Pub Date : 2024-10-18DOI: 10.1016/j.aohep.2024.101579
Jiaxin Zhao, Huiying Zhou, Rui Wu, Chen Ruan, Cheng Wang, Jiawei Ding, Tao Zhang, Zheyu Fang, Huilin Zheng, Lei Zhang, Jie Zhou, Zhenhua Hu
Introduction and objectives: This study aimed to investigate the association between biological aging and liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).
Materials and methods: We analyzed NHANES 2017-2020 data to calculate phenotypic age. Hepatic steatosis and fibrosis were identified using controlled attenuation parameters (CAP), fatty liver index (FLI) and transient elastography (TE). The odds ratios (ORs) and 95 % confidence intervals (CI) for significant MASLD fibrosis were calculated using multivariate logistic regression, and subgroup analyses were performed. We explored the potential causal relationship between telomere length and liver fibrosis using Mendelian randomization (MR). Additionally, we used the expression quantitative trait loci (eQTL) method and GSE197112 data to identify genes related to liver fibrosis and senescence. Finally, the APOLD1 expression was validated using GSE89632.
Results: Phenotypic age was associated with liver fibrosis occurrence in MASLD (OR = 1.08, 95 % CI 1.05-1.12). Subgroup analyses by BMI and age revealed differences. For obese or young to middle-aged MASLD patients, phenotypic age is significantly associated with liver fibrosis. (OR = 1.14, 95 % CI 1.10-1.18; OR = 1.07, 95 % CI 1.01-1.14 and OR = 1.14, 95 % CI 1.07-1.22). MR revealed a negative association between telomere length and liver fibrosis (IVW method: OR = 0.63288, 95 % CI 0.42498-0.94249). The gene APOLD1 was identified as a potential target through the intersection of the GEO dataset and eQTL genes.
Conclusions: This study emphasized the link between biological aging and fibrosis in young to middle-aged obese MASLD patients. We introduced phenotypic age as a clinical indicator and identified APOLD1 as a potential therapeutic target.
导言和目的：本研究旨在调查代谢功能障碍相关性脂肪性肝病（MASLD）患者的生物衰老与肝纤维化之间的关联：我们分析了 NHANES 2017-2020 年的数据，以计算表型年龄。使用受控衰减参数（CAP）、脂肪肝指数（FLI）和瞬态弹性成像（TE）确定肝脏脂肪变性和纤维化。采用多变量逻辑回归法计算了明显MASLD纤维化的几率（OR）和95%置信区间（CI），并进行了亚组分析。我们使用孟德尔随机法（MR）探讨了端粒长度与肝纤维化之间的潜在因果关系。此外，我们还使用表达定量性状位点（eQTL）方法和 GSE197112 数据来识别与肝纤维化和衰老相关的基因。最后，我们利用 GSE89632 验证了 APOLD1 的表达：结果：表型年龄与MASLD肝纤维化的发生相关（OR = 1.08，95% CI 1.05-1.12）。按体重指数和年龄进行的亚组分析显示出差异。对于肥胖或中青年 MASLD 患者，表型年龄与肝纤维化显著相关。(OR = 1.14，95% CI 1.10-1.18；OR = 1.07，95% CI 1.01-1.14；OR = 1.14，95% CI 1.07-1.22）。MR显示端粒长度与肝纤维化呈负相关（IVW法：OR = 0.63288，95% CI 0.42498-0.94249）。通过GEO数据集和eQTL基因的交叉，APOLD1基因被确定为潜在靶点：本研究强调了中青年肥胖 MASLD 患者的生物衰老与纤维化之间的联系。我们引入了表型年龄作为临床指标，并将 APOLD1 鉴定为潜在的治疗靶点。
{"title":"Biological aging accelerates hepatic fibrosis: Insights from the NHANES 2017-2020 and genome-wide association study analysis.","authors":"Jiaxin Zhao, Huiying Zhou, Rui Wu, Chen Ruan, Cheng Wang, Jiawei Ding, Tao Zhang, Zheyu Fang, Huilin Zheng, Lei Zhang, Jie Zhou, Zhenhua Hu","doi":"10.1016/j.aohep.2024.101579","DOIUrl":"10.1016/j.aohep.2024.101579","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>This study aimed to investigate the association between biological aging and liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Materials and methods: </strong>We analyzed NHANES 2017-2020 data to calculate phenotypic age. Hepatic steatosis and fibrosis were identified using controlled attenuation parameters (CAP), fatty liver index (FLI) and transient elastography (TE). The odds ratios (ORs) and 95 % confidence intervals (CI) for significant MASLD fibrosis were calculated using multivariate logistic regression, and subgroup analyses were performed. We explored the potential causal relationship between telomere length and liver fibrosis using Mendelian randomization (MR). Additionally, we used the expression quantitative trait loci (eQTL) method and GSE197112 data to identify genes related to liver fibrosis and senescence. Finally, the APOLD1 expression was validated using GSE89632.</p><p><strong>Results: </strong>Phenotypic age was associated with liver fibrosis occurrence in MASLD (OR = 1.08, 95 % CI 1.05-1.12). Subgroup analyses by BMI and age revealed differences. For obese or young to middle-aged MASLD patients, phenotypic age is significantly associated with liver fibrosis. (OR = 1.14, 95 % CI 1.10-1.18; OR = 1.07, 95 % CI 1.01-1.14 and OR = 1.14, 95 % CI 1.07-1.22). MR revealed a negative association between telomere length and liver fibrosis (IVW method: OR = 0.63288, 95 % CI 0.42498-0.94249). The gene APOLD1 was identified as a potential target through the intersection of the GEO dataset and eQTL genes.</p><p><strong>Conclusions: </strong>This study emphasized the link between biological aging and fibrosis in young to middle-aged obese MASLD patients. We introduced phenotypic age as a clinical indicator and identified APOLD1 as a potential therapeutic target.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101579"},"PeriodicalIF":3.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-11DOI: 10.1016/j.aohep.2024.101588
Alan Isaac Valderrama-Treviño, Andrés E. Castell-Rodríguez, Rolando Hernández-Muñoz, Nadia A. Vázquez-Torres, Andrés Macari-Jorge, Baltazar Barrera-Mera, Alfredo Maciel-Cerda, Ricardo Vera-Graziano, Natalia Nuño-Lámbarri, Eduardo E. Montalvo-Javé
{"title":"Development of a biodegradable prosthesis through tissue engineering, for the organ-replacement or substitution of the extrahepatic bile duct","authors":"Alan Isaac Valderrama-Treviño, Andrés E. Castell-Rodríguez, Rolando Hernández-Muñoz, Nadia A. Vázquez-Torres, Andrés Macari-Jorge, Baltazar Barrera-Mera, Alfredo Maciel-Cerda, Ricardo Vera-Graziano, Natalia Nuño-Lámbarri, Eduardo E. Montalvo-Javé","doi":"10.1016/j.aohep.2024.101588","DOIUrl":"10.1016/j.aohep.2024.101588","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 1","pages":"Article 101588"},"PeriodicalIF":3.7,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-11DOI: 10.1016/j.aohep.2024.101584
Mário Reis Álvares-da-Silva, Márcia da Silva Vargas, Soheyla Mohd Souza Rabie, Gabriella Jonko, Patricia Gabriela Riedel, Larisse Longo, Marcelo Rodrigues Gonçalves, Vivian Cristine Luft, Dvora Joveleviths
Introduction and objectives: Public health policies in metabolic dysfunction-associated steatotic liver disease (MASLD) are still lacking. This study aims to estimate the prevalence and severity of MASLD in primary health care (PHC) through non-invasive markers.
Patients and methods: Two-phase study, including a retrospective (RETR) and a prospective (PROS) one, was carried out in PHC in Brazil. In RETR, metabolic and hepatic profiles of 12,054 patients, including FIB-4, were evaluated. In PROS, 350 patients were randomly selected and submitted to a clinical and nutritional assessment.
