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Nutrition and physical activity in NAFLD:An overview of the epidemiological evidence

World Journal of Gastroenterology 2011年第29期17卷 3377-3389页

作者： Shira Zelber-Sagi Ran Oren Zelber-Sagi vlad ratziu The Liver Unit Department of GastroenterologyTel Aviv Sourasky Medical Center64239 Tel-AvivIsrael School of Public Health Faculty of Social Welfare and Health SciencesUniversity of Haifa31905 HaifaIsrael Université Pierre et Marie Curie Hpital Pitié Salpêtrière75013 ParisFrance The Sackler Faculty of Medicine Tel-Aviv University 64239 Tel-AvivIsrael

Nonalcoholic fatty liver disease(NAFLD)has been recognized as a major health *** high prevalence of NAFLD is probably due to the contemporary epidemics of obesity,unhealthy dietary pattern,and sedentary *** efficacy and safety profile of pharmacotherapy in the treatment of NAFLD remains uncertain and obesity is strongly associated with hepatic steatosis;therefore,the first line of treatment is lifestyle *** usual management of NAFLD includes gradual weight reduction and increased physical activity(PA)leading to an improvement in serum liver enzymes,reduced hepatic fatty infiltration,and,in some cases,a reduced degree of hepatic inflammation and *** has been demonstrated to be associated with NAFLD and Non-alcoholic steatohepatitis(NASH)in both animals and humans,and thus serves as a major route of prevention and ***,most human studies are observational and retrospective,allowing limited inference about causal *** prospective studies and clinical trials are now needed to establish a causal *** on available data,patients should optimally achieve a 5%-10%weight *** realistic goals is essential for long-term successful lifestyle modification and more effort must be devoted to informing NAFLD patients of the health benefits of even a modest weight ***,all NAFLD patients,whether obese or of normal weight,should be informed that a healthy diet has benefits beyond weight *** should be advised to reduce saturated/trans fat and increase polyunsaturated fat,with special emphasize on omega-3 fatty *** should reduce added sugar to its minimum,try to avoid soft drinks containing sugar,including fruit juices that contain a lot of fructose,and increase their fiber *** the heavy meat eaters,especially those of red and processed meats,less meat and increased fish intake should be *** fast food intake will also help mainta

关键词： Nonalcoholic fatty liver disease Nutrition Physical activity Weight reduction Fat Carbohydrates Soft drinks Nutrients

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Applicability and variability of liver stiffness measurements according to probe position

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World Journal of Gastroenterology 2009年第27期15卷 3398-3404页

作者： Patrick Ingiliz Kim Pav Chhay Mona Munteanu Pascal Lebray Yen Ngo Dominique Roulot Yves Benhamou Dominique Thabut vlad ratziu Thierry Poynard Dominique Thabut Vlad Ratziu Thierry Poynard AP-HP Hospital Group Pitié-Salpêtrière Hepatology Department47-83 Hospital Boulevard Paris 75651 France BioPredictive 40 Bac street Paris 75007 France AP-HP Hepatology Department Avicenne hospitalBobigny 93000France AP-HP Hospital Group Pitié-Salpêtrière Hepatology Department47-83 Hospital Boulevard Paris 75651 France

AIM: To investigate the liver stiffness measurement (LSM) applicability and variability with reference to three probe positions according to the region of liver biopsy. METHODS: The applicability for LSM was defined as at least 10 valid measurements with a success rate greater than 60% and an interquartile range/median LSM < 30%. The LSM variability compared the inter-position concordance and the concordance with FibroTest. RESULTS: Four hundred and forty two consecutive patients were included. The applicability of the anterior position (81%) was significantly higher than that of the reference (69%) and lower positions (68%), (both P = 0.0001). There was a signif icant difference (0.5 kPa, 95% CI 0.13-0.89; P < 0.0001) between mean LSM estimated at the reference position (9.3 kPa) vs the anterior position (8.8 kPa). Discordance between positions was associated with thoracic fold (P = 0.008). The discordance rate between the reference position result and FibroTest was higher when the 7.1 kPa cutoff was used to define advanced fibrosis instead of 8.8 kPa (33.6% vs 23.5%, P = 0.03).CONCLUSION: The anterior position of the probe should be the fi rst choice for LSM using Fibroscan, as it has a higher applicability without higher variability compared to the usual liver biopsy position.

关键词： Fibroscan Fibrotest Liver fibrosis Variability Concordance

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Vitamin D in addition to peg-interferon-alpha/ribavirin in chronic hepatitis C virus infection: ANRS-HC25-VITAVIC study

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World Journal of Gastroenterology 2015年第18期21卷 5647-5653页

