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1.
Medicine (Baltimore) ; 98(44): e17781, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689846

RESUMO

BACKGROUND: Opinion regarding whether Helicobacter pylori infection can promote the occurrence and development of nonalcoholic fatty liver (NAFLD) is divided. Therefore, we aimed to assess the exact relationship between H pylori infection and NAFLD by integrating all available data. METHODS: The articles about H pylori infection and NAFLD were collected by searching the databases of PubMed, Embase, Web of Science, Scopus, China National Knowledge Infrastructure, and WanFang. The random-effects model was used for data analysis, followed by subgroup analysis and meta-regression to explore sources of heterogeneity. RESULTS: Twenty-one articles were included in the study. Pooled analysis showed that H pylori infection indeed promoted NAFLD. Subgroup analysis and regression analysis showed that case-control ratio may be one of the sources of heterogeneity. CONCLUSIONS: H pylori infection is indeed one of the factors that promotes the progression of NAFLD for the Asian population. This provides new approaches for clinical prevention and treatment for NAFLD.


Assuntos
Infecções por Helicobacter/complicações , Infecções por Helicobacter/microbiologia , Helicobacter pylori , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/microbiologia , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Análise de Regressão , Fatores de Risco
2.
BMJ ; 367: l5367, 2019 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-31594780

RESUMO

OBJECTIVE: To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). DESIGN: Matched cohort study. SETTING: Population based, electronic primary healthcare databases before 31 December 2015 from four European countries: Italy (n=1 542 672), Netherlands (n=2 225 925), Spain (n=5 488 397), and UK (n=12 695 046). PARTICIPANTS: 120 795 adults with a recorded diagnosis of NAFLD or NASH and no other liver diseases, matched at time of NAFLD diagnosis (index date) by age, sex, practice site, and visit, recorded at six months before or after the date of diagnosis, with up to 100 patients without NAFLD or NASH in the same database. MAIN OUTCOME MEASURES: Primary outcome was incident fatal or non-fatal AMI and ischaemic or unspecified stroke. Hazard ratios were estimated using Cox models and pooled across databases by random effect meta-analyses. RESULTS: 120 795 patients with recorded NAFLD or NASH diagnoses were identified with mean follow-up 2.1-5.5 years. After adjustment for age and smoking the pooled hazard ratio for AMI was 1.17 (95% confidence interval 1.05 to 1.30; 1035 events in participants with NAFLD or NASH, 67 823 in matched controls). In a group with more complete data on risk factors (86 098 NAFLD and 4 664 988 matched controls), the hazard ratio for AMI after adjustment for systolic blood pressure, type 2 diabetes, total cholesterol level, statin use, and hypertension was 1.01 (0.91 to 1.12; 747 events in participants with NAFLD or NASH, 37 462 in matched controls). After adjustment for age and smoking status the pooled hazard ratio for stroke was 1.18 (1.11 to 1.24; 2187 events in participants with NAFLD or NASH, 134 001 in matched controls). In the group with more complete data on risk factors, the hazard ratio for stroke was 1.04 (0.99 to 1.09; 1666 events in participants with NAFLD, 83 882 in matched controls) after further adjustment for type 2 diabetes, systolic blood pressure, total cholesterol level, statin use, and hypertension. CONCLUSIONS: The diagnosis of NAFLD in current routine care of 17.7 million patient appears not to be associated with AMI or stroke risk after adjustment for established cardiovascular risk factors. Cardiovascular risk assessment in adults with a diagnosis of NAFLD is important but should be done in the same way as for the general population.


Assuntos
Hipertensão/epidemiologia , Fígado/patologia , Infarto do Miocárdio/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Fumar/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Estudos de Coortes , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/fisiopatologia , Países Baixos/epidemiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Modelos de Riscos Proporcionais , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Espanha/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia
3.
Medicine (Baltimore) ; 98(43): e17613, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651873

