Pub Date : 2024-06-26DOI: 10.1186/s43066-024-00356-1
F. Karahan, A. Atay, N. Ekinci, O. N. Dilek
The diagnosis and treatment of benign tumors of the gallbladder and bile ducts are difficult due to their anatomical relationships with neighboring vital organs. Hemangiomas are non-epithelial benign tumors of the gallbladder. The gallbladder is an extremely rare localization for cavernous hemangiomas. To date, 7 cases of cavernous gallbladder hemangioma have been reported in the literature. Although it is seen very rarely, the main problem is that it mimics malignant lesions. Pre-operative diagnosis of gallbladder hemangiomas is difficult. Ultrasound (US), computed tomography (CT) magnetic resonance imaging(MRI), endoscopic ultrasound (EUS), and angiography are helpful in differential diagnosis. Here, we aimed to present our case, which is the first case of cavernous gallbladder hemangioma and obstructive jaundice in the literature. A 49-year-old female patient was admitted with the complaint of pain in the right upper quadrant of her abdomen. Bilirubin levels were high due to obstructive jaundice. Abdominal CT and MRI showed an appearance in favor of hemangioma in the gallbladder. There was an increase in bile duct wall thickness on MRCP, and it was evaluated as suspicious for malignant neoplasia. The patient was operated on, and extrahepatic bile duct resection + Roux-en-Y hepaticojejunostomy procedure was performed. As a result of histopathology, hemangioma was detected in the gallbladder. There was no malignancy in the bile ducts. It should be kept in mind that the mass detected in the gallbladder in a patient with jaundice who is suspected of having a bile duct tumor may also be a hemangioma.
{"title":"A case of gallbladder hemangioma detected in a patient with jaundice and suspected Klatskin tumor: case report and review of the literature","authors":"F. Karahan, A. Atay, N. Ekinci, O. N. Dilek","doi":"10.1186/s43066-024-00356-1","DOIUrl":"https://doi.org/10.1186/s43066-024-00356-1","url":null,"abstract":"The diagnosis and treatment of benign tumors of the gallbladder and bile ducts are difficult due to their anatomical relationships with neighboring vital organs. Hemangiomas are non-epithelial benign tumors of the gallbladder. The gallbladder is an extremely rare localization for cavernous hemangiomas. To date, 7 cases of cavernous gallbladder hemangioma have been reported in the literature. Although it is seen very rarely, the main problem is that it mimics malignant lesions. Pre-operative diagnosis of gallbladder hemangiomas is difficult. Ultrasound (US), computed tomography (CT) magnetic resonance imaging(MRI), endoscopic ultrasound (EUS), and angiography are helpful in differential diagnosis. Here, we aimed to present our case, which is the first case of cavernous gallbladder hemangioma and obstructive jaundice in the literature. A 49-year-old female patient was admitted with the complaint of pain in the right upper quadrant of her abdomen. Bilirubin levels were high due to obstructive jaundice. Abdominal CT and MRI showed an appearance in favor of hemangioma in the gallbladder. There was an increase in bile duct wall thickness on MRCP, and it was evaluated as suspicious for malignant neoplasia. The patient was operated on, and extrahepatic bile duct resection + Roux-en-Y hepaticojejunostomy procedure was performed. As a result of histopathology, hemangioma was detected in the gallbladder. There was no malignancy in the bile ducts. It should be kept in mind that the mass detected in the gallbladder in a patient with jaundice who is suspected of having a bile duct tumor may also be a hemangioma.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141508256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endoscopic retrograde cholangiopancreatography (ERCP), a standard procedure used for diagnosing and treating pancreaticobiliary disorders, has the highest rate of complications among endoscopic procedures. We aimed to evaluate the association of post-ERCP pain onset and its severity with the development of acute complications. This cross-sectional study included 172 candidates for ERCP who were referred to Namazi Hospital, Shiraz, from January 21, 2021, to January 21, 2022. Demographic features of the participants, including age and gender, were recorded. ERCP indications, complications during and after ERCP, and narcotic requirements were also noted. Post-ERCP pain severity was evaluated using a 10-point visual analogue scale (VAS), with 0 indicating no pain and 10 indicating the worst pain. Pain severity was evaluated twice: once by the physician and once by the patient. The interval between the procedure and the onset of pain was also recorded. Out of the 172 participants of this study with a mean age of 53.77 ± 20.20 years, 98 (57%) were male. The most typical indication of ERCP was common bile duct stone (36%). Complications during and after ERCP occurred in 2.3% and 2.9%, respectively, with retroperitoneal/sphincterotomy perforation (1.2%) being the most common post-ERCP complication. Post-ERCP pain score (both by patient and physician) was significantly higher in patients with complications compared to those without complications (P < 0.001). The interval between the ERCP procedure and the onset of pain was significantly shorter in patients with post-ERCP complications (P = 0.003). Also, a significantly higher percentage of patients with complications required narcotics (40% vs 1.2%, P = 0.004). Although the presence of post-ERCP pain may not necessarily be indicative of complications, post-ERCP pain severity and onset, as well as narcotic requirement, appear to be associated with the development of post-ERCP complications.
