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A social media listening study of patients’ experiences relating to metabolic dysfunction-associated steatotic liver disease: The LISTEN-MASLD study 一项关于代谢功能障碍相关脂肪变性肝病患者经历的社交媒体聆听研究:LISTEN-MASLD研究
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2024.101741
Jeffrey V. Lazarus , William Alazawi , Ron Basuroy , Laurent Castera , Dmitry Estulin , Yiannoula Koulla , Preethy Prasad , Manuel Romero-Gomez , Hirokazu Takahashi , Vincent Wai-Sun Wong , Jörn M. Schattenberg

Introduction and Objectives

Patients increasingly use social media to share and access health-related information and experiences. This study employed social media listening to gain patient-centric insights into metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD).

Materials and Method

Publicly available social media data was collected between November 4th, 2020, and November 4th, 2022, about MASLD from eight countries: Brazil, China, France, Germany, Japan, South Korea, Spain, and the United Kingdom. The analysis involved capturing patient conversations on their journey stages (causes-risk factors, symptoms, diagnosis, and treatment), unmet needs, and impact on patient's quality of life (QoL) from various social media platforms to gain insights associated with MASLD.

Results

A total of 1600 patient-centric posts were analyzed. The patient journey was the most prevalent topic (92 %) mentioned, followed by comorbidities (38 %) and interactions with HCPs (26 %, health care professionals). Key causes discussed included unhealthy diet (39 %) and overweight/obese (32 %), while the most mentioned symptoms were fatigue (20 %) and pain or abdominal discomfort (20 %). Ultrasound (n=170/553, 31 %) was the most used diagnosis, followed by blood tests (n=130/553, 24 %) and liver function tests (n=91/553, 16 %). Lifestyle management techniques were mainly the standard of care, followed by treatment (n=270/1061, 25 %) and follow-ups with HCPs (n=133/1061, 13 %). Over half (54 %) of the QoL discussion (n=104/192) focused on patients’ comorbidities, and 27 % on disease severity, indicating that having MASLD in moderate to severe form with comorbidities significantly affects patients’ quality of life. An emotional analysis revealed that patients were worried and frustrated about their condition but were also hopeful and determined to improve their health. Nearly 38 % of the posts mentioned that patients were emotionally affected by negative feelings, especially those with multiple comorbidities. Lack of access to knowledgeable HCPs and treatment options were the most frequently discussed unmet needs.

Conclusions

This analysis of NAFLD patient experiences introduces a unique approach for deriving insights into patients' experiences and their impact on QoL. These insights have the potential to complement conventional methods and foster patient-centric research.
前言和目标:患者越来越多地使用社交媒体来分享和获取与健康相关的信息和经验。本研究采用社交媒体聆听来获得以患者为中心的代谢功能障碍相关脂肪性肝病(MASLD),以前称为非酒精性脂肪性肝病(NAFLD)。材料和方法:收集2020年11月4日至2022年11月4日期间来自巴西、中国、法国、德国、日本、韩国、西班牙和英国8个国家关于NAFLD的公开社交媒体数据。分析包括从各种社交媒体平台捕获患者在其旅程阶段的对话(原因-风险因素,症状,诊断和治疗),未满足的需求以及对患者生活质量(QoL)的影响,以获得与NAFLD相关的见解。结果:共分析了1600个以患者为中心的岗位。患者旅程是提及最多的话题(92%),其次是合并症(38%)和与医护人员的互动(26%,卫生保健专业人员)。讨论的主要原因包括不健康的饮食(39%)和超重/肥胖(32%),而提到最多的症状是疲劳(20%)和疼痛或腹部不适(20%)。超声(n=170/553, 31%)是最常用的诊断方法,其次是血液检查(n=130/553, 24%)和肝功能检查(n=91/553, 16%)。生活方式管理技术是主要的标准护理,其次是治疗(n=270/1061, 25%)和HCPs随访(n=133/1061, 13%)。超过一半(54%)的生活质量讨论(n=104/192)关注患者的合并症,27%关注疾病严重程度,表明中度至重度NAFLD合并合并症显著影响患者的生活质量。一项情绪分析显示,患者对自己的病情感到担忧和沮丧,但也抱有希望,并决心改善自己的健康。近38%的帖子提到,患者在情绪上受到负面情绪的影响,尤其是那些患有多种合并症的患者。缺乏知识渊博的医务人员和治疗方案是最常被讨论的未满足需求。结论:对MASLD患者体验的分析为深入了解患者体验及其对生活质量的影响提供了一种独特的方法。这些见解有可能补充传统方法并促进以患者为中心的研究。
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引用次数: 0
Rifaximin treatment in patients with severe alcoholic hepatitis: A multicenter, randomized controlled, open-label, pilot trial 利福昔明治疗重度酒精性肝炎:一项多中心、随机对照、开放标签的试点试验
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2024.101749
Do Seon Song , Jin Mo Yang , Young Kul Jung , Hyung Joon Yim , Hee Yeon Kim , Chang Wook Kim , Soon Sun Kim , Jae Youn Cheong , Hae Lim Lee , Sung Won Lee , Jeong-Ju Yoo , Sang Gyune Kim , Young Seok Kim