RESUMO

The aim was to test the association between dietary iron intake and the prevalence of nonalcoholic fatty liver disease (NAFLD) in a large sample of middle-aged and elderly Chinese population.The data included in this analysis were collected from a population-based cross-sectional study, that is, the Xiangya Hospital Health Management Center Study. Dietary iron intake was assessed using a validated semiquantitative food frequency questionnaire. The relationship between dietary iron intake and the prevalence of NAFLD was examined using logistic and spline regressions.A cross-sectional study including 5445 subjects was conducted. The prevalence of NAFLD was 36.9%. Compared with the lowest quintile, the energy-adjusted odds ratios (ORs) of NAFLD were 1.33 (95% confidence interval [CI]: 1.07-1.64), 1.80 (95% CI: 1.41-2.29) and 2.11 (95% CI: 1.60-2.80) in the 3rd, 4th, and 5th quintile of iron intake, respectively (P-value for trend <.001). In addition, dietary iron intake was positively associated with the OR of NAFLD in a dose-response relationship manner (test for trend P < .001). However, after stratifying the data by gender, such association only remained in the male, but not in the female population. With adjustment of additional potential confounders, the results did not change materially.Subjects with higher dietary iron intake were subject to a higher prevalence of NAFLD in a dose-response relationship manner. However, such association probably only exists in males, but not in females.


Assuntos
Ferro na Dieta/administração & dosagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários
4.
Zhonghua Nei Ke Za Zhi ; 58(10): 751-757, 2019 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-31594173

RESUMO

Objective: To investigate the characteristics of body composition (BC) in gout patients and its clinical significance. Methods: Consecutive gout patients were recruited between August 2017 and December 2018. Demographic information, clinical characteristics and comorbidities were collected. BC was assessed by bioelectric impedance analysis including body fat percentage (BF%), trunk and limb BF%, appendicular skeletal muscle index. Overfat was defined by BF% ≥25% for male and ≥35% for female. The association between BC and serum uric acid (sUA) was evaluated by multiple linear regression. Results: A total of 362 gout patients were recruited with median age 38 (30, 52) years, 96.1% (348/362) were male. Mean sUA was (551±133) µmol/L. The mean BF% was (25.8±6.4)% with 53.6%(194/362) patients overfat. Male gout patients with overfat showed more affected joints [4(2, 6) vs. 2(2, 5)], higher sUA [(576±126)µmol/L vs. (523±134) µmol/L], higher prevalence of dyslipidemia [70.1%(131/187) vs. 54.0%(87/161)], metabolic syndrome [60.8%(118/187) vs. 28.0%(47/161)], fatty liver [58.2%(113/187) vs. 35.1%(59/161)] and hypertension [44.4%(83/187) vs. 25.5%(41/161)] than male patients with normal fat (all P<0.05). Their BF%, trunk BF% and limb BF% were positively correlated with the numbers of affected joints, sUA, metabolic syndrome, fatty liver, and hypertension, respectively (r=0.154-0.435, all P<0.05). Multivariable linear regression suggested that BF% (ß=4.29, P=0.020) and trunk BF% (ß=9.11, P=0.007), but not limb BF%, were positively correlated with sUA. Conclusion: Overfat is very common in gout patients. The proportion of trunk fat in male patients is positively correlated with sUA. When assessing obesity in gout patients clinically, body composition analysis should be performed simultaneously.


Assuntos
Composição Corporal/fisiologia , Gota/diagnóstico , Obesidade/epidemiologia , Ácido Úrico/sangue , Adulto , Dislipidemias/epidemiologia , Feminino , Gota/sangue , Gota/epidemiologia , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/sangue , Prevalência
5.
Wei Sheng Yan Jiu ; 48(4): 552-559, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31601335

RESUMO

OBJECTIVE: To explore the relationship between different kinds of dietary fatty acids intake and non-alcoholic fatty liver disease(NAFLD). METHODS: A 1↿ frequency matched case-control study was conducted among 546 NAFLD patients diagnosed by ultrasound as case group, 546 people without NAFLD randomly selected and matched by sex and age(±5) as control group from April 2015 to August 2017 in Nanping first hospital. The data was obtained from participants using structured questionnaires during face-to-face interviews. Information on dietary intake was collected using semi-quantitative food frequency questionnaires. Residual method was used to derive energy-adjusted variable, unconditional Logistic regression was used to estimate odds ratios(OR) and their 95% CI. RESULTS: The NAFLD group consumed a significantly higher amount of fatty acid(FAs), saturated fatty acid(SFAs), mono-unsaturatedfattyacids(MUFAs), poly-unsaturated fatty acids(PUFAs), n-3 PUFAs, n-6 PUFAs, C16↿, C18↿, C16↿, C18↿, C18↿ and C18↿. Multivariate unconditional Logistic regression analysis indicated that daily intake of total fatty acids, MUFAs, n-6 PUFAs, C18↿, C18↿ more than 98. 96 g/d, 38. 83 g/d, 26. 23 g/d, 33. 55 g/d and 24. 91 g/d respectively, were the risk factors for NAFLD. The adjusted ORs and 95% CI were 2. 26(1. 49-3. 44), 1. 93(1. 29-2. 88), 5. 13(3. 40-7. 76), 1. 82(1. 22-2. 79) and 5. 24(3. 40-7. 76). Daily intake of C20↿, C22↿ in 0. 07-0. 09 g/d, 0. 01-0. 02 g/d were the protective factors for NAFLD. The adjusted ORs and 95% CI were 0. 58(0. 39-0. 85) and 0. 64(0. 43-0. 94). CONCLUSION: Daily intake of total fatty acids, MUFAs, n-6 PUFAs, C18↿, C18↿ more than 98. 96, 38. 83, 26. 23, 33. 55 and 24. 91 g/d respectively, were the risk factors for NAFLD. Daily intake of C20↿, C22↿ in 0. 07-0. 09 g/d, 0. 01-0. 02 g/d respectively, were the protective factors for NAFLD.


