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Current Medical Science 2024年第3期44卷 494-502页

作者： Jiang-hui LI Xue-yao MA Yun YI Lu-rao LI Zhi-yong XU Ying CHANG Department of Gastroenterology Zhongnan Hospital of Wuhan UniversityWuhan430071China Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal diseases Wuhan430071China Endoscopy Center The People’s Hospital of YingshanHuanggang438799China

Objective Ferritin,initially acting as an iron-storage protein,was found to be associated with metabolic diseases.Our study was designed to investigate the association between serum ferritin and metabolic-associated fatty liver disease(MAFLD)using data from the National Health and Nutrition Examination Survey(NHANES)of the United State of America.Methods A cross-sectional study was conducted,enrolling a total of 2145 participants from the NHANES in the 2017–2018 cycles.Hepatic steatosis and liver fibrosis were assessed by ultrasound images and several non-invasive indexes.Multiple regression analysis was conducted to determine the associations between serum ferritin concentration and MAFLD and liver fibrosis.Results The analysis revealed that participants with higher serum ferritin levels(Q3 and Q4 groups)had a higher prevalence of MAFLD than those with the lowest serum ferritin levels[Q3 vs.Q1:OR=2.17(1.33,3.53),Pfatty liver index(FLI);Q4 vs.Q1:OR=3.13(1.91,5.13),Pliver fibrosis[Q4 vs.Q1:OR=2.59(1.19,5.62),Pliver stiffness measurement;OR=5.06(1.12,22.94),Passociated with a higher prevalence of MAFLD and advanced liver fibrosis in patients.Elevated serum ferritin levels combined with diabetes are important risk factors for liver fibrosis.

关键词： serum ferritin liver fibrosis metabolic-associated fatty liver disease National Health and Nutrition Examination Survey

metabolic-associated fatty liver disease and sarcopenia:A double whammy

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World Journal of Hepatology 2024年第2期16卷 152-163页

作者： Aditya Viswanath Sherouk Fouda Cornelius James Fernandez Joseph M Pappachan School of Medicine Leicester UniversityLeicester LE17RHUnited Kingdom School of Health and Biomedical Sciences Rmit UniversityMelbourne VICAustralia Department of Endocrinology and Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease in the world,not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease,type 2 diabetes mellitus,obstructive sleep apnoea,lipid disorders and sarcopenia.Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies.Sarcopenia can be either part of the disease process that results in MAFLD(e.g.,obesity or adiposity)or a consequence of MAFLD,especially in the advanced stages such as fibrosis and cirrhosis.Sarcopenia can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical factors.Therefore,it is crucial to thoroughly understand how we deal with these diseases,especially when they coexist.We explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care.

关键词： metabolic-associated fatty liver disease Sarcopenia Sarcopenic obesity Lean metabolic-associated fatty liver disease Cardiovascular disease liver-muscle axis

Associations of PNPLA3 and LEP genetic polymorphisms with metabolic-associated fatty liver disease in Thai people living with human immunodeficiency virus

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World Journal of Hepatology 2024年第3期16卷 366-378页

作者： Kanuengnit Choochuay Punna Kunhapan Apichaya Puangpetch Sissades Tongsima Pornpen Srisawasdi Abhasnee Sobhonslidsuk Somnuek Sungkanuparph Mohitosh Biswas Chonlaphat Sukasem Program in Translational Medicine Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok 10400Thailand School of Pharmacy Walailak UniversityNakhon Si Thammarat 80161Thailand Laboratory for Pharmacogenomics Division of Pharmacogenomics and Personalized MedicineSomdech Phra Debaratana Medical CenterDepartment of PathologyFaculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok 10400Thailand Department of Medical Sciences Ministry of Public HealthNonthaburi 11000Thailand National Biobank of Thailand National Center for Genetic Engineering and BiotechnologyPathum Thani 12120Thailand Division of Clinical Chemistry Department of PathologyFaculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok 10400Thailand Division of Gastroenterology and Hepatology Department of MedicineFaculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok 10400Thailand Chakri Naruebodindra Medical Institute Faculty of Medicine Ramathibodi HospitalMahidol UniversitySamut Prakan 10540Thailand Department of Pharmacy University of RajshahiRajshahi 6205Bangladesh Pharmacogenomics Clinic Bumrungrad Genomic Medicine InstituteBumrungrad International HospitalBangkok 10110Thailand Research and Development Laboratory Bumrungrad International HospitalBangkok 10110Thailand MRC Centre for Drug Safety Science Department of Pharmacology and TherapeuticsInstitute of SystemsMolecular and Integrative BiologyUniversity of Liverpool Liverpool L693GLUnited Kingdom Faculty of Pharmaceutical Sciences Burapha UniversityChonburi 20131Thailand

BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.