Results: RETR (65.4 % women, mean age 55.3 years old): dyslipidemia, hypertension, and type 2 diabetes mellitus (T2DM) present in 40.8 %, 34.3 %, and 12.2 % of the electronic health records, respectively. Fasting glucose >100 mg/dL in 34.5 %, and glycated hemoglobin higher than 5.7 % in 51.5 %, total cholesterol >200 mg/dL and triglycerides >150 mg/dL in 40.8 % and 32.1 %, respectively. Median FIB-4 was of 1.33, 5 % >2.67. No one had MASLD as a diagnostic hypothesis; PROS(71.8 % women, mean age 58 years old): body mass index (BMI) ≥30 kg/m² in 31.8 %. MASLD prevalence (FLI≥ 30 + cardiometabolic features) of 62.1 %; 39.4 % of patients had FLI ≥60, with higher BMI, waist circumference, fasting glucose, triglycerides, AST, ALT and GGT, as well as lower HDL-cholesterol (p < 0.001). FIB-4>1.3 in 40 % and NAFLD Fibrosis Score (NFS)>-1.45 in 59.2 % of steatotic patients.
Conclusions: There is a high prevalence of MASLD in PHC, with a significant risk of liver fibrosis. These findings reinforce we need to develop public policies to defeat MASLD epidemics.
{"title":"FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant disease.","authors":"Mário Reis Álvares-da-Silva, Márcia da Silva Vargas, Soheyla Mohd Souza Rabie, Gabriella Jonko, Patricia Gabriela Riedel, Larisse Longo, Marcelo Rodrigues Gonçalves, Vivian Cristine Luft, Dvora Joveleviths","doi":"10.1016/j.aohep.2024.101584","DOIUrl":"https://doi.org/10.1016/j.aohep.2024.101584","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Public health policies in metabolic dysfunction-associated steatotic liver disease (MASLD) are still lacking. This study aims to estimate the prevalence and severity of MASLD in primary health care (PHC) through non-invasive markers.</p><p><strong>Patients and methods: </strong>Two-phase study, including a retrospective (RETR) and a prospective (PROS) one, was carried out in PHC in Brazil. In RETR, metabolic and hepatic profiles of 12,054 patients, including FIB-4, were evaluated. In PROS, 350 patients were randomly selected and submitted to a clinical and nutritional assessment.</p><p><strong>Results: </strong>RETR (65.4 % women, mean age 55.3 years old): dyslipidemia, hypertension, and type 2 diabetes mellitus (T2DM) present in 40.8 %, 34.3 %, and 12.2 % of the electronic health records, respectively. Fasting glucose >100 mg/dL in 34.5 %, and glycated hemoglobin higher than 5.7 % in 51.5 %, total cholesterol >200 mg/dL and triglycerides >150 mg/dL in 40.8 % and 32.1 %, respectively. Median FIB-4 was of 1.33, 5 % >2.67. No one had MASLD as a diagnostic hypothesis; PROS(71.8 % women, mean age 58 years old): body mass index (BMI) ≥30 kg/m² in 31.8 %. MASLD prevalence (FLI≥ 30 + cardiometabolic features) of 62.1 %; 39.4 % of patients had FLI ≥60, with higher BMI, waist circumference, fasting glucose, triglycerides, AST, ALT and GGT, as well as lower HDL-cholesterol (p < 0.001). FIB-4>1.3 in 40 % and NAFLD Fibrosis Score (NFS)>-1.45 in 59.2 % of steatotic patients.</p><p><strong>Conclusions: </strong>There is a high prevalence of MASLD in PHC, with a significant risk of liver fibrosis. These findings reinforce we need to develop public policies to defeat MASLD epidemics.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101584"},"PeriodicalIF":3.7,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.aohep.2024.101581
Nabiha Faisal , Lisa M. Lix , Randy Walld , Alexander Singer , Leanne Kosowan , Harminder Singh , Eberhard Renner , Alyson Mahar
Introduction and Objectives
The burden of chronic liver disease and cirrhosis continues to increase in North America. We sought to estimate the incidence and prevalence of cirrhosis in Manitoba, Canada over time and assess changes in trends between 2010-2019.
Material and Methods
We performed a population-based study using Manitoba administrative health care data, and two validated case-finding algorithms. Annual incidence and prevalence rates were estimated using a generalized linear model with generalized estimating equations, adjusting for age and sex. Changes in estimates were tested using linear trend regression models.
