising therapeutic strategy to counteract NAFLD development associated with obesity.
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Affiliation(s)
- Sabrine Louala
- Laboratory of Clinical and Metabolic Nutrition (LNCM), Department Biology, Faculty of Nature and Life Sciences, University Oran 1, Oran 31100, Algeria
| | - Myriem Lamri-Senhadji
- Laboratory of Clinical and Metabolic Nutrition (LNCM), Department Biology, Faculty of Nature and Life Sciences, University Oran 1, Oran 31100, Algeria
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The severity of coronary artery disease was not associated with non-alcoholic fatty liver disease in a series of 264 non-diabetic patients who underwent coronary angiography. ACTA ACUST UNITED AC 2019; 56:167-172. [PMID: 29561732 DOI: 10.2478/rjim-2018-0009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND It is now suggested an association between non-alcoholic fatty liver disease (NAFLD) and the occurrence of coronary artery disease even in non-diabetic patients. We will determine the rate of NAFLD and its main determinants in non-diabetic patients undergoing coronary angiography. METHODS This cross-sectional study was accomplished on 264 patients who were candidates for coronary angiography during the year 2016. Coronary angiography has been done to depict the presence or absence of coronary involvement, and the severity of coronary artery disease by determining the number of vessels involved and also the SYNTAX score. During 48 hours after coronary angiography, the patients underwent abdominal ultrasonography for detection of NAFLD. RESULTS The overall prevalence of NAFLD in the patients was 72.3%. The prevalence of NAFLD in those with and without coronary involvement was 71.9% and 73.1% respectively, with no notable difference (p = 0.837). The mean SYNTAX score in the patients with and without NAFLD was 22.32 ± 11.10 and 21.75 ± 10.71 respectively with no difference (p = 0.702). According to the multivariable regression models, the presence of NAFLD could not predict the likelihood of coronary artery disease (OR = 0.879, p = 0.669) or its severity assessed by the SYNTAX score (beta = 0.046, p = 0.456). NAFLD grade was also not a determinant for coronary artery disease (OR = 1.139, p = 0.178) or its severity (beta = 0.058, p = 0.165). CONCLUSION It seems that the presence and grade of NAFLD may not be correlated with atherosclerotic involvement of coronary arteries and its severity in non-diabetic patients. Future large studies and trials could elucidate the independent role of fatty liver in nondiabetic non-alcoholic patients.
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Zarei M, Barroso E, Palomer X, Escolà-Gil JC, Cedó L, Wahli W, Vázquez-Carrera M. Pharmacological PPARβ/δ activation upregulates VLDLR in hepatocytes. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2019; 31:111-118. [PMID: 30987865 DOI: 10.1016/j.arteri.2019.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/08/2019] [Accepted: 01/17/2019] [Indexed: 12/12/2022]
Abstract
The very low-density lipoprotein receptor (VLDLR) plays an important function in the control of serum triglycerides and in the development of non-alcoholic fatty liver disease (NAFLD). In this study, we investigated the role of peroxisome proliferator-activated receptor (PPAR)β/δ activation in hepatic VLDLR regulation. Treatment of mice fed a high-fat diet with the PPARβ/δ agonist GW501516 increased the hepatic expression of Vldlr. Similarly, exposure of human Huh-7 hepatocytes to GW501516 increased the expression of VLDLR and triglyceride accumulation, the latter being prevented by VLDLR knockdown. Finally, treatment with another PPARβ/δ agonist increased VLDLR levels in the liver of wild-type mice, but not PPARβ/δ-deficient mice, confirming the regulation of hepatic VLDLR by this nuclear receptor. Our results suggest that upregulation of hepatic VLDLR by PPARβ/δ agonists might contribute to the hypolipidemic effect of these drugs by increasing lipoprotein delivery to the liver. Overall, these findings provide new effects by which PPARβ/δ regulate VLDLR levels and may influence serum triglyceride levels and NAFLD development.
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Affiliation(s)
- Mohammad Zarei
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain; Spanish Biomedical Research Center in Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Spain; Research Institute, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Emma Barroso
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain; Spanish Biomedical Research Center in Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Spain; Research Institute, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Xavier Palomer
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain; Spanish Biomedical Research Center in Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Spain; Research Institute, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Joan Carles Escolà-Gil
- Spanish Biomedical Research Center in Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Spain; Institut d'Investigacions Biomèdiques (IIB) Sant Pau, Barcelona, Spain; Departament de Bioquímica i Biología Molecular, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lidia Cedó
- Spanish Biomedical Research Center in Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Spain; Institut d'Investigacions Biomèdiques (IIB) Sant Pau, Barcelona, Spain; Departament de Bioquímica i Biología Molecular, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Walter Wahli
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; INRA ToxAlim, UMR1331, Chemin de Tournefeuille, Toulouse Cedex, France
| | - Manuel Vázquez-Carrera
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain; Spanish Biomedical Research Center in Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Spain; Research Institute, Hospital Sant Joan de Déu, Barcelona, Spain.
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Synergistic increase in cardiovascular risk in diabetes mellitus with nonalcoholic fatty liver disease: a meta-analysis. Eur J Gastroenterol Hepatol 2018; 30:631-636. [PMID: 29351115 DOI: 10.1097/meg.0000000000001075] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) has been linked to an increased risk of cardiovascular disease (CVD). To explore the impact of diabetes mellitus (DM) as a cardiovascular risk factor, this meta-analysis quantitatively assessed the association of NAFLD and CVD in diabetic patients. METHODS PubMed, EMBASE, and the Cochrane Library database were analyzed until the end of March 2017. Original studies analyzing the association between NAFLD and cardiovascular risk factors in the diabetic population were included. The available data related to outcome were extracted for the effect estimate using a random-effects model. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. RESULTS Of the 770 initially identified studies, 11 studies involving 8346 patients were finally included. The Newcastle-Ottawa Quality Assessment Scale scores suggested that the studies included were of high quality. The pooled effects estimate showed that diabetic patients with NAFLD showed a two times increased risk for CVD compared with patients without NAFLD (odds ratio=2.20, 95% confidence interval: 1.67-2.90). Subgroup analysis also yielded a markedly increased risk, with odds ratio (95% confidence interval) values of 2.28 (1.61-3.23) and 1.90 (1.48-2.45) in cross-sectional and cohort studies, respectively. CONCLUSION This is the first meta-analysis investigating the relationship between NAFLD and CVD independent of the impact of DM. Our findings suggested that NAFLD increases the risk of CVD in populations with comparable DM profiles. Diabetic patients diagnosed with NAFLD might benefit from a more early cardiovascular risk assessment, thereby reducing CVD morbidity and mortality.
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Han E, Lee YH. Non-Alcoholic Fatty Liver Disease: The Emerging Burden in Cardiometabolic and Renal Diseases. Diabetes Metab J 2017; 41:430-437. [PMID: 29199410 PMCID: PMC5741551 DOI: 10.4093/dmj.2017.41.6.430] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 11/12/2017] [Indexed: 12/20/2022] Open
Abstract
As the number of individuals with non-alcoholic fatty liver disease (NAFLD) has increased, the influence of NAFLD on other metabolic diseases has been highlighted. Accumulating epidemiologic evidence indicates that NAFLD not only affects the liver but also increases the risk of extra-hepatic diseases such as type 2 diabetes mellitus, metabolic syndrome, dyslipidemia, hypertension, cardiovascular or cerebrovascular diseases, and chronic kidney disease. Non-alcoholic steatohepatitis, an advanced type of NAFLD, can aggravate these inter-organ relationships and lead to poorer outcomes. NAFLD induces insulin resistance and exacerbates systemic chronic inflammation and oxidative stress, which leads to organ dysfunction in extra-hepatic tissues. Although more research is needed to identify the pathophysiological mechanisms and causal relationship between NAFLD and cardiometabolic and renal diseases, screening for heart, brain, and kidney diseases, risk assessment for diabetes, and a multidisciplinary approach for managing these patients should be highly encouraged.
