Pub Date : 2024-12-12DOI: 10.1016/s2468-1253(24)00313-3
Andrea Lindfors, Rickard Strandberg, Hannes Hagström
<h3>Background</h3>International guidelines suggest screening for advanced fibrosis due to metabolic dysfunction-associated steatotic liver disease in people with type 2 diabetes, but how to implement these guidelines in clinical care remains unclear. We hypothesise that examination with VCTE could be implemented simultaneously with retina scanning with a high acceptance rate in people with type 2 diabetes.<h3>Methods</h3>In this cross-sectional study, we offered VCTE to people with type 2 diabetes referred to routine retina scanning in a large retina scanning facility in Stockholm, Sweden. We excluded people with type 1 diabetes, currently pregnant, with known liver disease, reporting high alcohol consumption, who did not speak Swedish, or younger than 18 years. Between Nov 6, 2020, and June 20, 2023, we conducted surveys with included participants and collected data from medical records on diabetes retinopathy, sex, and VCTE measurements. Increased liver stiffness was defined as at least 8·0 kPa, and possible advanced fibrosis as more than 12·0 kPa. Presence of metabolic dysfunction-associated steatotic liver disease was defined as a controlled attenuation parameter (CAP) value of 280 dB/m or higher. Participants with a liver stiffness measurement of at least 8·0 kPa or those with unreliable measurements were subsequently referred for a secondary evaluation at a liver specialist, including a follow-up liver stiffness measurement with VCTE. The primary outcome was the proportion of eligible people approached for screening who accepted. Secondary outcomes were the prevalence of elevated liver stiffness (≥8·0 kPa or >12·0 kPa), presence of metabolic dysfunction-associated steatotic liver disease, and the proportion of elevated liver stiffness readings at the first VCTE examination that were not elevated in the secondary evaluation with a liver specialist. Secondary outcomes were assessed in all participants who accepted screening, except false positives, which were assessed only in participants who had a second examination.<h3>Findings</h3>1301 participants were eligible to undergo assessment with VCTE, which was accepted by 1005 (77·2%). 973 (96·8%) participants had complete measurements, of whom 504 (51·8%) had CAP values of 280 dB/m or higher, indicating metabolic dysfunction-associated steatotic liver disease. Of 977 participants with reliable liver stiffness measurements, 154 (15·8%) had values of at least 8·0 kPa, suggestive of liver fibrosis, and 49 (5·0%) had values higher than 12·0 kPa, indicating possible advanced fibrosis. However, upon reassessment with a second VCTE after referral, 56 (45·2%) of 124 individuals had values less than 8·0 kPa. 74 (7·4%) of 1005 participants had a final liver stiffness of at least 8·0 kPa; 29 (2·9%) had values greater than 12·0 kPa.<h3>Interpretation</h3>Simultaneous examination with VCTE alongside retina scanning had a high acceptance rate among people with type 2 diabetes and could be a strategy for
{"title":"Screening for advanced liver fibrosis due to metabolic dysfunction-associated steatotic liver disease alongside retina scanning in people with type 2 diabetes: a cross-sectional study","authors":"Andrea Lindfors, Rickard Strandberg, Hannes Hagström","doi":"10.1016/s2468-1253(24)00313-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00313-3","url":null,"abstract":"<h3>Background</h3>International guidelines suggest screening for advanced fibrosis due to metabolic dysfunction-associated steatotic liver disease in people with type 2 diabetes, but how to implement these guidelines in clinical care remains unclear. We hypothesise that examination with VCTE could be implemented simultaneously with retina scanning with a high acceptance rate in people with type 2 diabetes.