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Han AL, Lee HK, Shin SR. Diagnostic Performance of Insulin Resistance Indices for Identifying Metabolic Dysfunction-Associated Fatty Liver Disease. Metab Syndr Relat Disord 2024. [PMID: 38574322 DOI: 10.1089/met.2023.0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Background/objectives: Insulin resistance (IR) plays an important role in metabolic dysfunction-associated fatty liver disease (MAFLD) pathogenesis. A modified triglyceride-glucose (TyG) index, including TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC), has been introduced to represent IR. This study aimed to investigate the diagnostic abilities of IR indices in MAFLD, in which fatty liver was diagnosed using computed tomography (CT). Subjects/methods: We retrospectively analyzed the clinical data and images of 852 adults aged ≥19 years who underwent abdominal CT. MAFLD was diagnosed based on the appearance of fatty liver on CT alongside at least one of the following three criteria: being overweight or obese, at least two metabolic risk abnormalities, and/or diabetes mellitus. IR indices were calculated by examining the following variables: homeostasis model assessment-IR, TyG index, TyG-BMI, TyG-WC, and visceral adiposity index. The diagnostic accuracy was evaluated using the area under the receiver operating characteristic curve. Results: For all patients, the area under the curve (AUC) of the TyG index, TyG-BMI, and TyG-WC were 0.834, 0.938, and 0.942, respectively. In men, the AUC of the TyG index, TyG-BMI, and TyG-WC were 0.812, 0.928, and 0.934, respectively. In women, the AUC of the TyG index was 0.841, and TyG-BMI and TyG-WC were 0.940 and 0.953, respectively. The AUC values tended to increase in the following order: TyG index < TyG-BMI < TyG-WC. Women showed a higher AUC than men in all items, and the TyG-WC of women showed the highest value with AUC 0.953 (95% confidence interval [CI]: 0.892-1.000, P < 0.0001). The AUC of the TyG index was 0.858 (95% CI: 0.828-0.888, P < 0.0001). Conclusions: In conclusion, TyG-WC is a powerful surrogate marker for identifying MAFLD in clinical settings.
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Affiliation(s)
- A Lum Han
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Hee Kyung Lee
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Sae Ron Shin
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
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2
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De Cól JP, de Lima EP, Pompeu FM, Cressoni Araújo A, de Alvares Goulart R, Bechara MD, Laurindo LF, Méndez-Sánchez N, Barbalho SM. Underlying Mechanisms behind the Brain-Gut-Liver Axis and Metabolic-Associated Fatty Liver Disease (MAFLD): An Update. Int J Mol Sci 2024; 25:3694. [PMID: 38612504 PMCID: PMC11011299 DOI: 10.3390/ijms25073694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
Metabolic-associated fatty liver disease (MAFLD) includes several metabolic dysfunctions caused by dysregulation in the brain-gut-liver axis and, consequently, increases cardiovascular risks and fatty liver dysfunction. In MAFLD, type 2 diabetes mellitus, obesity, and metabolic syndrome are frequently present; these conditions are related to liver lipogenesis and systemic inflammation. This study aimed to review the connection between the brain-gut-liver axis and MAFLD. The inflammatory process, cellular alterations in hepatocytes and stellate cells, hypercaloric diet, and sedentarism aggravate the prognosis of patients with MAFLD. Thus, to understand the modulation of the physiopathology of MAFLD, it is necessary to include the organokines involved in this process (adipokines, myokines, osteokines, and hepatokines) and their clinical relevance to project future perspectives of this condition and bring to light new possibilities in therapeutic approaches. Adipokines are responsible for the activation of distinct cellular signaling in different tissues, such as insulin and pro-inflammatory cytokines, which is important for balancing substances to avoid MAFLD and its progression. Myokines improve the quantity and quality of adipose tissues, contributing to avoiding the development of MAFLD. Finally, hepatokines are decisive in improving or not improving the progression of this disease through the regulation of pro-inflammatory and anti-inflammatory organokines.
