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Association of non-alcoholic fatty liver and metabolic-associated fatty liver with COVID-19 outcomes:A systematic review and metaanalysis

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World Journal of Gastroenterology 2023年第21期29卷 3362-3378页

作者： Gowthami Sai Kogilathota Jagirdhar Rakhtan K Qasba Harsha Pattnaik Kaanthi Rama Akshat Banga Shiva Teja Reddy Anna Carolina Flumignan Bucharles Rahul Kashyap Praveen Reddy Elmati Vikas Bansal Yatinder Bains Theodore DaCosta Salim Surani Department of Medicine Saint Michaels Medical CenterNewarkNJ 07102United States Department of Medicine Green Life Medical College and HospitalDhaka 1205Bangladesh Department of Medicine Lady Hardinge Medical CollegeNew Delhi 110001India Department of Medicine Gandhi Medical CollegeTelangana 500003India Department of Medicine Sawai Man Singh Medical CollegeJaipur 302004RajistanIndia Department of Medicine Universidade PositivoCuritiba 81290-000PRBrazil Research WellSpan HealthYorkPA 17403United States Department of Interventional Pain Medicine University of LouisvilleLouisvilleKY 40292United States Department of Internal Medicine Mayo ClinicRochesterMN 55902United States Department of Gastroenterology Saint Michaels Medical CenterNewarkNJ 07102United States Department of Medicine Texas A&M UniversityCollege StationTX 77843United States

BACKGROUND non-alcoholic fatty liver disease(NAFLD)and metabolic-associated fatty liver disease(MAFLD)are on the rise like any other liver disease,and tend to affect 25%of the United States population.The impact of NAFLD and MAFLD on patients with coronavirus disease 2019(COVID-19)remains unclear.AIM To identify the association of NAFLD and MAFLD with mortality,hospitalization,hospital length of stay,and supplemental oxygen utilization in COVID-19 patients.METHODS A systematic review of literature on Cochrane,Embase,PubMed,ScienceDirect,and Web of Science databases was conducted from January 2019 to July 2022.Studies that evaluated NAFLD/MAFLD using laboratory methods,noninvasive imaging,or liver biopsy were included.The study protocol was registered in PROSPERO(ID CRD42022313259)and PRISMA guidelines were followed.The National Institutes of Health quality assessment tool was used to assess the quality of the studies.Pooled analysis was conducted using software Rev Man version 5.3.The stability of the results was assessed using sensitivity analysis.RESULTS Thirty-two studies with 43388 patients were included in the meta-analysis of whom 8538(20%)patients were observed to have NAFLD.There were 42254 patients from 28 studies included in the mortality analysis.A total of 2008 patients died from COVID-19;837(10.52%)in the NAFLD group and 1171(3.41%)in the non-NAFLD group.The odds ratio(OR)was 1.38 for mortality with a 95%confidence interval(95%CI)=0.97-1.95 and P=0.07.A total of 5043 patients from eight studies were included in the hospital length of stay analysis.There were 1318 patients in the NAFLD group and 3725 patients in the non-NAFLD group.A qualitative synthesis showed that the mean difference in hospital length of stay was about 2 d between the NAFLD and non-NAFLD groups with a 95%CI=0.71-3.27 and P=0.002.For hospitalization rates,the OR was 3.25 with a 95%CI of 1.73-6.10 and P=0.0002.For supplemental oxygen utilization,the OR was 2.04 with a 95%CI of 1.17-3.53 and P=0.01.CONCLUSION Our meta-analysis sugges

关键词： non-alcoholic fatty liver fatty liver Coronavirus COVID-19 Metabolic-associated fatty liver

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Redefining non-alcoholic fatty liver disease to metabolic associated fatty liver disease: Is this plausible?

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World Journal of Hepatology 2022年第1期14卷 158-167页

作者： Jalpa Devi Aimun Raees Amna Subhan Butt Department of Gastroenterology Liaquat University of Medical and Health SciencesJamshoro 74800Pakistan Department of Gastroenterology Aga Khan University HospitalKarachi 74800Pakistan

Recently,a single letter change has taken the world by storm.A group of experts have developed a consensus to upgrade the term non-alcoholic fatty liver disease(NAFLD)to metabolic associated fatty liver disease(MAFLD),suggesting that MAFLD would more accurately reflect not only the disease pathogenesis but would also help in patient stratification for management with NAFLD.However,the difference of opinion exists,which has made the NAFLD vs MAFLD debate the current talk of the town.This review will focus on the plausibility and implications of redefining NAFLD as MAFLD.

