Annals of hepatology最新文献_第9页

P-14 DETECTION OF CIRRHOSIS DUE TO ALPHA-1 ANTITRYPSIN DEFICIENCY IN ADULTS: PHENOTYPE STUDY IN COSTA RICA

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101628

Fernanda Vásquez Carit , Francisco Hevia Urrutia , Jorge Vargas Madrigal , Mildred Jiménez Hernández , Natassia Camacho Matamoros , Danny Alvarado Romero , Jorge Herrera Corrales

Conflict of interest

No

Introduction and Objectives

Alpha-1 antitrypsin (A1AT) levels are normal in up to 20% of liver diseases, and this protein elevates in inflammatory states, causing false negatives. This disease does not follow an autosomal recessive inheritance pattern, so the classical concept of homozygosity does not apply. Instead, two codominant alleles manifest as liver or lung disease. Objectives: To determine the phenotypes associated with A1AT-related liver disease in Costa Rica.

Patients / Materials and Methods

Phenotypes detected in patients with suspected A1AT deficiency from 2014 to July 2024 were analyzed. Phenotype identification was carried out using isoelectric focusing in agarose gel with immunofixation. The presence of liver disease was determined through clinical, laboratory, and imaging findings.

Results and Discussion

During the specified period, 371 phenotype studies were conducted on 187 women and 184 men. The identified phenotypes were: 15 ZZ probands, 22 MZ probands, 1 SZ proband, 7 MS probands, 1 SS proband, 1 null proband, 1 M/null proband, 31 MM probands, and 2 null/null probands. No Z/null proband was detected. Among 53 probands, there were: 10 ZZ, 13 MZ, 1 SZ, 4 MS, 1 SS, 1 null, and 23 MM. It was established that the risk of liver disease is slightly increased in MZ, increased in SZ, and very increased in ZZ. Cirrhosis was diagnosed in 19 probands: 7 ZZ, 7 M/null, 4 MZ, and 1 SZ.

Conclusions

A1AT quantification has a 20% false-negative rate, so phenotype testing is recommended when there is suspicion. In Costa Rica, the ZZ variant has the highest risk of liver disease, followed by SZ and MZ; the M/null phenotype was also detected as a cause of liver disease. Medical monitoring is necessary, and in doubtful cases, genotype testing should be performed.

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引用次数: 0

P-58 PILOT STUDY OF HEPATITIS E VIRUS SEROPREVALENCE IN HEPATITIS B AND DELTA CARRIERS IN THE WESTERN AMAZON

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101672

Caio Lopes Borges Andrade , Luiz Felipe Monteiro Darzé , Maurício de Souza Campos , Sidelcina Rugieri Pacheco , Ezequiel Ridruejo , Juan Miguel Villalobos Salcedo , Katia Ingred da Silva Maia , Tárcio Peixoto Roca , Deusilene Souza Vieira Dallacqua , Jucara Magalhaes Simoes , Robert Eduard Schaer , Roberto Jose Meyer Nascimento , Raymundo Paraná Ferreira Filho , Songeli Menezes Freire , Maria Izabel Schinoni

Conflict of interest

No

Introduction and Objectives

Hepatitis E virus (HEV) is a zoonotic virus transmitted via the fecal-oral route with a generally favorable prognosis. However, higher risks exist for pregnant or immunocompromised patients. Infection occurs through contaminated food, water, or direct contact with infected blood. Its asymptomatic nature and favorable prognosis likely contribute to underreporting in Brazil, especially in peri-urban and rural areas with limited healthcare access. Objective: To evaluate the seroprevalence of HEV in patients with mono-infection of Hepatitis B and co-infection with Delta virus in Rondônia.

Patients / Materials and Methods

An exploratory cross-sectional study using the Dia.Pro HEV Ab total ELISA kit for serological evaluation of 177 samples from the serum bank of the Molecular Virology Laboratory at Fiocruz-RO of patients with viral hepatitis from the Tropical Medicine Center (CEMETRON) in Rondônia. The samples were stratified into 74 VHD co-infected and 103 HBV mono-infected groups. The diagnosis of the Delta virus was performed using molecular biology on samples collected between 2018 and 2022. The results were analyzed using T-test and chi-square test.

Results and Discussion

The total sample consisted of 177 participants, including 95 men, 54 women, and 28 without information. The average age of participants was 41 years (M = 41), with the Delta group averaging 40 years and the HBV mono-infected group averaging 42 years. Of the 74 VHB-VHD sera, 9 (12.16%) were HEV IgG positive, 58 (78.40%) were non-reactive, and 7 (9.45%) were indeterminate. Among the 103 HBV sera, 9 (8.73%) were HEV IgG positive, 86 (83.50%) were non-reactive, and 8 (7.76%) were indeterminate.

Conclusions

The findings of HEV in HBV and VHD patients in Rondônia showed results similar to those found in studies with other populations. This is the first study on HEV in HBV and VHD patients.

