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Nonalcoholic fatty liver disease in type 2 diabetes: A bad omen. But can we do something to change it? 2型糖尿病的非酒精性脂肪肝:一个不好的预兆。但我们能做些什么来改变它吗?
Pub Date : 2021-08-18 DOI: 10.20517/mtod.2021.06
F. Bril
© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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引用次数: 1
Risk of cardio-nephro-metabolic disease from NAFLD to MAFLD: fact or fiction? 从NAFLD到MAFLD的心肾代谢疾病风险:事实还是虚构?
Pub Date : 2021-08-17 DOI: 10.20517/mtod.2021.07
R. Hassouneh, M. Siddiqui, C. Bhati
Nonalcoholic fatty liver disease (NAFLD) is emerging as the most common etiology for chronic liver disease. Despite this, our understanding of this illness is lacking. The previous paradigm is that central adiposity, hyperlipidemia, hypertension, and insulin resistance, also known as metabolic syndrome, lead to NAFLD, and this relationship is unidirectional. However, recent evidence clearly shows that the clinical burden of this illness extends well beyond liver-related morbidity and mortality and is associated with multiple extrahepatic complications, particularly metabolic consequences. Due to this, the professional consensus has proposed using the term metabolic associated fatty liver disease (MAFLD) to more accurately reflect pathogenesis and help in patient stratification for management. This review discusses the shared pathophysiological mechanisms that link these diseases and how this can be leveraged to prevent these complications in individuals with NAFLD/MAFLD.
非酒精性脂肪肝(NAFLD)是慢性肝病最常见的病因。尽管如此,我们对这种疾病缺乏了解。以前的范式是,中心性肥胖、高脂血症、高血压和胰岛素抵抗,也称为代谢综合征,会导致NAFLD,并且这种关系是单向的。然而,最近的证据清楚地表明,这种疾病的临床负担远远超出了肝脏相关的发病率和死亡率,并与多种肝外并发症有关,特别是代谢后果。因此,专业界一致建议使用代谢相关脂肪肝(MAFLD)一词来更准确地反映发病机制,并有助于患者分层管理。这篇综述讨论了将这些疾病联系起来的共同病理生理机制,以及如何利用这一机制来预防NAFLD/MAFLD患者的这些并发症。
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引用次数: 1
Precision medicine approaches in metabolic disorders and target organ damage: where are we now, and where are we going? 代谢紊乱和靶器官损伤的精准医学方法:我们现在在哪里,我们要去哪里?
Pub Date : 2021-07-26 DOI: 10.20517/mtod.2021.03
A. Lonardo, C. Byrne, G. Targher
In this review, we discuss selected topics which are
在这篇综述中,我们讨论的主题是
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引用次数: 17
Nonalcoholic fatty liver disease on Twitter: a sentiment analysis 推特上的非酒精性脂肪肝:情绪分析
Pub Date : 2021-01-01 DOI: 10.20517/mtod.2021.09
A. Mantovani, Giorgia Beatrice, C. Zusi, A. Dalbeni
Sentiment analysis is a technique for exploring a piece of text with the aim to investigate sentiments hidden within it. The use of sentiment analysis in health care could assist in understanding how individuals discuss and feel about a specific topic. Currently, there are scarce data regarding the use of sentiment analysis related to nonalcoholic fatty liver disease (NAFLD), which is the most common chronic liver disease worldwide and is associated with hepatic and extra-hepatic complications. Hence, the aim of this report was to assess the sentiments of NAFLD expressed in messages posted on Twitter, one of the most popular social media platforms worldwide. We chose the hashtags #FattyLiver, #NAFLD, #NASH, and #MAFLD as terms to identify the messages related to NAFLD on Twitter. Messages containing at least one of these hashtags were collected using the standard Application Programming Interface provided by