关键词： non-alcoholic fatty liver disease Metabolic associated fatty liver disease fatty liver disease non-alcoholic fatty liver Review

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Machine learning-based comparison of factors influencing estimated glomerular filtration rate in Chinese women with or without nonalcoholic fatty liver

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World Journal of Clinical Cases 2024年第15期12卷 2506-2521页

作者： I-Chien Chen Lin-Ju Chou Shih-Chen Huang Ta-Wei Chu Shang-Sen Lee Department of Nursing Kaohsiung Armed Forces General HospitalKaohsiung 802Taiwan Department of Obstetrics and Gynecology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Chief Executive Officer's Office MJ Health Research FoundationTaipei 114Taiwan Department of Urology Taichung Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationTaichung 427Taiwan School of Medicine Tzu Chi UniversityHualian 970Taiwan Department of Urology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND The prevalence of non-alcoholic fatty liver(NAFLD)has increased recently.Subjects with NAFLD are known to have higher chance for renal function impairment.Many past studies used traditional multiple linear regression(MLR)to identify risk factors for decreased estimated glomerular filtration rate(eGFR).However,medical research is increasingly relying on emerging machine learning(Mach-L)methods.The present study enrolled healthy women to identify factors affecting eGFR in subjects with and without NAFLD(NAFLD+,NAFLD-)and to rank their importance.AIM To uses three different Mach-L methods to identify key impact factors for eGFR in healthy women with and without NAFLD.METHODS A total of 65535 healthy female study participants were enrolled from the Taiwan MJ cohort,accounting for 32 independent variables including demographic,biochemistry and lifestyle parameters(independent variables),while eGFR was used as the dependent variable.Aside from MLR,three Mach-L methods were applied,including stochastic gradient boosting,eXtreme gradient boosting and elastic net.Errors of estimation were used to define method accuracy,where smaller degree of error indicated better model performance.RESULTS Income,albumin,eGFR,High density lipoprotein-Cholesterol,phosphorus,forced expiratory volume in one second(FEV1),and sleep time were all lower in the NAFLD+group,while other factors were all significantly higher except for smoking area.Mach-L had lower estimation errors,thus outperforming MLR.In Model 1,age,uric acid(UA),FEV1,plasma calcium level(Ca),plasma albumin level(Alb)and T-bilirubin were the most important factors in the NAFLD+group,as opposed to age,UA,FEV1,Alb,lactic dehydrogenase(LDH)and Ca for the NAFLD-group.Given the importance percentage was much higher than the 2nd important factor,we built Model 2 by removing age.CONCLUSION The eGFR were lower in the NAFLD+group compared to the NAFLD-group,with age being was the most important impact factor in both groups of healthy Chinese women,followed by LDH,UA,FEV1 and

关键词： non-alcoholic fatty liver Estimated glomerular filtration rate Machine learning Chinese women

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Sini powder ameliorates the inflammatory response in rats with stress-induced non-alcoholic fatty liver disease by inhibiting the nuclear factor kappa-B/pyrin domain-containing protein 3 pathway

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Journal of Traditional Chinese Medicine 2020年第2期40卷 253-266页

作者： Mu Jie Cheng Fafeng Wang Qingguo Wang Xueqian Zhu Wenxiang Ma Chongyang Yin Xiangjun Ren Beida Lian Yajun Du Xin Zhang Haixia Liu Shuling Zhang Shuang Teaching and Research Office of Clinical Foundation of Chinese Medicine School of Basic MedicineInnovation Team of"Basic Research on the Application of Classical Formulas"Beijing University of Chinese MedicineBeijing 100029China