{"title":"Predicting acute complications in endoscopic retrograde cholangiopancreatography based on the severity and onset of post-procedural pain","authors":"Fardad Ejtehadi, Iraj Shahramian, Mojtaba Khademi Befrouei, Gholam Reza Sivandzadeh, Seyed Alireza Taghavi, Ramin Niknam, Masoud Tahani","doi":"10.1186/s43066-024-00355-2","DOIUrl":"https://doi.org/10.1186/s43066-024-00355-2","url":null,"abstract":"Endoscopic retrograde cholangiopancreatography (ERCP), a standard procedure used for diagnosing and treating pancreaticobiliary disorders, has the highest rate of complications among endoscopic procedures. We aimed to evaluate the association of post-ERCP pain onset and its severity with the development of acute complications. This cross-sectional study included 172 candidates for ERCP who were referred to Namazi Hospital, Shiraz, from January 21, 2021, to January 21, 2022. Demographic features of the participants, including age and gender, were recorded. ERCP indications, complications during and after ERCP, and narcotic requirements were also noted. Post-ERCP pain severity was evaluated using a 10-point visual analogue scale (VAS), with 0 indicating no pain and 10 indicating the worst pain. Pain severity was evaluated twice: once by the physician and once by the patient. The interval between the procedure and the onset of pain was also recorded. Out of the 172 participants of this study with a mean age of 53.77 ± 20.20 years, 98 (57%) were male. The most typical indication of ERCP was common bile duct stone (36%). Complications during and after ERCP occurred in 2.3% and 2.9%, respectively, with retroperitoneal/sphincterotomy perforation (1.2%) being the most common post-ERCP complication. Post-ERCP pain score (both by patient and physician) was significantly higher in patients with complications compared to those without complications (P < 0.001). The interval between the ERCP procedure and the onset of pain was significantly shorter in patients with post-ERCP complications (P = 0.003). Also, a significantly higher percentage of patients with complications required narcotics (40% vs 1.2%, P = 0.004). Although the presence of post-ERCP pain may not necessarily be indicative of complications, post-ERCP pain severity and onset, as well as narcotic requirement, appear to be associated with the development of post-ERCP complications.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141508260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-15DOI: 10.1186/s43066-024-00353-4
Ali Nada, Alzhraa Alkhatib, Fady Abdelmalik, Mona El-Abd, N. Elabd, Hossam El-Din Abdel-Latif
{"title":"Bile level of cytokeratin 7 as a diagnostic marker for cholangiocarcinoma: a case-control study in Egyptian patients","authors":"Ali Nada, Alzhraa Alkhatib, Fady Abdelmalik, Mona El-Abd, N. Elabd, Hossam El-Din Abdel-Latif","doi":"10.1186/s43066-024-00353-4","DOIUrl":"https://doi.org/10.1186/s43066-024-00353-4","url":null,"abstract":"","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-08DOI: 10.1186/s43066-024-00351-6
Ahmed M. Elghandour, E. Bayoumy, M. Sayed, Moheb S. Eskandaros, Abdelmomen Momen Mohamed Emam, N. Teama, M. Mohamed, S. El-Gaaly
{"title":"Value of zonulin as a diagnostic and prognostic marker in different degrees of nonalcoholic fatty liver disease","authors":"Ahmed M. Elghandour, E. Bayoumy, M. Sayed, Moheb S. Eskandaros, Abdelmomen Momen Mohamed Emam, N. Teama, M. Mohamed, S. El-Gaaly","doi":"10.1186/s43066-024-00351-6","DOIUrl":"https://doi.org/10.1186/s43066-024-00351-6","url":null,"abstract":"","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141368636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.1186/s43066-024-00349-0
A. Elsharkawy, S. A. Alem, Saeed Moustafa, Shymaa Elnggar, A. Cordie, G. Esmat, Ahmed Moustafa
{"title":"Prevalence and predictors of hepatic steatosis among HIV patients with and without chronic hepatitis C","authors":"A. Elsharkawy, S. A. Alem, Saeed Moustafa, Shymaa Elnggar, A. Cordie, G. Esmat, Ahmed Moustafa","doi":"10.1186/s43066-024-00349-0","DOIUrl":"https://doi.org/10.1186/s43066-024-00349-0","url":null,"abstract":"","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141374809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1186/s43066-024-00350-7
Akash Roy, Suprabhat Giri, Sanchit Sharma, Surender Singh, Arka De, Prasun Jalal, Mahesh Goenka