Assuntos
Dieta/estatística & dados numéricos , Ácidos Graxos , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Estudos de Casos e Controles , China/epidemiologia , Ácidos Graxos Insaturados , Humanos , Hepatopatia Gordurosa não Alcoólica/metabolismo
6.
Medicine (Baltimore) ; 98(39): e17277, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574842

RESUMO

Breast cancer is the most common cancer among women worldwide, and it is a main cause of death in women. As with breast cancer, metabolic components are important risk factors for the development of nonalcoholic fatty liver disease (NAFLD). In this retrospective cohort study, we aimed to determine the prevalence of NAFLD in patients with breast cancer and the impact of NAFLD on the prognosis of breast cancer.Patients with breast cancer were enrolled in the study from January 2007 to June 2017. Hepatic steatosis was evaluated through non-enhanced computed tomography scan by measuring Hounsfield Units in the liver and spleen, respectively; 123 healthy controls who underwent non-enhanced computed tomography scan were also analyzed.The prevalence of NAFLD in patients with breast cancer was 15.8% (251/1587), which was significantly higher than in healthy controls (8.9%, 11/123) (P = .036). Overall survival did not significantly differ between the groups with and without NAFLD (P = .304). However, recurrence-free survival was significantly higher in patients without NAFLD than in those with NAFLD (P = .009). Among breast cancer patients receiving endocrine treatment, the NAFLD group showed a higher cumulative incidence of significant liver injury than the group without NAFLD (P < .001).The prevalence of NAFLD in patients with breast cancer is significantly higher than in healthy controls. Moreover, breast cancer patients with NAFLD showed poorer prognosis in terms of recurrence. Therefore, diagnostic evaluation for NALFD is important in managing patients with breast cancer.


Assuntos
Neoplasias da Mama/patologia , Mastectomia/efeitos adversos , Recidiva Local de Neoplasia/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Neoplasias da Mama/complicações , Neoplasias da Mama/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/etiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Complicações Pós-Operatórias/etiologia , Período Pré-Operatório , Prevalência , Prognóstico , Estudos Retrospectivos , Fatores de Risco
7.
Medicine (Baltimore) ; 98(37): e17098, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517837

RESUMO

Lung cancer has become the leading cause of cancer-related deaths around the world. In addition to genetic risk factors and smoking, the metabolic risk factors remain to be elusive.To evaluate the associations between obesity, nonalcoholic fatty liver disease (NAFLD) and pulmonary adenocarcinoma in patients with lung cancer.Consecutive operation-proven lung cancer patients with assessment of metabolic disorders and liver ultrasound in 2009 and 2013 were retrospectively enrolled. T-test and multivariate logistic regression were applied to evaluate the contribution of individual factors to lung adenocarcinoma, as well as the synergistic effects between these factors.Among 3664 lung cancer patients with ultrasound examination, 2844 cases were enrolled for further analysis. Of them, 1053 (37.0%) were females, 1242 (43.7%) were cigarette smokers, 1658 (58.3%) were diagnosed as lung adenocarcinoma, 744 (26.2%) had obesity, and 614 (21.6%) had NAFLD. Proportion of female gender, nonsmoker, obesity, NAFLD, and serum lipid levels in patients with adenocarcinoma were significantly higher than those in other subtypes of lung cancer, and in 2013 than in 2009 (all P < .01). NAFLD and obesity were shown as independent factors and positively associated with pulmonary adenocarcinoma, along with female gender and nonsmoking, higher serum levels of cholesterol. NAFLD and other contributing factors exhibited no synergistic effects on adenocarcinoma.Obesity and NAFLD might increase the risk for pulmonary adenocarcinoma, especially in nonsmoking females, and underscore the need for further study into carcinogenic mechanisms and preventive interventions.