作者： Benjamin Terrier Nathanael Lapidus Stanislas Pol Lawrence Serfaty vlad ratziu Tarik Asselah Vincent Thibault Jean-Claude Souberbielle Fabrice Carrat Patrice Cacoub Inflammation-ImmunopathologyBiotherapy Department (DHU i2B) Sorbonne Universités Department of Internal Medicine Groupe Hospitalier Cochin AP-HP Université Paris Descartes INSERM UMR_S 1136 Institut Pierre Louis d’Epidémiologie et de Santé Publique Sorbonne Universités UPMC Univ Paris 06 UMR_S 1136 Institut Pierre Louis d’ Epidémiologie et de Santé Publique Public Health Department Saint-Antoine Hospital Department of Hepatology Groupe Hospitalier Cochin AP-HP Université Paris Descartes Department of Hepatology H?pital SaintAntoine AP-HP Université Pierre et Marie Curie Department of Hepatology Groupe Hospitalier Pitié-Salpetrière AP-HP Université Pierre et Marie Curie Department of Hepatology H?pital Beaujon Department of Virology Groupe Hospitalier Pitié-Salpetrière AP-HP Université Pierre et Marie Curie Explorations Fonctionnelles H?pital Necker-Enfants Malades AP-HP Université Paris Descartes INSERM UMR_S 959 F-75013 Paris France CNRS UMR 7211 F-75005 Paris France Department of Internal Medicine and Clinical Immunology H?pital Pitié-Salpétrière AP-HP 47-83 boulevard de l’H?pital

AIM: To investigate if correction of hypovitaminosis D before initiation of Peg-interferon-alpha/ribavirin(Peg IFN/RBV) therapy could improve the efficacy of Peg IFN/RBV in previously null-responder patients with chronic genotype 1 or 4 hepatitis C virus(HCV) ***:Genotype 1 or 4 HCV-infected patients with null response to previous Peg IFN/RBV treatment and with hypovitaminosis D(<30 ng/m L)prospectively received cholecalciferol 100000 IU per week for 4 wk[from week-4(W-4)to W0],followed by 100000 IUper month in combination with Peg IFN/RBV for 12 mo(from W0 to W48).The primary outcome was the rate of early virological response defined by an HCV RNA<12 IU/m L after 12 wk Peg IFN/RBV ***:A total of 32 patients were included,19(59%)and 13(41%)patients were HCV genotype1 and 4,*** median baseline vitamin D level was 15 ng/m L(range:7-28).In modified intention-to-treat analysis,29 patients who received at least one dose of Peg IFN/RBV were included in the *** patients except one normalized their vitamin D serum *** rate of early virologic response was 0/29(0%).The rate of HCV RNA<12IU/m L after 24 wk of Peg IFN/RBV was 1/27(4%).The safety profile was ***:Addition of vitamin D to Peg IFN/RBV does not improve the rate of early virologic response in previously null-responders with chronic genotype 1or 4 HCV infection.

关键词： Vitamin D Hepatitis C virus Chronic hepatitis Pegylated interferon Ribavirin

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Comparison of fatty liver index with noninvasive methods for steatosis detection and quantification

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World Journal of Gastroenterology 2013年第1期19卷 57-64页

作者： Shira Zelber-Sagi Muriel Webb Nimer Assy Laurie Blendis Hanny Yeshua Moshe Leshno vlad ratziu Zamir Halpern Ran Oren Erwin Santo Department of Gastroenterology Tel Aviv Sourasky Medical Center64239 Tel-AvivIsrael School of Public Health Faculty of Social Welfare and Health SciencesUniversity of Haifa31905 HaifaIsrael Liver Unit Ziv Medical CenterIsrael and Bar Ilan University13100 SafedIsrael The Sackler Faculty of Medicine Tel-Aviv University69978 Ramat AvivIsrael Université Pierre et Marie Curie H pital Pitié Salpêtrière75013 ParisFrance

AIM:To compare noninvasive methods presently used for steatosis detection and quantification in nonalcoholic fatty liver disease(NAFLD).METHODS:Cross-sectional study of subjects from the general population,a subgroup from the First Israeli National Health Survey,without excessive alcohol consumption or viral *** subjects underwent anthropometric measurements and fasting blood *** of liver fat was performed using four noninvasive methods:the SteatoTest;the fatty liver index(FLI);regular abdominal ultrasound(AUS);and the hepatorenal ultrasound index(HRI).Two of the noninvasive methods have been validated vs liver biopsy and were considered as the reference methods:the HRI,the ratio between the median brightness level of the liver and right kidney cortex;and the SteatoTest,a biochemical surrogate marker of liver *** FLI is calculated by an algorithm based on triglycerides,body mass index,γ-glutamyl-transpeptidase and waist circumference,that has been validated only vs *** < 30 rules out and FLI ≥ 60 rules in fatty ***:Three hundred and thirty-eight volunteers met the inclusion and exclusion criteria and had valid *** prevalence rate of NAFLD was 31.1% according to *** FLI was very strongly correlated with SteatoTest(r = 0.91,P < 0.001) and to a lesser but significant degree with HRI(r = 0.55,P < 0.001).HRI and SteatoTest were significantly correlated(r = 0.52,P < 0.001).The κ between diagnosis of fatty liver by SteatoTest(≥ S2) and by FLI(≥ 60) was 0.74,which represented good *** sensitivity of FLI vs SteatoTest was 85.5%,specificity 92.6%,positive predictive value(PPV) 74.7%,and negative predictive value(NPV) 96.1%.Most subjects(84.2%) with FLI < 60 had S0 and none had *** κ between diagnosis of fatty liver by HRI(≥ 1.5) and by FLI(≥ 60) was 0.43,which represented only moderate *** sensitivity of FLI vs HRI was 56.3%,specificity 86.5%,PPV 57.0%,and NPV 86.1%.The diagnostic accuracy of F

关键词： Steatosis Hepatorenal ultrasound index SteatoTest Fatty liver index Screening Agreement Sensitivity Specificity

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