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Chronic hepatitis B infection with concomitant hepatic steatosis:Current evidence and opinion

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World Journal of Gastroenterology 2021年第26期27卷 3971-3983页

作者： Yi-Wen Shi rui-xu yang Jian-Gao Fan Center for Fatty Liver Department of GastroenterologyXinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Lab of Pediatric Gastroenterology and NutritionShanghai 200092China

With the increasing incidence of obesity and metabolic syndrome worldwide,concomitant nonalcoholic fatty liver disease(NAFLD)in patients with chronic hepatitis B(CHB)has become highly *** risk of dual etiologies,outcome,and mechanism of CHB with concomitant NAFLD have not been fully *** this review,we assessed the overlapping prevalence of metabolic disorders and CHB,assessed the risk of advanced fibrosis/hepatocellular carcinoma in CHB patients concomitant with NAFLD,and discussed the remaining clinical issues to be addressed in the outcome of such *** also explored the possible roles of hepatitis B virus in the development of steatosis and discussed difficultiesof histological *** CHB patients,it is important to address concomitant NAFLD through lifestyle management and disease screening to achieve better *** assessment of progressive changes and novel therapies for CHB patients concomitant with NAFLD deserve further research.

关键词： Nonalcoholic fatty liver disease Hepatitis B Metabolic disorders Steatosis Mechanism Disease burden

Design and preliminary test of tritiated water online detector system based on plastic scintillators

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Nuclear Science and Techniques 2022年第10期33卷 68-78页

作者： Chun-Hui Dong Kai-Yong Liao rui-yang xu Hong-Wu Liu Qing-Xian Zhang Chengdu University of Technology Chengdu 610059China

In this study,an online detector system based on plastic scintillators is designed to monitor the activity of tritiated water in the liquid effluents of nuclear power *** feasibility of the detector is verified via simulation on Geant4,and the optimal detector structure size is determined.A back-end electronics system is designed and an experimental measurement platform forβ-rays based on a ^(40)KCl solution is *** ^(40)KC solutions with different activities ranging from 10 to4500 Bq/L are measured,and 1300 V is determined as the optimal operating high voltage of the photomultiplier tubes.A linear fit is performed in 10-min counts,and the maximum linear goodness of fit(R^(2))achieved is ***-term stability measurements are performed for two detectors,one filled with air and the other with a ^(40)KCl solution exhibiting an activity of 2000 Bq/*** relative deviation of the counts of the detector system every 10 min is 0.998%when the ^(40)KCl solution is used,and the maximum Gaussian R^(2) of the counts is 0.9849.

关键词： Tritiated water Geant4 Plastic scintillator Electronics system

PNPLA3 rs139051 is associated with phospholipid metabolite profile and hepatic inflammation in nonalcoholic fatty liver disease

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World Journal of Clinical Cases 2018年第10期6卷 355-364页

作者： Ji-Jun Luo Hai-Xia Cao rui-xu yang rui-Nan Zhang Qin Pan Department of Gastroenterology Xinhua HospitalShanghai Jiaotong University School of Medicine

AIM To investigate the effect of PNPLA3 polymorphisms on serum lipidomics and pathological characteristics in nonalcoholic fatty liver disease(NAFLD).METHODS Thirty-four biopsy-proven NAFLD patients from Northern, Central, and Southern China were subjected to stratification by genotyping their single nucleotide polymorphisms(SNPs) in PNPLA3. Ultra performance liquid chromatography-tandem mass spectrometry was then employed to characterize the effects of PNPLA3 SNPs on serum lipidomics. In succession, correlation analysis revealed the association of PNPLA3-related lipid profile and hepatic pathological characteristics on a basis of steatosis, activity, and fibrosis assessment. The variant-based scoring of hepatocyte steatosis, ballooning, lobular inflammation, and liver fibrosis was finally performed so as to uncover the actions of lipidomics-affecting PNPLA3 SNPs in NAFLD-specific pathological alterations. RESULTS PNPLA3 SNPs(rs139051, rs738408, rs738409, rs 2072906, rs2294918, rs2294919, and rs4823173) demonstrated extensive association with the serum lipidomics, especially phospholipid metabolites [lysophosphatidylcholine(LPC), lysophosphatidylcholine plasmalogen(LPCO), lysophosphatdylethanolamine(LPE), phosphatidylcholine(PC), choline plasmalogen(PCO), phosphatidylethanolamine(PE), ethanolamine plasmalogen(PEO)], of NAFLD patients. PNPLA3 rs139051(A/A genotype) and rs2294918(G/G genotype) dominated the up-regulatory effect on phospholipids of LPCs(LPC 17:0, LPC 18:0, LPC 20:0, LPC 20:1, LPC 20:2) and LPCOs(LPC O-16:1, LPC O-18:1). Moreover, subjects with high-level LPCs/LPCOs were predisposed to low-grade lobular inflammation of NAFLD(rho:-0.407 to-0.585, P < 0.05-0.001). The significant correlation of PNPLA3 rs139051 and inflammation grading [A/A vs A/G + G/G: 0.50(0.00, 1.75) vs 1.50(1.00, 2.00), P < 0.05] further demonstrated its pathological role based on the modulation of phospholipid metabolite *** The A/A genotype at PNPLA3 rs139051 exerts a