<h3>Methods</h3>In this cross-sectional study, we offered VCTE to people with type 2 diabetes referred to routine retina scanning in a large retina scanning facility in Stockholm, Sweden. We excluded people with type 1 diabetes, currently pregnant, with known liver disease, reporting high alcohol consumption, who did not speak Swedish, or younger than 18 years. Between Nov 6, 2020, and June 20, 2023, we conducted surveys with included participants and collected data from medical records on diabetes retinopathy, sex, and VCTE measurements. Increased liver stiffness was defined as at least 8·0 kPa, and possible advanced fibrosis as more than 12·0 kPa. Presence of metabolic dysfunction-associated steatotic liver disease was defined as a controlled attenuation parameter (CAP) value of 280 dB/m or higher. Participants with a liver stiffness measurement of at least 8·0 kPa or those with unreliable measurements were subsequently referred for a secondary evaluation at a liver specialist, including a follow-up liver stiffness measurement with VCTE. The primary outcome was the proportion of eligible people approached for screening who accepted. Secondary outcomes were the prevalence of elevated liver stiffness (≥8·0 kPa or >12·0 kPa), presence of metabolic dysfunction-associated steatotic liver disease, and the proportion of elevated liver stiffness readings at the first VCTE examination that were not elevated in the secondary evaluation with a liver specialist. Secondary outcomes were assessed in all participants who accepted screening, except false positives, which were assessed only in participants who had a second examination.<h3>Findings</h3>1301 participants were eligible to undergo assessment with VCTE, which was accepted by 1005 (77·2%). 973 (96·8%) participants had complete measurements, of whom 504 (51·8%) had CAP values of 280 dB/m or higher, indicating metabolic dysfunction-associated steatotic liver disease. Of 977 participants with reliable liver stiffness measurements, 154 (15·8%) had values of at least 8·0 kPa, suggestive of liver fibrosis, and 49 (5·0%) had values higher than 12·0 kPa, indicating possible advanced fibrosis. However, upon reassessment with a second VCTE after referral, 56 (45·2%) of 124 individuals had values less than 8·0 kPa. 74 (7·4%) of 1005 participants had a final liver stiffness of at least 8·0 kPa; 29 (2·9%) had values greater than 12·0 kPa.<h3>Interpretation</h3>Simultaneous examination with VCTE alongside retina scanning had a high acceptance rate among people with type 2 diabetes and could be a strategy for ","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"10 26 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00403-5
Holly Baker
<h2>Section snippets</h2><section><section><h2>Mirikizumab for Crohn's disease</h2>Mirikizumab, a monoclonal antibody targeting IL-23p19, shows promise for patients with moderately-to-severely active Crohn's disease, according to the <span><span>VIVID-1 phase 3 trial</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>. Marc Ferrante and colleagues randomly assigned patients who had a previous inadequate response, loss of response, or intolerance to one or more therapies to receive either mirikizumab (n=579), ustekinumab (n=287), or placebo (n=199). The coprimary composite endpoints (mirikizumab <em>vs</em> placebo) were the proportion of patients</section></section><section><section><h2>Endoscopic sphincterotomy for post-ERCP pancreatitis</h2>Endoscopic sphincterotomy does not reduce the risk of pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) in patients undergoing biliary drainage for distal malignant biliary obstruction, according