Corrigendum: Statins Reduce the Risk of Cirrhosis and Its Decompensation in Chronic Hepatitis B Patients: A Nationwide Cohort Study.

This corrects the article DOI: 10.1038/ajg.2017.494.

Long-term Nucleos(t)ides Analogues for Chronic Hepatitis B Improve Liver and Spleen Size: A Noninvasive Sonographic Study.

BACKGROUND: Histological improvement and regression of liver fibrosis after long-term use of nucleos(t)ides analogues (NUCs) have been documented. The aim of the present investigation was to evaluate the usefulness of traditional sonography to detect hepatic and splenic changes during NUC therapy in chronic hepatitis B (CHB) patients. METHODS: A total of 181 CHB patients receiving NUC treatment were enrolled in this study. The study population was divided into three groups 72 cirrhotic, 58 noncirrhotic CHB, and 51 nonreplicative hepatitis B virus carriers. All patients had blood chemistries taken and sonography at baseline and during the NUC treatment period. The changes in liver size, liver edge, spleen size, platelet count, and platelet count/spleen diameter (PC/SD) ratio were compared among the three groups of patients. RESULTS: CHB Patients with and without cirrhosis have improved clinical features during NUC therapy with lower aspartate aminotransferase, alanine aminotransferase, international normalized ratio, hepatitis B virus DNA, and spleen size and higher platelet, liver edge, liver size, and PC/SD ratio compared with the baseline data (p < 0.05). The differences in liver edge, liver size, spleen size, and PC/SD ratio are higher in the cirrhosis group than in the non-cirrhotic group (p < 0.001). A decrease in spleen size exhibited a linear relationship with treatment duration (R2 = 0.905). CONCLUSIONS: Traditional sonography is helpful to monitor changes in liver fibrosis of CHB patients under NUC therapy.Abbreviations: AFP, α-fetoprotein; ALT, alanine transaminase; AST, aspartate transaminase; CHB, chronic hepatitis B; Hb, hemoglobin; HBV, hepatitis B virus; INR, international normalized ratio; NUCs, nucleos(t)ides analogues; PC/SD, platelet count/spleen diameter; WBC, white blood cells.

Statins Reduce the Risk of Cirrhosis and Its Decompensation in Chronic Hepatitis B Patients: A Nationwide Cohort Study.

OBJECTIVES: The protective effect of statins in cirrhosis and its decompensation in chronic hepatitis B (CHB) patients remains unknown. METHODS: We conducted a population-based cohort study using data from the Taiwanese National Health Insurance Research Database from 1997 to 2009. A total of 298,761 CHB patients were identified. CHB patients using statins (n=6,543; defined as ≥28 cumulative defined daily doses (cDDD)) and a 1:1 ratio propensity score and inception point (the date of first use of statins)-matched non-statins (<28 cDDD) were followed up from the inception point until the development of cirrhosis or its decompensation or until withdrawal from insurance or December 2009. RESULTS: After adjustment for competing mortality, CHB patients using statins had a significantly lower cumulative incidence of cirrhosis (relative risk)=0.433; 95% confidence interval (CI)=0.344-0.515; modified log-rank test, P<0.001) and decompensated cirrhosis (relative risk=0.468; 95% CI=0.344-0.637; P<0.001) compared with patients not using statins. After adjustment for age, gender, comorbidity index, hypertension, diabetes, hyperlipidemia, hepatocellular carcinoma, obesity, non-alcoholic fatty liver disease, aspirin use, diabetes medication, CHB treatment, non-statin lipid-lowering drugs, and triglyceride lipid-lowering drugs using the Cox proportional hazard model, statins were still an independent protector against cirrhosis (adjusted hazard ratio (AHR)=0.512; 95% CI=0.413-0.634; P<0.001) and its decompensation (AHR=0.534; 95% CI=0.433-0.659; P<0.001). The AHRs for cirrhosis were 0.467 and 0.200, and the AHRs for decompensated cirrhosis were 0.611 and 0.231 with 91-365 and >365 cDDD of statins, respectively. CONCLUSIONS: CHB patients who receive statin therapy have a dose-dependent reduction in the risk of cirrhosis and its decompensation.

In vitro anti-inflammatory properties of fermented pepino (Solanum muricatum) milk by γ-aminobutyric acid-producing Lactobacillus brevis and an in vivo animal model for evaluating its effects on hypertension.