Twitter. The sentiment analysis revealed that sentiments hidden within messages related to NAFLD were substantially neutral and that “breastcancer” and “cancer” were two of the most common words used, suggesting that a large part of messages focused on the relationship between NAFLD and extra-hepatic cancers. Conversely, the association between NAFLD and cardiovascular disease seems to be less relevant for Twitter community. These observations might be useful for developing better public health strategies and for promoting a constructive attitude among subjects that read and discuss about NAFLD (and its complications) on social media. Page 2 of Mantovani et al. Metab Target Organ Damage 2021;1:6 https://dx.doi.org/10.20517/mtod.2021.09 5
情感分析是一种探索文本的技术,目的是调查隐藏在其中的情感。在医疗保健中使用情感分析可以帮助了解个人如何讨论和感受特定主题。非酒精性脂肪性肝病(NAFLD)是世界上最常见的慢性肝病,并与肝脏和肝外并发症相关,目前,关于使用与NAFLD相关的情绪分析的数据很少。因此,本报告的目的是评估NAFLD在Twitter(全球最受欢迎的社交媒体平台之一)上发布的信息中表达的情绪。我们选择了#脂肪肝,#NAFLD, #NASH和#MAFLD作为Twitter上与NAFLD相关的信息的标签。使用Twitter提供的标准应用程序编程接口收集包含至少一个这些标签的消息。情绪分析显示,与NAFLD相关的信息中隐藏的情绪基本上是中性的,“乳腺癌”和“癌症”是两个最常用的词,这表明大部分信息集中在NAFLD和肝外癌症之间的关系上。相反,NAFLD与心血管疾病之间的关联似乎与Twitter社区不太相关。这些观察结果可能有助于制定更好的公共卫生策略,并促进在社交媒体上阅读和讨论NAFLD(及其并发症)的主题的建设性态度。Mantovani等人的第2页。Metab靶器官损伤2021;1:6 https://dx.doi.org/10.20517/mtod.2021.09
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引用次数: 0
What should we advise MAFLD patients to eat and drink? 我们应该建议mald患者吃什么和喝什么?
Pub Date : 2021-01-01 DOI: 10.20517/mtod.2021.11
M. Machado
In a time of food abundance and waste, and when sedentarism is the norm, metabolic-associated fatty liver disease (MAFLD) has become a major health threat in the Western world. While research is committed to finding a pharmacological treatment for MAFLD, it is time to go back to the basis and address the behavioral pathogenesis of MAFLD. All patients with MAFLD, irrespective of body weight, should be submitted to thorough dietary counseling. Diet is a learned behavior and should be addressed holistically and in a personalized fashion. The benefits of a suitable diet surpass an improvement of liver disease, having the potential to improve cardiovascularand cancer-related mortality, in patients with MAFLD. This review summarizes the current state of the art of diet on MAFLD, presenting straightforward recommendations for everyday practice.
在一个食物丰富而浪费的时代,当久坐不动成为常态时,代谢性脂肪性肝病(MAFLD)已成为西方世界的主要健康威胁。当研究致力于寻找一种治疗MAFLD的药物时,是时候回到基础上来解决MAFLD的行为发病机制了。所有的mald患者,无论体重如何,都应该接受彻底的饮食咨询。饮食是一种习得的行为,应该以整体和个性化的方式来解决。适当饮食的好处不仅仅是改善肝脏疾病,还有可能改善mald患者的心血管和癌症相关死亡率。这篇综述总结了目前关于MAFLD的饮食艺术的现状,提出了日常实践的直接建议。
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引用次数: 4
The Fatty liver Index (FLI) 15 years later: a reappraisal 脂肪肝指数(FLI) 15年后:重新评估
Pub Date : 2021-01-01 DOI: 10.20517/mtod.2021.08
A. Lonardo, S. Ballestri, G. Bedogni, S. Bellentani, C. Tiribelli
The Fatty Liver Index (FLI) is a non-invasive biomarker proposed, in 2006, by Bedogni’s group, to aid in identifying patients with suspected nonalcoholic fatty liver disease (NAFLD) to be submitted to liver ultrasonography to confirm steatosis. Criteria of Assessment of Narrative Review Articles, a scale for the assessment of quality of narrative review articles, inspired our review article, which aims at evaluating the scope of published articles on FLI issued over the last 15-year period. The analysis of retrieved data identified the