Results
Two algorithms estimated the number of prevalent cirrhosis to be 16,140 and 29,943 respectively. The age- and sex-adjusted incidence rates increased over the study (from 149 to 264 cases per 100,000 population in 2010, to 177 to 388 cases per 100,000 population in 2019). Cirrhosis incidence increased annually by 2-6 %, with the largest increase (6-8 % 95 % CI 7-9 %, p <0.0001) in those aged 18-44 years. Irrespective of the algorithm used, females consistently exhibited higher cirrhosis incidence and prevalence compared to males over time (P <0.0001). Prevalence demonstrated an upward trend among all age groups over time for both algorithms (P < 0.0001).
Conclusions
This population-based study highlights concerning temporal trends in cirrhosis, characterized by rising annual incidence and prevalence estimates, particularly among young adults and females. These findings underscore the urgent need for comprehensive strategies that encompass prevention, early detection, and the delivery of high-quality healthcare and public health initiatives to effectively tackle this escalating health burden.
{"title":"Trends in the incidence and prevalence of cirrhosis in Manitoba, Canada: A population-based study (2010-2019)","authors":"Nabiha Faisal , Lisa M. Lix , Randy Walld , Alexander Singer , Leanne Kosowan , Harminder Singh , Eberhard Renner , Alyson Mahar","doi":"10.1016/j.aohep.2024.101581","DOIUrl":"10.1016/j.aohep.2024.101581","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The burden of chronic liver disease and cirrhosis continues to increase in North America. We sought to estimate the incidence and prevalence of cirrhosis in Manitoba, Canada over time and assess changes in trends between 2010-2019.</div></div><div><h3>Material and Methods</h3><div>We performed a population-based study using Manitoba administrative health care data, and two validated case-finding algorithms. Annual incidence and prevalence rates were estimated using a generalized linear model with generalized estimating equations, adjusting for age and sex. Changes in estimates were tested using linear trend regression models.</div></div><div><h3>Results</h3><div>Two algorithms estimated the number of prevalent cirrhosis to be 16,140 and 29,943 respectively. The age- and sex-adjusted incidence rates increased over the study (from 149 to 264 cases per 100,000 population in 2010, to 177 to 388 cases per 100,000 population in 2019). Cirrhosis incidence increased annually by 2-6 %, with the largest increase (6-8 % 95 % CI 7-9 %, p <0.0001) in those aged 18-44 years. Irrespective of the algorithm used, females consistently exhibited higher cirrhosis incidence and prevalence compared to males over time (P <0.0001). Prevalence demonstrated an upward trend among all age groups over time for both algorithms (P < 0.0001).</div></div><div><h3>Conclusions</h3><div>This population-based study highlights concerning temporal trends in cirrhosis, characterized by rising annual incidence and prevalence estimates, particularly among young adults and females. These findings underscore the urgent need for comprehensive strategies that encompass prevention, early detection, and the delivery of high-quality healthcare and public health initiatives to effectively tackle this escalating health burden.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101581"},"PeriodicalIF":3.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.aohep.2024.101585
Siwei Yang , Jianan Yu , Qiyang Chen , Xuedong Sun , Yuefeng Hu , Tianhao Su , Jian Li , Long Jin
Introduction and Objectives
With rising prevalence of pre-sarcopenia in metabolic dysfunction-associated steatotic liver disease (MASLD), this study aimed to develop and validate machine learning-based model to identify pre-sarcopenia in MASLD population.
Materials and Methods
A total of 571 MASLD subjects were screened from the National Health and Nutrition Examination Survey 2017–2018. This cohort was randomly divided into training set and internal testing set with a ratio of 7:3. Sixty-six MASLD subjects were collected from our institution as external validation set. Four binary classifiers, including Random Forest (RF), support vector machine, and extreme gradient boosting and logistic regression, were fitted to identify pre-sarcopenia. The best-performing model was further validated in external validation set. Model performance was assessed in terms of discrimination and calibration. Shapley Additive explanations were used for model interpretability.
