Annals of hepatology最新文献

Introduction and objectives: Bilirubin is negatively associated with neurodegenerative diseases, including multiple sclerosis (MS). Since previous studies were small or did not evaluate all diagnostic aspects, the objective of the present study was to assess a large cohort of MS patients with multiple determinations of serum bilirubin.

Patients and methods: The study was carried out in 2,696 consecutive MS patients (median age=37.1 years, disease duration=6.8 years, follow-up duration=7.2 years, and Expanded Disability Status Scale (EDSS)=2.5) with 28,501 visits. Individuals from the Czech post-MONICA study representing the general Czech population (n=2,621) were used as controls. Serum bilirubin concentrations in study subjects were compared with multiple diagnostic and clinical parameters.

Results: Serum bilirubin concentrations in MS patients were significantly lower compared to the general population (8.3 vs. 9.6 μmol/L, P<0.001). Hyperbilirubinemia >17 µmol/L in MS patients was much less frequent compared to the general population (8.2 vs. 12.5 %, P<0.001). An increase in disease duration by 10 years was associated with an 8 % decrease in bilirubin concentration (p<0.0001). Ten percent higher serum bilirubin concentration was associated with a 9 % decrease in EDSS (p=0.001) and a 1.5 % decrease in normalized brain volume (p<0.0001). The frequencies of individual UGT1A1 (TA)n/n genotypes did not differ between MS patients and the control population.

Conclusions: MS patients have markedly lower serum bilirubin concentrations, most likely due to consumption during the increased oxidative stress since the frequencies of UGT1A1 were comparable in the MS and control populations. Higher serum bilirubin is associated with lower disability and lower brain atrophy.

Introduction and objectives: Chronic liver disease (CLD) is characterized by a progressive decline in liver function, accompanied by inflammation, destruction, and scarring of the hepatic parenchyma. The most common etiologies of CLD globally include hepatitis B (HBV), hepatitis C (HCV), alcohol-related liver disease, autoimmune liver disease, and, more recently, metabolic dysfunction-associated steatotic liver disease (MASLD). The aim was to analyze the main etiologies of CLD observed in a Hepatology Center over a 25-year period.

Materials and methods: A retrospective and observational study was conducted with 2679 patients with CLD, recruited between January 1995 and December 2019. The patients were classified into three time periods: Group A (1995-2003), Group B (2004-2011), and Group C (2012-2019). A one-way analysis of variance was used to assess the differences between the groups.

Results: Significant differences were found in HCV, HBV, and MASLD between the analyzed periods (p = 0.0019, p < 0.001, and p < 0.001, respectively). Tukey's post hoc test revealed significant differences in HCV and HBV between group A and groups B and C (p < 0.01 and p < 0.001, respectively). For MASLD, a progressive increase was observed in each period (p < 0.01 for A vs. B; p ≤ 0.001 for A vs. C; p = 0.0042 for B vs. C).

Conclusions: Between 1995 and 2007, the predominant CLD in our clinic was caused by HCV. However, since 2008, MASLD has become the most frequent etiology (33 %), reaching 45 % in 2019 as the leading cause of CLD. By 2012, cirrhosis due to MASLD had the highest incidence among the analyzed etiologies, followed by HCV.