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Affiliation(s)
- Júlia Pauli De Cól
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil; (J.P.D.C.); (M.D.B.)
| | - Enzo Pereira de Lima
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil; (J.P.D.C.); (M.D.B.)
| | - Fernanda Moris Pompeu
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil; (J.P.D.C.); (M.D.B.)
| | - Adriano Cressoni Araújo
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil; (J.P.D.C.); (M.D.B.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil;
| | - Ricardo de Alvares Goulart
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil;
| | - Marcelo Dib Bechara
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil; (J.P.D.C.); (M.D.B.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil;
| | - Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, Faculdade de Medicina de Marília (FAMEMA), Marília, São Paulo 17519-080, Brazil;
| | - Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City 14050, Mexico;
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil; (J.P.D.C.); (M.D.B.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, School of Medicine, Universidade de Marília (UNIMAR), São Paulo 17525-902, Brazil;
- Department of Biochemistry and Nutrition, School of Food and Technology of Marília (FATEC), São Paulo 17500-000, Brazil
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Zhang M, Shi X, Tang M, Yin W, Luo C, Xie X. PRDX2 deficiency increases MCD-induced nonalcoholic steatohepatitis in female mice. Biochem Biophys Res Commun 2024; 701:149589. [PMID: 38309152 DOI: 10.1016/j.bbrc.2024.149589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE To evaluate the role of PRDX2 in nonalcoholic steatohepatitis (NASH). METHODS NASH was induced in wild-type (WT) mice and liver-specific PRDX2 knockout (PRDX2 LKO) mice that were fed a methionine-choline deficient diet (MCD) for 5 weeks. Assessments of PRDX2 LKO's impact on the pathogenesis of NASH include histological analyses, quantitative PCR (q-PCR), western blotting (WB), and RNA sequencing (RNA-Seq). RESULTS PRDX2 LKO mice exhibited a significant increase in hepatic lipid accumulation and inflammation compared to WT mice after MCD feeding. PRDX2 KO markedly elevated circulating levels of aspartate aminotransferase (AST) and the pro-inflammatory signaling pathways within the liver. There was a notable increase in the activities of signal transducer and activator of transcription 1 (STAT1) and nuclear factor kappa B (NF-кB). We also found that PRDX2 KO significantly increased the extent of lipid peroxidation in the liver, most likely owing to the impaired peroxidase activity of PRDX2. Of interest, these findings were observed only in MCD-fed female mice, suggesting the sexual dimorphism of PRDX2 KO in MCD-induced NASH. CONCLUSION PRDX2 deficiency increases MCD-induced NASH in female mice, suggesting a protective role for PRDX2.
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Affiliation(s)
- Mengqi Zhang
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
| | - Xiaofeng Shi
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
| | - Minglei Tang
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
| | - Wen Yin
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
| | - Cheng Luo
- Zhongshan Institute for Drug Discovery, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Zhongshan, 528437, China
| | - Xiangyang Xie
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China.
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Xu M, Lin Y, Yang N, Li J, Li L, Ding H, Xu C. Relationship between skeletal muscle mass loss and metabolic dysfunction-associated fatty liver disease among Chinese patients with metabolic dysregulation. Rev Assoc Med Bras (1992) 2024; 70:e20230963. [PMID: 38451586 PMCID: PMC10914329 DOI: 10.1590/1806-9282.20230963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/07/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVE The aim of this study was to explore the correlation between skeletal muscle content and the presence and severity of metabolic dysfunction-associated fatty liver disease in patients with metabolic dysregulation in China. METHODS A cross-sectional study was conducted among patients from the endocrinology outpatient department at Ningbo First Hospital, in Ningbo, China, in April 2021. Adult patients with metabolic dysregulation who accepted FibroScan ultrasound were included in the study. However, those without clinical data on skeletal muscle mass were excluded. FibroScan ultrasound was used to noninvasively evaluate metabolic dysfunction-associated fatty liver disease. The controlled attenuation parameter was used as an evaluation index for the severity of liver steatosis. Bioelectrical impedance analysis was used to measure the skeletal muscle index. RESULTS A total of 153 eligible patients with complete data were included in the final analysis. As the grading of liver steatosis intensifies, skeletal muscle index decreases (men: Ptrend<0.001, women: Ptrend=0.001), while body mass index, blood pressure, blood lipid, uric acid, aminotransferase, and homeostatic model assessment of insulin resistance increase (Ptrend<0.01). After adjusting for confounding factors, a negative association between skeletal muscle index and the presence of metabolic dysfunction-associated fatty liver disease was observed in men (OR=0.691, p=0.027) and women (OR=0.614, p=0.022). According to the receiver operating characteristic curve, the best cutoff values of skeletal muscle index for predicting the metabolic dysfunction-associated fatty liver disease presence were 40.37% for men (sensitivity, 87.5%; specificity, 61.5%) and 33.95% for women (sensitivity, 78.6%; specificity, 63.8%). CONCLUSION Skeletal muscle mass loss among patients with metabolic dysregulation was positively associated with metabolic dysfunction-associated fatty liver disease severity in both sexes. The skeletal muscle index cutoff value could be used to predict metabolic dysfunction-associated fatty liver disease.