关键词： Nonalcoholic fatty liver disease Patatin-like phospholipase domain containing 3 Single nucleotide polymorphism Phospholipid Inflammation

Prevalence and characteristics of MAFLD in Chinese adults aged 40 years or older:A community-based study

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Hepatobiliary & Pancreatic Diseases International 2022年第2期21卷 154-161页

作者： Jing Zeng Li Qin Qian Jin rui-xu yang Guang Ning Qing Su Zhen yang Jian-Gao Fan Department of Gastroenterology Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghai 200092China Department of Endocrinology Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghai 200092China Department of Endocrine and Metabolic Diseases Shanghai Institute of Endocrinology and MetabolismShanghai Clinical Center for Endocrine and Metabolic DiseasesRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China

Background: Nonalcoholic fatty liver disease(NAFLD) was recently proposed to be renamed metabolic dysfunction-associated fatty liver disease(MAFLD) with the diagnostic criteria revised. We investigated the similarities and differences in the prevalence and clinical characteristics of MAFLD and NAFLD in Chinese adults. Methods: A cross-sectional study of 9980 Chinese individuals aged 40 years or older was performed between 2011 and 2012 using randomized, stratifed cluster sampling in Shanghai, China. A detailed questionnaire and the results of abdominal ultrasonography, a standardized 2-h 75-g oral glucose tolerance test and blood biochemical examinations were collected. Results: A total of 9927 subjects were included in this study. The prevalence of MAFLD(40.3%) was significantly higher than that of NAFLD(36.9%)( P < 0.05). MAFLD was highly prevalent in type 2 diabetes mellitus(T2DM)(53.8%), impaired fasting glucose(35.7%) and impaired glucose tolerance(40.9%). High risk of advanced fbrosis based on fbrosis-4 was highly prevalent(14.7%) in lean MAFLD with T2DM. Among 9927 subjects, 3481(35.1%) fulflled the diagnostic criteria for MAFLD and NAFLD(MAFLD + NAFLD +), 521(5.2%) MAFLD + NAFLD-, and 181(1.8%) MAFLD-NAFLD +. The MAFLD + NAFLD-group had more signifcant metabolic disorders than those in the MAFLD + NAFLD + group(all P < 0.05). Among MAFLD-NAFLD + subjects, 82.9% had metabolic disorders. Conclusions: The new defnition of MAFLD may better reflect the pathogenesis related to metabolism. Future research should focus on studying the natural history, pathogenesis and treatment effectivity of the overlap and non-overlap of NAFLD and MAFLD subjects.

关键词： Nonalcoholic fatty liver disease Metabolic dysfunction-associated fatty liver disease Prevalence Oral glucose tolerance test

The global burden of fatty liver disease:the major impact of China

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Hepatobiliary Surgery and Nutrition 2024年第1期13卷 119-123页

作者： Tian-Wen Lou rui-xu yang Jian-Gao Fan Department of Gastroenterology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina The First Clinical Medical College Anhui Medical UniversityHefeiChina

Due to the energy-dense but nutrient-deficient diets,sedentary lifestyle and lack of exercise as well as an aging population,the prevalence and incidence of overweight/obesity/sarcopenic obesity,type 2 diabetes mellitus(T2DM),metabolic syndrome and their related non-alcoholic fatty liver disease(NAFLD)have been increasing globally in the last two *** Europe and the United States,NAFLD has become the second leading cause of end-stage liver disease and liver transplantation(1).Worse still,the onset age of NAFLD is becoming younger *** the new nomenclature of metabolic dysfunction-associated fatty liver disease(MAFLD)has been proposed for 3 years,MAFLD is not equivalent to NAFLD,and few epidemiologic investigations on MAFLD to ***,this invited editorial is focus on the global epidemiology of NAFLD and the major impact on China.

