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Impact of Proteinuria on Liver Enzyme Levels

Journal of Clinical and Translational Hepatology 2024年第9期12卷 759-760页

作者： David Yardeni asif hitawala Lilian Howard Theo Heller Meryl Waldman Department of Gastroenterology and Liver Diseases Soroka University Medical CenterBeer-ShevaIsrael Liver Diseases Branch National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthBethesdaMDUSA Kidney Diseases Branch National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthBethesdaMDUSA

Dear Editors,We read with great interest the recently published article“Subnormal Serum Liver Enzyme Levels:A Review of Pathophysiology and Clinical Significance”by Youssef and colleagues.1 While much attention is given to elevations of liver enzymes,the authors highlight clinically important,often unrecognized reasons leading to low liver enzyme *** example,chronic kidney disease was cited as a cause of low serum aspartate aminotransferase(AST)proportional to the progression of the disease,but the cause(s)are not well *** is known about the possible influence of nephrotic syndrome(NS)on liver enzymes.

关键词： Impact Liver Levels

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Prevalence of hypothyroidism and effect of thyroid hormone replacement therapy in patients with non-alcoholic fatty liver disease:A population-based study

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World Journal of Hepatology 2022年第3期14卷 551-558页

作者： Ashraf Almomani asif Ali hitawala Prabhat Kumar Sura Alqaisi Dana Alshaikh Motasem Alkhayyat Imad Asaad Department ofInternal Medicine Cleveland Clinic FoundationClevelandOH 44111United States Liver Disease Branch National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of HealthBethesdaMD 20892United States Mutah University Amman 00962Jordan Department of Digestive Disease and Surgery Institute Cleveland Clinic FoundationClevelandOH 44195United States

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is currently considered as the most common cause of chronic liver disease *** factors for NAFLD have been well-described,including obesity,type 2 diabetes mellites(T2DM),dyslipidemia(DLP)and metabolic *** has been identified as an independent risk factor for the development of NAFLD,although the literature is inconsistent AIM To evaluate the prevalence of hypothyroidism in patients with NAFLD,assess if it is an independent risk factor and explore the effect of thyroxine replacement *** Our cohort’s data was obtained using a validated,large,multicenter database(Explorys Inc,Cleveland,OH,United States)aggregated from pooled outpatient and inpatient records of 26 different healthcare systems,consisting of a total of 360 hospitals in the United States,and utilizing Systematized Nomenclature of Medicine-Clinical Terms for *** evaluated a cohort of patients with hypothyroidism and *** analysis was performed to adjust for confounding risk factors including hypertension(HTN),T2DM,DLP,obesity and metabolic *** version 25,IBM Corp was used for statistical analysis,and for all analyses,a 2-sided P value of<0.05 was considered statistically *** criteria were limited to age<18 *** Among the 37648180 included individuals in this database who are above the age of 18 years,there were a total of 2320 patients with NAFLD(6.16 per 100000)in the last five years(2015-2020),amongst which 520 patients(22.4%)had *** characteristics of patients in this database are described in Table *** with NAFLD were also more likely to have obesity,T2DM,DLP,HTN,and metabolic syndrome(Table 2).While males and females were equally affected,patients in the age group 18-65 years as well as Caucasians seem to be at a higher *** was an increased risk of NAFLD among patients with hypothyroidism(OR=1.587).Furthermore,thyroid ho

关键词： Hypothyroidism Non-alcoholic fatty liver disease Thyroid hormone replacement therapy Independent risk factor

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Prevalence of non-alcoholic fatty liver disease in patients with nephrotic syndrome:A population-based study

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World Journal of Hepatology 2023年第2期15卷 265-273页

作者： Somtochukwu Stephen Onwuzo asif Ali hitawala Antoine Boustany Prabhat Kumar Ashraf Almomani Chidera Onwuzo Jessy Mascarenhas Monteiro Imad Asaad Internal Medicine Cleveland Clinic FoundationClevelandOH 44111United States Digestive Disease and Hepatology Cleveland Clinic Foundation FloridaWestonFI 33331United States Department of Medicine&Surgery General Hospital Lagos IslandLagos Island 101223LagosNigeria Department of Medicine Ross University School of MedicineBridgetown B11093St MichaelBarbados Digestive Disease and Hepatology Cleveland Clinic FoundationClevelandOH 44111United States

