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Performance of the Enhanced Liver Fibrosis Score,Comparison with Vibration-controlled Transient Elastography Data,and Development of a Simple Algorithm to Predict Significant Liver Fibrosis in a Community-based Liver Service:A Retrospective Evaluation

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Journal of Clinical and Translational Hepatology 2023年第4期11卷 800-808页

作者： Tina Reinson Janisha Patel Mead Mathews Derek Fountain Ryan M.Buchanan christopher dbyrne Nutrition and Metabolism Faculty of MedicineUniversity of SouthamptonSouthamptonUK National Institute for Health and Care Research Southampton Biomedical Research CenterUniversity Hospital SouthamptonSouthamptonUK Hepatology Department University Hospital SouthamptonSouthamptonUK St Mary’s Surgery SouthamptonUK Core Minutes Ltd RingwoodUK Clinical and Experimental Sciences Faculty of MedicineUniversity of SouthamptonSouthamptonUK

Background and Aims:Liver fibrosis is a key risk factor for cirrhosis,hepatocellular carcinoma and end stage liver *** National Institute for Health and Care Excellence guidelines for assessment for advanced(≥F3)liver fibrosis in people with nonalcoholic fatty liver disease recommend the use of enhanced liver fibrosis(ELF)test,followed by vibration-controlled transient elastography(VCTE).Performance of ELF at predicting significant(≥F2)fibrosis in real-world practice is *** assess the accuracy of ELF using VCTE;investigate the optimum ELF cutoff value to identify≥F2and≥F3;and develop a simple algorithm,with and without ELF score,for detecting≥***:Retrospective evaluation of patients referred to a Community Liver Service for VCTE,Jan-Dec *** included:body mass index(BMI),diabetes status,alanine aminotransferase(ALT)levels,ELF score and biopsy-validated fibrosis stages according to ***:Data from 273 patients were available.n=110 patients had *** showed fair performance for≥F2 and≥F3,area under the curve(AUC)=0.70,95%confidence interval(CI)0.64-0.76 and AUC=0.72,95%CI:0.65-0.79 ***≥F2 Youden's index for ELF=9.85 and for≥F3,ELF=*** ALT,BMI,and HbA1c(ALBA algorithm)to predict≥F2 showed good performance(AUC=0.80,95%CI:0.69-0.92),adding ALBA to ELF improved performance(AUC=0.82,95%CI:0.77-0.88).Results were independently ***:Optimal ELF cutoff for≥F2 is 9.85 and 9.95 for≥***,BMI,and HbA1c(ALBA algorithm)can stratify patients at risk of≥*** is improved by adding ALBA.

关键词： Primary health care Retrospective evaluation Liver disease Diabetes Nonalcoholic fatty liver disease

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PNPLA3 rs738409 C>G Variant Influences the Association Between Visceral Fat and Significant Fibrosis in Biopsyproven Nonalcoholic Fatty Liver Disease

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Journal of Clinical and Translational Hepatology 2022年第3期10卷 439-448页

作者： Gang Li Liang-Jie Tang Pei-Wu Zhu Ou-Yang Huang Rafael SRios Kenneth IZheng Sui-Dan Chen Hong-Lei Ma Giovanni Targher christopher dbyrne Xiao-Yan Pan Ming-Hua Zheng NAFLD Research Center Department of Hepatologythe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina Department of Laboratory Medicine the First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina Department of Pathology the First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina Section of Endocrinology Diabetes and MetabolismDepartment of MedicineUniversity and Azienda Ospedaliera Universitaria Integrata of VeronaVeronaItaly Southampton National Institute for Health Research Biomedical Research Centre University Hospital SouthamptonSouthampton General HospitalSouthamptonUK Department of Endocrinology the First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina Institute of Hepatology Wenzhou Medical UniversityWenzhouZhejiangChina Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province WenzhouZhejiangChina