Assuntos
Adenocarcinoma/etiologia , Neoplasias Pulmonares/classificação , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade/complicações , Adenocarcinoma/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Modelos Logísticos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/epidemiologia , Estudos Retrospectivos , Fatores de Risco
8.
J Assoc Physicians India ; 67(8): 20-24, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31562711

RESUMO

Objective: The purpose of the study was to assess if non-alcoholic fatty liver disease (NAFLD) in diabetic patients increases the risk and/or severity of diastolic dysfunction. Research design and methods: We studied 70 type 2 diabetic individuals without a history of ischemic heart disease, hepatic diseases, or excessive alcohol consumption, in whom NAFLD was diagnosed by ultrasonography. All patients had normal left ventricular systolic function and blood pressure values under medication. Left ventricular diastolic dysfunction was assessed by pulsed wave Doppler and tissue Doppler imaging, studying mitral inflow patterns and E wave, E' wave velocities, E/A and E/E' ratios. Results and Conclusions: Fifty seven patients (81.43%) had NAFLD, and when compared with the other 13(18.57%) patients, age, sex, BMI, waist circumference, hypertension, smoking, diabetes duration, microvascular complication status, and medication use were not significantly different. In addition, the left ventricular (LV) mass and volumes, ejection fraction, systemic vascular resistance, arterial elasticity, and compliance were also not different. NAFLD patients had lower E' (8.42±0.89 vs.9.72±0.54, P <0.0001) tissue velocity, higher E-to-E' ratio (9.64±1.83 vs. 7.78±0.89, p<0.001), higher LV-end diastolic pressure (EDP) (15.52 ± 0.69 vs. 14.40±0.9 p <0.0001), higher LV EDP/end diastolic volume LV EDP/EDV (mmHg/ mL) (0.19 ±0.15 vs. 0.17±.02 p < 0.001) and higher glycosylated haemoglobin (HbA1C) (8.53±1.02 vs.7.65±0.66 p<0.01) than those without steatosis. All of these differences remained significant after adjustment for hypertension and other cardio metabolic risk factors. Our data show that in patients with type2 diabetes and NAFLD, even if the LV morphology and systolic function are preserved, early features of LV diastolic dysfunction detected. The frequency of diastolic dysfunction was significantly higher in diabetic patients with NAFLD versus controls.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Disfunção Ventricular Esquerda/epidemiologia , Diástole , Fígado Gorduroso Alcoólico , Hemoglobina A Glicada , Humanos , Função Ventricular Esquerda
9.
J Med Life ; 12(2): 168-172, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31406519

RESUMO

There is evidence that infection by H. pylori can have a critical proportion in the development of hepatocyte injury and both noncancerous and malignant liver conditions including non-alcoholic fatty liver disease (NAFLD). This is attributed to several mechanisms, the most important one being the toxic products of the bacterium H. pylori and oxidative injury for hepatocytes which promotes hepatic injury. The present research was aimed at determining the association between H. pylori infection and the prevalence of NAFLD in Birjand, Iran. Two groups were included in this cross-sectional study at the outpatient university clinic. One group had NAFLD (65 patients) and the other group was healthy controls without NAFLD (65 subjects). The diagnosis of NAFLD was performed using abdominal ultrasound examination and the absence of taking steatogenic medications or alcohol. Serum anti-H. pylori IgG and fecal H. pylori antigen were tested for diagnosing of H. pylori infection using ELISA method. H. pylori infection diagnosis was made if both tests were positive. None of the subjects in either group had symptoms related to the digestive system including dyspepsia, GERD (gastroesophageal reflux disease), or epigastric pain suspicious of peptic ulcer disease. There were 37 patients (28.5%) in both NAFLD (22 cases, 33.8%) and control (15 cases, 23.1%) groups whose H. pylori tests (both IgG and fecal antigen) were positive. Statistically, no significant difference was observed between the two studied groups regarding H. pylori infection frequency (p = 0.37). Asymptomatic H. pylori infection rate was not significantly different between NAFLD patients and control subjects in Birjand, Iran.