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Affiliation(s)
- Eugene Han
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Ho Lee
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Nonalcoholic fatty liver disease: implications for cardiovascular risk. Cardiovasc Endocrinol 2017; 6:62-72. [PMID: 31646122 DOI: 10.1097/xce.0000000000000126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/23/2017] [Indexed: 12/20/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a growing epidemic in the USA affecting ∼30% of the population. It has been closely linked to metabolic syndrome and type 2 diabetes, with strong implications for cardiovascular disease (CVD). This review focuses on the relationship between NAFLD and CVD and the proposed interactions interlinking these two diseases. This appraisal also discusses treatments targeting NAFLD in the context of CVD. NAFLD is a multisystem disease and ultimately the goals of therapy are to ameliorate CVD and prevent coronary artery disease morbidity and mortality.
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Lee HJ, Lee CH, Kim S, Hwang SY, Hong HC, Choi HY, Chung HS, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi DS, Choi KM. Association between vascular inflammation and non-alcoholic fatty liver disease: Analysis by 18F-fluorodeoxyglucose positron emission tomography. Metabolism 2017; 67:72-79. [PMID: 28081780 DOI: 10.1016/j.metabol.2016.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 10/26/2016] [Accepted: 11/02/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Growing evidence suggests that non-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular disease as well as metabolic syndrome. FDG-PET is a novel imaging technique that detects vascular inflammation, which may reflect rupture-prone vulnerable atherosclerotic plaques. METHODS Vascular inflammation was measured as the maximum target-to-background ratio (maxTBR), along with various cardiometabolic risk factors in 51 subjects with NAFLD, and compared with 100 age- and gender-matched subjects without NAFLD. The liver attenuation index (LAI), which was measured using computed tomography, was used as a parameter for the diagnosis of NAFLD. RESULTS After adjusting for age and sex, both maxTBR and LAI values were associated with several cardiometabolic risk parameters. Furthermore, there was a significant inter-relationship between LAI and maxTBR values (r=-0.227, P=0.005). Individuals with NAFLD had higher maxTBR values than those without NAFLD (P=0.026), although their carotid intima-media thickness (CIMT) values did not differ. The proportion of subjects with NAFLD showed a step-wise increment following the tertiles of maxTBR values (P for trend=0.015). In multiple logistic regression analysis, maxTBR tertiles were independently associated with NAFLD after adjusting for age, gender, systolic blood pressure, triglycerides, HDL-cholesterol, glucose, BUN, creatinine and homeostasis model assessment of insulin resistance (HOMA-IR) (P=0.030). However, their relationship was attenuated after further adjustment for waist circumference or high sensitive C-reactive protein. CONCLUSION Patients with NAFLD have an increased risk for vascular inflammation as measured via FDG-PET/CT even without difference in CIMT. (Clinical trials No. NCT01958411, http://www.clinicaltrials.gov/).
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Affiliation(s)
- Hyun Jung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Chang Hee Lee
- Division of Radiology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sungeun Kim
- Department of Nuclear Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Soon Young Hwang
- Department of Biostatistics, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ho Cheol Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hae Yoon Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Dong Seop Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.
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Katsiki N, Mikhailidis DP, Mantzoros CS. Non-alcoholic fatty liver disease and dyslipidemia: An update. Metabolism 2016; 65:1109-23. [PMID: 27237577 DOI: 10.1016/j.metabol.2016.05.003] [Citation(s) in RCA: 366] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/02/2016] [Accepted: 05/05/2016] [Indexed: 11/21/2022]
Abstract
Non-alcoholic fatty liver (NAFLD) is the most common liver disease worldwide, progressing from simple steatosis to necroinflammation and fibrosis (leading to non-alcoholic steatohepatitis, NASH), and in some cases to cirrhosis and hepatocellular carcinoma. Inflammation, oxidative stress and insulin resistance are involved in NAFLD development and progression. NAFLD has been associated with several cardiovascular (CV) risk factors including obesity, dyslipidemia, hyperglycemia, hypertension and smoking. NAFLD is also characterized by atherogenic dyslipidemia, postprandial lipemia and high-density lipoprotein (HDL) dysfunction. Most importantly, NAFLD patients have an increased risk for both liver and CV disease (CVD) morbidity and mortality. In this narrative review, the associations between NAFLD, dyslipidemia and vascular disease in NAFLD patients are discussed. NAFLD treatment is also reviewed with a focus on lipid-lowering drugs. Finally, future perspectives in terms of both NAFLD diagnostic biomarkers and therapeutic targets are considered.
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Affiliation(s)
- Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK.
| | - Christos S Mantzoros
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Mehta R, Otgonsuren M, Younoszai Z, Allawi H, Raybuck B, Younossi Z. Circulating miRNA in patients with non-alcoholic fatty liver disease and coronary artery disease. BMJ Open Gastroenterol 2016; 3:e000096. [PMID: 27493762 PMCID: PMC4964159 DOI: 10.1136/bmjgast-2016-000096] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 12/25/2022] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and coronary artery disease (CAD) is the cardiac manifestation of metabolic syndrome. NAFLD is strongly linked to CAD and hepatic steatosis is an independent risk factor for CAD and cardiac mortality. The pathogenic mechanism underlying this association remains poorly understood. In this study, we explored expression of circulating microRNAs (miRNAs) in patients with NAFLD and associated CAD. Results When compared to patients with NAFLD without CAD, patients with NAFLD and CAD had lower circulating levels of miR-132 (0.24±0.16 vs 0.30±0.11, p=0.03), while the circulating levels of miR-143 were higher (0.96±0.90 vs 0.64±0.77, p=0.02). The levels in circulation demonstrated trends opposite to previously observed intracellular levels in patients with CAD. In obese patients with NAFLD, lower circulating levels of miR-145 (1.42±1.00 vs 2.41±1.80), miR-211 (41.26±20.40 vs 57.56±25.45), miR-146a (2.13±1.40 vs 2.90±1.36) and miR-30c (6.92±4.99 vs 11.0±6.92) were detected when compared to lean patients with NAFLD. For miR-161 (0.59±1.19 vs 0.15±0.14) and miR-241 (0.28±0.29 vs 0.16±0.13), higher circulatory levels were detected in the obese patients with NAFLD. These observations suggest altered circulating levels of miRNAs that may serve to balance intracellular levels of miRNA in target tissues. Additional studies examining paired samples of target and producing tissues as well as respective plasma samples will help delineate the regulatory circuits governing the secretion and the uptake of miRNA in multitissue diseases.