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Affiliation(s)
- Miao Xu
- Zhejiang University School of Medicine, The First Affiliated
Hospital, Zhejiang Provincial Clinical Research Center for Digestive Diseases,
Department of Gastroenterology – Hangzhou, China
- The First Affiliated Hospital of Ningbo University, Department of
Endocrinology and Metabolism – Ningbo, China
| | - Yi Lin
- University of Nottingham, Faculty of Humanities and Social Sciences,
Center for Health Economics – Ningbo, China
| | - Naibin Yang
- The First Affiliated Hospital of Ningbo University, Metabolic
(Dysfunction)-Associated Fatty Liver Disease Research Center, Department of
Hepatology – Ningbo, China
| | - Jialin Li
- The First Affiliated Hospital of Ningbo University, Department of
Endocrinology and Metabolism – Ningbo, China
| | - Li Li
- The First Affiliated Hospital of Ningbo University, Department of
Endocrinology and Metabolism – Ningbo, China
| | - Huiqing Ding
- The First Affiliated Hospital of Ningbo University, Department of
Obstetrics and Gynecology – Ningbo, China
| | - Chengfu Xu
- Zhejiang University School of Medicine, The First Affiliated
Hospital, Zhejiang Provincial Clinical Research Center for Digestive Diseases,
Department of Gastroenterology – Hangzhou, China
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Huang W, Cao Z, Wang W, Yang Z, Jiao S, Chen Y, Chen S, Zhang L, Li Z. Discovery of LH10, a novel fexaramine-based FXR agonist for the treatment of liver disease. Bioorg Chem 2024; 143:107071. [PMID: 38199141 DOI: 10.1016/j.bioorg.2023.107071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/14/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024]
Abstract
Farnesoid X receptor (FXR) was considered as a promising drug target in the treatment of cholestasis, drug-induced liver injury, and non-alcoholic steatohepatitis (NASH). However, the existing FXR agonists have shown different degrees of side effects in clinical trials without clear interpretation. MET-409 in clinical phase Ⅲ, has been proven significantly fewer side effects than that of other FXR agonists. This may be due to the completely different structure of FEX and other non-steroidal FXR agonists. Herein, the structure-based drug design was carried out based on FEX, and the more active FXR agonist LH10 (FEX EC50 = 0,3 μM; LH10 EC50 = 0.14 μM)) was screened out by the comprehensive SAR studies. Furthermore, LH10 exhibited robust hepatoprotective activity on the ANIT-induced cholestatic model and APAP-induced acute liver injury model, which was even better than positive control OCA. In the nonalcoholic steatohepatitis (NASH) model, LH10 significantly improved the pathological characteristics of NASH by regulating several major pathways including lipid metabolism, inflammation, oxidative stress, and fibrosis. With the above attractive results, LH10 is worthy of further evaluation as a novel agent for the treatment of liver disorders.
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Affiliation(s)
- Wanqiu Huang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510006, PR China; Center for Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Zhijun Cao
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Center for Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Wenxin Wang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Zhongcheng Yang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Shixuan Jiao
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510006, PR China; Center for Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Ya Chen
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Siliang Chen
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Luyong Zhang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Center for Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Guangzhou Key Laboratory of Construction and Application of New Drug Screening Model Systems, Guangdong Pharmaceutical University, Guangzhou 510006, PR China.
| | - Zheng Li
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510006, PR China; Center for Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China; Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Guangzhou, 510006, PR China.