Assuntos
Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/fisiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Infecções por Helicobacter/sangue , Humanos , Irã (Geográfico)/epidemiologia , Lipídeos/sangue , Fígado/enzimologia , Fígado/patologia , Masculino , Hepatopatia Gordurosa não Alcoólica/sangue , Transaminases/metabolismo
10.
Nat Rev Gastroenterol Hepatol ; 16(9): 517-530, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31278377

RESUMO

Nonalcoholic fatty liver disease (NAFLD) has rapidly become the most common form of chronic liver disease in children and adolescents. Over the past 5 years, developments have revolutionized our understanding of the genetic factors, natural history, diagnostic modalities and therapeutic targets for this disease. New polymorphisms, such as those in PNPLA3, TM6SF2, MBOAT7 and GCKR, have been identified and used to predict the development and severity of NAFLD in both adults and children, and their interaction with environmental factors has been elucidated. Studies have demonstrated the true burden of paediatric NAFLD and its progression to end-stage liver disease in adulthood. In particular, nonalcoholic steatohepatitis can progress to advanced fibrosis and cirrhosis, emphasizing the importance of early diagnosis. Non-invasive imaging tests, such as transient elastography, will probably replace liver biopsy for the diagnosis of nonalcoholic steatohepatitis and the assessment of fibrosis severity in the near future. The therapeutic landscape is also expanding rapidly with the development of drugs that can modify liver steatosis, inflammation and fibrosis, indicating that pharmacotherapy for NAFLD will become available in the future. In this Review, we summarize current knowledge and new advances related to the pathogenesis and management of paediatric NAFLD.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Criança , Humanos , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/genética , Fatores de Risco
11.
J Assoc Physicians India ; 67(3): 34-38, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31304703

RESUMO

Introduction: Metabolic risk factors such as obesity, insulin resistance, type 2 diabetes mellitus and dyslipidemia are associated with non-alcoholic fatty liver disease (NAFLD). In the development and progression of NAFLD genetic mutations also play a significant role. NAFLD associated with the rs 738409 polymorphism of patatin-like phospholipase domain containing 3 gene (PNPLA3) G allele does not feature the typical metabolic abnormalities of NAFLD, including insulin resistance. In the light of rising epidemic of metaobesity in our population this study aimed to evaluate the relation of PNPLA3 polymorphism with insulin resistance. Methods: In this case control hospital based study, 100 patients of NAFLD were recruited based on ultrasound findings of hepatic steatosis. Healthy subjects age and gender matched(n = 100) from the institute who volunteered to be part of the study were recruited as controls based on the sole criteria of the absence of fatty liver on ultrasonography and normal alanine and aspartate transaminases (ALT and AST) levels. Anthropometry, biochemical profiles and insulin resistance by homeostatic model assessment of insulin resistance (HOMA-IR) were assessed. Results: A higher frequency of CG and GG genotypes of rs738409 polymorphism of PNPLA3 was observed in patients with NAFLD than controls. These patients with G allele had increased ALT, dyslipidemia and insulin resistance. The polymorphism had positive correlation with severity of hepatic steatosis. Conclusion: The presence of the PNPLA3 G allele is associated with a risk of NAFLD. Our study shows that subjects with variant PNPLA3 are not only at increased risk for the development and progression of NAFLD, but also have increased insulin resistance.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Resistência à Insulina/fisiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Humanos , Lipase , Proteínas de Membrana
12.
Intern Med ; 58(14): 1987-1992, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308341