Hyponatremia portends a poor prognosis in decompensated cirrhosis and is an independent predictor of mortality. Multiple modalities have been evaluated in the management of hyponatremia, including albumin infusion. However, the effect of albumin infusion on the resolution of hyponatremia is unclear. We conducted a systematic review to explore the available literature on the use of albumin infusion in hyponatremia. We performed a comprehensive search up to 31st December 2022 using MEDLINE, EMBASE, and Scopus for studies reporting the effectiveness of albumin infusion in the resolution of hyponatremia. The impact of albumin infusion of any dose, administration frequency, and duration of therapy was recorded. The study protocol was prospectively registered (CRD42021245914). The literature search yielded 1322 references after duplicate removal. Only seven studies (three randomized trials, three cohort studies, and one case series) satisfied the predefined selection criteria after a full-text review. While hyponatremia was clearly defined as serum sodium < 130 meEq/L in all studies, two studies explicitly defined hyponatremia resolution (serum sodium > 135 mEq/L). No differentiation was made between the types of hyponatremia. The strength of the albumin infusion used was 5% and 20%. All but one study reported significant improvement in hyponatremia with albumin infusion. A subgroup analysis showed albumin infusion improved 30-day survival (odds ratio 0.43, 95% CI 0.25–0.74, I2 = 0.) No studies reported adverse events or the impact of concomitant associations (diuretic withdrawal, lactulose use, sepsis). Despite available literature on the use of albumin infusion for the resolution of hyponatremia, the level of evidence remains low. Large prospective studies with pre-defined selection criteria and endpoints are required to generate the evidence.
{"title":"Effectiveness of albumin infusion for the management of hyponatremia in decompensated cirrhosis: a systematic review","authors":"Akash Roy, Suprabhat Giri, Sanchit Sharma, Surender Singh, Arka De, Prasun Jalal, Mahesh Goenka","doi":"10.1186/s43066-024-00350-7","DOIUrl":"https://doi.org/10.1186/s43066-024-00350-7","url":null,"abstract":"Hyponatremia portends a poor prognosis in decompensated cirrhosis and is an independent predictor of mortality. Multiple modalities have been evaluated in the management of hyponatremia, including albumin infusion. However, the effect of albumin infusion on the resolution of hyponatremia is unclear. We conducted a systematic review to explore the available literature on the use of albumin infusion in hyponatremia. We performed a comprehensive search up to 31st December 2022 using MEDLINE, EMBASE, and Scopus for studies reporting the effectiveness of albumin infusion in the resolution of hyponatremia. The impact of albumin infusion of any dose, administration frequency, and duration of therapy was recorded. The study protocol was prospectively registered (CRD42021245914). The literature search yielded 1322 references after duplicate removal. Only seven studies (three randomized trials, three cohort studies, and one case series) satisfied the predefined selection criteria after a full-text review. While hyponatremia was clearly defined as serum sodium < 130 meEq/L in all studies, two studies explicitly defined hyponatremia resolution (serum sodium > 135 mEq/L). No differentiation was made between the types of hyponatremia. The strength of the albumin infusion used was 5% and 20%. All but one study reported significant improvement in hyponatremia with albumin infusion. A subgroup analysis showed albumin infusion improved 30-day survival (odds ratio 0.43, 95% CI 0.25–0.74, I2 = 0.) No studies reported adverse events or the impact of concomitant associations (diuretic withdrawal, lactulose use, sepsis). Despite available literature on the use of albumin infusion for the resolution of hyponatremia, the level of evidence remains low. Large prospective studies with pre-defined selection criteria and endpoints are required to generate the evidence.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141197616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-31DOI: 10.1186/s43066-024-00346-3
Nehad Sobhy Mansour, Behairy El-Sayed Behairy, Ahmad Mohamed Sira, Sally Waheed Elkhadry, Ola Ahmed Fouad