Introduction and Objectives

The short-term mortality of severe alcoholic-associated hepatitis (SAH) is high, but there are no effective treatments to improve short-term mortality other than corticosteroids. This study investigated the effects of adding rifaximin to standard treatment in patients with SAH.

Material and Methods

In this randomized controlled open-label trial, patients with SAH (Maddrey's discriminant function≥32) were randomized to the rifaximin or control group. Patients were simultaneously treated with corticosteroid or pentoxifylline as standard treatment for 4 weeks. Randomization was stratified by SAH treatment.

Results

A total of 50 patients were enrolled in this study (29 in the control group and 21 in the rifaximin group). The mean Model for End-stage Liver Disease (MELD) scores were 24.4 and 27.5 in the control and rifaximin groups, respectively (P = 0.106). There were no significant differences in 6-month Liver Transplantation (LT)-free survival rate between the two groups (P = 0.502). When stratified by SAH treatment, there was no significant difference in 6-month LT-free survival rate between the control and rifaximin treatment groups (P = 0.186 in the corticosteroid group and P = 0.548 in the pentoxifylline group). There were no significant differences in the occurrence of liver-related complications between the two groups (all Ps>0.05). The MELD score was the only independent factor for 6-month LT-free survival (hazard ratio 1.188, 95 % confidence interval 1.094-1.289, P<0.001), and rifaximin was not.

Conclusions

In patients with SAH, adding rifaximin to corticosteroid or pentoxifylline had no survival benefit and no preventive effect on the development of liver-related complications. The MELD score was the only significant factor for short-term mortality.