RESUMO

Objective Sodium glucose co-transporter 2 inhibitor (SGLT-2i), recommended for patients with type 2 diabetes, has been reported to improve the liver function test results in non-alcoholic fatty liver disease (NAFLD). However, the long-term effects of SGLT-2i on the liver function and body weight in NAFLD patients have not been fully elucidated. In this study, we investigated the long-term effects of SGLT-2i in NAFLD patients. Methods Twenty-two diabetic patients with NAFLD were enrolled in this study. We assessed the body weight, liver enzyme levels, metabolism, and glucose levels at 12 months (22 cases) and 24 months (15 cases) after the initiation of SGLT-2i. The changes in controlled attenuation parameter (CAP) and liver stiffness in 20 of the 22 patients were evaluated using transient elastography (TE) and acoustic radiation force impulse (ARFI) elastography before the initiation of treatment and 1 year later. Results Body weight and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly decreased at 12 and 24 months after SGLT-2i treatment. The decrease in the levels of ALT at 12 and 24 months was significantly correlated with the level of ALT at the initiation of SGLT-2i (r=0.813, p=0.001 and r=0.867, p=0.0001, respectively). SGLT-2i also reduced the CAP and velocity of shear wave (Vs) values at 12 months (CAP 315.1±43.4 db/mL→293.1±27.2 db/mL, p=0.027; Vs 1.87±0.8 m/s→ 1.48±0.6 m/s, p=0.011). Conclusion SGLT-2i treatment improved the liver function test results and reduced the body weight in NAFLD patients over a period of 12-24 months. This improvement was greater in patients with higher ALT values at baseline than in those with lower values.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Peso Corporal , Técnicas de Imagem por Elasticidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
BMC Med ; 17(1): 135, 2019 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-31311600

RESUMO

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver illness with a genetically heterogeneous background that can be accompanied by considerable morbidity and attendant health care costs. The pathogenesis and progression of NAFLD is complex with many unanswered questions. We conducted genome-wide association studies (GWASs) using both adult and pediatric participants from the Electronic Medical Records and Genomics (eMERGE) Network to identify novel genetic contributors to this condition. METHODS: First, a natural language processing (NLP) algorithm was developed, tested, and deployed at each site to identify 1106 NAFLD cases and 8571 controls and histological data from liver tissue in 235 available participants. These include 1242 pediatric participants (396 cases, 846 controls). The algorithm included billing codes, text queries, laboratory values, and medication records. Next, GWASs were performed on NAFLD cases and controls and case-only analyses using histologic scores and liver function tests adjusting for age, sex, site, ancestry, PC, and body mass index (BMI). RESULTS: Consistent with previous results, a robust association was detected for the PNPLA3 gene cluster in participants with European ancestry. At the PNPLA3-SAMM50 region, three SNPs, rs738409, rs738408, and rs3747207, showed strongest association (best SNP rs738409 p = 1.70 × 10- 20). This effect was consistent in both pediatric (p = 9.92 × 10- 6) and adult (p = 9.73 × 10- 15) cohorts. Additionally, this variant was also associated with disease severity and NAFLD Activity Score (NAS) (p = 3.94 × 10- 8, beta = 0.85). PheWAS analysis link this locus to a spectrum of liver diseases beyond NAFLD with a novel negative correlation with gout (p = 1.09 × 10- 4). We also identified novel loci for NAFLD disease severity, including one novel locus for NAS score near IL17RA (rs5748926, p = 3.80 × 10- 8), and another near ZFP90-CDH1 for fibrosis (rs698718, p = 2.74 × 10- 11). Post-GWAS and gene-based analyses identified more than 300 genes that were used for functional and pathway enrichment analyses. CONCLUSIONS: In summary, this study demonstrates clear confirmation of a previously described NAFLD risk locus and several novel associations. Further collaborative studies including an ethnically diverse population with well-characterized liver histologic features of NAFLD are needed to further validate the novel findings.


Assuntos
Hepatopatia Gordurosa não Alcoólica/genética , Adulto , Idoso , Índice de Massa Corporal , Estudos de Casos e Controles , Redes Comunitárias/organização & administração , Redes Comunitárias/estatística & dados numéricos , Progressão da Doença , Registros Eletrônicos de Saúde/organização & administração , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Genômica/organização & administração , Genômica/estatística & dados numéricos , Humanos , Lipase/genética , Masculino , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Morbidade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Fenótipo , Polimorfismo de Nucleotídeo Único , Transdução de Sinais/genética
14.
Isr Med Assoc J ; 21(6): 386-389, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31280506

