3.Non-alcoholic steatohepatitis and risk of hepatocellular carcinoma.
Rafael S RIOS ; Kenneth I ZHENG ; Ming-Hua ZHENG
Chinese Medical Journal 2021;134(24):2911-2921
The emergence of non-alcoholic fatty liver disease (NAFLD) as the leading chronic liver disease worldwide raises some concerns. In particular, NAFLD is closely tied to sedentary lifestyle habits and associated with other metabolic diseases, such as obesity and diabetes. At the end of the disease spectrum, non-alcoholic steatohepatitis (NASH) may progress to cirrhosis and hepatocellular carcinoma (HCC), representing a serious health problem to modern society. Recently, an increasing number of HCC cases originating from this progressive disease spectrum have been identified, with different levels of severity and complications. Updating the current guidelines by placing a bigger focus on this emerging cause and highlighting some of its unique features is necessary. Since, the drivers of the disease are complex and multifactorial, in order to improve future outcomes, having a better understanding of NASH progression into HCC may be helpful. The risks that can promote disease progression and currently available management strategies employed to monitor and treat NASH-related HCC make up the bulk of this review.
Carcinoma, Hepatocellular/etiology*
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Humans
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Liver Cirrhosis
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Liver Neoplasms/etiology*
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Non-alcoholic Fatty Liver Disease
;
Obesity
4.Research progress on the relationship between dietary patterns and metabolic-associated fatty liver disease.
Bing Qian ZHOU ; Qing Nan HE ; Chun Xiang QIN ; Jing LU ; Xiao Ni CHAI ; Jing Chi ZHU ; Ni GONG
Chinese Journal of Hepatology 2022;30(9):1012-1016
Globally, metabolic-asssociated fatty liver disease has become a significant health burden due to its complex pathogenesis, and there are no specific and effective therapeutic drugs to date. The onset and progression of metabolic-asssociated fatty liver disease is closely associated with improper dietary habits. The cornerstone to treat metabolic-asssociated fatty liver disease is weight loss through a well-balanced diet. This article summarizes and discusses the research progress at home and abroad in relationship to metabolic-asssociated fatty liver disease and dietary patterns such as the Mediterranean diet, the DASH diet, an energy-restricted balanced diet, a low fat diet, a low carbohydrate diet, a western diet, an animal food diet, a traditional diet, and others. In addition, it categorizes the effects of various dietary patterns on the prevention, treatment, or induction of several issues that need further metabolic-asssociated fatty liver disease research for subsequent reference.
Animals
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Non-alcoholic Fatty Liver Disease/etiology*
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Diet, Fat-Restricted
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Weight Loss
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Diet, Mediterranean
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Liver
5.Research advances in pediatric nonalcoholic fatty liver disease.
Chinese Journal of Contemporary Pediatrics 2015;17(1):107-112
In recent years, nonalcoholic fatty liver disease (NAFLD) has increased because of the growing prevalence of obesity and overweight in the pediatric population. It has become the most common form of chronic liver diseases in children and the related research on NAFLD is expanded. The "two-hit" and "multiple hit" hypothesis have been widely accepted, and some research has shown that genetic, diet structure and environmental factors appear to play a crucial role in the development of pediatric NAFLD. Though it is expected by researchers, there is not an available satisfactory noninvasive marker for the diagnosis of this disease. Fortunately, some new non-invasive prediction scores for pediatric NAFLD have been developed. There is currently no established special therapy, and lifestyle intervention should be adequate for most cases of NAFLD in children. This article reviews the advances in the current knowledge and ideas concerning pediatric NAFLD, and discusses the diagnosis, perspective therapies and scoring methods for this disease.
Child
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Humans
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Non-alcoholic Fatty Liver Disease
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diagnosis
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etiology
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genetics
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Polymorphism, Single Nucleotide
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Risk Factors
6.Not only baseline but cumulative exposure of remnant cholesterol predicts the development of nonalcoholic fatty liver disease: a cohort study.