关键词： Fatty liver disease(FLD) prevalence obesity type 2 diabetes mellitus(T2DM) hepatitis B virus(HBV)

Prevalence,clinical characteristics,risk factors,and indicators for lean Chinese adults with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2020年第15期26卷 1792-1804页

作者： Jing Zeng rui-xu yang Chao Sun Qin Pan rui-Nan Zhang Guang-Yu Chen Ying Hu Jian-Gao Fan Department of Gastroenterology Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghai 200092China Clinical Epidemiology Research Center Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghai 200092China Department of Gastroenterology Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghai Key Laboratory of Children’s Digestion and NutritionShanghai 200092China

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is one of the most common chronic diseases in the ***,the percentage of non-obese or lean patients with NAFLD is *** in non-obese populations,especially the lean subgroup with a normal waist circumference(WC),might lead to more problems than obese individuals,as these individuals may not visit clinics for NAFLD diagnosis or ignore the diagnosis of *** the precise characteristics of these populations,especially the lean subgroup,are identified,the clinicians would be able to provide more appropriate advice and treatment to these *** To investigate the prevalence,clinical characteristics,risk factors,and possible indicators for NAFLD in lean Chinese adults with a normal *** People without diabetes mellitus or significant alcohol consumption who underwent routine health examinations were *** fatty liver index(FLI),abdominal ultrasonography results,and controlled attenuation parameter were all *** for single-nucleotide polymorphisms associated with NAFLD was performed in another small group consisting of biopsy-proven NAFLD subjects and healthy *** A total of 2715 subjects who underwent routine health examinations were included in the *** 810 lean participants with a normal WC,142(17.5%)fulfilled the diagnostic criteria for ***-height ratio,hemoglobin,platelets,and triglycerides were significant factors associated with the presence of NAFLD in these *** appropriate cut-off value of the FLI score in screening for NAFLD in the lean subjects with a normal WC was 25.15,which had a 77.8%sensitivity and 75.9%*** was no significant difference in the single-nucleotide polymorphisms in the SIRT1,APOC3,PNPLA3,AGTR1,and PPARGC1A genes between lean subjects with and without NAFLD(P<0.05).CONCLUSION NAFLD is not uncommon in lean Chinese adults even with a normal *** factors,rather than genetic fa

关键词： Non-alcoholic fatty liver disease Lean Body max index Waist circumference Fatty liver index Triglyceride

Efficacy of Intragastric Balloons in the Markers of Metabolic Dysfunction-associated Fatty Liver Disease:Results from Meta-analyses

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Journal of Clinical and Translational Hepatology 2021年第3期9卷 353-363页

作者： Zi-Yuan Zou Jing Zeng Tian-Yi Ren Yi-Wen Shi rui-xu yang Jian-Gao Fan Center for Fatty Liver Department of GastroenterologyXinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Lab of Pediatric Gastroenterology and NutritionShanghaiChina

Background and Aims:Nonalcoholic fatty liver disease,now renamed metabolic dysfunction-associated fatty liver disease(MAFLD),is common in obese *** balloon(IGB),an obesity management tool with low complication risk,might be used in MAFLD treatment but there is still unexplained heterogeneity in results across ***:We conducted a systematic search of 152 citations published up to September ***-analyses,stratified analyses,and meta-regression were performed to evaluate the efficacy of IGB on homeostasis model assessment of insulin resistance(HOMA-IR),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and gamma-glutamyl transpeptidase(GGT),and to identify patients most appropriate for IGB ***:Thirteen observational studies and one randomized controlled trial met the inclusion criteria(624 participants in total).In the overall estimate,IGB therapy significantly improved the serum markers change from baseline to follow-up[HOMA-IR:1.56,95%confidence interval(CI)=1.16–1.95;ALT:11.53 U/L,95%CI=7.10–15.96;AST:6.79 U/L,95%CI=1.69–11.90;GGT:10.54 U/L,95%CI=6.32–14.75].In the stratified analysis,there were trends among participants with advanced age having less change in HOMA-IR(1.07 vs.1.82).The improvement of insulin resistance and liver biochemistries with swallowable IGB therapy was no worse than that with endoscopic *** meta-regression analyses showed that greater HOMA-IR loss was predicted by younger age(p=0.0107).Furthermore,effectiveness on ALT and GGT was predicted by basal ALT(p=0.0004)and GGT(p=0.0026),***:IGB is effective among the serum markers of *** patients had a greater decrease of HOMA-IR after IGB therapy.

