Trends in prevalence and all-cause mortality of metabolic dysfunction-associated fatty liver disease among adults in the past three decades: Results from the NHANES study.

BACKGROUND: Given the escalating epidemic of obesity and diabetes coupled with redefined diagnostic criteria, it is critical to identify the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD). We sought to determine the prevalence and mortality outcomes of MAFLD subtypes based on diagnostic criteria in the USA over the past three decades. METHODS: Eleven cycles of the National Health and Nutrition Examination Surveys (NHANES; 1988-1994 and 1999-2020) were used, and 72,224 participants were included. MAFLD was defined according to the 2020 International Expert Consensus. Based on diagnostic criteria and risk factors, MAFLD was categorized into seven subtypes: type 1 (obesity subtype), 2 (metabolic unhealthy subtype), 3 (diabetes subtype), 4 (metabolic unhealthy non-diabetes subtype), 5 (obesity and diabetes subtype), 6 (metabolic unhealthy non-obesity subtype), and 7 (mixed subtype). RESULTS: Over the study period, the estimated prevalence of MAFLD increased significantly from 22% in 1988-1994 to 36% in 2017-2020. The prevalence of Type 4 was the highest, followed by that of Type 7, whereas other types were low and almost unchanged over time. Individuals with MAFLD had 19% and 38% increased mortality risks from all causes and cardiovascular disease, respectively. Among them, the metabolically unhealthy participants with normal weight demonstrated a 116% higher risk for all-cause mortality [hazard ratio (HR): 2.16, 95% CI: 1.52-3.08] and a 222% higher risk for cardiovascular mortality (HR: 3.22, 95% CI: 1.72-6.04). Interestingly, stratification and interaction analyses demonstrated a significant impact of metabolic parameters on the relationship between MAFLD and all-cause mortality. CONCLUSIONS: In conclusion, our study identified an increase in MAFLD prevalence and a significant association between metabolic derangements in MAFLD and all-cause or cardiovascular mortality.

Effects of temperature and physical state on heterogeneous oxidation of oleic acid droplets with ozone.

The heterogeneous reactions of pure micrometer-sized oleic acid droplets with ozone were studied as a function of temperature and physical state. Oxidation reactions were monitored using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FT-IR) and UV-vis spectrometry. Variations in droplet morphology due to the extent of oxidation were monitored using an optical microscope. Oleic acid droplets were maintained in either solid or liquid state at 9.0 °C. The physical state of the aerosol was determined from the IR absorbance spectra. Oxidation of solid state oleic acid with ozone at 9.0 °C was rapidly converted to the liquid state, which was most likely due to the presence of oxidation products on the surface of the droplets. The fast melting process that resulted from exposure of solid-phase droplets to ozone produced an oxidation rate similar to that for liquid-phase droplets exposed to ozone at the same temperature. Analysis of the carboxylic IR absorbance ratio for esters vs carboxylic acids indicates that the larger ester C═O-to-carboxylic acid C═O ratios at higher temperature appeared to correspond to the production of α-acyloxyalkyl hydroperoxide oligomers and polymers. The wide variation in product yields will result in vastly different physical properties of aerosol particles under different ambient environmental conditions.

[Association between cholesterol 7alpha-hydroxylase -204A/C gene polymorphism and endogenous hypertriglyceridemia in Chinese].

OBJECTIVE: To investigate the cholesterol 7alpha-hydroxylase gene -204A/C polymorphism and its relationship with serum lipids and apolipoproteins (apo) levels in patients with endogenous hypertriglyceridemia (HTG) in Chinese population in Chengdu area. METHODS: The genotype and allele frequencies of cholesterol 7alpha-hydroxylase gene -204A/C polymorphism were analyzed by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). Serum lipids were measured by enzymatic kits and apolipoproteins AI, AII, B100, CII, CIII and E were measured by the RID kits in 132 HTG patients and 212 control subjects. RESULTS: Allele frequencies of A and C were 0.602 and 0.398 in HTG group and 0.601 and 0.399 in control group, respectively. There was no significant difference of allele and genotypes frequencies between HTG and control groups (P> 0.05). In HTG group, carriers with the genotypes CC and AC were associated with significantly higher concentrations of triglycerides and apoCIII compared with those with genotype AA (P< 0.05). In the control group, carriers with the genotypes CC and AC were associated with significantly lower serum high density lipoprotein cholesterol (HDL-C) level compared with those with genotype AA (P< 0.05). In the male control group, carriers with the genotypes CC and AC had elevated levels of serum triglycerides than those with genotype AA (P< 0.05). CONCLUSION: These results suggest that -204A/C polymorphism in the CYP7A1 gene does not relate with HTG but may has an effect on serum triglyceride and apoCIII levels in patients with endogenous HTG, the serum HDL-C level in control subjects and the serum TG level in male control subjects.

Community-acquired bleb-related endophthalmitis caused by vancomycin-resistant enterococci.

CASE REPORT: We report a case of community-acquired bleb-related endophthalmitis caused by vancomycin-resistant enterococci (VRE) in a 79-year-old woman. COMMENTS: VRE has usually been considered a nosocomial infection of immune-compromised patients, but ophthalmologists should be alert to the possibility of community-acquired eye infections caused by VRE, particularly in those countries with a high VRE community reservoir.