关键词： PNPLA3 LEP metabolic-associated fatty liver disease People living with HIV Thai

Management of metabolic-associated fatty liver disease: The diabetology perspective

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World Journal of Gastroenterology 2023年第1期29卷 126-143页

作者： Mohammad Sadiq Jeeyavudeen Shahanas K A Khan Sherouk Fouda Joseph M Pappachan Department of Endocrinology and Metabolism University Hospitals of EdinburghEdinburgh EH42XUUnited Kingdom Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom School of Health and Biomedical Sciences RMIT UniversityMelbourneVIC 3046Australia Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology University of ManchesterManchester M139PLUnited Kingdom

The metabolic syndrome as a consequence of the obesity pandemic resulted in a substantial increase in the prevalence of metabolic-associated fatty live disease(MAFLD)and type 2 diabetes mellitus(T2DM).Because of the similarity in pathobiology shared between T2DM and MAFLD,both disorders coexist in many patients and may potentiate the disease-related outcomes with rapid progression and increased complications of the individual diseases.In fact,awareness about this coexistence and the risk of complications are often overlooked by both hepatologists and diabetologists.Management of these individual disorders in a patient should be addressed wholistically using an appropriate multidisciplinary team approach involving both the specialists and,when necessary,liaising with dieticians and surgeons.This comprehensive review is to compile the current evidence from a diabetologist's perspective on MAFLD and T2DM and to suggest optimal management strategies.

关键词： metabolic syndrome metabolic-associated fatty liver disease Type 2 diabetes mellitus Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Diabetology perspective Obesity

Discrepancies between Nonalcoholic and metabolic-associated fatty liver disease by Multiple Steatosis Assessment

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Journal of Clinical and Translational Hepatology 2022年第6期10卷 1013-1026页

作者： Congxiang Shao Junzhao Ye Xin Li Yansong Lin Shiting Feng Bing Liao Wei Wang Xiaorong Gong Bihui Zhong Department of Gastroenterology of the First Affiliated Hospital Sun Yat-sen UniversityGuangzhouGuangdongChina Department of Gastroenterology Affiliated Dongguan People’s HospitalSouthern Medical University(Dongguan People’s Hospital)DongguanGuangdongChina Department of Radiology of the First Affiliated Hospital Sun Yat-sen Univer-sityGuangzhouGuangdongChina Department of Pathology of the First Affiliated Hospital Sun Yat-sen UniversityGuangzhouGuangdongChina Department of Medical Ultrasonics of the First Affiliated Hospital Sun Yat-sen UniversityGuangzhouGuangdongChina Department of Gastroenterology First Affiliated HospitalGuangzhou Medical UniversityGuangzhouGuangdongChina

Background and Aims:The redefinition of metabolic-as-sociated fatty liver disease(MAFLD)from nonalcoholic fat-ty liver disease(NAFLD)has caused a revolution in clinical practice,and the characteristics of patients with steatosis but not MAFLD remain unclear.The aims were to compare the diagnosis rate of MAFLD in NAFLD using different steato-sis methods and explore the features of non-MAFLD-NAFLD and MAFLD-non-NAFLD.Methods:A cross-sectional study enrolling consecutive individuals was conducted at three medical centers in southern China from January 2015 to September 2020.Steatosis was evaluated by liver biopsy or magnetic resonance imaging-based proton density fat frac-tion(MRI-PDFF),ultrasound,controlled attenuation param-eter(CAP),and fatty liver index(FLI).Fibrosis was assessed by the NAFLD fibrosis score,transient elastography,or shear wave elastography.Results:The study enrolled 14,985 Chi-nese adults.The agreement of MAFLD and NAFLD diagnoses were 83%for FLI,95%for ultrasound,94%for both CAP and MRI-PDFF,and 95%for liver biopsy.The body mass index,blood pressure and lipid levels among non-MAFLD-NAFLD pa-tients were similar metabolic parameters(p>0.05 for all),but not the alanine aminotransferase and the proportion of pa-tients with insulin resistance,which were significantly higher in non-MAFLD-NAFLD with significant fibrosis.Conclusions:The new MAFLD definition ruled out 5-17%of NAFLD cases.NAFLD and MAFLD-NAFLD involved more severe metabolic abnormalities than MAFLD and MAFLD-non-NAFLD.Non-MAFLD-NAFLD patients with significant fibrosis had more se-vere liver injury and increased glycemic dysregulation within the normal range.Attention should be paid to its progression.