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Affiliation(s)
- Rohini Mehta
- Betty and Guy Beatty Center for Integrated Research, Inova Fairfax Medical Campus , Falls Church, Virginia , USA
| | - Munkzhul Otgonsuren
- Betty and Guy Beatty Center for Integrated Research, Inova Fairfax Medical Campus , Falls Church, Virginia , USA
| | - Zahra Younoszai
- Betty and Guy Beatty Center for Integrated Research, Inova Fairfax Medical Campus , Falls Church, Virginia , USA
| | - Hussain Allawi
- Betty and Guy Beatty Center for Integrated Research, Inova Fairfax Medical Campus , Falls Church, Virginia , USA
| | - Bryan Raybuck
- Betty and Guy Beatty Center for Integrated Research, Inova Fairfax Medical Campus , Falls Church, Virginia , USA
| | - Zobair Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Fairfax Medical Campus , Falls Church, Virginia , USA
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Yang MH, Sung J, Gwak GY. The associations between apolipoprotein B, A1, and the B/A1 ratio and nonalcoholic fatty liver disease in both normal-weight and overweight Korean population. J Clin Lipidol 2016; 10:289-98. [DOI: 10.1016/j.jacl.2015.11.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 11/20/2015] [Accepted: 11/26/2015] [Indexed: 12/27/2022]
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A Comprehensive Updated Review of Pharmaceutical and Nonpharmaceutical Treatment for NAFLD. Gastroenterol Res Pract 2016; 2016:7109270. [PMID: 27006654 PMCID: PMC4781972 DOI: 10.1155/2016/7109270] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/27/2016] [Indexed: 02/08/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in the western world with prevalence of 20–33%. NAFLD comprises a pathological spectrum. Nonalcoholic fatty liver (NAFL) is at one end and consists of simple hepatic steatosis. On the contrary, nonalcoholic steatohepatitis (NASH) consists of steatosis, inflammation, and ballooning degeneration and can progress to cirrhosis. Despite the rising incidence, definitive treatment for NAFLD, specifically NASH, has not yet been established. Lifestyle modification with dietary changes combined with regular aerobic exercise, along with multidisciplinary approach including cognitive behavior therapy, has been shown to be an effective therapeutic option, even without a significant weight loss. Pioglitazone and vitamin E have shown to be most effective in NASH patients. Surgery and weight loss medication are effective means of weight loss but can potentially worsen NASH related fibrosis. Other agents such as n-3 polyunsaturated fatty acids, probiotics, and pentoxifylline along with herbal agent such as milk thistle as well as daily intake of coffee have shown potential benefits, but further well organized studies are definitely warranted. This review focuses on the available evidence on pharmaceutical and nonpharmaceutical therapy in the treatment and the prevention of NAFLD, primarily NASH.
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Gaggini M, Saponaro C, Gastaldelli A. Not all fats are created equal: adipose vs. ectopic fat, implication in cardiometabolic diseases. Horm Mol Biol Clin Investig 2016; 22:7-18. [PMID: 25816312 DOI: 10.1515/hmbci-2015-0006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 02/23/2015] [Indexed: 01/06/2023]
Abstract
Adipose tissue is a recognized endocrine organ that acts not only as a fuel storage but also is able to secrete adipokines that can modulate inflammation. Most of the fat is composed of white adipocytes (WAT), although also brown/beige adipocytes (BAT/BeAT) have been found in humans. BAT is located close to the neck but also among WAT in the epicardial fat and perivascular fat. Adipocyte hypertrophy and infiltration of macrophages impair adipose tissue metabolism determining "adiposopathy" (i.e., sick fat) and increasing the risk to develop metabolic and cardiovascular diseases. The purpose of this review was to search and discuss the available literature on the impact of different types of fat and fat distribution on cardiometabolic risk. Visceral fat, but also ectopic fat, either in liver, muscle and heart, can increase the risk to develop insulin resistance, type 2 diabetes and cardiovascular diseases. Results recently published showed that BAT could have an impact on cardiometabolic risk, not only because it is implicated in energy metabolism but also because it can modulate glucose and lipid metabolism. Therapeutical interventions that can increase energy expenditure, successfully change fat distribution and reduce ectopic fat, also through BAT activation, were discussed.
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Michopoulos S, Chouzouri VI, Manios ED, Grapsa E, Antoniou Z, Papadimitriou CA, Zakopoulos N, Dimopoulos AM. Untreated newly diagnosed essential hypertension is associated with nonalcoholic fatty liver disease in a population of a hypertensive center. Clin Exp Gastroenterol 2016; 9:1-9. [PMID: 26834493 PMCID: PMC4716740 DOI: 10.2147/ceg.s92714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose Recent studies have demonstrated that hypertension (HTN) is associated with nonalcoholic fatty liver disease (NAFLD) in treated hypertensive patients. The aim of this study was to investigate the association between newly diagnosed essential HTN and NAFLD in untreated hypertensive patients. Patients and methods A consecutive series of 240 subjects (143 hypertensives and 97 normotensives), aged 30–80 years, without diabetes mellitus were enrolled in the study. Subjects with 24-hour systolic blood pressure (SBP) values ≥130 mmHg and/or diastolic BP values ≥80 mmHg were defined as hypertensives. NAFLD was defined as the presence of liver hyperechogenicity on ultrasound. Results Body mass index (P=0.002) and essential HTN (P=0.016) were independently associated with NAFLD in the multivariate logistic regression model. Furthermore, the multivariate analysis revealed that morning SBP (P=0.044) was independently associated with NAFLD. Conclusion Untreated, newly diagnosed essential HTN is independently associated with NAFLD. Ambulatory BP monitoring could be used for the diagnosis of essential HTN in patients with NAFLD.
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Affiliation(s)
- Spyros Michopoulos
- Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece
| | - Vasiliki I Chouzouri
- Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece
| | - Efstathios D Manios
- Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece
| | - Eirini Grapsa
- Nephrology Department, Medical School of Athens, Aretaieio Hospital, Athens, Greece
| | - Zoi Antoniou
- Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece
| | | | - Nikolaos Zakopoulos
- Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece
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Hsu HC, Liu CH, Tsai YC, Li SJ, Chen CY, Chu CH, Chen MF. Time-dependent cellular response in the liver and heart in a dietary-induced obese mouse model: the potential role of ER stress and autophagy. Eur J Nutr 2015; 55:2031-43. [PMID: 26264388 DOI: 10.1007/s00394-015-1017-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 08/05/2015] [Indexed: 12/31/2022]
Abstract
PURPOSE Both endoplasmic reticulum stress (ER stress) and autophagy are essential for the response of the protein quality control system to cellular stresses. This study investigated the influence of the duration of a high-fat diet (HFD) in mice on tissue-specific cellular responses, specifically with regard to the role of autophagy and ER stress. METHODS Male mice aged 6-7 weeks were fed ad libitum with a standard chow diet or with a HFD for 2, 4, 8, or 16 weeks. RESULTS The HFD progressively increased mean body weight and induced tissue hypertrophy. The expression of PERK was suppressed in the liver after 16 weeks of the HFD and in the heart after 8 weeks of the HFD. Procaspase 12 and its activated form were induced in the liver with the HFD after 2 weeks, but not in the heart over the 16-week period. The activation of hepatic AMPK was elevated following 4 weeks of the HFD, but was inhibited after 16 weeks of the HFD. The ratio of LC3II to LC3I in the liver did not increase except in those mice fed the HFD for 16 weeks. The expression of AMPK and LC3 in the heart did not change over the entire 16 weeks of feeding the HFD. Cleaved PARP was increased in the liver and heart of mice receiving the HFD for 8 weeks. CONCLUSIONS This study provides evidence that a HFD affects the cellular protein quality control processes responsible for metabolic disorder in a tissue- and duration-dependent manner.