to the <span><span>SPHINX trial</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>. Anke M Onnekink and colleagues randomly assigned patients to receive either endoscopic sphincterotomy (n=156) or no sphincterotomy (control group; n=141) before ERCP with fully covered self-expandable metal stent placement. The primary endpoint of</section></section><section><section><h2><span><span>FMT in Crohn's disease</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span></h2>Faecal microbiota transplantation (FMT) was not efficacious at inducing remission in patients with Crohn's disease, according to a results from a new study. Dina Kao and colleagues randomly assigned patients with mild-to-moderate Crohn's disease to receive either FMT, delivered initially via colonoscopy followed by weekly capsules, or placebo for 7 weeks. The trial was halted early due to futility—at week 8, none (0%) of 15 patients in the FMT group had achieved the primary endpoint of combined</section></section><section><section><h2>Switch maintenance therapy for gastric cancer</h2>Paclitaxel plus ramucirumab as switch maintenance could be a promising treatment strategy for patients with advanced gastric cancer, according to the <span><span>ARMANI phase 3 trial</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>. Giovanni Randon and colleagues randomly assigned patients with advanced gastric or gastro-oe
mirikizumab是一种靶向IL-23p19的单克隆抗体，根据VIVID-1 iii期临床试验显示，mirikizumab有望用于中度至重度活动性克罗恩病患者。Marc Ferrante及其同事随机分配先前对一种或多种治疗反应不足、反应丧失或不耐受的患者接受mirikizumab （n=579）、ustekinumab （n=287）或安慰剂（n=199）。根据SPHINX试验，主要复合终点（mirikizumab与安慰剂）是内镜下括约肌切开术治疗ERCP后胰腺炎的患者比例。内镜下括约肌切开术不能降低因远端恶性胆道梗阻而行胆道引流的患者内镜下逆行胆道造影术（ERCP）后胰腺炎的风险。Anke M Onnekink及其同事随机分配患者接受内窥镜括约肌切开术（n=156）或不接受括约肌切开术(对照组；n=141)在ERCP前置入全覆盖自膨胀金属支架。根据一项新研究的结果，粪便微生物群移植（FMT）在诱导克罗恩病患者缓解方面无效。Dina Kao及其同事随机分配轻度至中度克罗恩病患者接受FMT治疗，最初通过结肠镜检查，随后每周服用胶囊，或安慰剂治疗7周。该试验因无效而提前停止——在第8周时，FMT组的15名患者中没有（0%）达到联合切换维持治疗胃癌的主要终点紫杉醇加ramucirumab，根据ARMANI 3期试验，切换维持治疗可能是晚期胃癌患者的一种有希望的治疗策略。Giovanni Randon及其同事随机分配在一线化疗（FOLFOX或CAPOX） 3个月后疾病控制的晚期胃癌或胃食管结癌患者切换到紫杉醇加ramucirumab(切换维持组；新的研究表明，卡维地洛加辛伐他汀可能对肝硬化和严重门脉高压患者有益。Edilmar Alvarado-Tapias及其同事将对传统非选择性β受体阻滞剂反应不足的肝硬化和高危静脉曲张患者随机分配到卡维地洛加辛伐他汀组（n=41）或卡维地洛加安慰剂组（n=41）。肝静脉压梯度（HVPG）降低2.97±2.5 mm Hg
{"title":"Research in Brief","authors":"Holly Baker","doi":"10.1016/s2468-1253(24)00403-5","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00403-5","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Mirikizumab for Crohn's disease</h2>Mirikizumab, a monoclonal antibody targeting IL-23p19, shows promise for patients with moderately-to-severely active Crohn's disease, according to the <span><span>VIVID-1 phase 3 trial</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>. Marc Ferrante and colleagues randomly assigned patients who had a previous inadequate response, loss of response, or intolerance to one or more therapies to receive either mirikizumab (n=579), ustekinumab (n=287), or placebo (n=199). The coprimary composite endpoints (mirikizumab <em>vs</em> placebo) were the proportion of patients</section></section><section><section><h2>Endoscopic sphincterotomy for post-ERCP pancreatitis</h2>Endoscopic sphincterotomy does not reduce the risk of pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) in patients undergoing biliary drainage for distal malignant biliary obstruction, according to the <span><span>SPHINX trial</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>. Anke M Onnekink and colleagues randomly assigned patients to receive either endoscopic sphincterotomy (n=156) or no sphincterotomy (control group; n=141) before ERCP with fully covered self-expandable metal stent placement. The primary endpoint of</section></section><section><section><h2><span><span>FMT in Crohn's