Clinical trial registration

The study was registered on ClinicalTrials.gov (number: NCT02485106).
简介和目的:严重酒精性肝炎(SAH)的短期死亡率很高,但除皮质类固醇外,尚无有效的治疗方法来改善短期死亡率。本研究探讨了在SAH患者的标准治疗中加入利福昔明的效果。材料和方法:在这项随机对照开放标签试验中,SAH (Maddrey’s discriminant function≥32)患者被随机分为利福昔明组或对照组。同时给予皮质类固醇或己酮茶碱作为标准治疗,疗程4周。随机分组按SAH治疗分层。结果:共纳入49例患者(对照组29例,利福昔明组20例)。对照组和利福昔明组终末期肝病模型(MELD)平均评分分别为24.4分和27.8分(P=0.083)。两组患者6个月无肝移植生存率差异无统计学意义(P=0.698)。当按SAH治疗分层时,对照组和利福昔明治疗组6个月无lt生存率无显著差异(皮质类固醇组P=0.526,自酮茶碱组P=0.620)。两组患者肝脏相关并发症发生率比较,差异无统计学意义(p < 0.05)。MELD评分是6个月无lt生存的唯一独立因素(风险比1.360,95%可信区间1.021-1.810,P=0.035),而利福昔明则不是。结论:在SAH患者中,在皮质类固醇或己酮茶碱的基础上添加利福昔明对生存没有好处,对肝脏相关并发症的发生也没有预防作用。MELD评分是短期死亡率的唯一显著因素。
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引用次数: 0
Differentially expressed genes in Huh7 cells during co-culture with LX2 cells demonstrating dynamics of intercellular communication Huh7细胞与LX2细胞共培养过程中差异表达的基因显示了细胞间通讯的动态。
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2024.101746
Tania G. Heredia-Torres, Veronica Alvarado-Martínez, Ana R. Rincón-Sánchez, Sonia A. Lozano-Sepúlveda, Kame A. Galán-Huerta, Daniel Arellanos-Soto, Ana M. Rivas-Estilla
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引用次数: 0
Comment on “Development of machine learning-based personalized predictive models for risk evaluation of hepatocellular carcinoma in hepatitis B virus-related cirrhosis patients with low levels of serum alpha-fetoprotein” 对“开发基于机器学习的个性化预测模型,用于血清甲胎蛋白水平低的乙型肝炎病毒相关肝硬化患者的肝细胞癌风险评估”的评论。
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2024.101760
Liang Zhao, Husaiyin Erhati, Sailai Yalikun
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引用次数: 0
Diagnostic performance of FibroTouch® in assessing hepatic steatosis and fibrosis in patients with metabolic dysfunction-associated steatotic liver disease: An Asian experience FibroTouch®在评估代谢功能障碍相关脂肪性肝病患者的肝脂肪变性和纤维化中的诊断性能:亚洲经验
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2024.101753
Thanikan Sukaram , Soe Thiha Maung , Yuda Chongpison , Tassanan Jaihan , Chonlada Phathong , Roongruedee Chaiteerakij

Introduction and Objectives

FibroTouch® has shown efficacy in staging hepatic fibrosis in patients with chronic viral hepatitis B, but its performance in assessing liver steatosis and fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD) patients remains understudied. We aimed to evaluate the diagnostic performance of FibroTouch® in assessing steatosis and fibrosis in the MASLD population.

Materials and Methods

Liver stiffness measurements and steatosis were assessed using FibroTouch® and FibroScan®, with FibroScan® as the reference standard. Pearson's correlation test evaluated correlations, and kappa statistics determined agreement between the two methods. Optimal cut-off values of FibroTouch® for predicting hepatic steatosis and fibrosis stages were determined through ROC curve analysis with the Youden index method.

Results

Strong correlations were observed between FibroTouch® UAP and FibroScan® CAP (rho=0.74) and LSM values (rho=0.87) (p < 0.001 for both) in a total of 380 patients. The mean CAP value for the entire cohort was 285 ± 51 dB/m, and the median LSM for the cohort was 5 .3kPa. The optimal FibroTouch® UAP cutoffs were 229 dB/m for S0 vs. S1, 267 dB/m for S1 vs. S2, and 294 dB/m for S2 vs. S3. For FibroTouch® LSM, the optimal cutoffs were 6.0 kPa for F0-F1 vs. F2, 7.9 kPa for F2 vs. F3, and 10.6 kPa for F3 vs. F4. Moreover, FibroTouch® effectively assessed hepatic steatosis and fibrosis in patients with different BMIs.

