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Association between serumα-L-fucosidase andnon-alcoholic fatty liver disease:Cross-sectional study

World Journal of Gastroenterology 2016年第5期22卷 1884-1890页

作者： Zhen-ya Lu Chao Cen Zhou Shao Xin-hua Chen Cheng-fu Xu You-ming Li Department of Internal Medicine the First Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009Zhejiang ProvinceChina Division of Hepatobiliary and Pancreatic Surgery Department of Surgerythe First Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009Zhejiang ProvinceChina Department of Gastroenterology the First Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

AIM: To explore the association between serum α-Lfucosidase(Af U) and non-alcoholic fatty liver disease(NAf LD).METHODS: A total of 16473 individuals(9456 men and 7017 women) were included in the current study, who presented for a health examination at the first Affiliated hospital of Zhejiang University School of medicine in 2014. The baseline characteristics of the cohort were compared by NAf LD status. Linear regression analysis and stepwise multiple regression analysis were applied to assess the risk factors for NAf LD. Receiver operating characteristic curve was used to determine the sensitivity and specificity of Af U in the diagnosis of NAf ***: The prevalence rates of NAf LD and metabolic syndrome(met S) were 38.0% and 25.4%, respectively. The NAf LD group had significantly higher Af U levels than the non-NAf LD group(28.7 ± 7.9 U/L vs 26.0 ± 7.3 U/L, P < 0.001) and the prevalence rate of NAf LD increased with progressively higher serum Af U levels. Af U was positively correlated with met S and its five components: central obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, and elevated blood pressure and fasting glucose. Stepwise multiple logistic regression analysis showed that Af U was associated with an increased risk of NAf LD(OR = 1.009, 95%CI: 1.003-1.014, P < 0.001). The best cut-off value of Af U for the diagnosis of NAf LD was 27.5 U/L. The area under the curve(diagnostic efficacy index) was 0.606. The sensitivity and specificity were 54.6% and 61.8%, respectively. CONCLUSION: Af U level is significantly associated with NAf LD, and elevated Af U level is an independent risk factor for NAf LD.

关键词： α-L-fucosidase Biomarker non-alcoholicfatty liver disease metabolic syndrome Cross-sectionalstudy

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Histopathological differences utilizing the nonalcoholic fatty liver disease activity score criteria in diabetic(type 2 diabetes mellitus) and non-diabetic patients with nonalcoholic fatty liver disease

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World Journal of Hepatology 2015年第25期7卷 2610-2618页

作者： Bharat K Puchakayala Siddharth Verma Pushpjeet Kanwar John Hart Raghavendra R Sanivarapu Smruti R Mohanty Center for Liver Diseases Division of Gastroenterology and HepatologyNew York Methodist Hospital at Weill Cornell Medical College Department of Pathology University of Chicago Medical Center

AIM: To study clinical and histopathological features of nonalcoholic fatty liver disease(NAFLD) in patients with and without type 2 diabetes mellitus(T2DM) using updated nonalcoholic steatohepatitis clinical research network(NASH-CRN) grading ***: We retrospectively analyzed data of 235 patients with biopsy proven NAFLD with and without T2 *** database was utilized in the previously published study comparing ethnicity outcomes in NAFLD by the same corresponding *** pathology database from University of Chicago was utilized for enrolling consecutive patients who met the criteria for NAFLD and their detailed clinical and histopathology findings were obtained for *** relevant clinical profile of patients was collected from the Electronic Medical Records around the time of liver biopsy and the histology was read by a single well-trained *** updated criteria for type 2 diabetes have been utilized for *** data of patients with NASH and NAFLD has been *** mean differences were compared using χ2 and t-test along with regression analysis to evaluate the predictors of NASH and advanced ***: Patients with NAFLD and T2 DM were significantly older(49.9 vs 43.0,P < 0.01),predominantly female(71.4 vs 56.3,P < 0.02),had higher rate of metabolic syndrome(88.7 vs 36.4,P < 0.01),had significantly higher aspartate transaminase(AST)/alanine transaminase(ALT) ratio(0.94 vs 0.78,P < 0.01) and Fib-4 index(1.65 vs 1.06,P < 0.01) as markers of NASH,showed higher mean NAFLD activity score(3.5 vs 3.0,P = 0.03) and higher mean fibrosis score(1.2 vs 0.52,P < 0.01) compared to patients with NAFLD without T2 ***,advanced fibrosis(32.5 vs 12.0,P < 0.01) and ballooning(27.3 vs 13.3,P < 0.01) was significantly higher among patients with NAFLD and T2 DM compared to patients with NAFLD without T2 *** multivariate analysis,T2 DM was independently associated with NASH(OR = 3.27,95%CI: 1.43-7.50,P < 0.01)