关键词： Intragastric balloon Nonalcoholic fatty liver disease Insulin resistance Age groups Treatment outcome

Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring

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World Journal of Gastroenterology 2022年第16期28卷 1681-1691页

作者： Jing Zeng Feng Shen Zi-Yuan Zou rui-xu yang Qian Jin Jing yang Guang-Yu Chen Jian-Gao Fan Department of Gastroenterology Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghai 200092China Shanghai Key Lab of Pediatric Gastroenterology and Nutrition Shanghai 200092China

BACKGROUND Childhood obesity and fatty liver are associated with adverse outcomes such as diabetes,metabolic syndrome,and cardiovascular diseases in *** is very important to identify relevant risk factors and intervene as early as *** present,the relationship between maternal and offspring metabolic factors is *** To estimate the association of maternal obesity and gestational diabetes mellitus(GDM)with overweight/obesity and fatty liver risk in offspring at 8 years of *** The prospective study included mothers who all had a 75-g oral glucose tolerance test at 24-28 wk of gestation and whose offspring completed follow-up at 8 years of *** birth weight,sex,height,weight,and body mass index(BMI)were measured and ***-502 examination with an M probe(Echosens,Paris,France)was prospectively conducted in offspring aged 8 years from the Shanghai Prenatal Cohort *** A total of 430 mother-child pairs were included in the analysis.A total of 62(14.2%)mothers were classified as obese,and 48(11.1%)were classified as having *** mean age of the offspring at follow-up was 8 years ***-seven(8.6%)offspring were overweight,14(3.3%)had obesity,and 60(14.0%)had fatty *** prevalence of overweight,obesity and fatty liver in offspring increased significantly across maternal BMI quartiles(all P<0.05).Among offspring of mothers with GDM,12(25.0%)were overweight,4(8.3%)were obese,and 12(25.0%)had fatty liver vs.25(6.5%),10(2.6%)and 48(12.6%),respectively,for offspring of mothers without GDM(all P<0.05).In multiple logistic regression,after adjustment for variables,the OR for fatty liver in offspring was 8.26(95%CI:2.38-28.75)for maternal obesity and *** This study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring,and GDM status also increases the odds of overweight/obesity in *** management and glycemic control before and during

关键词： Maternal obesity Gestational diabetes mellitus Offspring overweight/obesity Offspring fatty liver FibroScan

mi R-192-5p regulates lipid synthesis in non-alcoholic fatty liver disease through SCD-1

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World Journal of Gastroenterology 2017年第46期23卷 8140-8151页

作者： Xiao-Lin Liu Hai-Xia Cao Bao-Can Wang Feng-Zhi Xin rui-Nan Zhang Da Zhou rui-xu yang Ze-Hua Zhao Qin Pan Jian-Gao Fan Center for Fatty Liver Department of GastroenterologyXinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

AIM To evaluate the levels of mi R-192-5 p in non-alcoholic fatty liver disease(NAFLD) models and demonstrate the role of mi R-192-5 p in lipid accumulation. METHODS Thirty Sprague Dawley rats were randomly divided into three groups, which were given a standard diet, a high-fat diet(HFD), and an HFD with injection of liraglutide. At the end of 16 weeks, hepatic mi R-192-5 p and stearoyl-Co A desaturase 1(SCD-1) levels were measured. Mi R-192-5 p mimic and inhibitor and SCD-1 si RNA were transfected into Huh7 cells exposed to palmitic acid(PA). Lipid accumulation was evaluated by oil red O staining and triglyceride assays. Direct interaction was validated by dual-luciferase reporter gene *** The HFD rats showed a 0.46-fold decrease and a 3.5-fold increase in hepatic mi R-192-5 p and SCD-1 protein levels compared with controls, respectively, which could be reversed after disease remission by liraglutide injection(P < 0.01). The Huh7 cells exposed to PA also showed down-regulation and up-regulation of mi R-192-5 p and SCD-1 protein levels, respectively(P < 0.01). Transfection with mi R-192-5 p mimic and inhibitor in Huh7 cells induced dramatic repression and promotion of SCD-1 protein levels, respectively(P < 0.01). Luciferase activity was suppressed and enhanced by mi R-192-5 p mimic and inhibitor, respectively, in wild-type SCD-1(P < 0.01) but not in mutant SCD-1. Mi R-192-5 p overexpression reduced lipid accumulation significantly in PA-treated Huh7 cells, and SCD-1 si RNA transfection abrogated the lipid deposition aggravated by mi R-192-5 p inhibitor(P < 0.01).CONCLUSION This study demonstrates that mi R-192-5 p has a negative regulatory role in lipid synthesis, which is mediated through its direct regulation of SCD-1.

关键词： mi R-192-5p Stearoyl-Co A desaturase 1 High fat diet Lipid synthesis Non-alcoholic fatty liver disease