OBJECTIVE: To evaluate the effectiveness of Sini powder for the treatment of non-alcoholic fatty liver disease(NAFLD) in rats and the molecular mechanisms involved.METHODS: A rat model of stress-induced NAFLD was established by a combination of long-term tethering and feeding of a high-fat, high-calorie diet. These rats were then intragastrically administered with either simvastatin, Sini powder, or vehicle for 1 week. The body mass and field test scores for each group were recorded weekly. Serum aspartate aminotransferase and alanine aminotransferase activities, and triglyceride, total cholesterol,and free fatty acid concentrations were measured.liver tissue histopathology was examined on hematoxylin and eosin-stained paraffin sections and oil red O-stained frozen sections. The hepatic m RNA expression of nuclear factor kappa-B(NF-κB),NOD-, LRR-, and pyrin domain-containing protein 3(NLRP3), apoptosis-associated speck-like protein containing CARD(ASC), and caspase-1 were measured by reverse transcription-polymerase chain reaction(RT-PCR). The hepatic protein concentrations of NF-κB and NLRP3, ASC, caspase-1, interleukin-1β(IL-1β), interleukin-6(IL-6), and the serum concentrations of IL-1β and IL-6 were measured by enzyme-linked immunosorbent assay.RESULTS: Compared with the Blank group, rats in the Compound model group showed significant pathologic manifestations of NAFLD, and the expression of NF-κB, NLRP3, ASC, caspase-1, IL-1βand IL-6 were significantly higher(all P < 0.01). Both simvastatin and Sini powder significantly ameliorated the NAFLD pathology and the abnormal expression of NF-κB, NLRP3, ASC, caspase-1, IL-1β, and IL-6(all P < 0.01).CONCLUSION: Sini powder inhibits the inflamma-tory response in rats with NAFLD, which is mediated by NF-κB/NLRP3, IL-1β, and IL-6, reduces the effects of psychological stress, and improves lipid metabolism. Therefore, Sini powder may be effective for the treatment of stress-related NAFLD through multiple mechanisms.

关键词： non-alcoholic fatty liver Stress,psychological NLR family,pyrin domain-containing 3 protein NF-kappa B Interleukins Sini powder

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Effect of Tiaozhi Yanggan Decoction(调脂养肝汤)in Treating Patients with non-alcoholic fatty liver

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Chinese Journal of Integrative Medicine 2007年第4期13卷 275-279页

作者：谷灿立张运克付月箫杨韶峰李新强 People's Hospital of Ruyang County Henan Province The First Affiliated Hospital of Henan College of Traditional Chinese Medicine Traditional Chinese Medicine Hospital of Ruyang County Henan Province

Objective： To observe the clinical efficacy and safety of Tiaozhi Yanggan Decoction （调脂养肝汤,TZYGD） in treating non-alcoholic fatty liver. Methods： One hundred and thirty-eight patients were enrolled and randomized into two groups according to the random number table in a ratio of 3：1, with 8 cases eventually dropping out. The symptoms, signs, liver function markers, blood lipids, iconographic indices and clinical comprehensive efficacy after a 12-week treatment course were assessed in 101 patients treated with TZYGD in the treated group and 29 patients treated with Thiola in the control group. Results： The total effective rate in the treated group and the control group was 81.19% and 68.97%, respectively, showing a significant difference between the two groups with the former being significantly higher than the latter （P〈0.05）. Moreover, the improvements in the symptoms, signs, liver function, blood lipids and iconographic indices in the treated group were favorable with no serious adverse reactions. Conclusion： TZYGD is effective and highly safe in treating non-alcoholic fatty liver.

关键词： non-alcoholic fatty liver Tiaozhi Yanggan decoction traditional Chinese medicine therapy efficacy assessment

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A Cross Sectional Study on the Correlation between Waist Circumference and fatty liver on Ultrasonography among non-alcoholic Filipino Adults

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Open Journal of Endocrine and Metabolic Diseases 2023年第1期13卷 1-16页

作者： Arriza Kryssan S. Monjardin-Soria Chong Hua Hospital Cebu City Philippines

Objectives: This study aimed to determine the correlation between waist circumference and fatty liver on ultrasonography among non-alcoholic Filipino adults. This will aid in detecting non-alcoholic fatty liver disease in its early course, hence improving our current therapeutic recommendations in preventing and managing the adverse health outcomes of NAFLD. Methods and Materials: A cross-sectional study with a total of 65 recruited participants. The data collected were age, sex, waist-circumference, co-morbidities with maintenance medications, history of alcohol intake with emphasis on the quantity and duration, and history of drug intake. Waist circumference was measured and recorded. The presence of NAFLD was determined through a review of the ultrasonography results of all subjects. The demographic profile and waist circumference of all subjects were described using descriptive statistics. The chi-square test was utilized to test the independence of the NAFLD and WC in the quartile. Pearson correlation was used to determine the linear relationship between the variables. Pearson correlation coefficient was statistically significant at p 0.05. Results: Among the subjects, 26 (42%) presented with fatty liver based on ultrasonography, 15 (58%) and 11 (42%), males and females, respectively. The mean waist circumference of 97.5 ± 12.43 was significantly related to the fatty liver with a p-value of 0.0001. Waist circumference showed a positive correlation with the frequency of fatty liver on ultrasonography with p-values of 0.000755 (r = 0.590083) and 3.04366E—05 (r = 0.659143523), in males and females, correspondingly. The overall correlation between waist circumference and fatty liver on ultrasonography is statistically significant with a p-value of 4.10503E—08 (r = 0.634737127). Conclusion: One measure used to assess central obesity is waist circumference. In addition, it can also be utilized to assess risk for NAFLD since they are strongly correlated as reported in this study. Waist circumference cut-off values