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Affiliation(s)
- Hsiu-Ching Hsu
- Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan S Rd, Taipei, Taiwan
| | - Chia-Hsin Liu
- Department of Animal Science and Technology, National Taiwan University, 50, Lane 155, Sec 3, Keelung Rd, Taipei, 10672, Taiwan
| | - Yi-Chen Tsai
- Department of Animal Science and Technology, National Taiwan University, 50, Lane 155, Sec 3, Keelung Rd, Taipei, 10672, Taiwan
| | - Sin-Jin Li
- Department of Animal Science and Technology, National Taiwan University, 50, Lane 155, Sec 3, Keelung Rd, Taipei, 10672, Taiwan
| | - Ching-Yi Chen
- Department of Animal Science and Technology, National Taiwan University, No. 50, Lane 155, Sec 3, Keelung Rd, Taipei, 10672, Taiwan.
| | - Chun-Han Chu
- Department of Animal Science and Technology, National Taiwan University, 50, Lane 155, Sec 3, Keelung Rd, Taipei, 10672, Taiwan
| | - Ming-Fong Chen
- Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan S Rd, Taipei, Taiwan
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Traussnigg S, Kienbacher C, Halilbasic E, Rechling C, Kazemi-Shirazi L, Hofer H, Munda P, Trauner M. Challenges and Management of Liver Cirrhosis: Practical Issues in the Therapy of Patients with Cirrhosis due to NAFLD and NASH. Dig Dis 2015; 33:598-607. [PMID: 26159280 DOI: 10.1159/000375353] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome and comprises a liver disease spectrum ranging from steatosis to nonalcoholic steatohepatitis (NASH) with risk of progression to liver cirrhosis and hepatocellular carcinoma (HCC). Associated metabolic conditions and comorbidities such as obesity, diabetes and cardiovascular diseases are common and require concerted management. Adiponutrin (PNPLA3) variants may help to identify NAFLD patients at higher risk for liver disease progression towards advanced fibrosis and HCC. The therapeutic options in NAFLD/NASH include lifestyle modification, pharmacological treatment, bariatric surgery for patients with morbid obesity and treatment of complications of liver cirrhosis and HCC, including liver transplantation. Insulin sensitizers and antioxidative treatment strategies with vitamin E are among the best-established pharmacological approaches, but both drugs have long-term safety issues and there is limited evidence in cirrhotic patients. Treatment of concomitant/underlying metabolic conditions with statins or metformin may also have beneficial effects on portal hypertension, complications of liver cirrhosis and HCC prevention. The bile acid receptor FXR may be a promising novel therapeutic target for the treatment of NAFLD/NASH, fibrosis and portal hypertension, but the prognostic implications of associated changes in low- and high-density lipoprotein cholesterol require further studies. Morbidly obese NASH patients can benefit from bariatric surgery which may reduce liver fibrosis but carries a risk of decompensation in patients with advanced liver cirrhosis. When carefully selected, patients with NASH cirrhosis undergoing liver transplantation have a good outcome. This review summarizes recent progress in the management of patients with liver cirrhosis due to NASH.
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Affiliation(s)
- Stefan Traussnigg
- Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
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Polimeni L, Del Ben M, Baratta F, Perri L, Albanese F, Pastori D, Violi F, Angelico F. Oxidative stress: New insights on the association of non-alcoholic fatty liver disease and atherosclerosis. World J Hepatol 2015; 7:1325-1336. [PMID: 26052378 PMCID: PMC4450196 DOI: 10.4254/wjh.v7.i10.1325] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 12/01/2014] [Accepted: 03/18/2015] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) represents the most common and emerging chronic liver disease worldwide. It includes a wide spectrum of liver diseases ranging from simple fatty liver to non-alcoholic steatohepatitis (NASH), which may progress to fibrosis and more severe liver complications such as cirrhosis, hepatocellular carcinoma and liver mortality. NAFLD is strongly associated with obesity, insulin resistance, hypertension, and dyslipidaemia, and is now regarded as the liver manifestation of the metabolic syndrome. The increased mortality of patients with NAFLD is primarily a result of cardiovascular disease and, to a lesser extent, to liver related diseases. Increased oxidative stress has been reported in both patients with NAFLD and patient with cardiovascular risk factors. Thus, oxidative stress represents a shared pathophysiological disorder between the two conditions. Several therapeutic strategies targeting oxidative stress reduction in patients with NAFLD have been proposed, with conflicting results. In particular, vitamin E supplementation has been suggested for the treatment of non-diabetic, non-cirrhotic adults with active NASH, although this recommendation is based only on the results of a single randomized controlled trial. Other antioxidant treatments suggested are resveratrol, silybin, L-carnitine and pentoxiphylline. No trial so far, has evaluated the cardiovascular effects of antioxidant treatment in patients with NAFLD. New, large-scale studies including as end-point also the assessment of the atherosclerosis markers are needed.
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Abstract
Obesity and metabolic syndrome pose significant risk for the progression of many types of chronic illness, including liver disease. Hormones released from adipocytes, adipocytokines, associated with obesity and metabolic syndrome, have been shown to control hepatic inflammation and fibrosis. Hepatic fibrosis is the final common pathway that can result in cirrhosis, and can ultimately require liver transplantation. Initially, two key adipocytokines, leptin and adiponectin, appeared to control many fundamental aspects of the cell and molecular biology related to hepatic fibrosis and its resolution. Leptin appears to act as a profibrogenic molecule, while adiponectin has strong-antifibrotic properties. In this review, we emphasize pertinent data associated with these and other recently discovered adipocytokines that may drive or halt the fibrogenic response in the liver.
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Affiliation(s)
- Neeraj K Saxena
- University of Maryland School of Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Howard Hall, Room 301, 660W. Redwood Street, Baltimore, MD 21201, USA.
| | - Frank A Anania
- Emory University School of Medicine, Division of Digestive Diseases, Suite 201, 615 Michael Street, NE, Atlanta, GA 30322, USA.
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Yang W, Xu H, Yu X, Wang Y. Association between retinal artery lesions and nonalcoholic fatty liver disease. Hepatol Int 2015; 9:278-82. [PMID: 25788195 PMCID: PMC4387273 DOI: 10.1007/s12072-015-9607-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 01/07/2015] [Indexed: 12/21/2022]
Abstract
Objective Retinal artery lesions have been reported to be a risk marker of morbidity and mortality for cardiovascular and cerebrovascular diseases in various study populations. Nonalcoholic fatty liver disease (NAFLD) is also a risk factor for cardiovascular disease. However, the relationship between retinal artery lesions and NAFLD is less certain. Methods Data were obtained from 2,454 patients who attended their annual health examination (2,143 males and 311 females, aged 62.34 ± 10.03 years). NAFLD was diagnosed by hepatic ultrasonography. Retinal artery lesions were diagnosed according to the criteria. Total plasma cholesterol, plasma triglyceride and fasting glucose levels were determined by using a multichannel analyzer; the body mass index, systolic blood pressure, diastolic blood pressure, incidence of hypertension and coronary artery disease were measured or analyzed by statistical analysis. Results Patients with NAFLD had older age and higher values of BMI, systolic blood pressure, diastolic blood pressure, fasting glucose, total cholesterol and triglycerides and had a higher incidence of hypertension, coronary artery disease and retinal artery lesions (p < 0.01). Retinal artery lesions were taken as a dependent variable, and age, gender, BMI, systolic blood pressure, diastolic blood pressure, fasting glucose, total cholesterol and triglyceride levels, and NAFLD were taken as covariates. We found that age ≥65 years (p < 0.01, OR 1.968), being male (p < 0.01, OR 1.668), BMI ≥ 25 (p < 0.01, OR 0.743), SBP ≥ 140 mmHg (p < 0.01, OR 1.368) and NAFLD (p < 0.01, OR 2.378) were significantly associated with a risk of retinal artery lesions by binary logistic regression analysis. Conclusions Patients with NAFLD were older and had higher values for BMI, systolic blood pressure, diastolic blood pressure, fasting glucose, total cholesterol and triglycerides, and higher incidence of hypertension, coronary artery disease and retinal artery lesions. NAFLD is a risk factor for retinal artery lesions.