disease</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span></h2>Faecal microbiota transplantation (FMT) was not efficacious at inducing remission in patients with Crohn's disease, according to a results from a new study. Dina Kao and colleagues randomly assigned patients with mild-to-moderate Crohn's disease to receive either FMT, delivered initially via colonoscopy followed by weekly capsules, or placebo for 7 weeks. The trial was halted early due to futility—at week 8, none (0%) of 15 patients in the FMT group had achieved the primary endpoint of combined</section></section><section><section><h2>Switch maintenance therapy for gastric cancer</h2>Paclitaxel plus ramucirumab as switch maintenance could be a promising treatment strategy for patients with advanced gastric cancer, according to the <span><span>ARMANI phase 3 trial</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>. Giovanni Randon and colleagues randomly assigned patients with advanced gastric or gastro-oe","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"15 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00402-3
Bethany Gomersall
Section snippets
Subcutaneous guselkumab for Crohn's disease
Induction with subcutaneous guselkumab—a dual acting IL-23p19 subunit inhibitor—was safe and efficacious in patients with Crohn's disease according to the phase 3 GRAVITI study presented by Remo Panaccione (Calgary, AB, Canada). 347 patients with moderate-to-severe Crohn's disease with an inadequate response or intolerance to oral corticosteroids and advanced therapies were randomly assigned to subcutaneous guselkumab 400 mg at weeks 0, 4, and 8, then 200 mg every 4 weeks (n=115); subcutaneous
Auxora in acute pancreatitis and SIRS
In the phase 2b CARPO trial presented by Robert Sutton (Liverpool, UK), 216 patients with acute pancreatitis and at least two criteria for systemic inflammatory response syndrome (SIRS) were randomly assigned to receive, with standard of care, intravenous auxora (zegocractin)—a calcium release-activated calcium channel inhibitor—at a dose of 2 mg/kg (n=54), 1 mg/kg (n=54), or 0·5 mg/kg (n=54), or placebo (n=54), over 4 h for 3 days. Median time to solid food tolerance (the primary endpoint) in
Biofeedback vs dextranomer–hyaluronate acid injection for faecal incontinence
There was no difference in the efficacy of biofeedback therapy versus dextranomer–hyaluronate acid anal injection for the treatment of faecal incontinence, according to a trial presented by Adil Bharucha (Rochester, MN, USA). Adults with faecal incontinence who had not responded at 4 or 12 weeks of enhanced medical management, including bowel agents and pelvic floor exercises, were randomly assigned to receive biofeedback therapy (n=99) or injection (n=101). There was no difference in the
Bezlotoxumab plus FMT for Clostridiodes difficile in IBD
According to data presented by Jessica R Allegretti (Boston, MA, USA), the addition of bezlotoxumab did not enhance the efficacy of faecal microbiota transplantation (FMT) for the treatment of recurrent Clostridioides difficile infection in patients with inflammatory bowel disease (IBD). 61 patients with IBD who had had at least two episodes of C difficile infection were randomly assigned to receive a single bezlotoxumab infusion (n=30) or placebo (n=31) before receiving a single colonoscopic