{"title":"P-58 PILOT STUDY OF HEPATITIS E VIRUS SEROPREVALENCE IN HEPATITIS B AND DELTA CARRIERS IN THE WESTERN AMAZON","authors":"Caio Lopes Borges Andrade , Luiz Felipe Monteiro Darzé , Maurício de Souza Campos , Sidelcina Rugieri Pacheco , Ezequiel Ridruejo , Juan Miguel Villalobos Salcedo , Katia Ingred da Silva Maia , Tárcio Peixoto Roca , Deusilene Souza Vieira Dallacqua , Jucara Magalhaes Simoes , Robert Eduard Schaer , Roberto Jose Meyer Nascimento , Raymundo Paraná Ferreira Filho , Songeli Menezes Freire , Maria Izabel Schinoni","doi":"10.1016/j.aohep.2024.101672","DOIUrl":"10.1016/j.aohep.2024.101672","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Hepatitis E virus (HEV) is a zoonotic virus transmitted via the fecal-oral route with a generally favorable prognosis. However, higher risks exist for pregnant or immunocompromised patients. Infection occurs through contaminated food, water, or direct contact with infected blood. Its asymptomatic nature and favorable prognosis likely contribute to underreporting in Brazil, especially in peri-urban and rural areas with limited healthcare access. <em>Objective:</em> To evaluate the seroprevalence of HEV in patients with mono-infection of Hepatitis B and co-infection with Delta virus in Rondônia.</div></div><div><h3>Patients / Materials and Methods</h3><div>An exploratory cross-sectional study using the Dia.Pro HEV Ab total ELISA kit for serological evaluation of 177 samples from the serum bank of the Molecular Virology Laboratory at Fiocruz-RO of patients with viral hepatitis from the Tropical Medicine Center (CEMETRON) in Rondônia. The samples were stratified into 74 VHD co-infected and 103 HBV mono-infected groups. The diagnosis of the Delta virus was performed using molecular biology on samples collected between 2018 and 2022. The results were analyzed using T-test and chi-square test.</div></div><div><h3>Results and Discussion</h3><div>The total sample consisted of 177 participants, including 95 men, 54 women, and 28 without information. The average age of participants was 41 years (M = 41), with the Delta group averaging 40 years and the HBV mono-infected group averaging 42 years. Of the 74 VHB-VHD sera, 9 (12.16%) were HEV IgG positive, 58 (78.40%) were non-reactive, and 7 (9.45%) were indeterminate. Among the 103 HBV sera, 9 (8.73%) were HEV IgG positive, 86 (83.50%) were non-reactive, and 8 (7.76%) were indeterminate.</div></div><div><h3>Conclusions</h3><div>The findings of HEV in HBV and VHD patients in Rondônia showed results similar to those found in studies with other populations. This is the first study on HEV in HBV and VHD patients.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101672"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095203","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}

引用次数: 0

P-74 GLYCOSYLATED HEMOGLOBIN LEVELS AS A PREDICTOR OF HEPATIC FIBROSIS DUE TO MASLD

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101688

Stefanny Cornejo Hernández , Esly Esquivel Alarcón , Reyna Hernández Espinoza , Juan Salvador García Hernández , Mayra Gabriela García Araiza , Trinidad Baldovinos Hernández , Javier Bastida Alquicira , Eira Cerda Reyes , Adriana Martinez Cuazitl

Conflict of interest

No

Introduction and Objectives

Hepatic steatosis associated with metabolic dysfunction (MASLD) has a prevalence of 30% worldwide, and 80% of these patients do not present alterations in liver biochemistry. One of the cardiometabolic criteria is having glycosylated hemoglobin ≥5.6%, so an analysis was carried out using the ADA criteria for the diagnosis of prediabetes with HbA1C levels 5.7% - 6.4% and the degree of liver fibrosis.

Objectives

Compare the values of glycosylated hemoglobin and fibrosis determined by Transient Elastography.

Patients / Materials and Methods

Patients with MASLD criteria were included who underwent Transient Liver Elastography (Fibroscan ® 630 Expert v10720), APRI, FIB4, NAFLD score, blood count, liver biochemistry, lipid profile, glucose, glycosylated hemoglobin, clotting times. (TP, INR). It was compared with a control of healthy people. For statistical analysis, SPSS V24 was used for continuous quantitative variables expressed as mean and percentage, with moderate Spearman's Rho correlation.

Results and Discussion

Seventy-five patients with steatosis determined by CAP ≥ 232 were included. The age of the patients was 45 (40, 50).

Patients were classified as healthy (HbA1C <5.7%), prediabetic (HbA1C 5.7%-6.4%), diabetic (HbA1C >6.5%), and patients with a previous diagnosis of diabetes were classified as diabetic controlled (HbA1C <7%). and uncontrolled diabetics (HbA1C >7%), HbA1C levels were 5.7% (5.4%-5.9%). According to the MASLD criteria, 25 patients had HbA1C < 5.6% and 50 with HbA1C > 5.6% or with treatments for T2D.

Sixty-five patiens (86.7%) had no fibrosis, and 10 (13.3%) had fibrosis, with 5.1 kPa (4.3 kPa, 6.5 kPa).

Although no association was found between the degree of steatosis and the degree of fibrosis, the patient with the highest level of fibrosis presented the highest degree of steatosis. ^X2= 8.916, p=0.178

No association was found between the degree of steatosis and diabetes.

^X2= 11.723,p=0.068

However, the degree of diabetes is associated with the presence of fibrosis and the degree of fibrosis, with a weak positive correlation existing between HbA1C levels and CAP levels, Spearman's rho 0.280 p=0.015. Tables 1 and 2

Although no assessment was found between BMI and kPa to determine if there is an association between the degree of fibrosis and the nutritional level, curiously, it can be observed that a healthy patient with grade 3 fibrosis has uncontrolled diabetes. Table 3

Conclusions

Prediabetes may be a predictor of the presence of liver fibrosis associated with MASLD.