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Affiliation(s)
- Wen Yang
- Geriatric Digestive System Department, Navy General Hospital, No. 6 Fuchenglu Road, Beijing, 100048, China,
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Chang CH, Chang YC, Lee YC, Liu YC, Chuang LM, Lin JW. Severe hepatic injury associated with different statins in patients with chronic liver disease: a nationwide population-based cohort study. J Gastroenterol Hepatol 2015; 30:155-62. [PMID: 25041076 DOI: 10.1111/jgh.12657] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM The hepatotoxicity of statins in patients with chronic liver diseases remains unclear. In this study, we aimed to estimate the risk of severe hepatic injury associated with different statins in patients with chronic liver disease. METHODS A nationwide population-based cohort study was conducted by analyzing the Taiwan National Health Insurance database. A total of 37,929 subjects with chronic liver disease who started statin therapy were identified during the period of January 1, 2005 to December 31, 2009. Outcome was defined as hospitalization due to liver injury. RESULTS During a total of 118,772 person-years of follow-up, 912 incident cases of hospitalization due to hepatic injury are identified. The incidence rate was 2.95, 2.49, 2.92, 1.94, 2.65, and 2.52 per 100,000 person-days for atorvastatin, lovastatin, fluvastatin, pravastatin, simvastatin, and rosuvastatin initiators, respectively. Overall, there was no difference in the incidence associated with different statins. However, when each statin was further categorized to high (≧ 0.5 defined daily dose) or low (< 0.5 defined daily dose) mean daily dose, only high-dose atorvastatin was significantly associated with increased risk of hospitalization due to hepatic injury (hazard ratio, 1.62; 95% confidence interval, 1.29, 2.03) as compared with low-dose atorvastatin. CONCLUSION The overall incidence of hospitalization due to severe hepatic injury was low among statin initiators with chronic liver disease. Only high-dose atorvastatin was associated with increased risk.
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Affiliation(s)
- Chia-Hsuin Chang
- Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Ichimura M, Minami A, Nakano N, Kitagishi Y, Murai T, Matsuda S. Cigarette smoke may be an exacerbation factor in nonalcoholic fatty liver disease via modulation of the PI3K/AKT pathway. AIMS MOLECULAR SCIENCE 2015. [DOI: 10.3934/molsci.2015.4.427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Perazzo H, Munteanu M, Ngo Y, Lebray P, Seurat N, Rutka F, Couteau M, Jacqueminet S, Giral P, Monneret D, Imbert-Bismut F, Ratziu V, Hartemann-Huertier A, Housset C, Poynard T. Prognostic value of liver fibrosis and steatosis biomarkers in type-2 diabetes and dyslipidaemia. Aliment Pharmacol Ther 2014; 40:1081-93. [PMID: 25186086 DOI: 10.1111/apt.12946] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 07/09/2014] [Accepted: 08/13/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND In cardiometabolic disorders, non-alcoholic fatty liver disease is frequent and presumably associated with increased mortality and cardiovascular risk. AIM To evaluate the prognostic value of non-invasive biomarkers of liver fibrosis (FibroTest) and steatosis (SteatoTest) in patients with type-2 diabetes and/or dyslipidaemia. METHODS A total of 2312 patients with type-2 diabetes and/or dyslipidaemia were included and prospectively followed up for 5-15 years. The cardiovascular Framingham-risk score was calculated; advanced fibrosis and severe steatosis, were defined by FibroTest >0.48 and SteatoTest >0.69, respectively, as previously established. RESULTS During a median follow-up of 12 years, 172 patients (7.4%) died. The leading causes of mortality were cancer (31%) and cardiovascular-related death (20%). The presence of advanced fibrosis [HR (95% CI)] [2.98 (95% CI 1.78-4.99); P < 0.0001] or severe steatosis [1.86 (1.34-2.58); P = 0.0002] was associated with an increased risk of mortality. In a multivariate Cox model adjusted for confounders: the presence of advanced fibrosis was associated with overall mortality [1.95 (1.12-3.41); P = 0.02]; advanced fibrosis at baseline [n = 50/677; 1.92 (1.04-3.55); P = 0.04] and progression to advanced fibrosis during follow-up [n = 16/127; 4.8 (1.5-14.9); P = 0.007] were predictors of cardiovascular events in patients with type-2 diabetes. In patients with a Framingham-risk score ≥20%, the presence of advanced fibrosis was predictive of cardiovascular events [2.24 (1.16-4.33); P < 0.05]. CONCLUSIONS Liver biomarkers, such as FibroTest and SteatoTest, have prognostic values in patients with metabolic disorders. FibroTest has prognostic value for predicting overall survival in patients with type-2 diabetes and/or dyslipidaemia. In type-2 diabetes, FibroTest predicted cardiovascular events and improved the Framingham-risk score.
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Affiliation(s)
- H Perazzo
- Hepatology Department, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Centre de Recherche Saint-Antoine & Institute of Cardiometabolism and Nutrition (ICAN), INSERM & Université Pierre et Marie Curie - Univ Paris 06 UMR_S 938, Paris, France
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Leach NV, Dronca E, Vesa SC, Sampelean DP, Craciun EC, Lupsor M, Crisan D, Tarau R, Rusu R, Para I, Grigorescu M. Serum homocysteine levels, oxidative stress and cardiovascular risk in non-alcoholic steatohepatitis. Eur J Intern Med 2014; 25:762-7. [PMID: 25262992 DOI: 10.1016/j.ejim.2014.09.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/09/2014] [Accepted: 09/08/2014] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Hyperhomocysteinemia is considered an independent risk factor for cardiovascular disease. Oxidative stress is one of the major pathogenic mechanisms in non-alcoholic fatty liver disease and atherosclerosis. AIM Our study aimed to evaluate serum homocysteine levels and oxidative stress in patients with biopsy-proven non-alcoholic steatohepatitis and possible association with cardiovascular risk measured by carotid artery intima-media thickness (c-IMT). PATIENTS AND METHODS 50 patients with non-alcoholic steatohepatitis and 30 healthy controls, age and gender matched, were recruited. Lipid profile, liver biochemical markers, serum homocysteine, vitamins B6 and B12, folic acid, glutathione (reduced and total), erythrocyte superoxide dismutase, whole blood glutathione peroxidase, malondialdehyde and carotid intima-media thickness were assayed. RESULTS Patients had an altered lipid profile and liver biochemical markers; carotid intima-media thickness and serum homocysteine levels were significantly higher compared to controls, but there were no differences in folate, B12 and B6 vitamins levels. Patients had significantly lower levels of glutathione peroxidase activity, total and reduced glutathione and higher levels of malondialdehyde, but unchanged superoxide dismutase activity compared to control group. Also, serum homocysteine level showed significant positive correlation with waist circumference, body mass index, free cholesterol, triglycerides, LDL-cholesterol, amino transferases and negative correlation with reduced and total glutathione, superoxide dismutase and γ-GT. CONCLUSION Non-alcoholic steatohepatitis is an independent cardiovascular risk factor, associated with elevated homocysteine levels, oxidative stress and c-IMT. c-IMT could be used as an indicator of early atherosclerotic changes initiated by dyslipidemia and oxidative stress, while higher level of homocysteine might be an effect of liver damage.