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Pal SC, Castillo-Castañeda SM, Díaz-Orozco LE, Ramírez-Mejía MM, Dorantes-Heredia R, Alonso-Morales R, Eslam M, Lammert F, Méndez-Sánchez N. Molecular Mechanisms Involved in MAFLD in Cholecystectomized Patients: A Cohort Study. Genes (Basel) 2023; 14:1935. [PMID: 37895284 PMCID: PMC10606482 DOI: 10.3390/genes14101935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/05/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Gallstone disease and metabolic dysfunction-associated fatty liver disease (MAFLD) share numerous common risk factors and progression determinants in that they both manifest as organ-specific consequences of metabolic dysfunction. Nevertheless, the precise molecular mechanisms underlying fibrosis development in cholecystectomized MAFLD patients remain inadequately defined. This study aimed to investigate the involvement of farnesoid X receptor 1 (FXR1) and fibroblast growth factor receptor 4 (FGFR4) in the progression of fibrosis in cholecystectomized MAFLD patients. A meticulously characterized cohort of 12 patients diagnosed with MAFLD, who had undergone liver biopsies during programmed cholecystectomies, participated in this study. All enrolled patients underwent a follow-up regimen at 1, 3, and 6 months post-cholecystectomy, during which metabolic biochemical markers were assessed, along with elastography, which served as indirect indicators of fibrosis. Additionally, the hepatic expression levels of FGFR4 and FXR1 were quantified using quantitative polymerase chain reaction (qPCR). Our findings revealed a robust correlation between hepatic FGFR4 expression and various histological features, including the steatosis degree (r = 0.779, p = 0.023), ballooning degeneration (r = 0.764, p = 0.027), interphase inflammation (r = 0.756, p = 0.030), and steatosis activity score (SAS) (r = 0.779, p = 0.023). Conversely, hepatic FXR1 expression did not exhibit any significant correlations with these histological features. In conclusion, our study highlights a substantial correlation between FGFR4 expression and histological liver damage, emphasizing its potential role in lipid and glucose metabolism. These findings suggest that FGFR4 may play a crucial role in the progression of fibrosis in cholecystectomized MAFLD patients. Further research is warranted to elucidate the exact mechanisms through which FGFR4 influences metabolic dysfunction and fibrosis in this patient population.
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Affiliation(s)
- Shreya C. Pal
- Faculty of Medicine, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico; (S.C.P.); (L.E.D.-O.)
| | - Stephany M. Castillo-Castañeda
- Medical, Dental and Health Sciences Master and Doctorate Program, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico;
- Liver Research Unit, Medica Sur Clinic & Foundation, Tlalpan, Mexico City 14050, Mexico; (M.M.R.-M.); (R.D.-H.)
| | - Luis E. Díaz-Orozco
- Faculty of Medicine, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico; (S.C.P.); (L.E.D.-O.)
| | - Mariana M. Ramírez-Mejía
- Liver Research Unit, Medica Sur Clinic & Foundation, Tlalpan, Mexico City 14050, Mexico; (M.M.R.-M.); (R.D.-H.)
- Plan of Combined Studies in Medicine, Faculty of Medicine, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico
| | - Rita Dorantes-Heredia
- Liver Research Unit, Medica Sur Clinic & Foundation, Tlalpan, Mexico City 14050, Mexico; (M.M.R.-M.); (R.D.-H.)
| | - Rogelio Alonso-Morales
- Genetic and Molecular Biology Laboratory, Faculty of Veterinary, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico;
| | - Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW 2145, Australia;
| | - Frank Lammert
- Health Sciences, Hannover Medical School (MHH), 30625 Hannover, Germany;
| | - Nahum Méndez-Sánchez
- Faculty of Medicine, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico; (S.C.P.); (L.E.D.-O.)
- Liver Research Unit, Medica Sur Clinic & Foundation, Tlalpan, Mexico City 14050, Mexico; (M.M.R.-M.); (R.D.-H.)