Lei LIU ; Changfa WANG ; Zhongyang HU ; Shuwen DENG ; Saiqi YANG ; Xiaoling ZHU ; Yuling DENG ; Yaqin WANG
Environmental Health and Preventive Medicine 2024;29():5-5
BACKGROUND AND AIM:
Remnant cholesterol (remnant-C) mediates the progression of major adverse cardiovascular events. It is unclear whether remnant-C, and particularly cumulative exposure to remnant-C, is associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to explore whether remnant-C, not only baseline but cumulative exposure, can be used to independently evaluate the risk of NAFLD.
METHODS:
This study included 1 cohort totaling 21,958 subjects without NAFLD at baseline who underwent at least 2 repeated health checkups and 1 sub-cohort totaling 2,649 subjects restricted to those individuals with at least 4 examinations and no history of NAFLD until Exam 3. Cumulative remnant-C was calculated as a timeweighted model for each examination multiplied by the time between the 2 examinations divided the whole duration. Cox regression models were performed to estimate the association between baseline and cumulative exposure to remnant-C and incident NAFLD.
RESULTS:
After multivariable adjustment, compared with the quintile 1 of baseline remnant-C, individuals with higher quintiles demonstrated significantly higher risks for NAFLD (hazard ratio [HR] 1.48, 95%CI 1.31-1.67 for quintile 2; HR 2.07, 95%CI 1.85-2.33 for quintile 3; HR 2.55, 95%CI 2.27-2.88 for quintile 4). Similarly, high cumulative remnant-C quintiles were significantly associated with higher risks for NAFLD (HR 3.43, 95%CI 1.95-6.05 for quintile 2; HR 4.25, 95%CI 2.44-7.40 for quintile 3; HR 6.29, 95%CI 3.59-10.99 for quintile 4), compared with the quintile 1.
CONCLUSION
Elevated levels of baseline and cumulative remnant-C were independently associated with incident NAFLD. Monitoring immediate levels and longitudinal trends of remnant-C may need to be emphasized in adults as part of NAFLD prevention strategy.
Adult
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Humans
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Cohort Studies
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Non-alcoholic Fatty Liver Disease/etiology*
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Cholesterol
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Proportional Hazards Models
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Risk Factors
7.Assessment of fibrosis during the development of fatty liver in rabbits using real-time shear-wave elastography.
Yong-ping LU ; Jia WEI ; Li-rong XU ; Yue-yue TANG ; Yuan YUAN ; Yong ZHANG ; Yun-yan LI
Journal of Huazhong University of Science and Technology (Medical Sciences) 2014;34(6):921-928
Nonalcoholic and alcoholic rabbit models of fatty liver were established by feeding on high-fat diet and alcohol, respectively, and fatty liver stiffness at different pathological stages was assessed with real-time shear-wave elastography (SWE), so as to investigate the fibrosis process during the development of fatty liver. The fatty liver stiffness of rabbit in nonalcoholic and alcoholic groups was higher than that in the control group, and that in alcohol group was higher than that in the nonalcoholic group (P<0.01). The elasticity modulus of liver in fatty liver rabbits of nonalcoholic and alcoholic groups showed a positive correlation with progression of liver fibrosis (P<0.01). Real-time SWE, as a noninvasive diagnostic method, can objectively reflect the liver stiffness change and progression of liver fibrosis during the development of fatty liver.
Animals
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Elasticity
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Elasticity Imaging Techniques
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methods
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Fatty Liver, Alcoholic
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complications
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diagnostic imaging
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Liver Cirrhosis
;
diagnostic imaging
;
etiology
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Male
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Non-alcoholic Fatty Liver Disease
;
complications
;
diagnostic imaging
;
Rabbits
8.Uncoupling protein and nonalcoholic fatty liver disease.
Xi JIN ; Zun XIANG ; Yi-peng CHEN ; Kui-fen MA ; Yue-fang YE ; You-ming LI
Chinese Medical Journal 2013;126(16):3151-3155
OBJECTIVETo review the current advances on the role of uncoupling protein (UCP) in the pathogenesis and progress of nonalcoholic fatty liver disease (NAFLD).
DATA SOURCESA comprehensive search of the PubMed literature without restriction on the publication date was carried out using keywords such as UCP and NAFLD.
STUDY SELECTIONArticles containing information related to NAFLD and UCP were selected and carefully analyzed.