关键词： Controlled attenuation parameter fatty liver index liver biopsy metabolic-associated fatty liver disease Magnetic resonance imaging-based proton density fat fraction

Validation of Non-invasive Fibrosis Scores for Predicting Advanced Fibrosis in metabolic-associated fatty liver disease

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Journal of Clinical and Translational Hepatology 2022年第4期10卷 589-594页

作者： Xiaoning Chen George Boon-Bee Goh Jiaofeng Huang Yinlian Wu Mingfang Wang Rahul Kumar Su Lin Yueyong Zhu Department of Hepatology Hepatology Research InstituteThe First Affiliated Hospital of Fujian Medical UniversityFu-zhouFujianChina Department of Gastroenterology&Hepatology Singapore General HospitalSingapore Duke-NUS Medical School Singapore Department of Gastroenterology and Hepatology Duke-NUS Academic Medical CentreChangi General HospitalSingapore

Background and Aims:metabolic-associated fatty liver disease(MAFLD)is a newly proposed terminology from 2020;yet,the applicability of conventional noninvasive fi-brosis models is still unknown for it.We aimed to evaluate the performance of conventional noninvasive fibrosis scores in MAFLD.Methods:The NHANES 2017-2018 datasets were used to compare the performances of different non-invasive fibrosis scores in MAFLD,including the aspartate aminotransferase(AST)to platelet ratio index(APRI),body mass index(BMI)-AST/alanine aminotransferase(ALT)ratio and diabetes score(BARD),fibrosis-4 index(FIB-4),and NAFLD fibrosis score(NFS).Moreover,Asian patients with biopsy-proven MAFLD were enrolled to further validate the findings.Results:A total of 2,622 participants in the Na-tional Health and Nutrition Examination Survey(NHANES)cohort and 293 patients with MAFLD in the Asian cohort were included.Patients in the Asian cohort had a lower BMI and higher liver enzymes(pliver enzymes when NFS is unavailable.Novel efficient noninvasive fibrosis scor-ing systems are highly required for patients with MAFLD.

关键词： FIB-4 metabolic-associated fatty liver disease liver fibrosis NFS Noninvasive fibrosis scores

Nuclear factor erythroid 2-related factor 2-mediated signaling and metabolic associated fatty liver disease

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World Journal of Gastroenterology 2022年第48期28卷 6909-6921页

作者： Vidyasagar Naik Bukke Archana Moola Gaetano Serviddio Gianluigi Vendemiale Francesco Bellanti Department of Medical and Surgical Sciences University of FoggiaFoggia 71122Italy

Oxidative stress is a key driver in the development and progression of several diseases,including metabolic associated fatty liver disease(MAFLD).This condition includes a wide spectrum of pathological injuries,extending from simple steatosis to inflammation,fibrosis,cirrhosis,and hepatocellular carcinoma.Excessive buildup of lipids in the liver is strictly related to oxidative stress in MAFLD,progressing to liver fibrosis and cirrhosis.The nuclear factor erythroid 2-related factor 2(NRF2)is a master regulator of redox homeostasis.NRF2 plays an important role for cellular protection by inducing the expression of genes related to antioxidant,anti-inflammatory,and cytoprotective response.Consistent evidence demonstrates that NRF2 is involved in every step of MAFLD development,from simple steatosis to inflammation,advanced fibrosis,and initiation/progression of hepatocellular carcinoma.NRF2 activators regulate lipid metabolism and oxidative stress alleviating the fatty liver disease by inducing the expression of cytoprotective genes.Thus,modulating NRF2 activation is crucial not only in understanding specific mechanisms underlying MAFLD progression but also to characterize effective therapeutic strategies.This review outlined the current knowledge on the effects of NRF2 pathway,modulators,and mechanisms involved in the therapeutic implications of liver steatosis,inflammation,and fibrosis in MAFLD.

关键词： Nonalcoholic fatty liver disease metabolic-associated fatty liver disease Nuclear factor erythroid 2-related factor 2 Oxidative stress Antioxidants liver injury

Atherogenic index of plasma combined with waist circumference and body mass index to predict metabolic-associated fatty liver disease

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World Journal of Gastroenterology 2022年第36期28卷 5364-5379页

作者： Shao-Jie Duan Zhi-Ying Ren Tao Zheng Hong-Ye Peng Zuo-Hu Niu Hui Xia Jia-Liang Chen Yuan-Chen Zhou Rong-Rui Wang Shu-Kun Yao Graduate School Beijing University of Chinese MedicineBeijing 100029China Center of Integrative Medicine Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Graduate school Peking University China-Japan Friendship School of Clinical MedicineBeijing 100029China Department of Gastroenterology China-Japan Friendship HospitalBeijing 100029China