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Suárez M, Martínez R, Torres AM, Ramón A, Blasco P, Mateo J. A Machine Learning-Based Method for Detecting Liver Fibrosis. Diagnostics (Basel) 2023; 13:2952. [PMID: 37761319 PMCID: PMC10529519 DOI: 10.3390/diagnostics13182952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/03/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Cholecystectomy and Metabolic-associated steatotic liver disease (MASLD) are prevalent conditions in gastroenterology, frequently co-occurring in clinical practice. Cholecystectomy has been shown to have metabolic consequences, sharing similar pathological mechanisms with MASLD. A database of MASLD patients who underwent cholecystectomy was analysed. This study aimed to develop a tool to identify the risk of liver fibrosis after cholecystectomy. For this purpose, the extreme gradient boosting (XGB) algorithm was used to construct an effective predictive model. The factors associated with a better predictive method were platelet level, followed by dyslipidaemia and type-2 diabetes (T2DM). Compared to other ML methods, our proposed method, XGB, achieved higher accuracy values. The XGB method had the highest balanced accuracy (93.16%). XGB outperformed KNN in accuracy (93.16% vs. 84.45%) and AUC (0.92 vs. 0.84). These results demonstrate that the proposed XGB method can be used as an automatic diagnostic aid for MASLD patients based on machine-learning techniques.
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Affiliation(s)
- Miguel Suárez
- Gastroenterology Department, Virgen de la Luz Hospital, 16002 Cuenca, Spain
- Medical Analysis Expert Group, Institute of Technology, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Medical Analysis Expert Group, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
| | - Raquel Martínez
- Gastroenterology Department, Virgen de la Luz Hospital, 16002 Cuenca, Spain
- Medical Analysis Expert Group, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
| | - Ana María Torres
- Medical Analysis Expert Group, Institute of Technology, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Medical Analysis Expert Group, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
| | - Antonio Ramón
- Department of Pharmacy, General University Hospital, 46014 Valencia, Spain
| | - Pilar Blasco
- Department of Pharmacy, General University Hospital, 46014 Valencia, Spain
| | - Jorge Mateo
- Medical Analysis Expert Group, Institute of Technology, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Medical Analysis Expert Group, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
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8
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Huttler A, Murugappan G, Stentz NC, Cedars MI. Reproduction as a window to future health in women. Fertil Steril 2023; 120:421-428. [PMID: 36641001 DOI: 10.1016/j.fertnstert.2023.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/16/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
Cultivating awareness for reproduction as a window to future health presents an opportunity for early identification and modification of risk factors that can affect both individual and population-level morbidity and mortality. Infertility could serve as both a window into future health as well as a pathway to future pathology. The underlying mechanisms of infertility may share common pathways with long-term risk for health and well-being. Making this identification early in the disease process may improve opportunities for intervention, and deepen our understanding of long-term risk. Additionally, fertility treatments may increase individual risk. Only by making these associations and designing studies to understand how disease and treatment risk impact health can we truly fulfill our goal of building healthy families. The aim of this review is to discuss the short-term impact of fertility challenges and treatment, long-term associations of infertility with morbidity and mortality, and the role of parity in modifying these risk associations.
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Pal SC, Méndez-Sánchez N. Insulin resistance and adipose tissue interactions as the cornerstone of metabolic (dysfunction)-associated fatty liver disease pathogenesis. World J Gastroenterol 2023; 29:3999-4008. [PMID: 37476582 PMCID: PMC10354585 DOI: 10.3748/wjg.v29.i25.3999] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/09/2023] [Accepted: 03/20/2023] [Indexed: 06/28/2023] Open
Abstract
The relationship between metabolic derangements and fatty liver development are undeniable, since more than 75% of patients with type 2 diabetes mellitus present with fatty liver. There is also significant epidemiological association between insulin resistance (IR) and metabolic (dysfunction)-associated fatty liver disease (MAFLD). For little more than 2 years, the nomenclature of fatty liver of non-alcoholic origin has been intended to change to MAFLD by multiple groups. While a myriad of reasons for which MAFLD is thought to be of metabolic origin could be exposed, the bottom line relies on the role of IR as an initiator and perpetuator of this disease. There is a reciprocal role in MAFLD development and IR as well as serum glucose concentrations, where increased circulating glucose and insulin result in increased de novo lipogenesis by sterol regulatory element-binding protein-1c induced lipogenic enzyme stimulation; therefore, increased endogenous production of triglycerides. The same effect is achieved through impaired suppression of adipose tissue (AT) lipolysis in insulin-resistant states, increasing fatty acid influx into the liver. The complementary reciprocal situation occurs when liver steatosis alters hepatokine secretion, modifying fatty acid metabolism as well as IR in a variety of tissues, including skeletal muscle, AT, and the liver. The aim of this review is to discuss the importance of IR and AT interactions in metabolic altered states as perhaps the most important factor in MAFLD pathogenesis.