Conclusions

FibroTouch® proved valuable in assessing hepatic steatosis and liver fibrosis staging in MASLD patients, enhancing its applicability in various clinical settings as a suitable and convenient option for MASLD patients.
简介和目的:FibroTouch® 在对慢性乙型病毒性肝炎患者的肝纤维化进行分期方面已显示出疗效,但其在评估代谢功能障碍相关性脂肪性肝病(MASLD)患者肝脏脂肪变性和纤维化方面的性能仍未得到充分研究。我们的目的是评估 FibroTouch® 在评估 MASLD 患者脂肪变性和肝纤维化方面的诊断性能:使用 FibroTouch® 和 FibroScan® 评估肝脏硬度测量值和脂肪变性,FibroScan® 作为参考标准。皮尔逊相关性检验评估了相关性,卡帕统计确定了两种方法之间的一致性。通过采用尤登指数法进行 ROC 曲线分析,确定了 FibroTouch® 预测肝脂肪变性和肝纤维化分期的最佳临界值:结果:FibroTouch® UAP 与 FibroScan® CAP 值(rho=0.74)和 LSM 值(rho=0.87)(pConclusions:事实证明,FibroTouch® 在评估 MASLD 患者的肝脂肪变性和肝纤维化分期方面很有价值,它作为 MASLD 患者的一种合适而方便的选择,提高了其在各种临床环境中的适用性。
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引用次数: 0
Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standard 慢性肝病肝纤维化评估:以组织病理学评估为参考标准的弥散加权MR弹性成像与二维剪切波弹性成像的比较
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2024.101743
Li Yang , Guofeng Zhou , Liheng Liu , Shengxiang Rao , Wentao Wang , Kaipu Jin , Caixia Fu , Mengsu Zeng , Ying Ding

Introduction and Objectives

Liver stiffness measurement (LSM) by two-dimensional shear-wave elastography (2D SWE) is a well-established method for assessing hepatic fibrosis. Diffusion-weighted imaging (DWI) can be converted into virtual shear modulus (µDiff) to estimate liver elasticity. The purpose of this study was to correlate and compare the diagnostic performance of DWI-based virtual elastography and 2D SWE for staging hepatic fibrosis in patients with chronic liver disease, using histopathologic assessment as the reference standard.

Patients and Methods

This retrospective study included 111 patients who underwent preoperative multiple b-value DWI and 2D SWE. The µDiff was calculated using DWI acquisition with b-values of 200 and 1,500 /mm2, and LSM was obtained by 2D SWE. Correlation between µDiff and LSM was assessed, as well as the correlation between these noninvasive methods and histologic fibrosis stages. The diagnostic efficacy of µDiff and LSM for staging liver fibrosis was compared with receiver operating characteristic (ROC) curve analysis.

Results

There was a significant positive correlation between µDiff and LSM (rho= 0.48, P < 0.001). µDiff (rho= 0.54, P < 0.001) and LSM (rho= 0.76, P < 0.001) were positively correlated with liver fibrosis stages. Areas under the curves (AUCs) of µDiff and LSM, respectively, were 0.81 and 0.90 for significant fibrosis, 0.89 and 0.98 for advanced fibrosis, and 0.77 and 0.91 for cirrhosis. The AUCs of 2D SWE for diagnosing advanced fibrosis and cirrhosis were significantly higher than those of µDiff (P < 0.05 for both).

Conclusions

LSM by 2D SWE yields larger AUCs compared to µDiff obtained from DWI-based virtual elastography for various stages of liver fibrosis. LSM is superior to µDiff in predicting advanced fibrosis and cirrhosis.
简介和目的:通过二维剪切波弹性成像(2D SWE)测量肝脏硬度(LSM)是一种公认的评估肝纤维化的方法。扩散加权成像(DWI)可以转换为虚拟剪切模量(µDiff)来估计肝脏弹性。本研究的目的是以组织病理学评估为参考标准,将基于dwi的虚拟弹性成像与2D SWE对慢性肝病患者肝纤维化分期的诊断性能进行关联和比较。患者和方法:本回顾性研究纳入111例术前行b值DWI和2D SWE检查的患者。利用b值为200和1500 /mm2的DWI采集计算µDiff,并通过2D SWE获得LSM。评估µDiff和LSM之间的相关性,以及这些无创方法与组织学纤维化分期之间的相关性。采用受试者工作特征(ROC)曲线分析比较µDiff和LSM对肝纤维化分期的诊断效果。结果:µDiff与LSM呈显著正相关(rho= 0.48), PDiff与LSM呈显著正相关(rho= 0.54),显著纤维化PDiff与LSM分别为0.81、0.90,晚期纤维化PDiff与0.89、0.98,肝硬化PDiff与LSM分别为0.77、0.91。2D SWE诊断晚期纤维化和肝硬化的auc显著高于µDiff (P)。结论:对于不同阶段的肝纤维化,与基于dwi的虚拟弹性成像获得的µDiff相比,2D SWE的LSM产生更大的auc。LSM在预测晚期纤维化和肝硬化方面优于µDiff。
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引用次数: 0
Effect of bariatric endoscopy on liver fibrosis and steatosis and the course of NAFLD – a prospective interventional study 减肥内镜对肝纤维化和脂肪变性以及非酒精性脂肪肝病程的影响--一项前瞻性干预研究。
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2024.101765
Adam Vašura , Evžen Machytka , Ondřej Urban , Jitka Macháčková , Lubomír Pavliska , Zdeněk Berka , Zdeněk Švagera , Marek Bužga