Acute liver failure (ALF) is a serious condition that refers to the development of synthetic function impairment after severe acute liver injury in an individual without pre-existing liver disease. Understanding the epidemiology of ALF in children constitutes a cornerstone in its preventive and treatment plans. Nevertheless, there is a lack of information about its epidemiology in Egypt. The aim of this study was to assess the epidemiologic data of ALF in Egyptian children. The medical records of children with ALF aged from 6 months to 18 years who were admitted from 2015 to 2020 were analyzed to identify the patient’s epidemiologic, laboratory, and investigational data together with their outcome. The study included 154 patients who fulfilled the definition of ALF were included. Their age ranged from 7 months to 17 years, with a median of 5.8 years. Hepatitis A virus (HAV) was the most commonly identifiable etiology (37.7%). Mortality was the outcome for 73 patients (47.4%). The prognostic factors associated with mortality were elevated international normalized ratio (INR), total bilirubin (TB), creatinine, and ammonia levels at presentation with cutoff values (2.97, 21.15, 0.385, and 212, respectively). Hepatitis A virus is the most commonly identified etiology of ALF in Egyptian children. The mortality rate is high, and most of the deaths occurred early in the first 5 days of admission. So, early preparation for liver transplantation is recommended. Higher values of INR, TB, and creatinine above the cutoff levels at presentation may be potential markers for predicting death in affected children.
{"title":"Epidemiology of acute liver failure in Egyptian children","authors":"Nehad Sobhy Mansour, Behairy El-Sayed Behairy, Ahmad Mohamed Sira, Sally Waheed Elkhadry, Ola Ahmed Fouad","doi":"10.1186/s43066-024-00346-3","DOIUrl":"https://doi.org/10.1186/s43066-024-00346-3","url":null,"abstract":"Acute liver failure (ALF) is a serious condition that refers to the development of synthetic function impairment after severe acute liver injury in an individual without pre-existing liver disease. Understanding the epidemiology of ALF in children constitutes a cornerstone in its preventive and treatment plans. Nevertheless, there is a lack of information about its epidemiology in Egypt. The aim of this study was to assess the epidemiologic data of ALF in Egyptian children. The medical records of children with ALF aged from 6 months to 18 years who were admitted from 2015 to 2020 were analyzed to identify the patient’s epidemiologic, laboratory, and investigational data together with their outcome. The study included 154 patients who fulfilled the definition of ALF were included. Their age ranged from 7 months to 17 years, with a median of 5.8 years. Hepatitis A virus (HAV) was the most commonly identifiable etiology (37.7%). Mortality was the outcome for 73 patients (47.4%). The prognostic factors associated with mortality were elevated international normalized ratio (INR), total bilirubin (TB), creatinine, and ammonia levels at presentation with cutoff values (2.97, 21.15, 0.385, and 212, respectively). Hepatitis A virus is the most commonly identified etiology of ALF in Egyptian children. The mortality rate is high, and most of the deaths occurred early in the first 5 days of admission. So, early preparation for liver transplantation is recommended. Higher values of INR, TB, and creatinine above the cutoff levels at presentation may be potential markers for predicting death in affected children.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141197404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nonalcoholic fatty liver disease (NAFLD) is a prevalent metabolic disorder that has been associated with an increased risk of cardiovascular diseases. Endothelial dysfunction, characterized by impaired flow-mediated dilation (FMD) of the brachial artery, is a known predictor of cardiovascular risk. However, the relationship between NAFLD and endothelial dysfunction, as well as the impact of NAFLD on clinical cardiovascular events, remains unclear. The aim of this systematic literature review was to determine the association between endothelial dysfunction, as measured by FMD of the brachial artery, and NAFLD. Additionally, we aimed to investigate the relationship between NAFLD and clinical cardiovascular events (CVE). A systematic search was conducted in PubMed, Scopus, ScienceDirect, and Google Scholar for articles published between 2000 and July 2023. The reference lists of the included studies were also searched to retrieve possible additional studies. Original studies published in English focusing on adults with NAFLD and endothelial dysfunction are included. Editorials, commentaries, letters and studies focusing on pediatric populations and non-NAFLD liver diseases were excluded. The quality of included studies was appraised using the Newcastle–Ottawa scale. Meta-analyses were performed using Review Manager 5.4 software. The initial search yielded a total of 1792 articles and ultimately only 20 studies met the criteria. A total 