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Affiliation(s)
- Shreya C Pal
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City 04510, Mexico
| | - Nahum Méndez-Sánchez
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City 04510, Mexico
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Ma YL, Ke JF, Wang JW, Wang YJ, Xu MR, Li LX. Blood lactate levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease in type 2 diabetes: a real-world study. Front Endocrinol (Lausanne) 2023; 14:1133991. [PMID: 37223022 PMCID: PMC10200915 DOI: 10.3389/fendo.2023.1133991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/17/2023] [Indexed: 05/25/2023] Open
Abstract
Aim To investigate the association between blood lactate levels and metabolic dysfunction-associated fatty liver disease (MAFLD) in type 2 diabetes mellitus (T2DM). Methods 4628 Chinese T2DM patients were divided into quartiles according to blood lactate levels in this real-world study. Abdominal ultrasonography was used to diagnosis MAFLD. The associations of blood lactate levels and quartiles with MAFLD were analyzed by logistic regression. Results There were a significantly increased trend in both MAFLD prevalence (28.9%, 36.5%, 43.5%, and 54.7%) and HOMA2-IR value (1.31(0.80-2.03), 1.44(0.87-2.20), 1.59(0.99-2.36), 1.82(1.15-2.59)) across the blood lactate quartiles in T2DM patients after adjustment for age, sex, diabetic duration, and metformin use (all p<0.001 for trend). After correcting for other confounding factors, not only increased blood lactate levels were obviously associated with MAFLD presence in the patients with (OR=1.378, 95%CI: 1.210-1.569, p<0.001) and without taking metformin (OR=1.181, 95%CI: 1.010-1.381, p=0.037), but also blood lactate quartiles were independently correlated to the increased risk of MAFLD in T2DM patients (p<0.001 for trend). Compared with the subjects in the lowest blood lactate quartiles, the risk of MAFLD increased to 1.436-, 1.473-, and 2.055-fold, respectively, in those from the second to the highest lactate quartiles. Conclusions The blood lactate levels in T2DM subjects were independently associated with an increased risk of MAFLD, which was not affected by metformin-taking and might closely related to insulin resistance. Blood lactate levels might be used as a practical indicator for assessing the risk of MAFLD in T2DM patients.
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Affiliation(s)
- Yi-Lin Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Jiang-Feng Ke
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Jun-Wei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Yu-Jie Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Man-Rong Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Lian-Xi Li
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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Ren Q, Chen Y, Zhou Z, Cai Z, Jiao S, Huang W, Wang B, Chen S, Wang W, Cao Z, Yang Z, Deng L, Hu L, Zhang L, Li Z. Discovery of the First-in-Class Intestinal Restricted FXR and FABP1 Dual Modulator ZLY28 for the Treatment of Nonalcoholic Fatty Liver Disease. J Med Chem 2023; 66:6082-6104. [PMID: 37079895 DOI: 10.1021/acs.jmedchem.2c01918] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
The prevalence of nonalcoholic steatohepatitis (NASH) is increasing rapidly worldwide, and NASH has become a serious problem for human health. Recently, the selective activation of the intestinal farnesoid X receptor (FXR) was considered as a more promising strategy for the treatment of NASH with lesser side effects due to reduced systemic exposure. Moreover, the inhibition of intestinal fatty acid binding protein 1 (FABP1) alleviated obesity and NASH by reducing dietary fatty acid uptake. In this study, the first-in-class intestinal restricted FXR and FABP1 dual-target modulator ZLY28 was discovered by comprehensive multiparameter optimization studies. The reduced systemic exposure of ZLY28 might provide better safety by decreasing the on- and off-target side effects in vivo. In NASH mice, ZLY28 exerted robust anti-NASH effects by inhibiting FABP1 and activating the FXR-FGF15 signaling pathway in the ileum. With the above attractive efficacy and preliminary safety profiles, ZLY28 is worthy of further evaluation as a novel anti-NASH agent.