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Affiliation(s)
- Nicoleta V Leach
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Eleonora Dronca
- Department of Medical Genetics, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Stefan C Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dorel P Sampelean
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Elena C Craciun
- Department of Pharmaceutical Biochemistry and Clinical Laboratory, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Monica Lupsor
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Crisan
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Roxana Tarau
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Razvan Rusu
- Department of Medical Biochemistry, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Para
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mircea Grigorescu
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Nseir W, Hellou E, Assy N. Role of diet and lifestyle changes in nonalcoholic fatty liver disease. World J Gastroenterol 2014; 20:9338-9344. [PMID: 25071328 PMCID: PMC4110565 DOI: 10.3748/wjg.v20.i28.9338] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 04/16/2014] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has become one of the most common causes of liver disease worldwide and has been recognized as a major health burden. The prevalence of NAFLD has grown proportionally with the rise in obesity, sedentary lifestyle, unhealthy dietary pattern, and metabolic syndrome. Currently, there is no drug therapy that can be formulated for treating NAFLD. A combination of dietary modifications and increased physical activity remains the mainstay of NAFLD management. It is hard to maintain this mode of management; however, it seems to have significant long-term benefits. Furthermore, NAFLD patients, whether obese or not, should be educated that a healthy diet and physical activity have benefits beyond weight reduction. Further large controlled randomized trials are needed in order to identify the best dietary regimen and physical activity in the management of NAFLD patients. This review highlights the role of diet and lifestyle modifications in the management of NAFLD, and focuses on human studies regarding dietary modifications and physical activity.
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Munteanu MA, Mircea PA. From NAFLD to Cardiovascular Disease. Is it (Still) the Metabolic Syndrome? ACTA ACUST UNITED AC 2014; 87:80-6. [PMID: 26528002 PMCID: PMC4620846 DOI: 10.15386/cjmed-277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 06/04/2014] [Indexed: 12/28/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in developed countries. The incidence of NAFLD in the general population is 30–38% deppending on the geographical area and the diagnostic method used. NAFLD is considered to be the liver manifestation of the metabolic syndrome. A better understanding of the natural evolution would have practical consequences related mainly to the need of early and aggressive diagnosis, active monitoring and therapeutic solutions. Cardiovascular disease appears to be the main cause of death in these patients. The mechanisms linking NAFLD with cardiovascular disease are not fully understood yet, but attention was focused primarily on insulin resistance. The visceral adipose tissue, the epicardial adipose tissue, the systemic inflammatory response syndrome, the lipid profile, the procoagulants factors, the oxidative stress, and type 2 diabetes mellitus, they all might play a role in the link between NAFLD and cardiovascular disease. Currently, there isn’t any medication specifically recommended for the treatment of NAFLD. Although the mechanisms underlying the association between NAFLD and cardiovascular disease are not fully known, attention must be paid to this association, given that these patients are more likely to die due to heart disease rather than liver disease.
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Affiliation(s)
- Mihai Alexandru Munteanu
- Department of Internal Medicine, 1 Medical Clinic - Internal Medicine, Cardiology and Gastroenterology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Petru Adrian Mircea
- Department of Internal Medicine, 1 Medical Clinic - Internal Medicine, Cardiology and Gastroenterology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Clinical evidence of statin therapy in non-dyslipidemic disorders. Pharmacol Res 2014; 88:20-30. [PMID: 24548821 DOI: 10.1016/j.phrs.2014.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 01/30/2014] [Accepted: 02/05/2014] [Indexed: 12/16/2022]
Abstract
The clinical benefits of statins are strongly related to their low density lipoprotein cholesterol (LDL-C) lowering properties. However, considering that the pharmacological target of statins, the 3-hydroxy-3-methyl-3-glutaryl coenzyme A (HMG-CoA) reductase, is one of the upstream enzyme of the mevalonate pathway, its inhibition may determine a substantial impoverishment of additional lipid moieties required for a proper cellular function. From this hypothesis, several experimental and clinical evidences have been reported indicating additional effects of statins beyond the LDL-C lowering, in particular anti-inflammatory and immunomodulatory effects. Thus statin therapy, indicated for hyperlipidemic patients for primary and secondary prevention of coronary heart disease (CHD) has begun to be considered effective in other diseases not necessarily linked to altered lipid profile. In the present review we summarized the current clinical evidence of the efficacy and safety profile of statins in a variety of diseases, such as rheumatoid arthritis, venous thromboembolism, liver diseases, polycystic ovary syndrome, and age-related macular degeneration. As discussed in the review, pending large, well designed, randomized trials, it is reasonable to conclude that there is no definitive evidence for the use of statins in the aforementioned diseases.
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High red blood cell distribution width is closely associated with nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 2014; 26:174-8. [PMID: 24025980 DOI: 10.1097/meg.0b013e328365c403] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The red blood cell distribution width (RDW) has been reported to be a risk marker of morbidity and mortality for cardiovascular diseases in various study populations. Nonalcoholic fatty liver disease (NAFLD) is also a risk factor for cardiovascular diseases. However, the relationship between RDW and NAFLD is less certain. PATIENTS AND METHODS RDW was determined using a Coulter counter together with the hemoglobin level in 1637 normal control individuals and 619 NAFLD patients who were consecutively referred by general practitioners for routine medical check-up. The total plasma cholesterol, plasma triglyceride, and fasting glucose were determined using a multichannel analyzer, and BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), and the incidence of hypertension and coronary artery disease were measured using statistical analysis. RESULTS Patients with NAFLD had a higher RDW, BMI, waist to hip ratio, SBP and DBP, fasting glucose, triglycerides, and hypertension incidence (P<0.01), and were also younger (P<0.01). NAFLD was considered as a dependent variable, whereas age, sex, BMI, waist to hip ratio, RDW, hemoglobin, SBP and DBP, fasting glucose, total cholesterol, triglyceride, and hypertension were considered as covariate variables. We found that age (β=-0.031, P<0.01), BMI (β=0.265, P<0.01), waist to hip ratio (β=6.166, P<0.01), RDW (β=0.154, P<0.01), fasting plasma glucose (β=0.301, P<0.01), and triglyceride (β=0.222, P<0.01) were significantly associated with the risk for NAFLD, analyzed by binary logistic regression analysis. CONCLUSION Patients with NAFLD were more likely to have high levels of RDW. Moreover, NAFLD was associated with age, BMI, RDW, fasting plasma glucose, and triglyceride. If confirmed in future follow-up studies, this association might provide a rationale to introduce the easy, inexpensive RDW in algorithms for NAFLD risk prediction.
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Meta-omic platforms to assist in the understanding of NAFLD gut microbiota alterations: tools and applications. Int J Mol Sci 2014; 15:684-711. [PMID: 24402126 PMCID: PMC3907832 DOI: 10.3390/ijms15010684] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 12/29/2013] [Accepted: 01/02/2014] [Indexed: 12/13/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide as a result of the increasing prevalence of obesity, starting from early life stages. It is characterized by a spectrum of liver diseases ranging from simple fatty liver (NAFL) to steatohepatitis (NASH), with a possible progression to fibrosis, thus increasing liver-related morbidity and mortality. NAFLD development is driven by the co-action of several risk factors, including obesity and metabolic syndrome, which may be both genetically induced and diet-related. Recently, particular attention has been paid to the gut-liver axis, which may play a physio-pathological role in the onset and progression of the disease. The gut microbiota is intended to act as a bioreactor that can guarantee autonomous metabolic and immunological functions and that can drive functional strategies within the environment of the body in response to external stimuli. The complexity of the gut microbiota suggests that it behaves as an organ. Therefore, the concept of the gut-liver axis must be complemented with the gut-microbiota-liver network due to the high intricacy of the microbiota components and metabolic activities; these activities form the active diet-driven power plant of the host. Such complexity can only be revealed using systems biology, which can integrate clinical phenomics and gut microbiota data.