{"title":"ACG 2024","authors":"Bethany Gomersall","doi":"10.1016/s2468-1253(24)00402-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00402-3","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Subcutaneous guselkumab for Crohn's disease</h2>Induction with subcutaneous guselkumab—a dual acting IL-23p19 subunit inhibitor—was safe and efficacious in patients with Crohn's disease according to the phase 3 GRAVITI study presented by Remo Panaccione (Calgary, AB, Canada). 347 patients with moderate-to-severe Crohn's disease with an inadequate response or intolerance to oral corticosteroids and advanced therapies were randomly assigned to subcutaneous guselkumab 400 mg at weeks 0, 4, and 8, then 200 mg every 4 weeks (n=115); subcutaneous</section></section><section><section><h2>Auxora in acute pancreatitis and SIRS</h2>In the phase 2b CARPO trial presented by Robert Sutton (Liverpool, UK), 216 patients with acute pancreatitis and at least two criteria for systemic inflammatory response syndrome (SIRS) were randomly assigned to receive, with standard of care, intravenous auxora (zegocractin)—a calcium release-activated calcium channel inhibitor—at a dose of 2 mg/kg (n=54), 1 mg/kg (n=54), or 0·5 mg/kg (n=54), or placebo (n=54), over 4 h for 3 days. Median time to solid food tolerance (the primary endpoint) in</section></section><section><section><h2>Biofeedback <em>vs</em> dextranomer–hyaluronate acid injection for faecal incontinence</h2>There was no difference in the efficacy of biofeedback therapy versus dextranomer–hyaluronate acid anal injection for the treatment of faecal incontinence, according to a trial presented by Adil Bharucha (Rochester, MN, USA). Adults with faecal incontinence who had not responded at 4 or 12 weeks of enhanced medical management, including bowel agents and pelvic floor exercises, were randomly assigned to receive biofeedback therapy (n=99) or injection (n=101). There was no difference in the</section></section><section><section><h2>Bezlotoxumab plus FMT for <em>Clostridiodes difficile</em> in IBD</h2>According to data presented by Jessica R Allegretti (Boston, MA, USA), the addition of bezlotoxumab did not enhance the efficacy of faecal microbiota transplantation (FMT) for the treatment of recurrent <em>Clostridioides difficile</em> infection in patients with inflammatory bowel disease (IBD). 61 patients with IBD who had had at least two episodes of <em>C difficile</em> infection were randomly assigned to receive a single bezlotoxumab infusion (n=30) or placebo (n=31) before receiving a single colonoscopic</section></section>","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"41 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00284-x
Jolien Schol, I-Hsuan Huang, Florencia Carbone, Luis Maria Bustos Fernandez, Guillaume Gourcerol, Vincent Ho, Geoffrey Kohn, Brian E Lacy, Aurelio Lopez Colombo, Hiroto Miwa, Baha Moshiree, Linda Nguyen, Greg O’Grady, Kewin T H Siah, Vincenzo Stanghellini, Jan Tack
To establish a consensus on the definition and management of idiopathic gastroparesis, international experts (selected by neurogastroenterology and motility societies and initiated by the Rome Foundation) devised 144 statements using the Delphi method, with at least 80% agreement required. This consensus defined idiopathic gastroparesis as the presence of symptoms associated with delayed gastric emptying in the absence of mechanical obstruction. Nausea and vomiting were identified as cardinal symptoms. Frequently co-existing symptoms are early satiation and postprandial fullness. Diagnosis requires the presence of these symptoms alongside delayed gastric emptying, measured by a 4 h scintigraphy or gastric emptying breath test of a mixed composition meal in the absence of mechanical obstruction. Therapeutic options with proven efficacy were sparse. Dietary adjustments, nutritional support (per guidelines from the European Society for Clinical Nutrition and Metabolism for substantial weight loss or intractable vomiting), and opioid cessation were recommended by a consensus opinion. Antiemetic and prokinetic agents were also considered potentially beneficial. This consensus offers a global perspective on idiopathic gastroparesis.