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Affiliation(s)
- Qiang Ren
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Ya Chen
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Zongtao Zhou
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Guangzhou Key Laboratory of Construction and Application of New Drug Screening Model Systems, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Zongyu Cai
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Shixuan Jiao
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Wanqiu Huang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Bin Wang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Siliang Chen
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Wenxin Wang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Zhijun Cao
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Zhongcheng Yang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Liming Deng
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Lijun Hu
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
| | - Luyong Zhang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Guangzhou Key Laboratory of Construction and Application of New Drug Screening Model Systems, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, PR China
| | - Zheng Li
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510006, PR China
- Key Laboratory of New Drug Discovery and Evaluation of the Guangdong Provincial Education Department, Guangdong Pharmaceutical University, Guangzhou 510006, PR China
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12
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Di Sessa A, Cembalo Sambiase Sanseverino N, De Simone RF, Marrapodi MM, Cirillo G, Umano GR, Guarino S, Papparella A, Miraglia Del Giudice E, Marzuillo P. Association between non-alcoholic fatty liver disease and subclinical hypothyroidism in children with obesity. J Endocrinol Invest 2023:10.1007/s40618-023-02041-3. [PMID: 36828986 DOI: 10.1007/s40618-023-02041-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 02/10/2023] [Indexed: 02/26/2023]
Abstract
PURPOSE We aimed (i) evaluating the relationship between non-alcoholic fatty liver disease (NAFLD) and thyroid function tests, (ii) testing if the relationship between NAFLD and thyroid dysfunction could be driven by the obesity and the IR degree, and (iii) exploring the influence of the patatin-like phospholipase domain-containing protein-3 (PNPLA3) I148M and the transmembrane 6 superfamily member 2 (TM6SF2) E167K polymorphisms on the association between NAFLD and thyroid function in children. METHODS We examined 2275 children and adolescents with obesity. Subclinical hypothyroidism (SH) was defined by thyroid-stimulating hormone (TSH) > 4.2 μUI/ml with normal fT3 and fT4. RESULTS Children with NAFLD showed higher SH prevalence than those without NAFLD (15.7% Vs 7.4%;p = 0.001) and showed an adjusted odds ratio (aOR) to have SH of 1.68 (95% CI:1.01-2.80;p = 0.04) while patients with SH had an aOR to show NAFLD of 2.13(95% CI:1.22-3.73;p = 0.008). Patients having severe obesity and IR degree presented an aOR to show both NAFLD and SH of 3.61 (95% CI:1.78-7.33;p < 0.0001). Subjects with NAFLD carrying the TM6SF2 167 K allele had lower TSH levels than non-carriers (p = 0.03) and showed an aOR to have SH of 0.10 (95% CI: 0.01-0.79;p = 0.02). No differences were found in carriers of the PNPLA3 148 M allele. A general linear model for TSH variance showed a significant association of TSH with TM6SF2 genotypes only in the NAFLD group (p = 0.001). CONCLUSION Children with obesity and NAFLD presented increase risk of SH and vice versa likely due to the adverse effect of duration of obesity, obesity degree, and IR. The TM6SF2 E167K exerts a protective role against SH in children with obesity and NAFLD.
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Affiliation(s)
- A Di Sessa
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy.
| | - N Cembalo Sambiase Sanseverino
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy
| | - R F De Simone
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy
| | - M M Marrapodi
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy
| | - G Cirillo
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy
| | - G R Umano
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy
| | - S Guarino
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy
| | - A Papparella
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy
| | - E Miraglia Del Giudice
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy
| | - P Marzuillo
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio no 2, 80138, Naples, Italy
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Preshy A, Brown J. A Bidirectional Association Between Obstructive Sleep Apnea and Metabolic-Associated Fatty Liver Disease. Endocrinol Metab Clin North Am 2023. [PMID: 37495341 DOI: 10.1016/j.ecl.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Obesity is considered a twentieth-century epidemic and is a growing concern among health professionals. Obesity and its complications contribute to multiple chronic illnesses, such as type 2 diabetes (T2D), metabolic syndrome, obstructive sleep apnea (OSA), malignancy, and cardiovascular and liver diseases. In the last two decades, a bidirectional association between OSA and metabolic-associated fatty liver disease (MAFLD), independent of obesity, has been established. Both conditions have similar risk factors and metabolic comorbidities that may imply a common disease pathway. This review compiles the evidence and delineates the relationship between OSA and MAFLD from a clinical and diagnostic aspect.