{"title":"P-74 GLYCOSYLATED HEMOGLOBIN LEVELS AS A PREDICTOR OF HEPATIC FIBROSIS DUE TO MASLD","authors":"Stefanny Cornejo Hernández , Esly Esquivel Alarcón , Reyna Hernández Espinoza , Juan Salvador García Hernández , Mayra Gabriela García Araiza , Trinidad Baldovinos Hernández , Javier Bastida Alquicira , Eira Cerda Reyes , Adriana Martinez Cuazitl","doi":"10.1016/j.aohep.2024.101688","DOIUrl":"10.1016/j.aohep.2024.101688","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Hepatic steatosis associated with metabolic dysfunction (MASLD) has a prevalence of 30% worldwide, and 80% of these patients do not present alterations in liver biochemistry. One of the cardiometabolic criteria is having glycosylated hemoglobin ≥5.6%, so an analysis was carried out using the ADA criteria for the diagnosis of prediabetes with HbA1C levels 5.7% - 6.4% and the degree of liver fibrosis.</div></div><div><h3>Objectives</h3><div>Compare the values of glycosylated hemoglobin and fibrosis determined by Transient Elastography.</div></div><div><h3>Patients / Materials and Methods</h3><div>Patients with MASLD criteria were included who underwent Transient Liver Elastography (Fibroscan ® 630 Expert v10720), APRI, FIB4, NAFLD score, blood count, liver biochemistry, lipid profile, glucose, glycosylated hemoglobin, clotting times. (TP, INR). It was compared with a control of healthy people. For statistical analysis, SPSS V24 was used for continuous quantitative variables expressed as mean and percentage, with moderate Spearman's Rho correlation.</div></div><div><h3>Results and Discussion</h3><div>Seventy-five patients with steatosis determined by CAP ≥ 232 were included. The age of the patients was 45 (40, 50).</div><div>Patients were classified as healthy (HbA1C <5.7%), prediabetic (HbA1C 5.7%-6.4%), diabetic (HbA1C >6.5%), and patients with a previous diagnosis of diabetes were classified as diabetic controlled (HbA1C <7%). and uncontrolled diabetics (HbA1C >7%), HbA1C levels were 5.7% (5.4%-5.9%). According to the MASLD criteria, 25 patients had HbA1C < 5.6% and 50 with HbA1C > 5.6% or with treatments for T2D.</div><div>Sixty-five patiens (86.7%) had no fibrosis, and 10 (13.3%) had fibrosis, with 5.1 kPa (4.3 kPa, 6.5 kPa).</div><div>Although no association was found between the degree of steatosis and the degree of fibrosis, the patient with the highest level of fibrosis presented the highest degree of steatosis. <sup>X2</sup>= 8.916, p=0.178</div><div>No association was found between the degree of steatosis and diabetes.</div><div><sup>X2</sup>= 11.723,p=0.068</div><div>However, the degree of diabetes is associated with the presence of fibrosis and the degree of fibrosis, with a weak positive correlation existing between HbA1C levels and CAP levels, Spearman's rho 0.280 p=0.015. Tables 1 and 2</div><div>Although no assessment was found between BMI and kPa to determine if there is an association between the degree of fibrosis and the nutritional level, curiously, it can be observed that a healthy patient with grade 3 fibrosis has uncontrolled diabetes. Table 3</div></div><div><h3>Conclusions</h3><div>Prediabetes may be a predictor of the presence of liver fibrosis associated with MASLD.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101688"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095221","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}

引用次数: 0

P-35 CLINICAL AND EPIDEMIOLOGICAL DIFFERENCES BETWEEN PATIENTS MONOINFECTED WITH HEPATITIS B AND COINFECTED WITH HEPATITIS DELTA IN A HYPERENDEMIC REGION OF HEPATITIS B

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101649

Walter Silva Junior Junior , Jadson Dourado Costa , Ingrid Laise Vivas , Sidelcina Rugieri Pacheco , Ezequiel Ridruejo , Juan Salcedo , Deusilene Souza Dallacqua , Raymundo Paraná , Maria Izabel Schinoni

Conflict of interest

No

Introduction and Objectives

Hepatitis B and co-infection with hepatitis delta are viral liver diseases that can rapidly progress to cirrhosis and hepatocellular carcinoma (HCC). Objectives: To compare the epidemiological profile between patients mono-infected with hepatitis B and patients co-infected with hepatitis B and delta in a hyperendemic region.

Patients / Materials and Methods

A cross-sectional and historical cohort study analyzing 286 medical records of co-infected individuals and 649 medical records of mono-infected. Variables: sex, age, stage of liver fibrosis, levels of liver enzymes, albumin, platelets, alpha-fetoprotein, presence of HCC, and outcomes (liver transplant or death).

Results and Discussion

Of the 286 co-infected, 189 (70.5%) were male, mean age 56 ± 19. About stage of fibrosis, 97 (34%) had no fibrosis, 163 (57%) had (F1F3), and 26 (9%) had cirrhosis (F4). Mean GGT were 64.6 ± 86.6 U/L, ALT 36.2 ± 33.1 U/L, AST 41.2 ± 61.1 U/L, albumin 4.1 ± 0.75 g/dL, platelets 192 ± 77 thousand/mm³, alpha-fetoprotein 122.7 ± 181.1 ng/mL. 12 (4.2%) developed HCC, mean age of 53 ± 11.8; 8 (2.8%) underwent liver transplantation, and 22 (7.7%) died. Of the 659 mono-infected, 449 (68.14%) were male, mean age 53 ± 12.7. About stage of fibrosis, 248 (36%) had no fibrosis, 335 (48.69%) had fibrosis (F1F3), and 105 (15.26%) had cirrhosis (F4). Mean GGT were 64.4 ± 85.9 U/L, ALT 36.2 ± 33.8 U/L, AST 40.7 ± 59.9 U/L, albumin 4.19 ± 0.74 g/dL, platelets 3.27 ± 3.4 thousand/mm³, alpha-fetoprotein 117.6 ± 2133.5 ng/mL. 31 (4.7%) developed HCC, mean age of 57.4 ± 12.6; 18 (2.7%) died.

Conclusions

Co-infected patients have a higher prevalence of liver fibrosis and develop HCC at a younger age. There was statistical significance in platelet count, indicating greater severity of liver dysfunction in the mono-infected group.