Introduction and Objectives

With increases in obesity and metabolic syndrome because of lifestyle-related factors, the prevalence of non-alcoholic fatty liver disease (NAFLD) also is increasing worldwide. In a subset of patients with NAFLD, an inflammatory process arises in the steatotic liver, known as non-alcoholic steatohepatitis, that leads to liver fibrosis and liver cirrhosis. In selected patients with obesity, bariatric surgery, and bariatric endoscopy are important therapeutic options.

Materials and Methods

This prospective interventional pilot study was conducted to investigate two types of intragastric balloons (IGB). The IGBs were the Orbera and the Spatz3. Liver fibrosis changes were monitored non-invasively using point and 2D shear wave ultrasound elastography (SWE) and transient elastography that allowed for quantification of liver steatosis using the controlled attenuation parameter (CAP). Patients were followed for 12 months.

Results

Of 34 patients implanted with an IGB, 30 completed follow-up at month 12; results for one patient were excluded because of initiation of obesity pharmacotherapy. Fifteen patients received the Orbera IGB, and nineteen patients received the Spatz3 type. In month 12, total and excess weight loss was 7.88 % and 30.13 %. Elastography values decreased from baseline (3.88 kPa) to 3.61 kPa at month 12 (p 0.024). 2D SWE values decreased from baseline (5.42 kPa) to a value of 4.91 kPa at month twelve (p 0.135). Transient elastography values decreased from baseline (5.62 kPa) to a value of 4.17 kPa at month twelve (p 0.009).

Conclusions

Bariatric endoscopy in the form of IGB implantation leads to weight reduction and improvement of liver fibrosis and steatosis.