{"title":"Rome Foundation and international neurogastroenterology and motility societies’ consensus on idiopathic gastroparesis","authors":"Jolien Schol, I-Hsuan Huang, Florencia Carbone, Luis Maria Bustos Fernandez, Guillaume Gourcerol, Vincent Ho, Geoffrey Kohn, Brian E Lacy, Aurelio Lopez Colombo, Hiroto Miwa, Baha Moshiree, Linda Nguyen, Greg O’Grady, Kewin T H Siah, Vincenzo Stanghellini, Jan Tack","doi":"10.1016/s2468-1253(24)00284-x","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00284-x","url":null,"abstract":"To establish a consensus on the definition and management of idiopathic gastroparesis, international experts (selected by neurogastroenterology and motility societies and initiated by the Rome Foundation) devised 144 statements using the Delphi method, with at least 80% agreement required. This consensus defined idiopathic gastroparesis as the presence of symptoms associated with delayed gastric emptying in the absence of mechanical obstruction. Nausea and vomiting were identified as cardinal symptoms. Frequently co-existing symptoms are early satiation and postprandial fullness. Diagnosis requires the presence of these symptoms alongside delayed gastric emptying, measured by a 4 h scintigraphy or gastric emptying breath test of a mixed composition meal in the absence of mechanical obstruction. Therapeutic options with proven efficacy were sparse. Dietary adjustments, nutritional support (per guidelines from the European Society for Clinical Nutrition and Metabolism for substantial weight loss or intractable vomiting), and opioid cessation were recommended by a consensus opinion. Antiemetic and prokinetic agents were also considered potentially beneficial. This consensus offers a global perspective on idiopathic gastroparesis.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"24 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00310-8
Jacob J Gries, Jeffrey V Lazarus, Paul N Brennan, Mohammad S Siddiqui, Giovanni Targher, Chim C Lang, Salim S Virani, Carl J Lavie, Scott Isaacs, Juan Pablo Arab, Kenneth Cusi, Chayakrit Krittanawong
Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a public health threat as it affects approximately 38% of the adult population worldwide, with its prevalence rising in step with that of obesity and type 2 diabetes. Beyond the implications of MASLD for liver health, it is also associated with cardiovascular and vascular dysfunction. Although the many shared risk factors and common metabolic milieu might indicate that cardiovascular disease and MASLD are discrete outcomes from common systemic pathogeneses, a growing body of evidence has identified a potential causal relationship between MASLD and coronary artery disease, which is the leading cause of morbidity and mortality in people with MASLD and all-cause mortality worldwide. This Review takes an interdisciplinary approach, drawing on hepatology, cardiology, endocrinology, and metabolic and internal medicine specialists to help to delineate the intricate interplay between MASLD and coronary artery disease. It sheds light on novel opportunities for targeted interventions and personalised management strategies.
{"title":"Interdisciplinary perspectives on the co-management of metabolic dysfunction-associated steatotic liver disease and coronary artery disease","authors":"Jacob J Gries, Jeffrey V Lazarus, Paul N Brennan, Mohammad S Siddiqui, Giovanni Targher, Chim C Lang, Salim S Virani, Carl J Lavie, Scott Isaacs, Juan Pablo Arab, Kenneth Cusi, Chayakrit Krittanawong","doi":"10.1016/s2468-1253(24)00310-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00310-8","url":null,"abstract":"Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a public health threat as it affects approximately 38% of the adult population worldwide, with its prevalence rising in step with that of obesity and type 2 diabetes. Beyond the implications of MASLD for liver health, it is also associated with cardiovascular and vascular dysfunction. Although the many shared risk factors and common metabolic milieu might indicate that cardiovascular disease and MASLD are discrete outcomes from common systemic pathogeneses, a growing body of evidence has identified a potential causal relationship between MASLD and coronary artery disease, which is the leading cause of morbidity and mortality in people with MASLD and all-cause mortality worldwide. This Review takes an interdisciplinary approach, drawing on hepatology, cardiology, endocrinology, and metabolic and internal medicine specialists to help to delineate the intricate interplay between MASLD and coronary artery disease. It sheds light on novel opportunities for targeted interventions and personalised management strategies.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"15 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00395-9
Cahal McQuillan
No Abstract
没有抽象的
{"title":"Shitbag: the story of a diagnosis","authors":"Cahal McQuillan","doi":"10.1016/s2468-1253(24)00395-9","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00395-9","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"118 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00309-1
Kate Glyn-Owen, Ryan M Buchanan, Ahmed M Elsharkawy, Leah Avery, Stuart Flanagan, Heather Parsons, Ashwin Dhanda
No Abstract
没有抽象的
{"title":"Unifying the approach to tackling inequalities in liver health: learning from working with underserved populations","authors":"Kate Glyn-Owen, Ryan M Buchanan, Ahmed M Elsharkawy, Leah Avery, Stuart Flanagan, Heather Parsons, Ashwin Dhanda","doi":"10.1016/s2468-1253(24)00309-1","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00309-1","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"28 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：