{"title":"P-35 CLINICAL AND EPIDEMIOLOGICAL DIFFERENCES BETWEEN PATIENTS MONOINFECTED WITH HEPATITIS B AND COINFECTED WITH HEPATITIS DELTA IN A HYPERENDEMIC REGION OF HEPATITIS B","authors":"Walter Silva Junior Junior , Jadson Dourado Costa , Ingrid Laise Vivas , Sidelcina Rugieri Pacheco , Ezequiel Ridruejo , Juan Salcedo , Deusilene Souza Dallacqua , Raymundo Paraná , Maria Izabel Schinoni","doi":"10.1016/j.aohep.2024.101649","DOIUrl":"10.1016/j.aohep.2024.101649","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Hepatitis B and co-infection with hepatitis delta are viral liver diseases that can rapidly progress to cirrhosis and hepatocellular carcinoma (HCC). <em>Objectives:</em> To compare the epidemiological profile between patients mono-infected with hepatitis B and patients co-infected with hepatitis B and delta in a hyperendemic region.</div></div><div><h3>Patients / Materials and Methods</h3><div>A cross-sectional and historical cohort study analyzing 286 medical records of co-infected individuals and 649 medical records of mono-infected. Variables: sex, age, stage of liver fibrosis, levels of liver enzymes, albumin, platelets, alpha-fetoprotein, presence of HCC, and outcomes (liver transplant or death).</div></div><div><h3>Results and Discussion</h3><div>Of the 286 co-infected, 189 (70.5%) were male, mean age 56 ± 19. About stage of fibrosis, 97 (34%) had no fibrosis, 163 (57%) had (F1F3), and 26 (9%) had cirrhosis (F4). Mean GGT were 64.6 ± 86.6 U/L, ALT 36.2 ± 33.1 U/L, AST 41.2 ± 61.1 U/L, albumin 4.1 ± 0.75 g/dL, platelets 192 ± 77 thousand/mm³, alpha-fetoprotein 122.7 ± 181.1 ng/mL. 12 (4.2%) developed HCC, mean age of 53 ± 11.8; 8 (2.8%) underwent liver transplantation, and 22 (7.7%) died. Of the 659 mono-infected, 449 (68.14%) were male, mean age 53 ± 12.7. About stage of fibrosis, 248 (36%) had no fibrosis, 335 (48.69%) had fibrosis (F1F3), and 105 (15.26%) had cirrhosis (F4). Mean GGT were 64.4 ± 85.9 U/L, ALT 36.2 ± 33.8 U/L, AST 40.7 ± 59.9 U/L, albumin 4.19 ± 0.74 g/dL, platelets 3.27 ± 3.4 thousand/mm³, alpha-fetoprotein 117.6 ± 2133.5 ng/mL. 31 (4.7%) developed HCC, mean age of 57.4 ± 12.6; 18 (2.7%) died.</div></div><div><h3>Conclusions</h3><div>Co-infected patients have a higher prevalence of liver fibrosis and develop HCC at a younger age. There was statistical significance in platelet count, indicating greater severity of liver dysfunction in the mono-infected group.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101649"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094740","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}

引用次数: 0

P-21 THE ROLE SP-INDUCED MAST CELL ACTIVATION IN LIVER FIBROSIS

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101635

Larissa Aleman Franco , Beatriz Gárate Pérez De Tudela , Bárbara Castro Rebolledo , Elisa Balboa Castillo , Jaime Poniachik Teller , Caroll J Beltrán Muñoz

Conflict of interest

No

Introduction and Objectives

A high density of liver mast cell is associated to liver damage progression in chronic liver diseases. Emerging evidence have suggested that MC degranulation play a crucial role in liver fibrosis induced by hepatic stellate cells (HSCs) activation. However, the contribution of neuroimmune activation of MC by stress related neuropeptide Substance P(SP)remains unexplored. Objective: To evaluate the impact of SP-dependent MC activation in HSCs transdifferentiation.

Patients / Materials and Methods

In vitro studies were performed by using Human mast cell line (HMC-1), stimulated with SP (30min), and HSCs cell line (LX-2), subsequently stimulated by 24h with supernatants of SP-MC activated. Supernatants of unstimulated (ns) MC and MC stimulated with 48/80 compound, as well as a direct LX-2 SP (dSP) stimulation were considered as experimental control. Western blotting was performed to measure alfa-smooth muscle actine (α-SMA) expression level, a HSCs transdifferentiation marker, and GADPH, as loading control. A direct stimulation of HSCs by tryptase for 24h and subsequent α-SMA immunostaining by indirect immunofluorescent was performed for qualitative assessment of HSC morphology. Statistical analyses: ANOVA test in experimental replicates (N=3), by using GraphPad Prisma. Significance was set at p<0.05.

Results and Discussion

Despite not statistically differences were observed infold change α-SMA/GADPH level expression among SP stimulated MC and other experimental groups (ns MC, 0.394 ± 0.08; 48/80 MC, 0.256 ± 0.130; SP MC, 0. 274 ± 0.120; dSP, 0.621 ± 0.524) p=0.544, morphological changes of HSCs associated to cell transdifferentiation were observed after 24h of tryptase stimulation.

Conclusions

Our results shown that MC tryptase can induce HSCs transdifferentiaton. Short-term effect of SP-MC activation fail to achieve in HSCs activation, suggesting long term MC stimulation need to be explored to evaluate SP-MC impact in HSCs transdifferentiaton. Funding OAIC n°13022.

{"title":"P-21 THE ROLE SP-INDUCED MAST CELL ACTIVATION IN LIVER FIBROSIS","authors":"Larissa Aleman Franco , Beatriz Gárate Pérez De Tudela , Bárbara Castro Rebolledo , Elisa Balboa Castillo , Jaime Poniachik Teller , Caroll J Beltrán Muñoz","doi":"10.1016/j.aohep.2024.101635","DOIUrl":"10.1016/j.aohep.2024.101635","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>A high density of liver mast cell is associated to liver damage progression in chronic liver diseases. Emerging evidence have suggested that MC degranulation play a crucial role in liver fibrosis induced by hepatic stellate cells (HSCs) activation. However, the contribution of neuroimmune activation of MC by stress related neuropeptide Substance P(SP)remains unexplored. <em>Objective:</em> To evaluate the impact of SP-dependent MC activation in HSCs transdifferentiation.</div></div><div><h3>Patients / Materials and Methods</h3><div>In vitro studies were performed by using Human mast cell line (HMC-1), stimulated with SP (30min), and HSCs cell line (LX-2), subsequently stimulated by 24h with supernatants of SP-MC activated. Supernatants of unstimulated (ns) MC and MC stimulated with 48/80 compound, as well as a direct LX-2 SP (dSP) stimulation were considered as experimental control. Western blotting was performed to measure alfa-smooth muscle actine (α-SMA) expression level, a HSCs transdifferentiation marker, and GADPH, as loading control. A direct stimulation of HSCs by tryptase for 24h and subsequent α-SMA immunostaining by indirect immunofluorescent was performed for qualitative assessment of HSC morphology. Statistical analyses: ANOVA test in experimental replicates (N=3), by using GraphPad Prisma. Significance was set at p<0.05.</div></div><div><h3>Results and Discussion</h3><div>Despite not statistically differences were observed infold change α-SMA/GADPH level expression among SP stimulated MC and other experimental groups (ns MC, 0.394 ± 0.08; 48/80 MC, 0.256 ± 0.130; SP MC, 0. 274 ± 0.120; dSP, 0.621 ± 0.524) p=0.544, morphological changes of HSCs associated to cell transdifferentiation were observed after 24h of tryptase stimulation.</div></div><div><h3>Conclusions</h3><div>Our results shown that MC tryptase can induce HSCs transdifferentiaton. Short-term effect of SP-MC activation fail to achieve in HSCs activation, suggesting long term MC stimulation need to be explored to evaluate SP-MC impact in HSCs transdifferentiaton. Funding OAIC n°13022.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101635"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095168","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}