Background and Aims:Intra-abdominal visceral fat accumulation and patatin-like phospholipase domain containing 3(PNPLA3)rs738409 G/C gene polymorphism confer a greater susceptibility to nonalcoholic fatty liver disease(NAFLD).We examined whether the relationship between visceral fat accumulation and liver disease severity may be influenced by PNPLA3 rs738409 ***:The variant of PNPLA3 rs738409 was genotyped within 523 Han individuals with biopsy-confirmed *** fat area(VFA)was measured by bioelectrical *** liver fibrosis(SF),defined as stage F≥2 on histology,was the outcome measure of ***:The distribution of PNPLA3 genotypes was CC:27.5%,CG:48.2%,and GG:24.3%.Higher VFA was associated with greater risk of having SF(adjusted-odds ratio[OR]:1.03;95%confidence interval[CI]:1.02–1.04,p<0.05),independent of potential *** subjects with the same VFA level,the risk of SF was greater among carriers of the rs738409 G genotype than among those who did *** analysis showed that PNPLA3 rs738409 significantly influenced the association between VFA and *** remained significantly associated with SF only among the rs738409 G-allele carriers(adjusted-OR:1.05;95%CI:1.03–1.08 for the GG group;and adjusted-OR:1.03;95%CI:1.01–1.04 for the GC group).There was a significant interaction between VFA and PNPLA3 rs738409 genotype(Pinteraction=0.004).Conclusions:PNPLA3 rs738409 G allele has a moderate effect on the association between VFA and risk of SF in adult individuals with biopsy-proven *** of the PNPLA3 rs738409 G allele and VFA interact to increase risk of SF。

关键词： Nonalcoholic fatty liver disease Significant fibrosis Visceral fat area Single nucleotide polymorphism Metabolic dysfunction-associated fatty liver disease

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Interaction of SAMM50-rs738491,PARVB-rs5764455 and PNPLA3-rs738409 Increases Susceptibility to Nonalcoholic Steatohepatitis

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Journal of Clinical and Translational Hepatology 2022年第2期10卷 219-229页

作者： Ke Xu Kenneth IZheng Pei-Wu Zhu Wen-Yue Liu Hong-Lei Ma Gang Li Liang-Jie Tang Rafael SRios Giovanni Targher christopher dbyrne Xiao-Dong Wang Yong-Ping Chen Ming-Hua Zheng NAFLD Research Center Department of HepatologyFirst Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina Department of Thoracic Surgery Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghaiChina Department of Laboratory Medicine First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina Department of Endocrinology First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina Section of Endocrinology Diabetes and MetabolismDepartment of MedicineUniversity and Azienda Ospedaliera Universitaria Integrata of VeronaVeronaItaly Southampton National Institute for Health Research Biomedical Research Centre University Hospital SouthamptonSouthampton General HospitalSouthamptonUK Institute of Hepatology Wenzhou Medical UniversityWenzhouZhejiangChina Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province WenzhouZhejiangChina

Background and Aims:Previous studies have reported that the single nucleotide polymorphisms(SNPs)of SAMM50-rs738491,PARVB-rs5764455 and PNPLA3-rs738409 are associated with nonalcoholic fatty liver disease(NAFLD).However,no studies have examined the effect of interactions between these three genotypes to affect liver disease *** assessed the effect of these three SNPs on nonalcoholic steatohepatitis(NASH)and also examined the gene-gene interactions in a Chinese population with biopsy-confirmed ***:We enrolled 415 consecutive adult individuals with biopsy-proven *** logistic regres-sion analysis was undertaken to test associations between NASH and SNPs in SAMM50-rs738491,PARVB-rs5764455 and ***-gene interactions were ana-lyzed by performing a generalized multifactor dimensionality reduction(GMDR)***:The mean±standard deviation age of these 415 patients was 41.3±12.5 years,and 75.9%were *** with SAMM50-rs738491 TT,PARVB-rs5764455 AA or PNPLA3-rs738409 GG genotypes had a higher risk of NASH,even after adjustment for age,sex and body mass *** analysis showed that the combination of all three SNPs was the best model for predicting ***,the odds ratio of the haplotype T-A-G for predicting the risk of NASH was nearly three times higher than that of the haplotype ***:NAFLD patients carrying the SAMM50-rs738491 TT,PARVB-rs5764455 AA or PNPLA3-rs738409 GG genotypes are at greater risk of *** three SNPs may synergistically interact to increase susceptibility to NASH.

关键词： Gene polymorphisms Gene-gene interaction SAMM50 PARVB PNPLA3 NASH

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