ClinicalTrials.gov registration

NCT04895943
简介和目的:随着生活方式相关因素导致肥胖和代谢综合征的增加,全球非酒精性脂肪性肝病(NAFLD)的患病率也在增加。在一部分NAFLD患者中,脂肪变性肝出现炎症过程,称为非酒精性脂肪性肝炎,可导致肝纤维化和肝硬化。在选定的肥胖患者中,减肥手术和减肥内窥镜检查是重要的治疗选择。材料和方法:本前瞻性介入试验研究了两种类型的胃内球囊(IGB)。igb是Orbera和Spatz3。使用点和二维剪切波超声弹性成像(SWE)和瞬时弹性成像(允许使用控制衰减参数(CAP)量化肝脏脂肪变性)无创监测肝纤维化变化。随访12个月。结果:34例植入IGB的患者中,30例在12个月完成随访;1例患者因开始肥胖药物治疗而被排除。15例患者接受Orbera IGB, 19例患者接受Spatz3型。第12个月,总减重7.88%,超重减重30.13%。弹性成像值从基线(3.88 kPa)下降到第12个月的3.61 kPa (p 0.024)。2D SWE值从基线(5.42 kPa)下降到第12个月的4.91 kPa (p 0.135)。瞬时弹性图值从基线(5.62 kPa)下降到12个月时的4.17 kPa (p 0.009)。结论:IGB植入形式的减肥内窥镜可减轻体重,改善肝纤维化和脂肪变性。临床试验:政府注册:NCT04895943。
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引用次数: 0
From gut to liver: Exploring the crosstalk between gut-liver axis and oxidative stress in metabolic dysfunction-associated steatotic liver disease 从肠道到肝脏:探索代谢功能障碍相关脂肪变性肝病中肠-肝轴与氧化应激之间的串扰。
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2025.101777
Mi Zhou , Jianyu Lv , Xinli Chen , Yujie Shi , Guanqun Chao , Shuo Zhang
Non-alcoholic fatty liver disease (NAFLD), now recognized as metabolic dysfunction-associated steatotic liver disease (MASLD), represents a significant and escalating global health challenge. Its prevalence is intricately linked to obesity, insulin resistance, and other components of the metabolic syndrome. As our comprehension of MASLD deepens, it has become evident that this condition extends beyond the liver, embodying a complex, multi-systemic disease with hepatic manifestations that mirror the broader metabolic landscape. This comprehensive review delves into the critical interplay between the gut-liver axis and oxidative stress, elucidating their pivotal roles in the etiology and progression of MASLD. Our analysis reveals several key findings: (1) Bile acid dysregulation can trigger oxidative stress through enhanced ROS production in hepatocytes and Kupffer cells, leading to mitochondrial dysfunction and lipid peroxidation; (2) Gut microbiota dysbiosis disrupts intestinal barrier function, allowing increased translocation of endotoxins like LPS, which activate inflammatory pathways through TLR4 signaling and promote oxidative stress via NADPH oxidase activation; (3) The redox-sensitive transcription factors NF-κB and Nrf2 serve as crucial mediators in the gut-liver axis, with NF-κB regulating inflammatory responses and Nrf2 orchestrating antioxidant defenses; (4) Oxidative stress-induced damage to intestinal barrier function creates a destructive feedback loop, further exacerbating liver inflammation and disease progression. These findings highlight the complex interrelationship between gut-liver axis dysfunction and oxidative stress in MASLD pathogenesis, suggesting potential therapeutic targets for disease management.
非酒精性脂肪性肝病(NAFLD),现在被认为是代谢功能障碍相关的脂肪变性肝病(MASLD),是一项重大且不断升级的全球健康挑战。它的流行与肥胖、胰岛素抵抗和代谢综合征的其他组成部分有着复杂的联系。随着我们对MASLD理解的加深,很明显,这种疾病已经延伸到肝脏之外,体现了一种复杂的、多系统的疾病,其肝脏表现反映了更广泛的代谢景观。这篇全面的综述深入研究了肠肝轴和氧化应激之间的关键相互作用,阐明了它们在MASLD的病因和进展中的关键作用。我们的分析揭示了几个关键发现:(1)胆汁酸失调可以通过增强肝细胞和库普弗细胞中ROS的产生引发氧化应激,导致线粒体功能障碍和脂质过氧化;(2)肠道菌群失调破坏肠道屏障功能,使内毒素如LPS易位增加,内毒素通过TLR4信号激活炎症通路,并通过NADPH氧化酶激活促进氧化应激;(3)氧化还原敏感转录因子NF-κB和Nrf2是肠-肝轴的重要介质,NF-κB调节炎症反应,Nrf2协调抗氧化防御;(4)氧化应激对肠道屏障功能的损伤形成了一个破坏性的反馈循环,进一步加剧了肝脏炎症和疾病进展。这些发现强调了肠-肝轴功能障碍和氧化应激在MASLD发病机制中的复杂相互关系,提示了疾病管理的潜在治疗靶点。
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引用次数: 0
The rationale for the aggressive progression of MASLD in patients with type 2 diabetes 2型糖尿病患者MASLD侵袭性进展的基本原理
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2025.101778
Valeria Michelle Fernández-Garibay, Norberto C. Chavez-Tapia
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引用次数: 0
Examining the prevalence of hepatic steatosis and advanced fibrosis using non-invasive measures across Canada: A national estimate using the Canadian Health Measures Survey (CHMS) from 2009-2019 使用无创措施检查加拿大各地肝脂肪变性和晚期纤维化的患病率:2009-2019年加拿大健康措施调查(CHMS)的全国估计。
IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.aohep.2024.101757
Jacob Romano , Jessica Burnside , Giada Sebastiani , Alnoor Ramji , Keyur Patel , Mark Swain , Sahar Saeed