6396 NAFLD patients were studied. Meta-analysis showed that individuals diagnosed with NAFLD had significantly lower brachial FMD values compared to their respective control groups (standardized mean difference: -4.63, 95% confidence interval: -5.68 to -3.58, p < 0.0001). Furthermore, NAFLD patients exhibited a significantly higher risk of clinical cardiovascular events compared to controls (odds ratio: 2.61; 95% CI: 1.41–4.83, p < 0.002). Subgroup analysis of studies focusing on non-alcoholic steatohepatitis (NASH) versus pure steatosis demonstrated that individuals with NASH had even lower FMD values than those with pure steatosis (standardized mean difference: -3.84, 95% confidence interval: -7.56 to -0.13, p = 0.03, I2 = 66%). The review included studies published in English language, over last 23 years and specified database resulted in language bias and might have missed older pertinent studies from another important database. The overall heterogeneity is attributed to variations in study populations, outcome measurements, differences in methodological approaches among included studies, and diverse diagnostic criteria for NAFLD. Individuals with NAFLD exhibited impaired brachial FMD, indicating compromised endothelial function. Furthermore, NAFLD patients had an elevated risk of clinical cardiovascular events.
{"title":"Endothelial dysfunction and cardiovascular risk in non-alcoholic fatty liver disease – a systematic review and meta-analysis","authors":"Nilesh Toke, Ajit Rathod, Pooja Phalak, Vikas Patel","doi":"10.1186/s43066-024-00348-1","DOIUrl":"https://doi.org/10.1186/s43066-024-00348-1","url":null,"abstract":"Nonalcoholic fatty liver disease (NAFLD) is a prevalent metabolic disorder that has been associated with an increased risk of cardiovascular diseases. Endothelial dysfunction, characterized by impaired flow-mediated dilation (FMD) of the brachial artery, is a known predictor of cardiovascular risk. However, the relationship between NAFLD and endothelial dysfunction, as well as the impact of NAFLD on clinical cardiovascular events, remains unclear. The aim of this systematic literature review was to determine the association between endothelial dysfunction, as measured by FMD of the brachial artery, and NAFLD. Additionally, we aimed to investigate the relationship between NAFLD and clinical cardiovascular events (CVE). A systematic search was conducted in PubMed, Scopus, ScienceDirect, and Google Scholar for articles published between 2000 and July 2023. The reference lists of the included studies were also searched to retrieve possible additional studies. Original studies published in English focusing on adults with NAFLD and endothelial dysfunction are included. Editorials, commentaries, letters and studies focusing on pediatric populations and non-NAFLD liver diseases were excluded. The quality of included studies was appraised using the Newcastle–Ottawa scale. Meta-analyses were performed using Review Manager 5.4 software. The initial search yielded a total of 1792 articles and ultimately only 20 studies met the criteria. A total 6396 NAFLD patients were studied. Meta-analysis showed that individuals diagnosed with NAFLD had significantly lower brachial FMD values compared to their respective control groups (standardized mean difference: -4.63, 95% confidence interval: -5.68 to -3.58, p < 0.0001). Furthermore, NAFLD patients exhibited a significantly higher risk of clinical cardiovascular events compared to controls (odds ratio: 2.61; 95% CI: 1.41–4.83, p < 0.002). Subgroup analysis of studies focusing on non-alcoholic steatohepatitis (NASH) versus pure steatosis demonstrated that individuals with NASH had even lower FMD values than those with pure steatosis (standardized mean difference: -3.84, 95% confidence interval: -7.56 to -0.13, p = 0.03, I2 = 66%). The review included studies published in English language, over last 23 years and specified database resulted in language bias and might have missed older pertinent studies from another important database. The overall heterogeneity is attributed to variations in study populations, outcome measurements, differences in methodological approaches among included studies, and diverse diagnostic criteria for NAFLD. Individuals with NAFLD exhibited impaired brachial FMD, indicating compromised endothelial function. Furthermore, NAFLD patients had an elevated risk of clinical cardiovascular events.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141197405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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