关键词： non-alcoholic fatty liver Waist Circumference NAFLD

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Systematic review and meta-analysis of the research on the relationship between TCM constitution type and non-alcoholic fatty liver disease

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Journal of Hainan Medical University 2020年第18期26卷 46-50页

作者： Gai-Ya Gao Jing-Dong Xue Shaanxi university of traditional Chinese medicine xianyang 712046China Shaanxi provincial hospital of traditional Chinese medicine xi'an 710004China

Objective:Through literature research,the distribution of TCM constitution of nonalcoholic fatty liver(NAFLD)was discussed,the common constitution types of the disease were determined,and medical evidence was provided for the prevention and treatment of NAFLD by traditional Chinese medicine.Methods:The literatures on the correlation between NAFLD and TCM constitution published in domestic journals from the database establishment to April 2020 were searched with"non-alcoholic fatty liver disease and TCM constitution"as the search term,and screening,quality evaluation and data extraction were conducted according to the na exclusion criteria.Statistical software stata16.0 was used for meta analysis of the included literature.Results:Sixteen studies were included.The results showed that the proportions of TCM constitution types and 95%CI of NAFLD patients were phlegm-dampness0.28(0.24,0.31),moisture-heat0.16(0.13,0.20),qi-asthenia0.13(0.10,0.16),qi-stagnation0.11(0.06,0.17),qi-stagnation0.08(0.06,0.10),yi-stagnation0.08(0.06,0.10),yi--stagnation0.08(0.06,0.10),blood stasis0.07(0.04,0.08),yang-asthenia0.06(0.04,0.08),and special report 0.02(0.01,0.02).Conclusion:The common constitution types of patients with nonalcoholic fatty liver are phlegm-dam-pness,damp-heat,q-asthenia,and mild,especially phlegm-dampness,which are most closely related to nonalcoholic fatty liver.

关键词： non-alcoholic fatty liver TCM constitution Correlation System evaluation Meta analysis

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Is there a role of lipid-lowering therapies in the management of fatty liver disease?

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World Journal of Hepatology 2022年第1期14卷 119-139页

作者： Ismini Tzanaki Aris P Agouridis Michael S Kostapanos School of Medicine European University CyprusNicosiaCyprusNicosia 2404Cyprus School of Medicine European University CyprusNicosia 2404Cyprus General Medicine Addenbrooke's HospitalCambridge University HospitalsCambridge CB20QQUnited Kingdom

Atherogenic dyslipidemia is characterized by increased triglyceride-rich lipoproteins and low high-density lipoprotein cholesterol concentrations.It is highly prevalent in non-alcoholic fatty liver disease(NAFLD)and contributes to the increased cardiovascular risk associated with this condition.Alongside insulin resistance it plays an important pathogenetic role in NAFLD/non-alcoholic steatohepatitis(NASH)development and progression.It has been shown that cholesterol-lowering reduces cardiovascular risk more in NAFLD vs non-NAFLD high-risk individuals.This evidence highlights the importance of effective lipid modulation in NAFLD.In this narrative review the effects of the most commonly used lipid-lowering therapies on liver outcomes alongside their therapeutic implications in NAFLD/NASH are critically discussed.Preclinical and clinical evidence suggests that statins reduce hepatic steatosis,inflammation and fibrosis in patients with NAFLD/NASH.Most data are derived from observational and small prospective clinical studies using changes in liver enzyme activities,steatosis/fibrosis scores,and imaging evidence of steatosis as surrogates.Also,relevant histologic benefits were noted in small biopsy studies.Atorvastatin and rosuvastatin showed greater benefits,whereas data for other statins are scarce and sometimes conflicting.Similar studies to those of statins showed efficacy of ezetimibe against hepatic steatosis.However,no significant anti-inflammatory and anti-fibrotic actions of ezetimibe have been shown.Preclinical studies showed that fibrates through peroxisome proliferator-activated receptor(PPAR)αactivation may have a role in NAFLD prevention and management.Nevertheless,no relevant benefits have been noted in human studies.Species-related differences in PPARαexpression and its activation responsiveness may help explain this discrepancy.Omega-3 fatty acids reduced hepatic steatosis in numerous heterogeneous studies,but their benefits on hepatic inflammation and fibrosis have not been established.Promising pre