RESUMO

BACKGROUND: Recently, studies have found that non-alcholic fatty liver disease (NAFLD) is associated with bacterial infections. Attempts to identify risk factors for recurrent urinary tract infections (rUTIs) are still underway. OBJECTIVES: To examine a possible association between NAFLD and rUTIs among premenopausal women. METHODS: In a case-control study, 1009 hospitalized premenopausal women with a UTI during a period of 3 years were retrospectively studied. A total of 186 subjects with rUTIs and 186 controls without a history of rUTIs were included in this study. Each participant had an abdominal ultrasonogram as part of the inclusion criteria. The two groups were compared in terms of risk factors for rUTIs, such as maternal history of rUTIs, use of contraceptives, frequency of sexual intercourse, metabolic syndrome, obesity, use of probiotics, serum levels of vitamin D, and NAFLD. An rUTI was defined as three or more episodes of UTI over a period of 1 year. NAFLD was diagnosed based on abdominal ultrasonography examination. RESULTS: Mean age of the 372 participants was 39.7 ± 5 years. NAFLD was diagnosed in 81/186 subjects (43.5%) with rUTIs vs. 40/186 controls (21.5%), P = 0.05. Women with rUTIs were more often obese and presented with lower serum levels of vitamin D than controls. Multivariate analysis showed that NAFLD (odds ratio = 1.6, 95% confidence interval 1.3-2.0, P = 0.04) were associated with rUTIs in premenopausal women. CONCLUSIONS: NAFLD was associated with rUTI in premenopausal women, independent of metabolic syndrome. Further studies are needed to confirm this association.


Assuntos
Síndrome Metabólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Pré-Menopausa , Infecções Urinárias/epidemiologia , Adulto , Estudos de Casos e Controles , Comorbidade , Feminino , Humanos , Israel/epidemiologia , Recidiva , Estudos Retrospectivos , Fatores de Risco
15.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(7): 731-736, 2019 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-31288346

RESUMO

Childhood obesity has been an important public health issue worldwide. We searched PubMed, CNKI, and Wanfang databases to perform a systematic review of how to identify early target organ (including heart, vessel, kidney and liver etc) damage in children, the effects of obesity on early target organ damage (including left ventricular hypertrophy, left ventricular diastolic dysfunction, increased carotid intima-media thickness, increased arterial stiffness, impaired glomerular filtration rate, and non-alcoholic fatty liver disease, etc), the possible biological mechanisms (including hemodynamic changes, abnormal metabolic indices, and effects of cytokines and inflammatory factors, etc), and the effects of exercise training and dietary interventions on target organ damage in obese children. Thus, it is important to take effective measures to prevent and control childhood obesity, and finally to reduce the prevalence of target organ damage.


Assuntos
Obesidade Pediátrica/fisiopatologia , Espessura Intima-Media Carotídea/estatística & dados numéricos , Criança , Taxa de Filtração Glomerular/fisiologia , Humanos , Hipertrofia Ventricular Esquerda/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Rigidez Vascular/fisiologia , Disfunção Ventricular Esquerda/epidemiologia
16.
Medicine (Baltimore) ; 98(27): e16018, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277096

RESUMO

There have been reports linking nonalcoholic fatty liver disease (NAFLD) with gallstone disease (GD) owing to shared risk factors. However, there are no reported associations between the different NAFLD grades and GD. This study aimed to determine whether NAFLD grade is an independent risk factor for GD in a Korean population.This study enrolled 7886 participants who completed a questionnaire and underwent medical examination and ultrasound scanning at the Health Promotion Center of Jeju National University Hospital in Korea, from January 2009 to December 2017. Fatty liver grading and presence of gallstones were investigated using abdominal ultrasound. Body mass index and biochemical parameters were measured, and age, sex, and metabolic syndrome status were collected from medical records. Univariate and multivariate analyses were performed to identify risk factors for GD.The estimated prevalences of NAFLD and GD were 40.6% and 4.5%, respectively. In the univariate analysis, factors associated with GD were age; NAFLD; presence of metabolic syndrome; and levels of fasting blood glucose, high-density lipoproteins, aspartate aminotransferase, and alanine aminotransferase. Multivariate logistic regression analysis revealed older age and higher NAFLD grade as independent risk factors for GD.Older age and higher grade of NAFLD were independent risk factors for GD in our cohort. There was a strong correlation between grade of NAFLD on abdominal ultrasonography and GD.


