Background It is well known that the incidence of developing hepatocelluler carcinoma (HCC) is increased in liver cirrhosis of different etiologies. However, comparison of HCC incidence in various liver diseases has not yet been estimated. We surveyed this comparison. Methods The PubMed database was examined (1989‐2017) for studies published in English language regarding the prospective follow‐up results for the development of HCC in various liver diseases. A meta‐analysis was performed for each liver disease. Results The annual incidence (%) of HCC in the non‐cirrhotic stage and cirrhotic stage, and the ratio of HCC incidence in the cirrhotic stage/non‐cirrhotic stage were as follows. (a) hepatitis B virus liver disease: 0.37%→3.23% (8.73‐fold), (b) hepatitis C virus liver diseases: 0.68%→4.81% (7.07‐fold), (c) primary biliary cholangitis (0.26%→1.79%, 6.88‐fold), (d) autoimmune hepatitis (0.19%→0.53%, 2.79‐fold), and (e) NASH (0.03%→1.35%, 45.00‐fold). Regarding primary hemochromatosis and alcoholic liver diseases, only follow‐up studies in the cirrhotic stage were presented, 1.20% and 2.06%, respectively. Conclusions When the liver diseases advance to cirrhosis, the incidence of HCC is markedly increased. The development of HCC must be closely monitored by ultrasonography, magnetic resonance imaging, and computed tomography, irrespective of the different kinds of liver diseases.

Background. Iron overload syndromes include a wide spectrum of genetic and acquired conditions. Recent studies suggest suppressed hepcidin synthesis in the liver to be the molecular basis of hemochromatosis. However, a liver with acquired iron overload synthesizes an adequate amount of hepcidin. Thus, hepcidin could function as a biochemical marker for differential diagnosis of iron overload syndromes.Methods. We measured serum iron parameters and hepcidin-25 levels followed by sequencing HFE, HJV, HAMP, TFR2, and SLC40A1 genes in 13 Japanese patients with iron overload syndromes. In addition, we performed direct measurement of serum hepcidin-25 levels using liquid chromatography-tandem mass spectrometry in 3 Japanese patients with aceruloplasminemia and 4 Italians with HFE-hemochromatosis. Results.One patient with HJV-hemochromatosis, 2 with TFR2-hemochromatosis, and 3 with ferroportin disease were found among the 13 Japanese patients. The remaining 7 Japanese patients showed no evidence for genetic basis of iron overload syndrome. As far as the serum hepcidin-25 was concerned, seven patients with hemochromatosis and 3 with aceruloplasminemia showed markedly decreased serum hepcidin-25 levels. In contrast, 3 patients with ferroportin disease and 7 with secondary iron overload syndromes showed serum hepcidin levels parallel to their hyperferritinemia. Patients with iron overload syndromes were divided into 2 phenotypes presenting as low and high hepcidinemia. These were then associated with their genotypes. Conclusion.Determining serum hepcidin-25 levels may aid differential diagnosis of iron overload syndromes prior to genetic analysis. (231 words)

The GS group showed stronger anticancer activity than the G group, suggesting the need for a large randomized phase III study to confirm GS advantages in a specific subset.

ObjectiveSocial isolation is a risk factor for depression in older age. However, little is known regarding whether its impact varies depending on country-specific cultural contexts regarding social relationships. The present study examined the association of social isolation with depression onset among older adults in England, which has taken advanced measures against social isolation, and Japan, a super-aged society with a rapidly increasing number of socially isolated people.DesignProspective longitudinal study.SettingWe used data from two ongoing studies: the English Longitudinal Study of Ageing (ELSA) and the Japan Gerontological Evaluation Study (JAGES).ParticipantsOlder adults aged ≥65 years without depression at baseline were followed up regarding depression onset for 2 years (2010/2011–2012/2013) for the ELSA and 2.5 years (2010/2011–2013) for the JAGES.Primary outcome measureDepression was assessed with eight items from the Centre for Epidemiologic Studies Depression Scale for the ELSA and Geriatric Depression Scale for the JAGES. Multivariable logistic regression analysis was performed to evaluate social isolation using multiple parameters (marital status; interaction with children, relatives and friends; and social participation).ResultsThe data of 3331 respondents from the ELSA and 33 127 from the JAGES were analysed. Multivariable logistic regression analysis demonstrated that social isolation was significantly associated with depression onset in both countries. In the ELSA, poor interaction with children was marginally associated with depression onset, while in the JAGES, poor interaction with children and no social participation significantly affected depression onset.ConclusionsDespite variations in cultural background, social isolation was associated with depression onset in both England and Japan. Addressing social isolation to safeguard older adults’ mental health must be globally prioritised.

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