引用次数: 0

OP-5 ACUTE-ON-CHRONIC LIVER FAILURE (ACLF) CRITERIA IN ALCOHOL-ASSOCIATED HEPATITIS: IMPLICATIONS FOR LIVER TRANSPLANTATION

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101603

LUIS ANTONIO DÍAZ PIGA , Paula Huerta , Renata Farias , Bastian Alcayaga , Francisco Idalsoaga , Gustavo Ayares , Jorge Arnold , María Ayala-Valverde , Diego Perez , Jaime Gomez , Rodrigo Escarate , Eduardo Fuentes-López , Katherine Maldonado , Juan Pablo Roblero , Daniela Simian , Blanca Norero , Raul Lazarte , José Antonio Velarde , Jacqueline Córdova , Fátima Higuera-de-la-Tijera , Juan Pablo Arab

Conflict of interest

No

Introduction and Objectives

Background: Severe alcohol-associated hepatitis (AH) is considered a common precipitant of acute-on-chronic liver failure (ACLF). This study aims to characterize the association between AH and ACLF, focusing on mortality across different ACLF grades.

Patients / Materials and Methods

Multicenter prospective cohort study. We included patients admitted with severe AH between 2015–2022. The main outcome was mortality by ACLF grade during admission. The analysis included survival analysis using Cox regression. We adjusted multivariable models based on the main predictors of mortality observed in prior studies.

Results and Discussion

We prospectively included 646 patients from 24 centers and 8 countries. Age 49.9±11.7 years, 85.1% of men and 64.4% had a previous diagnosis of cirrhosis. Median MELD at admission was 25 [20-31] points, 46.5% of patients were treated with corticosteroids, and only 2.2% underwent liver transplantation (LT). Around 67.4% of patients fulfilled ACLF criteria: 10.1% grade 1, 19.2% grade 2, and 38.1% grade 3. The most frequent organ dysfunctions were 76.2% liver, 40.8% brain, 43.2% coagulation, 29.6% renal, 29.4% circulatory, and 18.9% lung failure. Survival at 180 days was 77.8% (95%CI: 72.1-82.6%) in those without ACLF grade 3 and 28.0% (95%CI: 20.5–36.0%) in those with ACLF grade 3 (p<0.001). In the multivariable model adjusted by age, body mass index, and MELD score, individuals with ACLF grade 3 had lower survival than those without ACLF (HR 2.67, 95%CI: 1.50–4.76; p=0.001). However, those with ACLF grade 1 (HR 1.50, 95%CI: 0.76–2.96; p=0.243) and grade 2 (HR 0.70, 95%CI: 0.31–1.56; p=0.380) were not associated with a higher mortality than those without ACLF.

Conclusions

Among patients with AH, only ACLF grade 3 is a major determinant of morbimortality. Thus, patients who fulfill ACLF grade 3 should promptly be referred for early LT. The redefinition of ACLF in AH is essential for better quantifying the severity and determining therapeutic goals.

{"title":"OP-5 ACUTE-ON-CHRONIC LIVER FAILURE (ACLF) CRITERIA IN ALCOHOL-ASSOCIATED HEPATITIS: IMPLICATIONS FOR LIVER TRANSPLANTATION","authors":"LUIS ANTONIO DÍAZ PIGA , Paula Huerta , Renata Farias , Bastian Alcayaga , Francisco Idalsoaga , Gustavo Ayares , Jorge Arnold , María Ayala-Valverde , Diego Perez , Jaime Gomez , Rodrigo Escarate , Eduardo Fuentes-López , Katherine Maldonado , Juan Pablo Roblero , Daniela Simian , Blanca Norero , Raul Lazarte , José Antonio Velarde , Jacqueline Córdova , Fátima Higuera-de-la-Tijera , Juan Pablo Arab","doi":"10.1016/j.aohep.2024.101603","DOIUrl":"10.1016/j.aohep.2024.101603","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div><em>Background:</em> Severe alcohol-associated hepatitis (AH) is considered a common precipitant of acute-on-chronic liver failure (ACLF). This study aims to characterize the association between AH and ACLF, focusing on mortality across different ACLF grades.</div></div><div><h3>Patients / Materials and Methods</h3><div>Multicenter prospective cohort study. We included patients admitted with severe AH between 2015–2022. The main outcome was mortality by ACLF grade during admission. The analysis included survival analysis using Cox regression. We adjusted multivariable models based on the main predictors of mortality observed in prior studies.</div></div><div><h3>Results and Discussion</h3><div>We prospectively included 646 patients from 24 centers and 8 countries. Age 49.9±11.7 years, 85.1% of men and 64.4% had a previous diagnosis of cirrhosis. Median MELD at admission was 25 [20-31] points, 46.5% of patients were treated with corticosteroids, and only 2.2% underwent liver transplantation (LT). Around 67.4% of patients fulfilled ACLF criteria: 10.1% grade 1, 19.2% grade 2, and 38.1% grade 3. The most frequent organ dysfunctions were 76.2% liver, 40.8% brain, 43.2% coagulation, 29.6% renal, 29.4% circulatory, and 18.9% lung failure. Survival at 180 days was 77.8% (95%CI: 72.1-82.6%) in those without ACLF grade 3 and 28.0% (95%CI: 20.5–36.0%) in those with ACLF grade 3 (p<0.001). In the multivariable model adjusted by age, body mass index, and MELD score, individuals with ACLF grade 3 had lower survival than those without ACLF (HR 2.67, 95%CI: 1.50–4.76; p=0.001). However, those with ACLF grade 1 (HR 1.50, 95%CI: 0.76–2.96; p=0.243) and grade 2 (HR 0.70, 95%CI: 0.31–1.56; p=0.380) were not associated with a higher mortality than those without ACLF.</div></div><div><h3>Conclusions</h3><div>Among patients with AH, only ACLF grade 3 is a major determinant of morbimortality. Thus, patients who fulfill ACLF grade 3 should promptly be referred for early LT. The redefinition of ACLF in AH is essential for better quantifying the severity and determining therapeutic goals.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101603"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093988","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}