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Oni ET, Sinha P, Karim A, Martin SS, Blaha MJ, Agatston AS, Blumenthal RS, Meneghelo RS, Conceiçao RD, Santos RD, Nasir K. Statin use is not associated with presence of and severity of nonalcoholic fatty liver disease. Arch Med Res 2013; 45:52-7. [PMID: 24333254 DOI: 10.1016/j.arcmed.2013.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/11/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS There is concern that statin use may exacerbate nonalcoholic fatty liver disease (NAFLD). We aimed to assess the association of statin use with NALFD and severity of liver fibrosis among NAFLD individuals. METHODS We evaluated 6,385 cross-sectional healthy Brazilian subjects (43 ± 10 years, 79% males) without clinical coronary heart disease between November 2008 and July 2010. NAFLD was diagnosed by ultrasound. Severity of liver fibrosis was predicted by fatty liver index and FIB-4. RESULTS NAFLD prevalence was 36% (n = 2310). Overall 552 (9%) individuals were using statins of whom 49% had NAFLD. Statin users were more likely to be men, older age, and have higher burden of risk factors (p <0.05). In age gender adjusted analysis the odds ratio for NAFLD with statin use was 0.87 (0.61-1.25, p = 0.46) in the presence of metabolic syndrome and 1.08 (0.88-1.32, p = 0.56) in its absence. On further adjustment for metabolic risk factors, LDL and smoking the results remained unchanged (OR: 0.89, 95% CI: 0.65-1.32, p = 0.56 and 0.90 (0.69-1.18, p = 0.46). There was no significant association between statin use and fatty liver index in a subanalysis of NAFLD individuals (71 ± 18 vs. 69 ± 23, p = 0.18). Although FIB-4 was mildly elevated with statin use (1.20 ± 0.51 vs. 1.02 ± 0.46, p <0.001), a multivariate analysis adjusted for age, gender and risk factors revealed statin use was not associated with severe fibrosis (FIB >1.45) (OR 0.88, 95% CI: 0.60-1.29, p = 0.50). CONCLUSIONS The results of this study favor statin use in subjects with NAFLD as its use is not associated with the presence of NAFLD or increased fibrosis.
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Affiliation(s)
- Ebenezer T Oni
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida
| | - Pragya Sinha
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida
| | - Adil Karim
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida
| | - Seth S Martin
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland
| | - Michael J Blaha
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland
| | - Arthur S Agatston
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Roger S Blumenthal
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland
| | - Romeu S Meneghelo
- Preventive Medicine Center Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Raquel D Conceiçao
- Preventive Medicine Center Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Raul D Santos
- Lipid Clinic-Heart Institute (InCor) University of São Paulo Medical School Hospital, Sao Paulo-São Paulo, Brazil
| | - Khurram Nasir
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida; The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida.
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Arinc H, Sarli B, Baktir AO, Saglam H, Demirci E, Dogan Y, Kurtul S, Karaman H, Erden A, Karaman A. Serum gamma glutamyl transferase and alanine transaminase concentrations predict endothelial dysfunction in patients with non-alcoholic steatohepatitis. Ups J Med Sci 2013; 118:228-34. [PMID: 23829707 PMCID: PMC4190884 DOI: 10.3109/03009734.2013.814734] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Cardiovascular diseases are the leading cause of death in patients with non-alcoholic steatohepatitis (NASH). We aimed to investigate the presence of endothelial dysfunction and whether serum concentrations of liver enzymes may reflect the severity of such an endothelial dysfunction in patients with NASH. METHODS Fifty patients with NASH diagnosed by liver biopsies and 30 healthy controls were included. Blood samples after fasting were harvested for measurements of glucose, insulin, cholesterol, triglyceride, and liver enzymes. All patients underwent transthoracic echocardiography and brachial and carotid artery Doppler ultrasonography to evaluate flow-mediated dilatation (FMD) and carotid artery intima-media thickness (CIMT). RESULTS Patients with NASH had impaired FMD (4.9 ± 2.8% to 9.3 ± 4.4%, P < 0.001) and higher CIMT (0.79 ± 0.16 mm to 0.64 ± 0.11 mm, P < 0.001) when compared with healthy controls. Linear regression analyses revealed that serum concentrations of gamma glutamyl transferase (GGT) and alanine transaminase (ALT) were associated with FMD and CIMT. CONCLUSIONS Patients with NASH have impaired FMD and increased CIMT when compared with healthy controls. In patients with NASH, serum concentrations of GGT and ALT might have a predictive value for FMD and CIMT.
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Affiliation(s)
- Huseyin Arinc
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Bahadir Sarli
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Ahmet Oguz Baktir
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Hayrettin Saglam
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Erkan Demirci
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Yasemin Dogan
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Serkan Kurtul
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Hatice Karaman
- Department of Pathology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Abdulsamet Erden
- Department of Gastroenterology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Ahmet Karaman
- Department of Gastroenterology, Kayseri Education and Research Hospital, Kayseri, Turkey
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Josef P, Ali I, Ariel P, Alon M, Nimer A. Relationship between retinal vascular caliber and coronary artery disease in patients with non-alcoholic fatty liver disease (NAFLD). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3409-23. [PMID: 23924883 PMCID: PMC3774445 DOI: 10.3390/ijerph10083409] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/11/2013] [Accepted: 07/31/2013] [Indexed: 12/13/2022]
Abstract
Objective: To evaluate the relationship between retinal vascular caliber and cardiovascular disease in non-alcoholic fatty liver disease (NAFLD) patients without diabetes and hypertension. Methods: Intention to treat study of individuals who underwent cardiac computed tomography (CT) during a two year period. Coronary artery disease (CAD) was defined as stenosis of >50% in at least one major coronary artery. Liver and spleen density were measured by abdominal (CT); intima-media thickness (IMT) by Doppler ultrasound; retinal artery and vein diameter by colored-retinal angiography; and metabolic syndrome by ATP III guidelines. Serum biomarkers of insulin resistance, inflammation, and oxidant-antioxidant status were assessed. Results: Compared with 22 gender and age matched controls, the 29 NAFLD patients showed higher prevalence of coronary plaques (70% vs. 30%, p < 0.001), higher prevalence of coronary stenosis (30% vs. 15%, p < 0.001), lower retinal arteriole-to-venule ratio (AVR) (0.66 ± 0.06 vs. 0.71 ± 0.02, p < 0.01), higher IMT (0.98 ± 0.3 vs. 0.83 ± 0.1, p < 0.04), higher carotid plaques (60% vs. 40%, p < 0.001), higher homeostasis model assessment of insulin resistance (HOMA) (4.0 ± 3.4 vs. 2.0 ± 1.0, p < 0.005), and higher triglyceride levels (200 ± 80 vs. 150 ± 60, p < 0.005) than controls. Multivariate analysis showed fatty liver (OR 2.5; p < 0.01), IMT (OR 2.3 p < 0.001), and retinal AVR ratio (OR 1.5, p < 0.01) to be strongly associated with CAD independent of metabolic syndrome (OR 1.2, p < 0.05). Conclusions: Patients with smaller retinal AVR (<0.7) are likely to be at increased risk for CAD and carotid atherosclerosis in patients with NAFLD even without hypertension or diabetes.