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Di Bonito P, Di Sessa A, Licenziati MR, Corica D, Wasniewska M, Umano GR, Morandi A, Maffeis C, Faienza MF, Mozzillo E, Calcaterra V, Franco F, Maltoni G, Valerio G. Is Metabolic Syndrome Useful for Identifying Youths with Obesity at Risk for NAFLD? Children (Basel) 2023; 10:children10020233. [PMID: 36832363 PMCID: PMC9955487 DOI: 10.3390/children10020233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
The definition of metabolic syndrome (MetS) in childhood is controversial. Recently, a modified version of the International Diabetes Federation (IDF) definition was proposed using reference data from an international population for high waist circumference (WC) and blood pressure (BP), while the fixed cutoffs for lipids and glucose were not changed. We analyzed MetS prevalence using this modified definition (MetS-IDFm) and its association with non-alcoholic fatty liver disease (NAFLD) in 1057 youths (age 6-17 years) with overweight/obesity (OW/OB). A comparison with another modified definition of MetS according to the Adult Treatment Panel III (MetS-ATPIIIm) was performed. The prevalence of MetS-IDFm was 27.8% and 28.9% by MetS-ATPIIIm. The Odds (95% Confidence Intervals) of NAFLD was 2.70 (1.30-5.60) (p = 0.008) for high WC, 1.68 (1.25-2.26)(p = 0.001) for MetS, 1.54 (1.12-2.11)(p = 0.007) for low HDL-Cholesterol, 1.49 (1.04-2.13)(p = 0.032) for high triglycerides and 1.37 (1.03-1.82)(p = 0.033) for high BP. No substantial difference was found in the prevalence of MetS-IDFm and frequency of NAFLD compared to Mets-ATPIIIm definition. Our data demonstrate that one third of youths with OW/OB have MetS, whichever was the criterion. Neither definition was superior to some of their components in identifying youths with OW/OB at risk for NAFLD.
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Affiliation(s)
- Procolo Di Bonito
- Department of Internal Medicine, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy
| | - Anna Di Sessa
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Maria Rosaria Licenziati
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80122 Napoli, Italy
| | - Domenico Corica
- Department of Human Pathology in Adulthood and Childhood, University of Messina, 98122 Messina, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology in Adulthood and Childhood, University of Messina, 98122 Messina, Italy
| | - Giuseppina Rosaria Umano
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Anita Morandi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
| | - Maria Felicia Faienza
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples “Federico II”, 80131 Napoli, Italy
| | - Valeria Calcaterra
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Francesca Franco
- Pediatric Department, Azienda Sanitaria Universitaria Friuli Centrale, Hospital of Udine, 33100 Udine, Italy
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Napoli “Parthenope”, 80133 Napoli, Italy
- Correspondence:
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Abstract
Metabolic-associated fatty liver disease (MAFLD) is a highly prevalent disease with increasing prevalence worldwide. Currently, no universal screening methods have been standardized, even when this disease poses a major health burden. MAFLD as a spectrum of diseases can range from simple steatosis, and steatohepatitis to fibrosis and hepatocellular carcinoma. Its extra-hepatic manifestations are vast and include cardiovascular diseases, extra-hepatic malignancies, cognitive and respiratory alterations. Given its extensive damage targets as well as its high prevalence, timely identification of the high-risk population presenting metabolic dysfunction should undergo universal non-invasive screening methods, which can be carried out through blood tests, easy and effective imaging techniques, such as ultrasound, score calculation and general clinical information brought together from primary patient-physician contact.
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Affiliation(s)
- Shreya C. Pal
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
- Liver Research Unit, Medica Sur Clinic Foundation, Mexico City, Mexico
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Stratakis CA. Genetics of hyperaldosteronism and a wealth of new information on topics ranging from MEN1 to Cushing's disease and metabolic syndrome. Hormones (Athens) 2022; 21:521-523. [PMID: 36380266 DOI: 10.1007/s42000-022-00418-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Constantine A Stratakis
- Hormones, Athens, Greece.
- Human Genetics & Precision Medicine, IMBB, FORTH, Nikolaou Plastira 100, Vassilika Vouton, GR 700 13, Heraklion, Crete, Greece.
- Medical Genetics, H. Dunant Hospital, Athens, Greece.
- ELPEN Research Institute, Athens, Greece.
- NIH Clinical Center, NICHD, NIH, Bethesda, MD, USA.
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