Results
The pre-sarcopenia rate was 17.51 % and 15.16 % in NHANES cohort and external validation set, respectively. RF outperformed other models with area under receiver operating characteristic curve (AUROC) of 0.819 (95 %CI: 0.749, 0.889). When six top-ranking features were retained as per variable importance, including weight-adjusted waist, sex, race, creatinine, education and alkaline phosphatase, a final RF model reached an AUROC being 0.824 (0.737, 0.910) and 0.732 (95 %CI: 0.529, 0.936) in internal and external validation sets, respectively. The model robustness was proved in sensitivity analysis. The calibration curve and decision curve analysis confirmed a good calibration capacity and good clinical usage.
Conclusions
This study proposed a user-friendly model using explainable machine learning algorithm to predict pre-sarcopenia in MASLD population. A web-based tool was provided to screening pre-sarcopenia in community and hospitalization settings.
{"title":"Development and external validation of a machine-learning based model to predict pre-sarcopenia in MASLD population: Results from NHANES 2017–2018","authors":"Siwei Yang , Jianan Yu , Qiyang Chen , Xuedong Sun , Yuefeng Hu , Tianhao Su , Jian Li , Long Jin","doi":"10.1016/j.aohep.2024.101585","DOIUrl":"10.1016/j.aohep.2024.101585","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>With rising prevalence of pre-sarcopenia in metabolic dysfunction-associated steatotic liver disease (MASLD), this study aimed to develop and validate machine learning-based model to identify pre-sarcopenia in MASLD population.</div></div><div><h3>Materials and Methods</h3><div>A total of 571 MASLD subjects were screened from the National Health and Nutrition Examination Survey 2017–2018. This cohort was randomly divided into training set and internal testing set with a ratio of 7:3. Sixty-six MASLD subjects were collected from our institution as external validation set. Four binary classifiers, including Random Forest (RF), support vector machine, and extreme gradient boosting and logistic regression, were fitted to identify pre-sarcopenia. The best-performing model was further validated in external validation set. Model performance was assessed in terms of discrimination and calibration. Shapley Additive explanations were used for model interpretability.</div></div><div><h3>Results</h3><div>The pre-sarcopenia rate was 17.51 % and 15.16 % in NHANES cohort and external validation set, respectively. RF outperformed other models with area under receiver operating characteristic curve (AUROC) of 0.819 (95 %CI: 0.749, 0.889). When six top-ranking features were retained as per variable importance, including weight-adjusted waist, sex, race, creatinine, education and alkaline phosphatase, a final RF model reached an AUROC being 0.824 (0.737, 0.910) and 0.732 (95 %CI: 0.529, 0.936) in internal and external validation sets, respectively. The model robustness was proved in sensitivity analysis. The calibration curve and decision curve analysis confirmed a good calibration capacity and good clinical usage.</div></div><div><h3>Conclusions</h3><div>This study proposed a user-friendly model using explainable machine learning algorithm to predict pre-sarcopenia in MASLD population. A web-based tool was provided to screening pre-sarcopenia in community and hospitalization settings.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101585"},"PeriodicalIF":3.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1016/j.aohep.2024.101589
Shan Hong , Yiwei Hao , Lei Sun , Ping Li , Junru Yang , Fuyang Zhang , Lingling He , Jing Zhang , Hongshan Wei
Introduction and objectives
Significant fibrosis is an indicator of clinical intervention for both chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD). There remains a paucity of data regarding the clinical impact of biopsy-defined MASLD on significant fibrosis in CHB patients. The current study aims to elucidate whether patients with concomitant MASLD are at higher risk of significant fibrosis in patients with CHB.
Patients and methods
This retrospective research of two tertiary hospitals comprised 1818 patients between 2009 and 2021 with CHB and hepatic steatosis who had not received antiviral therapy. Pathologic findings by liver biopsy were contrasted between CHB group (n = 844) and CHB + MASLD (n = 974) group. METAVIR values of F≥2 were used to categorize significant fibrosis.
Results
Patients with CHB + MASLD had more significant fibrosis (35.5 % vs. 23.5 %, p < 0.001) than CHB group. The presence of MASLD [adjusted odds ratio (aOR) 2.055, 95 % confidence interval (CI) 1.635–2.584; p < 0.001] was strongly associated with significant fibrosis in all CHB patients. There was a trend for patients with more cardiometabolic risk factors (CMRFs) to have a higher prevalence of significant fibrosis: (25.7 % in CMRF1 subgroup v.s. 34.9 % in CMRF2 subgroup v.s. 53.7 % in CMRF≥ 3 subgroup, p < 0.001). Patients with CMRF≥3 had a three-fold higher significant fibrosis than those with just one CMRF.