引用次数: 0

P-72 HEPATITIS B AND C VIRUS PREVALENCE USING RAPID TEST IN A CHILEAN COHORT

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101686

Javier Eduardo Pérez Valenzuela , Franco Antonio Weisser Vuskovic , Freddy Siegel , Herman Aguirre , Jaime Poniachik , Gonzalo Vizueta , Elizabeth Araya , Juan Rozas , Luis Felipe Bustamante , Fabiola Castro , Lilian Isla , Daniela Simian , Andrea Martínez , Luis Sotillet , Daniela García , Javiera Achondo , Lorena Castro Solari , Gabriel Mezzano Puentes

Conflict of interest

Yes, Laboratorio Gador financió los tests rápidos.

Introduction and Objectives

Hepatitis B (HBV) and C (HCV) viruses are one of the main causes of morbidity and mortality worldwide. Their epidemiology in Chile is not completely known, with an estimated prevalence of 0.034-0.15% for HBV and 0.1-0.19% for HCV. Although, in Chile, there is a wide coverage and availability of antiviral treatments, the main barrier to achieve the elimination of these viruses is the lack of knowledge of the serological condition. Objectives: To stablish the prevalence of HBV and HCV infection in the population at risk in Chile.

Patients / Materials and Methods

Cross-sectional, multicenter study, with participation of 8 Chilean health centers. HBV/HCV rapid tests (CTK-BIOTECH) were applied in people aged 18 years-old or older with at least 1 risk factor. Demographic and clinical data were collected using REDCap®. Statistical analysis was performed using Stata 16.0 software.

Results and Discussion

A total of 806 patients were included in the analysis, mean age was 44.6 ± 15.1 years and 53.6% were women. The main risk factors were: being in prison (22.5%), exposed health care personnel (16.9%) and obesity with steatotic liver disease (16.6%). Three patients tested positive for HBV and one patient had HBV/HCV coinfection. Seroprevalence of HBV and HCV infection was 0.49% and 0.12%, respectively. Two of the patients had coinfection with HIV. Serological confirmation to date was done in 3 of the 5 positive tests and confirmed the diagnosis in 3 of them (2 HBV and 1 HCV).

Conclusions

In this preliminary study, the prevalence of HBV and HCV infection in the population at risk is low. Further patient recruitment is required to identify the population on which to focus screening efforts and other preventive public health measures.

{"title":"P-72 HEPATITIS B AND C VIRUS PREVALENCE USING RAPID TEST IN A CHILEAN COHORT","authors":"Javier Eduardo Pérez Valenzuela , Franco Antonio Weisser Vuskovic , Freddy Siegel , Herman Aguirre , Jaime Poniachik , Gonzalo Vizueta , Elizabeth Araya , Juan Rozas , Luis Felipe Bustamante , Fabiola Castro , Lilian Isla , Daniela Simian , Andrea Martínez , Luis Sotillet , Daniela García , Javiera Achondo , Lorena Castro Solari , Gabriel Mezzano Puentes","doi":"10.1016/j.aohep.2024.101686","DOIUrl":"10.1016/j.aohep.2024.101686","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>Yes, Laboratorio Gador financió los tests rápidos.</div></div><div><h3>Introduction and Objectives</h3><div>Hepatitis B (HBV) and C (HCV) viruses are one of the main causes of morbidity and mortality worldwide. Their epidemiology in Chile is not completely known, with an estimated prevalence of 0.034-0.15% for HBV and 0.1-0.19% for HCV. Although, in Chile, there is a wide coverage and availability of antiviral treatments, the main barrier to achieve the elimination of these viruses is the lack of knowledge of the serological condition. <em>Objectives:</em> To stablish the prevalence of HBV and HCV infection in the population at risk in Chile.</div></div><div><h3>Patients / Materials and Methods</h3><div>Cross-sectional, multicenter study, with participation of 8 Chilean health centers. HBV/HCV rapid tests (CTK-BIOTECH) were applied in people aged 18 years-old or older with at least 1 risk factor. Demographic and clinical data were collected using REDCap®. Statistical analysis was performed using Stata 16.0 software.</div></div><div><h3>Results and Discussion</h3><div>A total of 806 patients were included in the analysis, mean age was 44.6 ± 15.1 years and 53.6% were women. The main risk factors were: being in prison (22.5%), exposed health care personnel (16.9%) and obesity with steatotic liver disease (16.6%). Three patients tested positive for HBV and one patient had HBV/HCV coinfection. Seroprevalence of HBV and HCV infection was 0.49% and 0.12%, respectively. Two of the patients had coinfection with HIV. Serological confirmation to date was done in 3 of the 5 positive tests and confirmed the diagnosis in 3 of them (2 HBV and 1 HCV).</div></div><div><h3>Conclusions</h3><div>In this preliminary study, the prevalence of HBV and HCV infection in the population at risk is low. Further patient recruitment is required to identify the population on which to focus screening efforts and other preventive public health measures.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101686"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103871","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}

引用次数: 0

P-23 PORTAL VEIN THROMBOSIS IS ASSOCIATED WITH HEPATIC DECOMPENSATIONS WITHOUT LIVER STIFFNESS INCREASE IN HEPATOSPLENIC SCHISTOSOMIASIS

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101637

Rafael Theodoro , Guilherme Grossi Lopes Cançado , Mateus Jorge Nardelli , Guilherme Augusto Lima Figueira , Carlos Eduardo Franca Vargas , Ludmila Resende Guedes , Fernanda Maria Farage Osório , Luciana Costa Faria , Claudia Alves Couto

Conflict of interest

No

Introduction and Objectives

Hepatosplenic schistosomiasis (HSS) is one of the main causes of non-cirrhotic presinusoidal portal hypertension. Although liver stiffness in HSS is typically lower than in cirrhosis, it is still unknown if over the years liver injury related to periportal fibrosis, to metabolic disease or vascular complications can alter liver stiffness and impact in serious hepatic events. This study aims to determine whether metabolic factors, portal vein thrombosis (PVT), or changes in liver stiffness over time are associated with serious hepatic events (SHE) in HSS patients.