BACKGROUND Non-alcoholic fatty liver disease(NAFLD) is a global health concern with a prevalence of about 25% amongst United States adults. Its increased prevalence is attributed to increase in patients with obesity and metabolic syndrome, partly due to similar mechanisms of injury. Nephrotic syndrome(NS) is a clinical entity resulting from extensive proteinuria leading to hypoalbuminemia, hyperlipidemia, edema, and other complications. Given its association with hyperlipidemia, there is concern that patients with NS may be at increased risk of *** To perform a cross-sectional population-based study to investigate the prevalence and risk factors of NAFLD in patients with *** A large multicenter database(Explorys Inc., Cleveland, OH, United States) was utilized for this retrospective cohort study. A cohort of 49700 patients with a diagnosis of “Non-Alcoholic fatty liver disease” using the Systematized Nomenclature of Medicine-Clinical Terms(SNOMED-CT) between 1999-2022 was identified. Inclusion criteria were age ≥ 18 years, presence of NAFLD, presence of NS. There were no specific exclusion criteria. Univariate and multivariate analysis were performed to adjust for multiple risk factors including age, gender, Caucasian race, NS, type Ⅱ diabetes mellitus, hypothyroidism, dyslipidemia, obesity, metabolic syndrome and chronic kidney disease. Statistical analysis was conducted using R, and for all analyses, a 2-sided P value of < 0.05 was considered statistically *** Among the 78734750 individuals screened in this database, there were a total of 49700 subjects with NAFLD. In univariate analysis, the odds of having NAFLD in patients with NS, type 2 diabetes mellitus, hypothyroidism, dyslipidemia, obesity, metabolic syndrome and chronic kidney disease were 14.84 [95% confidence interval(95%CI) 13.67-16.10], 17.05(95%CI 16.78-17.32), 6.99(95%CI 6.87-7.11), 13.61(95%CI 13.38-13.84), 19.19(95%CI 18.89-19.50), 29.09(95%CI 28.26--29.95), and 9.05(95

关键词： Non-alcoholic fatty liver disease Nephrotic syndrome Chronic kidney disease Hyperlipidemia Population-based study Database

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Implications of artificial intelligence in inflammatory bowel disease: Diagnosis, prognosis and treatment follow up

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Artificial Intelligence in Gastroenterology 2021年第3期2卷 85-93页

作者： Ashraf Almomani asif hitawala Mohammad Abureesh Thabet Qapaja Dana Alshaikh Mohammad Zmaili Mohannad Abou Saleh Motasem Alkhayyat Department of Internal Medicine Cleveland Clinic Fairview HospitalClevelandOH 44111United States Department of Internal Medicine Staten Island University HospitalNew York CityNY 10305United States Department of Internal Medicine Cleveland Clinic FoundationClevelandOH 44195United States School of Medicine Mutah UniversityAlkarak 61710Jordan Department of Gastroenterology and Hepatology Cleveland Clinic FoundationClevelandOH 44195United States

Driven by the tremendous availability of data,artificial intelligence(AI)using deep learning has emerged as a breakthrough computer technology in the last few decades and has recently been acknowledged by the Task Force on AI as a golden opportunity for *** its ability to understand,learn from and build on non-linear relationships,AI aims to individualize medical care in an attempt to save time,cost,effort and improve patient’s *** has been applied in multiple medical fields with substantial progress made in gastroenterology mainly to facilitate accurate detection of pathology in different disease processes,among which inflammatory bowel disease(IBD)seems to drag significant attention,specifically by interpreting imaging studies,endoscopic images and videos and-to a lesser extent-disease ***,models have been built to predict IBD occurrence,flare ups,persistence of histological inflammation,disease-related structural abnormalities as well as disease *** this article,we will review the applications of AI in IBD in the present medical literature at multiple points of IBD timeline,starting from disease prediction via genomic assessment,diagnostic phase via interpretation of radiological studies and AI-assisted endoscopy,and the role of AI in the evaluation of therapy response and prognosis of IBD patients.

关键词： Artificial intelligence Machine learning Inflammatory bowel disease

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