Assuntos
Colelitíase/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Índice de Gravidade de Doença , Adulto , Fatores Etários , Idoso , Estudos de Casos e Controles , Colelitíase/diagnóstico por imagem , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/classificação , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Razão de Chances , República da Coreia/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
17.
Eur J Epidemiol ; 34(9): 871-878, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31165323

RESUMO

Incidence of non-alcoholic fatty liver disease (NAFLD) and liver cancer are 2-3 times higher in males than females. Hormonal mechanisms are hypothesized, with studies suggesting that oophorectomy may increase risk, but population-based evidence is limited. Thus, we conducted a study within the Clinical Practice Research Datalink, with controls matched to cases of NAFLD (n = 10,082 cases/40,344 controls) and liver cancer (n = 767 cases/3068 controls). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression. Effect measure modification by menopausal hormone therapy (MHT) was examined, using likelihood ratio tests and relative excess risk due to interaction (RERI). Oophorectomy was associated with a 29% elevated NAFLD risk (OR = 1.29, 95% CI 1.18-1.43), which was more pronounced in women without diabetes (OR = 1.41, 95% CI 1.27-1.57) and in women who had oophorectomy prior to age 50 (OR = 1.37, 95% CI 1.22-1.52). Compared to women without oophorectomy or MHT use, oophorectomy and MHT were each associated with over 50% elevated risk of NAFLD. However, the combination of oophorectomy and MHT showed evidence of a negative interaction on the multiplicative (p = 0.003) and additive scales (RERI = - 0.28, 95% CI - 0.60 to 0.03, p = 0.08). Oophorectomy, overall, was not associated with elevated liver cancer risk (OR = 1.16, 95% CI 0.79-1.69). These findings suggest that oophorectomy may increase the risk of NAFLD, but not liver cancer.


Assuntos
Terapia de Reposição Hormonal/efeitos adversos , Neoplasias Hepáticas/induzido quimicamente , Hepatopatia Gordurosa não Alcoólica/induzido quimicamente , Ovariectomia/efeitos adversos , Ovário/cirurgia , Idoso , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Neoplasias Hepáticas/epidemiologia , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Fatores de Risco , Saúde da Mulher
18.
J Frailty Aging ; 8(3): 150-153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31237317

RESUMO

This study aimed to assess the relationship between grip strength (GS) and nonalcoholic fatty liver (NAFLD) in treated HIV-infected men. We included 169 HIV-infected men. GS was assessed using a hand-grip dynamometer. NALFD was defined by liver-spleen attenuation ratio <1.1 on computed tomography. Mean (SD) age was 57 (6) years and BMI 24.5 (2.9) kg/m2. NAFLD was diagnosed in 33% of men; sarcopenia was present in 28%. Mean (SD) hand grip strength in the dominant hand was 37.5 (7.6) kg. In multivariate logistic regression, intermediate and low GS were associated with higher risk of NAFLD (OR 3.05; CI 1.27-7.61, p=0.01; OR 2.47; CI 1.01-6.19, p=0.05, respectively). GS has an inverse association with NAFLD prevalence in HIV-infected men. Specific mechanisms through which muscle weakness and NAFLD are related require further exploration but are not accounted for merely by the burden of comorbid illness, HIV disease stage, or ART exposure.


Assuntos
Infecções por HIV/epidemiologia , Força da Mão/fisiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Sarcopenia/epidemiologia , Comorbidade , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Medição de Risco
20.
Zhonghua Gan Zang Bing Za Zhi ; 27(5): 347-351, 2019 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-31177658

RESUMO

Objective: To investigate the prevalence and risk factors of non-alcoholic fatty liver disease(NAFLD) in patients with chronic hepatitis B(CHB) receiving antiviral treatment. Methods: The cross-sectional study included 3 477 cases with CHB who received antiviral therapy. The prevalence of NAFLD was investigated, and then the risk factors were screened and analyzed by stepwise regression method in CHB patients with NAFLD as the dependent variable and the related influencing factors as independent variables. Results: The prevalence of NAFLD was 24.1% in CHB patients who received antiviral therapy. After adjusting for age and gender, central obesity (OR: 7.44, 95%CI: 6.06 ~ 9.14), hypertension (OR: 1.74, 95%CI: 1.51 ~ 2.20), and triglyceride (OR: 1.52, 95%CI: 1.18 ~ 1.96) were positively associated with NAFLD, and cirrhosis was negatively associated with NAFLD (OR: 0.42, 95%CI: 0.34 ~ 0.53). Patients with long-term antiviral therapy had increased risk of NAFLD. Conclusion: A significant proportion of CHB patients receiving antiviral therapy have suffered from NAFLD. Therefore, CHB patients receiving long-term antiviral treatment should pay more attention to the prevalence of NAFLD.


Assuntos
Antivirais/uso terapêutico , Hepatite B Crônica/tratamento farmacológico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , China/epidemiologia , Estudos Transversais , Humanos , Prevalência , Fatores de Risco
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