Patients / Materials and Methods

In this prospective study, adults with laboratory and radiologically confirmed HSS, without concurrent cirrhosis or other liver diseases, were included. All participants underwent initial transient elastography, followed by a second assessment after at least 3 years. The primary outcome was the occurrence of SHE, defined as upper variceal bleeding and/or ascites.

Results and Discussion

Among the 26 patients studied, 65.4% were male, with a mean age of 55 ± 9 years. The main metabolic comorbidities were obesity (27%), hypertriglyceridemia (8%), low HDL-c (4%), and diabetes (13%). Baseline liver stiffness measurement (LSM) was 9.9 kPa (±3.9) and the controlled attenuation parameter (CAP) was 238 dB/m (IQR 121-270). After a median follow-up of 59 months (IQR 51-64), serious hepatic events occurred in 46% of the patients. There was a non-significant median absolute increase in LSM of 1.4 kPa (IQR -1.5 to +3.6) and a median relative increase of +14% (IQR -17% to +50%), with no statistically significant differences in paired analysis (p = 0.140). No metabolic or anthropometric factors were associated with changes in liver stiffness. PVT occurred in 7 patients (26.9%) and was the only factor significantly associated with the occurrence of serious hepatic events (p = 0.026), although it did not significantly interfere with LSM (p = 0.842).

Conclusions

LSM remained relatively stable in HSS patients over a median follow-up of almost 5 years, proving to be a useful tool in distinguishing HSS from cirrhosis. SHE were primarily associated with PVT, which may further elevate portal pressure.

{"title":"P-23 PORTAL VEIN THROMBOSIS IS ASSOCIATED WITH HEPATIC DECOMPENSATIONS WITHOUT LIVER STIFFNESS INCREASE IN HEPATOSPLENIC SCHISTOSOMIASIS","authors":"Rafael Theodoro , Guilherme Grossi Lopes Cançado , Mateus Jorge Nardelli , Guilherme Augusto Lima Figueira , Carlos Eduardo Franca Vargas , Ludmila Resende Guedes , Fernanda Maria Farage Osório , Luciana Costa Faria , Claudia Alves Couto","doi":"10.1016/j.aohep.2024.101637","DOIUrl":"10.1016/j.aohep.2024.101637","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Hepatosplenic schistosomiasis (HSS) is one of the main causes of non-cirrhotic presinusoidal portal hypertension. Although liver stiffness in HSS is typically lower than in cirrhosis, it is still unknown if over the years liver injury related to periportal fibrosis, to metabolic disease or vascular complications can alter liver stiffness and impact in serious hepatic events. This study aims to determine whether metabolic factors, portal vein thrombosis (PVT), or changes in liver stiffness over time are associated with serious hepatic events (SHE) in HSS patients.</div></div><div><h3>Patients / Materials and Methods</h3><div>In this prospective study, adults with laboratory and radiologically confirmed HSS, without concurrent cirrhosis or other liver diseases, were included. All participants underwent initial transient elastography, followed by a second assessment after at least 3 years. The primary outcome was the occurrence of SHE, defined as upper variceal bleeding and/or ascites.</div></div><div><h3>Results and Discussion</h3><div>Among the 26 patients studied, 65.4% were male, with a mean age of 55 ± 9 years. The main metabolic comorbidities were obesity (27%), hypertriglyceridemia (8%), low HDL-c (4%), and diabetes (13%). Baseline liver stiffness measurement (LSM) was 9.9 kPa (±3.9) and the controlled attenuation parameter (CAP) was 238 dB/m (IQR 121-270). After a median follow-up of 59 months (IQR 51-64), serious hepatic events occurred in 46% of the patients. There was a non-significant median absolute increase in LSM of 1.4 kPa (IQR -1.5 to +3.6) and a median relative increase of +14% (IQR -17% to +50%), with no statistically significant differences in paired analysis (p = 0.140). No metabolic or anthropometric factors were associated with changes in liver stiffness. PVT occurred in 7 patients (26.9%) and was the only factor significantly associated with the occurrence of serious hepatic events (p = 0.026), although it did not significantly interfere with LSM (p = 0.842).</div></div><div><h3>Conclusions</h3><div>LSM remained relatively stable in HSS patients over a median follow-up of almost 5 years, proving to be a useful tool in distinguishing HSS from cirrhosis. SHE were primarily associated with PVT, which may further elevate portal pressure.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101637"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095170","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}

引用次数: 0

P-5 A LARGE REGISTER OF LIVER STIFFNESS AND STEATOSIS BY TRANSIENT ELASTOGRAPHY IN METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE – THE FIRST STEP FOR AN ADEQUATE PATIENT ALLOCATION

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101619

Ana Carolina Cardoso , João Marcello De Araújo Neto , Pedro Miguel Mattos Nogueira , Nathalie Carvalho Leite , Cristiane Villela-Nogueira

Conflict of interest

No

Introduction and Objectives

In Metabolically Associated Steatotic Liver Disease (MASLD), transient elastography (TE) is the best validated point-of-care tool to assess liver fibrosis. Outpatients without advanced fibrosis might be managed at low-complexity centers, aiming to increase the availability of experts to manage patients with advanced fibrosis. We sought to evaluate the prevalence of advanced fibrosis among MASLD outpatients from a university center compared to those from lower complexity settings.

Patients / Materials and Methods

This was a sectional study of MASLD outpatients at a university hospital (G1) and those followed up at lower complexity settings such as primary care or medium complexity clinics(G2). All patients performed TE with CAP by Fibroscan Touch 502 (Echosens, Fr) from Jan-2015 to Mar-2024. TE and CAP results were compared between the two groups and the groups' prevalence of individuals with TE<8 kPa and TE≥12 kPa.