关键词： non-alcoholic fatty liver non-alcoholic steatohepatitis Statin Ezetimibe Fibrates ω-3 fatty acids Bile acid resins

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A meta-analysis of the treatment of nonalcoholic fatty liver by soothing the liver and strengthening the spleen

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Journal of Hainan Medical University 2020年第17期26卷 27-31页

作者： Gai-Ya Gao Jing-Dong Xue Shaanxi university of traditional Chinese medicine xianyang 712046China Shaanxi provincial hospital of traditional Chinese medicine xi'an 710004China

Objective:Through literature research,the distribution of TCM constitution of nonalcoholic fatty liver(NAFLD)was discussed,the common constitution types of the disease were determined,and medical evidence was provided for the prevention and treatment of NAFLD by traditional Chinese medicine.Methods:The literatures on the correlation between NAFLD and TCM constitution published in domestic journals from the database establishment to April 2020 were searched with"non-alcoholic fatty liver disease and TCM constitution"as the search term,and screening,quality evaluation and data extraction were conducted according to the na exclusion criteria.Statistical software stata16.0 was used for meta analysis of the included literature.Results:Sixteen studies were included.The results showed that the proportions of TCM constitution types and 95%CI of NAFLD patients were phlegm-dampness0.28(0.24,0.31),moisture-heat0.16(0.13,0.20),qi-asthenia0.13(0.10,0.16),qi-stagnation0.11(0.06,0.17),qi-stagnation0.08(0.06,0.10),yi-stagnation0.08(0.06,0.10),yi--stagnation0.08(0.06,0.10),blood stasis0.07(0.04,0.08),yang-asthenia0.06(0.04,0.08),and special report 0.02(0.01,0.02).Conclusion:The common constitution types of patients with nonalcoholic fatty liver are phlegm-dam-pness,damp-heat,q-asthenia and mild,especially phlegm-dampness,which are most closely related to nonalcoholic fatty liver.

关键词： non-alcoholic fatty liver TCM constitution Correlation System evaluation Meta analysis

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Preserved liver regeneration capacity after partial hepatectomy in rats with non-alcoholic steatohepatitis

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World Journal of Hepatology 2018年第1期10卷 8-21页

作者： David Haldrup Sara Heeboll Karen Louise Thomsen Kasper Jarlhelt Andersen Michelle Meier Frank Viborg Mortensen Jens Randel Nyengaard Stephen Hamilton-Dutoit Henning Gronbaek Department of Hepatology and Gastroenterology Aarhus University HospitalAarhus C DK-8000Denmark Department of Internal Medicine Randers Regional HospitalRanders NO DK-8930Denmark Department of Surgical Gastroenterology Aarhus University HospitalAarhus C DK-8000Denmark Stereology and Electron Microscopy Laboratory Centre for Stochastic Geometry and Advanced BioimagingAarhus University HospitalAarhus C DK-8000Denmark Institute of Pathology Aarhus University HospitalAarhus C DK-8000Denmark

AIM To evaluate the liver regeneration capacity(LRC) after partial hepatectomy(PH) in experimental non-alcoholic steatohepatitis(NASH).METHODS Fifty-four female rats were fed a high-fat, high-cholesterol diet(HFCD, 65% fat, 1% cholesterol) or standard diet(STD) for 16 wk. A 70% PH was performed and the animals were euthanised before PH or 2 or 5 d postPH. LRC was evaluated using: The total number of Ki-67 positive hepatocytes in the caudate lobe, N(Ki-67, lobe) evaluated in a stereology-based design, the regenerated protein ratio(RPR), prothrombin-proconvertin ratio(PP), and m RNA expression of genes related to regeneration.RESULTS The HFCD NASH model showed significant steatosis with ballooning and inflammation, while no fibrosis was present. Mortality was similar in HFCD and STD animals following PH. HFCD groups were compared to respective STD groups and HFCD animals had a significantly elevated alanine transaminase at baseline(P liver regeneration genes(e.g., hepatic growth factor) was higher at both day 2 and 5 post-PH in HFCD groups(P < 0.05).CONCLUSION NASH rats had a preserved LRC after hepatectomy when compared to STD rats. The methods and models of NASH are essential in understanding and evaluating LRC.

关键词： Rat non-alcoholic fatty liver non-alcoholic steatohepatitis liver regeneration Hepatectomy Ki-67 Gene expression

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