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Affiliation(s)
- Pikkel Josef
- Department of Ophtalmology, Ziv Medical Centre, Safed 13100, Israel; E-Mails: (P.J.); (I.A.)
- Faculty of Medicine at Galilee, Bar Ilan University, Safed 13100, Israel; E-Mail:
| | - Ibrahim Ali
- Department of Ophtalmology, Ziv Medical Centre, Safed 13100, Israel; E-Mails: (P.J.); (I.A.)
- Liver Unit, Ziv Medical Centre, Safed 13100, Israel
| | - Prober Ariel
- Department of Radiology, Safed 13100, Israel; E-Mail:
| | - Marmor Alon
- Faculty of Medicine at Galilee, Bar Ilan University, Safed 13100, Israel; E-Mail:
| | - Assy Nimer
- Faculty of Medicine at Galilee, Bar Ilan University, Safed 13100, Israel; E-Mail:
- Liver Unit, Ziv Medical Centre, Safed 13100, Israel
- Author to whom correspondence should be addresse; E-Mail: ; Tel.: +972-4682-8442; Fax: +972-4682-8165
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Yatsuzuka SI, Shimomura Y, Akuzawa M, Ando Y, Kobayashi I, Nakano T, Tokita Y, Nagamine T, Ono H, Tanaka A, Schaefer E, Nakajima K. Plasma adiponectin is a more specific marker of fatty liver than a marker of metabolic syndrome in Japanese men. Ann Clin Biochem 2013; 51:68-79. [PMID: 23897104 DOI: 10.1177/0004563213487892] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The association of plasma cardiovascular risk markers and metabolic syndrome (MetS) with non-alcoholic fatty liver disease (NAFLD) has not been well defined. METHODS Japanese men (n = 809) had standard anthropometric measurements done, and had their liver fat quantitated by ultrasound. Three groups were identified: (1) normal controls without significant disease, (2) preliminary-metabolic syndrome (pre-MetS) cases and (3) MetS cases. Plasma adiponectin, high sensitivity-C reactive protein (hs-CRP), HOMA-IR, lipids, lipoproteins and liver enzymes were evaluated among the three groups. RESULTS The prevalence of fatty liver was 13% in controls, 39% in pre-MetS and 62% in MetS. Plasma adiponectin and high density lipoprotein cholesterol (HDL-C) were significantly decreased, and HOMA-IR, hs-CRP, TG, remnant lipoproteins (RLPs) and small dense-LDL-C (sd LDL-C) were significantly increased in subjects with fatty liver compared to those without fatty liver. Multivariate analyses of serum parameters associated with fatty liver revealed that adiponectin and hs-CRP were more strongly associated with the presence of fatty liver than waist circumference. However, HOMA-IR, HDL-C, TG, RLP-C, RLP-TG and sd LDL-C were more strongly associated with waist circumference than with fatty liver. Factor analysis revealed that adiponectin and HDL-C were linked to liver enzymes, lipoproteins and HOMA-IR associated with fatty liver, but not with waist circumference. CONCLUSIONS Adiponectin was found to be a more specific diagnostic marker for the presence of fatty liver regardless of MetS status, and was inversely correlated with liver enzyme concentrations. However, RLPs were found to be more specifically associated with the presence of MetS.
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Affiliation(s)
- Shin-Ichi Yatsuzuka
- Diabetes and Metabolic Disease Research Center, Hidaka Hospital, Takasaki, Japan
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Nseir W, Mahamid M. Statins in nonalcoholic fatty liver disease and steatohepatitis: updated review. Curr Atheroscler Rep 2013; 15:305. [PMID: 23328905 DOI: 10.1007/s11883-012-0305-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that refers to the presence of hepatic steatosis without significant intake of alcohol. NAFLD is an asymptomatic disease that can progress to nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. The most common cause of mortality in patients with NAFLD or NASH is cardiovascular disease (CVD). Currently, the treatment of NAFLD focuses on gradual weight loss and life style modifications. However, multifactorial treatment of NAFLD or NASH risk factors may be needed to reduce the likelihood of these patients developing CVD. This review discusses the mechanisms that link hyperlipidemia and NAFLD. In addition, the review focuses on the safety and efficacy of statins in patients with NAFLD or NASH, and their effect on the extent of hepatic steatosis and fibrosis based on human studies.
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Affiliation(s)
- William Nseir
- Department of Internal Medicine, Holy Family Hospital, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed Israel, POB 8, Nazareth, 16100, Israel.
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Uzun H, OĞullar S, Ünal H, Zorba OÜ, Yazar S, Kalkan M. Non-alcoholic fatty liver disease is associated with benign prostate hyperplasia in men and with overactive bladder in women. Scand J Urol 2013; 47:497-502. [DOI: 10.3109/21681805.2013.780258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Feitosa MF, Wojczynski MK, North KE, Zhang Q, Province MA, Carr JJ, Borecki IB. The ERLIN1-CHUK-CWF19L1 gene cluster influences liver fat deposition and hepatic inflammation in the NHLBI Family Heart Study. Atherosclerosis 2013; 228:175-80. [PMID: 23477746 DOI: 10.1016/j.atherosclerosis.2013.01.038] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 12/20/2012] [Accepted: 01/24/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Nonalcoholic fatty liver disease (NAFLD) ranges from simple steatosis to hepatic inflammation to cirrhosis. We sought to identify common genetic variants contributing to NAFLD, using CT measured fatty liver (FL), and alanine aminotransferase levels (ALT), as a biochemical marker of hepatic inflammation. METHODS We employed a correlated meta-analysis (CMA) to test whether combining FL and ALT genomewide association (GWA) results, using ∼2.5 million imputed SNPs, could enhance ability to detect variants influencing both traits. RESULTS Variants of the ERLIN1-CHUK-CWF19L1 gene cluster were associated with concomitant variation of FL and ALT. Nine variants (rs2862954, rs1408579, rs10883451, rs11597086, rs11591741, rs17729876, rs17668255, rs17668357, rs12784396) displayed genomewide significant associations at loci concomitantly influencing FL and ALT (2.47 × 10(-9) ≤ CMA-p ≤ 4.29 × 10(-10)) as compared with the suggestive significance of marginal tests (4.11 × 10(-5) ≤ GWA-p ≤ 2.34 × 10(-6)). For example, the missense variant in ERLIN1-rs2862954 was genomewide significant (CMA-p = 4.88 × 10(-10)) for the combination of FL and ALT, while the respective univariate associations were suggestive (FL:p = 5.74 × 10(-6), ALT:p = 3.71 × 10(-6)). Further we investigated whether the concomitant associations were driven mainly by ALT levels. When we adjusted FL by ALT, the correlated associations diminished but did not vanish (CMA-p ≤ 3.3 × 10(-7)). Our findings suggest ERLIN1-CHUK-CWF19L1 variants are associated with early stage of FL accumulation (measured by CT) to hepatic inflammation (ALT levels), and the association enhances when accounting for the correlations between their scans. CONCLUSIONS CMA approach enhanced the ability to identify novel variants of the ERLIN1-CHUK-CWF19L1 influencing both simple steatosis and hepatic steatosis with inflammation, which suggest that this gene cluster may regulate the susceptibility of NAFLD in a wide spectrum of disease.
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Affiliation(s)
- Mary F Feitosa
- Department of Genetics, Washington University School of Medicine, St Louis, MO 63108-2212, USA.
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