BACKGROUND: The objectives of this study were to determine the in vitro anti-inflammatory and in vivo antihypertensive effects of fermented pepino (Solanum muricatum) milk by Lactobacillus brevis with the goal of developing functional healthy products. The inflammatory factors of fermented pepino milk with L. brevis were assessed in RAW 264.7 macrophages, including nitric oxide (NO) production. Inflammatory factor genes of cyclooxygenase (COX)-1 and -2, and tumor necrosis factor (TNF)-α were also assayed by a reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Results showed that fermented PE inhibited NO production in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells with 150 mg mL(-1) fermented PE completely blocking LPS-induced NO production. The mRNA expressions of COX-1, COX-2, and iNOS were attenuated by treatment with higher concentrations of fermented PE (150 mg/ml). Cells treated with fermented pepino extract (PE) (100 ng mL(-1)) exhibited strikingly decreased LPS-induced expression of TNF-α mRNA. During the feeding trial, rats treated with 10% fermented pepino milk (100 µg 2.5 mL(-1)) and 100% fermented pepino milk (1000 µg 2.5 mL(-1)) exhibited significant decreases in the systolic blood pressure. CONCLUSION: Our results showed that fermented pepino milk has wide potential applications for development as a health food.

Increased risk of cirrhosis and its decompensation in chronic hepatitis C patients with new-onset diabetes: a nationwide cohort study.

UNLABELLED: The effect of diabetes on cirrhosis, its decompensation, and their time relationship in chronic hepatitis C (CHC) patients remains unclear. We conducted a nation-wide cohort study by using the Taiwanese National Health Insurance Research Database, which is comprised of data from >99% of the entire population. Among having randomly sampled 1 million enrollees, 6,251 adult CHC patients were identified from 1997 to 2009. Diabetes was defined as new onset in CHC patients who were given the diagnosis in the years 1999-2003, but not in 1997-1998. The cohorts of CHC with new-onset diabetes (n=424) and nondiabetes (n=1,708) were followed up from inception point in diabetes and from year 1999 in the nondiabetes cohort until development of cirrhosis or its decompensation, withdrawal from insurance, or December 2009. Kaplan-Meier's survival analysis showed a significantly higher cumulative incidence of cirrhosis (relative risk [RR]=1.53; 95% confidence interval [CI]=1.11-2.11; log-rank test; P<0.001) and decompensated cirrhosis (RR=2.01; 95% CI=1.07-3.79; log-rank test; P<0.001) among patients with new-onset diabetes, as compared to those without. After adjustment for age, gender, CHC treatment, diabetes treatment, hepatocellular carcinoma, comorbidity index, hypertension, hyperlipidemia, and obesity by Cox's proportional hazard model, diabetes was still an independent predictor for cirrhosis (hazard ratio [HR]=2.505; 95% CI=1.609-3.897; P<0.001) and its decompensation (HR=3.560; 95% CI=1.526-8.307; P=0.003). CONCLUSION: CHC patients who develop diabetes are at an increased risk of liver cirrhosis and its decompensation over time.

Improvement in antioxidant activity, angiotensin-converting enzyme inhibitory activity and in vitro cellular properties of fermented pepino milk by Lactobacillus strains containing the glutamate decarboxylase gene.

BACKGROUND: The purpose of this study was to evaluate the functional potential of fermented pepino extract (PE) milk by Lactobacillus strains containing the glutamate decarboxylase (GAD) gene. Three Lactobacillus strains were selected, including L. brevis BCRC 12310, L. casei BCRC 14082 and L. salivarius subsp. salivarius BCRC 14759. The contents of free amino acids, total phenolics content, total carotenoids and the associated functional and antioxidant abilities were analyzed, including angiotensin-converting enzyme (ACE) inhibition activity, 1,1-diphenyl-2-picylhydrazyl (DPPH) radical-scavenging ability and oxygen radical absorbance capacity (ORAC). Cell proliferation of fermented PE milk was also evaluated by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. RESULTS: Compared to the unfermented PE, fermented PE milk from Lactobacillus strains with the GAD gene showed higher levels of total phenolics, γ-aminobutyric acid, ACE inhibitory activity, DPPH, and ORAC. The viability of human promyelocytic leukemia cells (HL-60) determined by the MTT method decreased significantly when the cells were incubated with the PE and the fermented PE milk extracts. CONCLUSION: The consumption of fermented PE milk from Lactobacillus strains with the GAD gene is expected to benefit health. Further application as a health food is worthy of investigation. © 2012 Society of Chemical Industry.