Results and Discussion

4058 exams were registered (70% women, mean age 60 ±12 yrs, BMI 32.7 ± 6.5). Outpatients from G1 were older (p< 0.001) and comprised 80% of included patients. Although G1 had higher CAP measures [298Db/m (258-336) vs 293 Db/m (249-334);p=0.034], both groups seemed similar regarding steatosis severity. Surprisingly, liver stiffness between G1 and G2 was similar [6,4 kPa (4.9-8.1) vs 6.3 kPa (4.9-9.1);p=0.49]. Advanced fibrosis (TE< 8.0 kPa) was discarded in 66.7% of G1 and 69,2% of G2 (p=0.18). Overall, 15% had advanced fibrosis with a trend to a higher prevalence in G1 (16.1% vs 13.5%; p=0.08).

Conclusions

Although outpatients from lower complexity settings were younger, advanced fibrosis prevalence was similar and not neglectable compared to high complexity center outpatients. Screening MASLD patients in lower-complexity settings increases the chance of identifying younger individuals with advanced liver disease who need expert's evaluation to prevent liver-related complications. Additionally, public policies might be implemented to reallocate patients with lower and severe diseases accordingly.

{"title":"P-5 A LARGE REGISTER OF LIVER STIFFNESS AND STEATOSIS BY TRANSIENT ELASTOGRAPHY IN METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE – THE FIRST STEP FOR AN ADEQUATE PATIENT ALLOCATION","authors":"Ana Carolina Cardoso , João Marcello De Araújo Neto , Pedro Miguel Mattos Nogueira , Nathalie Carvalho Leite , Cristiane Villela-Nogueira","doi":"10.1016/j.aohep.2024.101619","DOIUrl":"10.1016/j.aohep.2024.101619","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>In Metabolically Associated Steatotic Liver Disease (MASLD), transient elastography (TE) is the best validated point-of-care tool to assess liver fibrosis. Outpatients without advanced fibrosis might be managed at low-complexity centers, aiming to increase the availability of experts to manage patients with advanced fibrosis. We sought to evaluate the prevalence of advanced fibrosis among MASLD outpatients from a university center compared to those from lower complexity settings.</div></div><div><h3>Patients / Materials and Methods</h3><div>This was a sectional study of MASLD outpatients at a university hospital (G1) and those followed up at lower complexity settings such as primary care or medium complexity clinics(G2). All patients performed TE with CAP by Fibroscan Touch 502 (Echosens, Fr) from Jan-2015 to Mar-2024. TE and CAP results were compared between the two groups and the groups' prevalence of individuals with TE<8 kPa and TE≥12 kPa.</div></div><div><h3>Results and Discussion</h3><div>4058 exams were registered (70% women, mean age 60 ±12 yrs, BMI 32.7 ± 6.5). Outpatients from G1 were older (p< 0.001) and comprised 80% of included patients. Although G1 had higher CAP measures [298Db/m (258-336) vs 293 Db/m (249-334);p=0.034], both groups seemed similar regarding steatosis severity. Surprisingly, liver stiffness between G1 and G2 was similar [6,4 kPa (4.9-8.1) vs 6.3 kPa (4.9-9.1);p=0.49]. Advanced fibrosis (TE< 8.0 kPa) was discarded in 66.7% of G1 and 69,2% of G2 (p=0.18). Overall, 15% had advanced fibrosis with a trend to a higher prevalence in G1 (16.1% vs 13.5%; p=0.08).</div></div><div><h3>Conclusions</h3><div>Although outpatients from lower complexity settings were younger, advanced fibrosis prevalence was similar and not neglectable compared to high complexity center outpatients. Screening MASLD patients in lower-complexity settings increases the chance of identifying younger individuals with advanced liver disease who need expert's evaluation to prevent liver-related complications. Additionally, public policies might be implemented to reallocate patients with lower and severe diseases accordingly.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101619"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095138","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}

引用次数: 0

P-52 CHARACTERIZATION OF SERUM METABOLOMIC PROFILE BY NMR IN PATIENTS WITH VARIOUS DEGREES OF HEPATIC ENCEPHALOPATHY.

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2024-12-01 DOI: 10.1016/j.aohep.2024.101666

Paula Cordero Pérez , Ricardo Andrés Gómez Quiroz , Luis Andrés González Torres , Ernesto Sánchez Mendoza , Diana Patricia Moreno Peña , Liliana Torres Gonzalez , Linda Elsa Muñoz Espinosa , Alma Leticia Saucedo Yáñez

Conflict of interest

No

Introduction and Objectives

Hepatic encephalopathy (HE) is a complication of liver failure whose clinical identification is commonly delayed. Measurement of parameters reflecting HE would be desirable in clinical practice. Metabolomic study using nuclear magnetic resonance (NMR) represents a strategy in this regard, with advantages such as detecting numerous types of metabolites. Objetive: To characterize the serum metabolomic profile (SMP) of various clinical stages of HE severity using NMR.

Patients / Materials and Methods

Observational, cross-sectional, analytical, prospective study. Anthropometric, hematologic, and biochemical parameters were evaluated in patients >18 years: 15 controls (C), 18 hepatopathy without HE (HSHE), 11 minimal HE (HEM), 9 West Haven (WH) I, 12 WHII, 9 WHIII, and 8 WHIV. SMP was analyzed by NMR, characterizing the profile per patient, study group, and analyzed by PLS-DA using MetaboAnalyst 5.0 platform.

Results and Discussion

Signals from 45 metabolites were assigned, quantifying 43. PLS-DA showed differences in SMP between groups, with metabolite concentrations decreasing as HE severity increased, except for 3-methylhistidine, which increased with HE severity. Acetone, lysine, glycerol, and serine were higher in C compared to HSHE and HEM; proline, cysteine, threonine, alanine, 3-hydroxybutyrate, and isoleucine were higher in HEM or HSHE compared to WHI and WHII. The metabolite/creatinine index identified 14 metabolites that differentiated the groups (3-methylhistidine, acetone, proline, 3-hydroxybutyrate, lysine, cysteine, threonine, glycerol, glycine, lactate, alanine, serine, valine, and isoleucine).

Conclusions

SMP differed among the groups, with metabolites implicated in severe HE including arginine, isoleucine, valine, alanine, histidine, threonine, glycerol, serine, tyrosine, glutamine, phenylalanine, formate, ornithine, tau-methylhistidine, and methionine. Implicated metabolic pathways were phenylalanine, tyrosine, and tryptophan; phenylalanine; histidine; glycine, serine, and threonine; glutathione. WH has an objective and measurable explanation using metabolomics.

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