Conclusions
MASLD was associated with higher fibrosis stage in patients with CHB. Early detection and intervention are crucial to patients with three or more cardiometabolic risk factors.
引言和目的：显著纤维化是慢性乙型肝炎（CHB）和代谢功能障碍相关性脂肪性肝病（MASLD）临床干预的指标。关于活组织检查确定的 MASLD 对慢性乙型肝炎患者显著纤维化的临床影响的数据仍然很少。目前的研究旨在阐明伴有MASLD的CHB患者发生明显纤维化的风险是否更高：这项在两家三甲医院进行的回顾性研究包括2009年至2021年间1818例未接受抗病毒治疗的CHB和肝脂肪变性患者。CHB组（n=844）和CHB+MASLD组（n=974）的肝活检病理结果进行了对比。METAVIR的F≥2值用于对明显纤维化进行分类：结果：CHB + MASLD 患者的纤维化程度更高（35.5% vs. 23.5%，p）：MASLD与CHB患者较高的纤维化分期有关。对于有三个或三个以上心脏代谢风险因素的患者来说，早期发现和干预至关重要。
{"title":"Prevalence and risk factors of significant fibrosis in chronic hepatitis B patients with concurrent metabolic dysfunction-associated steatotic liver disease","authors":"Shan Hong , Yiwei Hao , Lei Sun , Ping Li , Junru Yang , Fuyang Zhang , Lingling He , Jing Zhang , Hongshan Wei","doi":"10.1016/j.aohep.2024.101589","DOIUrl":"10.1016/j.aohep.2024.101589","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Significant fibrosis is an indicator of clinical intervention for both chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD). There remains a paucity of data regarding the clinical impact of biopsy-defined MASLD on significant fibrosis in CHB patients. The current study aims to elucidate whether patients with concomitant MASLD are at higher risk of significant fibrosis in patients with CHB.</div></div><div><h3>Patients and methods</h3><div>This retrospective research of two tertiary hospitals comprised 1818 patients between 2009 and 2021 with CHB and hepatic steatosis who had not received antiviral therapy. Pathologic findings by liver biopsy were contrasted between CHB group (<em>n</em> = 844) and CHB + MASLD (<em>n</em> = 974) group. METAVIR values of F≥2 were used to categorize significant fibrosis.</div></div><div><h3>Results</h3><div>Patients with CHB + MASLD had more significant fibrosis (35.5 % <em>vs.</em> 23.5 %, <em>p</em> < 0.001) than CHB group. The presence of MASLD [adjusted odds ratio (aOR) 2.055, 95 % confidence interval (CI) 1.635–2.584; <em>p</em> < 0.001] was strongly associated with significant fibrosis in all CHB patients. There was a trend for patients with more cardiometabolic risk factors (CMRFs) to have a higher prevalence of significant fibrosis: (25.7 % in CMRF1 subgroup <em>v.s.</em> 34.9 % in CMRF2 subgroup <em>v.s.</em> 53.7 % in CMRF≥ 3 subgroup, <em>p</em> < 0.001). Patients with CMRF≥3 had a three-fold higher significant fibrosis than those with just one CMRF.</div></div><div><h3>Conclusions</h3><div>MASLD was associated with higher fibrosis stage in patients with CHB. Early detection and intervention are crucial to patients with three or more cardiometabolic risk factors.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101589"},"PeriodicalIF":3.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-17DOI: 10.1016/j.aohep.2024.101576
Golasa Samadi Kochaksaraei , Fengjuan Yang , Cynthia H. Seow , Herman W Barkema , Carla S Coffin , Abdel-Aziz Shaheen
Introduction and Objectives
There are limited recent data on the burden of chronic hepatitis B (CHB) in the North American general population. We aimed to identify the CHB burden from a Canadian population-based perspective.