RESULTSThe typical concepts, up-to-date findings, and existing controversies of UCP2 in NAFLD were summarized. Besides, the effect of a novel subtype of UCP (hepatocellular down regulated mitochondrial carrier protein, HDMCP) in NAFLD was also analyzed. Finally, the concept that any mitochondrial inner membrane carrier protein may have, more or less, the uncoupling ability was reinforced.
CONCLUSIONSConsidering the importance of NAFLD in clinics and UCP in energy metabolism, we believe that this review may raise research enthusiasm on the effect of UCP in NAFLD and provide a novel mechanism and therapeutic target for NAFLD.
Animals ; Fatty Acids, Nonesterified ; metabolism ; Fatty Liver ; etiology ; metabolism ; Humans ; Ion Channels ; physiology ; Mitochondrial Proteins ; analysis ; chemistry ; physiology ; Non-alcoholic Fatty Liver Disease ; Uncoupling Protein 2
9.The key target of Chinese medicine treatment on alcoholic and nonalcoholic fatty liver disease: the gut.
Yi-yang HU ; Jing-hua PENG ; Qin FENG
Chinese Journal of Integrated Traditional and Western Medicine 2011;31(9):1269-1272
In recent years, the pathogenesis of "gut-liver axis" in alcoholic and nonalcoholic fatty liver disease has attracted more attention in this field. In this paper, the relationship among fatty liver, gut-permeability, gut-derived endotoxin, and gut microbiota was systematically clarified. Based on the researches of treatment and prevention of fatty liver and gut injury by Chinese medicine, the gut is believed as the curative target for fatty liver disease, which not only is the modern annotation for the Chinese medicine practice, but also might possibly become an important view angle and strategy for fatty liver disease treatment.
Drugs, Chinese Herbal
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administration & dosage
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therapeutic use
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Fatty Liver
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etiology
;
therapy
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Gastrointestinal Tract
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Humans
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Medicine, Chinese Traditional
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methods
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Non-alcoholic Fatty Liver Disease
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Phytotherapy
;
methods
10.Comparison of time trends in the incidence of primary liver cancer between China and the United States: an age-period-cohort analysis of the Global Burden of Disease 2019.
Zhiyong ZOU ; Zuofeng ZHANG ; Ce LU ; Hui WANG
Chinese Medical Journal 2022;135(17):2035-2042
BACKGROUND:
China and the United States (US) ranked first and third in terms of new liver cancer cases and deaths globally in 2020. Therefore, a comprehensive assessment of trends in the incidence of primary liver cancer with four major etiological factors between China and the US during the past 30 years with age-period-cohort (APC) analyses is warranted.
METHODS:
Data were obtained from the Global Burden of Disease 2019, and period/cohort relative risks were estimated by APC modeling from 1990 to 2019.
RESULTS:
In 2019, there were 211,000 new liver cancer cases in China and 28,000 in the US, accounting for 39.4% and 5.2% of global liver cancer cases, respectively. For China, the age-standardized incidence rate (ASIR) consecutively decreased before 2005 but increased slightly since then, whereas the ASIR continuously increased in the US. Among the four etiological factors of liver cancer, the fastest reduction in incidence was observed in hepatitis B virus-related liver cancer among Chinese women, and the fastest increase was in nonalcoholic steatosis hepatitis (NASH)-related liver cancer among American men. The greatest reduction in the incidence of liver cancer was observed at the age of 53 years in Chinese men (-5.2%/year) and 33 years in Chinese women (-6.6%/year), while it peaked at 58 years old in both American men and women (4.5%/year vs . 2.8%/year). Furthermore, the period risks of alcohol- and NASH-related liver cancer among Chinese men have been elevated since 2013. Simultaneously, leveled- off period risks were observed in hepatitis C viral-related liver cancer in both American men and women.
CONCLUSIONS
Currently, both viral and lifestyle factors have been and will continue to play an important role in the time trends of liver cancer in both countries. More tailored and efficient preventive strategies should be designed to target both viral and lifestyle factors to prevent and control liver cancer.
Male
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Humans
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United States/epidemiology*
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Female
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Middle Aged
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Incidence
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Global Burden of Disease
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Non-alcoholic Fatty Liver Disease/complications*
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Cohort Studies
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Liver Neoplasms/etiology*
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China/epidemiology*