Introduction and Objectives

Prevalence estimates are crucial for enhancing preparedness to prevent and manage chronic diseases. This is the first study to estimate the prevalence of hepatic steatosis and advanced fibrosis in Canada, leveraging a nationally representative survey and multiple validated non-invasive tests (NITs).

Materials and Methods

The Canadian Health Measures Survey (CHMS) is Canada's largest direct health measures survey, which collects data on sociodemographic, clinical factors, and blood chemistry. We determined steatosis using two NITs: the Hepatic Steatosis Index (HSI) and the NAFLD Ridge Score (NRS). The FIB-4 Index and NAFLD fibrosis score (NFS) were used to assess the risk of advanced fibrosis among adults with steatosis. Survey weights were incorporated to account for oversampling, survey nonresponse, and post-stratification.

Results

Between 2009 and 2019, 1365 children (55 % males, median age 13 (IQR: 10–15) and 4664 adults (51 % males, median age 45 (IQR: 34–62), 57 % reporting weekly alcohol consumption) were included in our study. The weighted steatosis prevalence ranged from 9 to 11 % among children to 38–48 % among adults based on the NRS and HSI, respectively. Between 86–87 % of adults with type 2 diabetes and 65–72 % with hypertension had evidence of steatosis. Overall, 1.2–2.4 % of adults with steatosis were at risk of advanced liver fibrosis.

Conclusions

We estimate between 1 in 3 and 1 in 2 adults have hepatic steatosis, and 195,000–406,200 are at high risk of advanced liver fibrosis in Canada. No routine screening guidelines for liver fibrosis exist in Canada, and most patients are unaware of their condition. Prevalence studies are essential for raising awareness and advocating for the inclusion of steatotic liver disease on national public health agendas.
前言和目标:流行率估计对于加强预防和管理慢性病的准备工作至关重要。这是第一项估计加拿大肝脂肪变性和晚期纤维化患病率的研究,利用全国代表性调查和多次验证的非侵入性测试(NITs)。材料和方法:加拿大健康措施调查(CHMS)是加拿大最大的直接健康措施调查,收集有关社会人口、临床因素和血液化学的数据。我们使用两个nit来确定脂肪变性:肝脂肪变性指数(HSI)和NAFLD Ridge评分(NRS)。FIB-4指数和NAFLD纤维化评分(NFS)用于评估成人脂肪变性患者发生晚期纤维化的风险。调查权重被纳入考虑过抽样、调查无反应和后分层。结果:在2009年至2019年期间,我们的研究纳入了1365名儿童(55%男性,中位年龄13岁(IQR: 10-15))和4664名成年人(51%男性,中位年龄45岁(IQR: 34-62), 57%报告每周饮酒)。根据NRS和HSI,加权脂肪变性患病率在儿童中为9-11%,在成人中为38-48%。86-87%的成人2型糖尿病患者和65-72%的高血压患者有脂肪变性的证据。总体而言,1.2-2.4%的成人脂肪变性患者存在晚期肝纤维化的风险。结论:我们估计加拿大有1 / 3到1 / 2的成年人患有肝脂肪变性,195,000-406,200人处于晚期肝纤维化的高风险中。加拿大没有肝纤维化的常规筛查指南,大多数患者不知道自己的病情。流行病学研究对于提高认识和倡导将脂肪变性肝病纳入国家公共卫生议程至关重要。
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Annals of hepatology
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