Patients and Methods
Using a retrospective cohort design, we searched Alberta Analytics administrative databases including the Provincial Laboratory database, to describe CHB epidemiology and natural history in Alberta, Canada between fiscal years 2012-2020. We analyzed incidence and prevalence trends using a Poisson regression model and conducted Kaplan-Meier analyses to examine the incident cohort's survival.
Results
The age/sex-adjusted incidence of CHB between 2015-2020 was 27.1/100,000 person/years (29.6/100,000 in males and 24.5/100,000 in females) and was highest among individuals aged 45-64 years. Despite a decrease in annual incidence of CHB from 36.4 to 13.4/100,000 between 2015-2020, prevalence increased from 98.9 to 210.3/100,000 in the same period. Of 6,860 incident cases, 2.1% died, and 0.2% underwent liver transplantation during a median follow-up of 3.6 years (interquartile range 2.0-4.9 years). CHB patients had significantly lower survival rates compared to age/sex-matched Canadians, with a standardized mortality ratio of 3.9 (95% confidence interval [CI] 3.3-4.6). Male sex (hazard ratio [HR] 1.7; 95% CI 1.2-2.5), older age at diagnosis (HR, 1.08; 95% CI 1.07-1.09) independently predicted mortality.
Conclusions
CHB incidence decreased in Alberta, which is consistent with nationwide trends. Males and individuals aged 45-64 had higher CHB incidence and prevalence. CHB patients’ lower survival rates emphasize the need to address barriers to guideline recommended HBV care linkage.
{"title":"Epidemiology and natural history of chronic Hepatitis B in the Canadian province of Alberta from 2012 to 2021: A population-based study","authors":"Golasa Samadi Kochaksaraei , Fengjuan Yang , Cynthia H. Seow , Herman W Barkema , Carla S Coffin , Abdel-Aziz Shaheen","doi":"10.1016/j.aohep.2024.101576","DOIUrl":"10.1016/j.aohep.2024.101576","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>There are limited recent data on the burden of chronic hepatitis B (CHB) in the North American general population. We aimed to identify the CHB burden from a Canadian population-based perspective.</div></div><div><h3>Patients and Methods</h3><div>Using a retrospective cohort design, we searched Alberta Analytics administrative databases including the Provincial Laboratory database, to describe CHB epidemiology and natural history in Alberta, Canada between fiscal years 2012-2020. We analyzed incidence and prevalence trends using a Poisson regression model and conducted Kaplan-Meier analyses to examine the incident cohort's survival.</div></div><div><h3>Results</h3><div>The age/sex-adjusted incidence of CHB between 2015-2020 was 27.1/100,000 person/years (29.6/100,000 in males and 24.5/100,000 in females) and was highest among individuals aged 45-64 years. Despite a decrease in annual incidence of CHB from 36.4 to 13.4/100,000 between 2015-2020, prevalence increased from 98.9 to 210.3/100,000 in the same period. Of 6,860 incident cases, 2.1% died, and 0.2% underwent liver transplantation during a median follow-up of 3.6 years (interquartile range 2.0-4.9 years). CHB patients had significantly lower survival rates compared to age/sex-matched Canadians, with a standardized mortality ratio of 3.9 (95% confidence interval [CI] 3.3-4.6). Male sex (hazard ratio [HR] 1.7; 95% CI 1.2-2.5), older age at diagnosis (HR, 1.08; 95% CI 1.07-1.09) independently predicted mortality.</div></div><div><h3>Conclusions</h3><div>CHB incidence decreased in Alberta, which is consistent with nationwide trends. Males and individuals aged 45-64 had higher CHB incidence and prevalence. CHB patients’ lower survival rates emphasize the need to address barriers to guideline recommended HBV care linkage.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 1","pages":"Article 101576"},"PeriodicalIF":3.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of a biodegradable prosthesis through tissue engineering: the lack of the physiological abstractions prevents bioengineering innovations","authors":"Ilya Klabukov , Anna Smirnova , Ekaterina Evstratova , Denis Baranovskii","doi":"10.1016/j.aohep.2024.101587","DOIUrl":"10.1016/j.aohep.2024.101587","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 1","pages":"Article 101587"},"PeriodicalIF":3.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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