BACKGROUND Early identification of metabolic-associated fatty liver disease(MAFLD)is urgent.Atherogenic index of plasma(AIP)is a reference predictor of obesity-related diseases,but its predictive value for MAFLD remains unclear.No studies have reported whether its combination with waist circumference(WC)and body mass index(BMI)can improve the predictive performance for MAFLD.AIM To systematically explore the relationship between AIP and MAFLD and evaluate its predictive value for MAFLD and to pioneer a novel noninvasive predictive model combining AIP,WC,and BMI while validating its predictive performance for MAFLD.METHODS This cross-sectional study consecutively enrolled 864 participants.Multivariate logistic regression analysis and receiver operating characteristic curve were used to evaluate the relationship between AIP and MAFLD and its predictive power for MAFLD.The novel prediction model A-W-B combining AIP,WC,and BMI to predict MAFLD was established,and internal verification was completed by magnetic resonance imaging diagnosis.RESULTS Subjects with higher AIP exhibited a significantly increased risk of MAFLD,with an odds ratio of 12.420(6.008-25.675)for AIP after adjusting for various confounding factors.The area under receiver operating characteristic curve of the A-W-B model was 0.833(0.807-0.858),which was significantly higher than that of AIP,WC,and BMI(all Passociated with the liver proton density fat fraction(r=0.630,P<0.001)and significantly increased with the severity of MAFLD(P<0.05).CONCLUSION AIP was strongly

关键词： Atherogenic index of plasma metabolic-associated fatty liver disease Receiver operating characteristic curve Predictor

Gut microbiome and metabolic-associated fatty liver disease:Current status and potential applications

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World Journal of Hepatology 2023年第7期15卷 867-882页

作者： Gong-Jing Guo Fei Yao Wei-Peng Lu Hao-Ming Xu Gastroenterology Department of The Second Affiliated Hospital School of MedicineThe Chinese University of Hong KongShenzhen&Longgang District People’s Hospital of ShenzhenShenzhen 518172Guangdong ProvinceChina Department of Science and Education The Affiliated Brain Hospital of Guangzhou Medical UniversityGuangzhou 510370Guangdong ProvinceChina The First Clinical School Guangzhou Medical UniversityGuangzhou 510120Guangdong ProvinceChina Department of Gastroenterology and Hepatology Guangzhou First People's HospitalSchool of MedicineSouth China University of TechnologyGuangzhou 510180Guangdong ProvinceChina

metabolic-associated fatty liver disease(MAFLD)is one of the most common chronic liver diseases worldwide.In recent years,the occurrence rate of MAFLD has been on the rise,mainly due to lifestyle changes,high-calorie diets,and imbalanced dietary structures,thereby posing a threat to human health and creating heavy social and economic burdens.With the development of 16S sequencing and integrated multi-omics analysis,the role of the gut microbiota(GM)and its metabolites in MAFLD has been further recognized.The GM plays a role in digestion,energy metabolism,vitamin synthesis,the prevention of pathogenic bacteria colonisation,and immunoregulation.The gut-liver axis is one of the vital links between the GM and the liver.Toxic substances in the intestine can enter the liver through the portal vascular system when the intestinal barrier is severely damaged.The liver also influences the GM in various ways,such as bile acid circulation.The gut-liver axis is essential in maintaining the body’s normal physiological state and plays a role in the onset and prognosis of many diseases,including MAFLD.This article reviews the status of the GM and MAFLD and summarizes the GM characteristics in MAFLD.The relationship between the GM and MAFLD is discussed in terms of bile acid circulation,energy metabolism,micronutrients,and signalling pathways.Current MAFLD treat ments targeting the GM are also listed.

关键词： metabolic-associated fatty liver disease Gut microbiota Current status Application

metabolic-associated fatty liver disease:New nomenclature and approach with hot debate

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World Journal of Hepatology 2023年第2期15卷 123-128页

作者： Yasser Fouad Department of Gastroenterology and Endemic Medicine Minia UniversityMinia 19111Egypt

An international panel recently proposed an update to the terminology and diagnostic criteria for fatty liver disease.The experts proposed a change in the nomenclature from non-alcoholic fatty liver disease(NAFLD)to metabolic(dysfunction)-associated fatty liver disease(MAFLD).This single-letter change,we believe,heralds the dawn of a new era in clinical practice and in clinical and basic research as well.The new nomenclature with the easily applicable approach has stimulated the enthusiasm of the researchers worldwide,resulting in a large number of publications over the past two years.Several recent studies have provided tremendous evidence of the superiority of the MAFLD criteria over the NAFLD criteria.Many studies in different geographic areas of the world including the United States,Europe,and Asia on a large number of patients proved that the utility of MAFLD criteria was higher than that of the NAFLD criteria in different aspects of fatty liver diseases.Consequently,many societies,physician and nurse groups,health stakeholders,representatives of regulatory sciences,and others endorsed the new nomenclature.Here we highlight the endorsement of the new name by different societies and groups and the outcome of different studies on the new nomenclature in addition to a short discussion of the debate by some experts.

关键词： Non-alcoholic fatty liver disease metabolic-associated fatty liver disease liver disease Fibrosis New nomenclature Redefinition