following conclusions. First, given that FLI and NAFLD share the same risk factors, FLI can be used to identify NAFLD among populations at risk to be submitted to screening. Second, FLI is able to identify the hazard of atherosclerosis, both at a subclinical stage and as an overt disease. Third, FLI detects incident diabetes and chronic kidney disease. However, evidence supporting the notion that FLI also predicts the metabolic syndrome, some endocrine disorders, certain tumor types, and overall and cause-specific mortality appears to be more limited. In conclusion, 15 years after its first publication, FLI has been validated as a robust biomarker of both steatosis and NAFLD. Moreover, the scope of FLI has been expanded to previously unexpected areas. Finally, we discuss FLI limitations and a research agenda aimed at further improving the accuracy of FLI scores in predicting liver-related outcomes, endocrine-metabolic disorders, cancer risk, and survival. Page 2 of Lonardo et al. Metab Target Organ Damage 2021;1:10 https://dx.doi.org/10.20517/mtod.2021.08 20
脂肪肝指数(FLI)是由Bedogni小组于2006年提出的一种非侵入性生物标志物,用于帮助识别疑似非酒精性脂肪性肝病(NAFLD)的患者,并将其提交肝脏超声检查以确认脂肪变性。叙述性评论文章的评估标准是一种评估叙述性评论文章质量的量表,它启发了我们的综述文章,旨在评估过去15年期间在FLI上发表的文章的范围。对检索数据的分析确定了以下结论。首先,考虑到FLI和NAFLD具有相同的危险因素,FLI可以用于识别需要进行筛查的高危人群中的NAFLD。其次,FLI能够识别动脉粥样硬化的危害,无论是在亚临床阶段还是作为显性疾病。第三,FLI检测糖尿病和慢性肾脏疾病。然而,支持FLI也能预测代谢综合征、某些内分泌紊乱、某些肿瘤类型以及总体死亡率和病因特异性死亡率的证据似乎更为有限。总之,在首次发表15年后,FLI已被证实是脂肪变性和NAFLD的强有力的生物标志物。此外,FLI的范围已扩展到以前意想不到的领域。最后,我们讨论了FLI的局限性和研究议程,旨在进一步提高FLI评分在预测肝脏相关预后、内分泌代谢紊乱、癌症风险和生存方面的准确性。罗纳多等人的第二页。Metab靶器官损伤2021;1:10 https://dx.doi.org/10.20517/mtod.2021.08
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引用次数: 19
Diagnostic accuracy of ultrasonography for the detection of hepatic steatosis: an updated meta-analysis of observational studies 超声诊断肝脏脂肪变性的准确性:一项观察性研究的最新荟萃分析
Pub Date : 2021-01-01 DOI: 10.20517/mtod.2021.05
S. Ballestri, A. Mantovani, C. Byrne, A. Lonardo, G. Targher
Aim: We examined the diagnostic accuracy of ultrasonography to detect any HS (defined as steatotic hepatocytes ≥ 5% on histology) and moderate-severe HS (defined as steatotic hepatocytes ≥ 30% on histology) by performing a systematic review and meta-analysis. Methods: We systematically searched PubMed, Web of Science, and Scopus databases, from January 2011 to February 2021, to identify studies conducted in adults investigating the diagnostic accuracy of ultrasonography vs . histology for detecting either ≥ 5% histologically defined HS or moderate-severe HS ( ≥ 30%). Meta-analysis was performed using random-effects modeling. Results: Twelve studies were included involving a total of 2921 individuals, 1710 (58.5%) of whom had HS ≥ 5% by histology. The overall sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of ultrasonography for the detection of ≥ 5% histologically defined HS, compared to histology, were 82% (95%
目的:我们通过系统回顾和meta分析,检查超声检查任何HS(定义为组织学上脂肪变性肝细胞≥5%)和中重度HS(定义为组织学上脂肪变性肝细胞≥30%)的诊断准确性。方法:从2011年1月到2021年2月,我们系统地检索了PubMed、Web of Science和Scopus数据库,以确定在成人中进行的研究,调查超声检查与组织学诊断≥5% HS或中重度HS(≥30%)的诊断准确性。采用随机效应模型进行meta分析。结果:12项研究共纳入2921例患者,其中组织学HS≥5%的患者1710例(58.5%)。超声检测≥5%组织学定义的HS的总体敏感性、特异性、阳性似然比和阴性似然比与组织学相比为82% (Ballestri et al.页2 95%)。Metab靶器官损伤2021;1:7 https://dx.doi.org/10.20517/mtod.2021.05 15置信区间分别为76%-86%,80%(72%-86%),4.0(2.90-5.70),0.23(0.18-0.30)。汇总分析7项研究,超声检查组织学定义≥30%的HS的总体敏感性为85%(72% ~ 92%),特异性为85%(73% ~ 93%),阳性似然比为5.72(3.06 ~ 10.7),阴性似然比为0.18(0.10 ~ 0.33)。漏斗图未显示任何显著的发表偏倚。结论:与组织学检查相比,常规超声检查可可靠、准确地检测出≥5%的组织学定义的HS。这些发现要求在临床领域广泛使用常规超声检查。