关键词： non-alcoholic steatohepatitis non-alcoholicfatty liver disease Advanced fibrosis non-alcoholicfatty live

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non-alcoholic fatty liver disease in 2015

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World Journal of Hepatology 2015年第11期7卷 1450-1459页

作者： Monjur Ahmed Division of Gastroenterology and Hepatology Department of Internal Medicine Thomas Jefferson University

There is worldwide epidemic of non-alcoholic fatty liver disease(NAFLD). NAFLD is a clinical entity related to metabolic syndrome. Majority of the patients are obese but the disease can affect non-obese individuals as well. Metabolic factors and genetics play important roles in the pathogenesis of this disorder. The spectrum of disorders included in NAFLD are benign macrovesicular hepatic steatosis, non-alcoholic steatohepatitis, hepatic fibrosis, cirrhosis of liver and hepatocellular carcinoma. Although the disease remains asymptomatic most of the time, it can slowly progress to end stage liver disease. It will be the most common indication of liver transplantation in the future. It is diagnosed by abnormal liver chemistry, imaging studies and liver biopsy. As there are risks of potential complications during liver biopsy, many patients do not opt for liver biopsy. There are some noninvasive scoring systems to find out whether patients have advanced hepatic fibrosis. At the present time, there are limited treatment options which include lifestyle modification to loose weight, vitamin E and thioglitazones. Different therapeutic agents are being investigated for optimal management of this entity. There are some studies done on incretin based therapies in patients with NAFLD. Other potential agents will be silent information regulator protein Sirtuin and antifibrotic monoclonal antibody Simtuzumab against lysyl oxidase like molecule 2. But they are still in the investigational phase.

关键词： Fatty liver Hepatic steatosis non-alcoholicfatty liver disease non-alcoholic steatohepatitis

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“Weighing the risk”: Obesity and outcomes following liver transplantation

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World Journal of Hepatology 2015年第11期7卷 1484-1493页

作者： Trevor W Reichman George Therapondos Maria-Stella Serrano John Seal Rachel Evers-Meltzer Humberto Bohorquez Ari Cohen Ian Carmody Emily Ahmed David Bruce George E Loss Multi-Organ Transplant Institute Ochsner Medical Center

Obesity is on the rise worldwide. As a result, unprecedented rates of patients are presenting with end stage liver disease in the setting of non-alcoholic fatty liver disease(NAFLD) and are requiring liver transplantation. There are significant concerns that the risk factors associated with obesity and the metabolic syndrome might have a detrimental effect on the long term outcomes following liver transplantation. In general, short term patient and graft outcomes for both obese and morbidly obese patients are comparable with that of non-obese patients, however, several studies report an increase in peri-operative morbidity and increased length of stay. Continued studies documenting the long-term outcomes from liver transplantation are needed to further examine the risk of recurrent disease(NAFLD) and also further define the role risk factors such cardiovascular disease might play long term. Effective weight reduction in the post liver transplant setting may mitigate the risks associated with the metabolic syndrome long-term.

关键词： End stage liver disease Obesity Morbidobesity non-alcoholic steatohepatitis non-alcoholicfatty liver disease Cirrhosis Liver transplantation

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Hepatic glycogenosis: An underdiagnosed complication of diabetes mellitus?

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World Journal of Diabetes 2015年第2期6卷 321-325页

作者： María Teresa Julián Núria Alonso Isabel Ojanguren Eduarda Pizarro Enric Ballestar Manel Puig-Domingo Department of Medicine Universitat Autònoma de Barcelona Department of Endocrinology Hospital de Mataró Department of Pathology Hospital Germans Trias i Pujol

Hepatic glycogenosis(HG) is characterized by excessive glycogen accumulation in hepatocytes and represents a hepatic complication of diabetes that particularly occurs in patients with longstanding poorly controlled type 1 diabetes(T1D). HG has been reported to be a very rare disease, although it is believed to be extremely underdiagnosed because it is not possible to distinguish it from non-alcoholic fatty liver disease(NAFLD) unless a liver biopsy is performed. In contrast to HG, NAFLD is characterized by liver fat accumulation and is the more likely diagnosis for patients with type 2 diabetes and metabolic syndrome. The pathogenesis of HG involves the concomitant presence of insulin and excess glucose, which increases glycogen storage in the liver. HG is characterized by a transient elevation in liver transaminases and hepatomegaly. Differentiating between these two conditions is of the utmost importance because HG is a benign disease that is potentially reversible by improving glycemic control, whereas NAFLD can progress to cirrhosis. Therefore, HG should be suspected when liver dysfunction occurs in patients with poorly controlled T1 D. The aim of this article is to review the epidemiology, clinical characteristics, pathogenesis and histology of HG.

关键词： Hepatic complications Diabetes mellitus Type 1 diabetes Hepatic glycogenosis non-alcoholicfatty liver disease

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