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引用次数: 21
Editorial: Metabolism and Target Organ Damage 社论:代谢和靶器官损伤
Pub Date : 2021-01-01 DOI: 10.20517/MTOD.2021.01
A. Lonardo
© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Editorial: Metabolism and Target Organ Damage
©作者2021。开放获取本文遵循知识共享署名4.0国际许可协议(https://creativecommons.org/licenses/by/4.0/),该协议允许不受限制地使用、共享、改编、分发和复制,以任何媒介或格式,用于任何目的,甚至商业目的,只要您适当地注明原作者和来源,提供知识共享许可协议的链接,并注明是否进行了更改。社论:代谢和靶器官损伤
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引用次数: 3
Male hypogonadism and pre-diabetes interplay: association or causal interaction? A systematic review 男性性腺功能减退与糖尿病前期相互作用:关联还是因果关系?系统回顾
Pub Date : 2021-01-01 DOI: 10.20517/mtod.2021.14
C. Greco, R. Corleto, Riccardo Ebert, M. Simoni, V. Rochira, D. Santi
Aim: The association between type 2 diabetes mellitus (T2DM) and male hypogonadism has been largely demonstrated. Testosterone (T) serum levels are often lower in men with T2DM compared to the general population, and, conversely, men with higher T serum levels have shown lower risk of T2DM. On the contrary, the association between pre-diabetes and male hypogonadism has been less investigated thus far. Pre-diabetes is a common clinical condition preceding T2DM and has been recognized as a potential risk factor for other metabolic disorders and cardiovascular diseases. Therefore, the aims of this review are to investigate the association between pre-diabetes and male hypogonadism and to evaluate the potential effect of T treatment on glucose metabolism and anti-diabetic therapy on T serum levels. Methods: We conducted this systematic review developing different literature searches, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol. Page 2 of Greco et al. Metab Target Organ Damage 2022;2:11 https://dx.doi.org/10.20517/mtod.2021.14 18 Results: In our analysis, male hypogonadism has a prevalence of around 24%-35% in pre-diabetic men. Moreover, we observed improvement of metabolic parameters in pre-diabetes with T treatment. On the contrary, antidiabetic therapy seems to have no particular effects on T serum levels. Conclusion: Overall, we demonstrated that, although T administration could be considered in pre-diabetic men, pre-diabetes-related treatments should be confined to the control glucose metabolism, since no evidence for a positive effect on total T serum levels is available. Future research should be oriented to study the role of new antidiabetic drugs in the sex hormonal status in hypogonadal men.
目的:2型糖尿病(T2DM)与男性性腺功能减退之间的关系已被广泛证实。与一般人群相比,2型糖尿病男性血清睾酮(T)水平通常较低,相反,血清睾酮水平较高的男性患2型糖尿病的风险较低。相反,糖尿病前期与男性性腺功能减退之间的关系迄今为止研究较少。糖尿病前期是T2DM之前常见的临床状况,被认为是其他代谢紊乱和心血管疾病的潜在危险因素。因此,本文旨在探讨糖尿病前期与男性性腺功能减退之间的关系,并评估T治疗对糖代谢和抗糖尿病治疗对T血清水平的潜在影响。方法:我们按照系统评价和荟萃分析方案的首选报告项目进行了系统评价,并进行了不同的文献检索。Greco等人的第二页。结果:在我们的分析中,男性性腺功能减退症在糖尿病前期男性中的患病率约为24%-35%。此外,我们观察到T治疗对糖尿病前期代谢参数的改善。相反,抗糖尿病治疗似乎对T血清水平没有特别的影响。结论:总的来说,我们证明,尽管糖尿病前期男性可以考虑给予T治疗,但糖尿病前期相关治疗应局限于控制葡萄糖代谢,因为没有证据表明T对血清总T水平有积极影响。今后的研究应着眼于研究新型降糖药对性腺功能低下男性性激素状况的影响。
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引用次数: 0
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Metabolism and target organ damage
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