Metabolic syndrome and severity of fibrosis in nonalcoholic fatty liver disease: An age‐dependent risk profiling study

Petta, Salvatore; Eslam, Mohammed; Valenti, Luca; Bugianesi, Elisabetta; Barbàra, Marco; Cammà, Calogero; Porzio, Marianna; Rosso, Chiara; Fargion, Silvia; George, Jacob; Craxı̀, Antonio

doi:10.1111/liv.13397

Cited by 48 publications

(55 citation statements)

References 39 publications

(105 reference statements)

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“…Previous studies have reported that an increase in liver stiffness is independently associated with metabolic syndrome in the general population 29 and that visceral obesity and diabetes are associated with severe hepatic fibrosis. 30 Thus, the present findings are consistent with previous findings. Petta et al reported that low HDL cholesterol is associated with severe hepatic fibrosis.…”

Section: Discussionsupporting

confidence: 94%

“…Furthermore, of the four components of metabolic syndrome, the presence of central obesity, and an elevation of blood pressure and fasting plasma glucose levels were associated with an increase in advanced hepatic fibrosis. Previous studies have reported that an increase in liver stiffness is independently associated with metabolic syndrome in the general population and that visceral obesity and diabetes are associated with severe hepatic fibrosis . Thus, the present findings are consistent with previous findings.…”

Section: Discussionsupporting

confidence: 93%

“…Petta et al . reported that low HDL cholesterol is associated with severe hepatic fibrosis . However, in our study, there was no association between dyslipidemia and the prevalence of advanced hepatic fibrosis.…”

Section: Discussioncontrasting

confidence: 84%

“…Although the reason for this discrepancy remains unclear, it might be influenced by the ethnic differences of the participants. Caucasian patients were enrolled in the previous study and Asian patients were enrolled in the present study. Caucasians have a high prevalence of visceral obesity, which might differ from the prevalence in the general population, especially in Asians .…”

Section: Discussionmentioning

confidence: 99%

“…Caucasian patients were enrolled in the previous study and Asian patients were enrolled in the present study. Caucasians have a high prevalence of visceral obesity, which might differ from the prevalence in the general population, especially in Asians . In fact, the prevalence of central obesity was 63.5% in the previous study, which is approximately twice the prevalence in the present study …”

Section: Discussionmentioning

confidence: 99%

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Profiles of advanced hepatic fibrosis evaluated by FIB‐4 index and shear wave elastography in health checkup examinees

Yamamura

Kawaguchi

Nakano

et al. 2019

Hepatology Research

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Aim Advanced hepatic fibrosis is seen in individuals with potential hepatocellular carcinoma and cardiovascular disease. Hepatic fibrosis can be assessed using a combination of the FIB‐4 index and imaging modalities, including shear wave elastography. We aimed to investigate the prevalence of advanced fibrosis in the general population and the profiles associated with advanced fibrosis using a data‐mining analysis. Methods We enrolled 1155 health checkup examinees (median age 53 years, 685 women, 470 male). Advanced fibrosis was defined by FIB‐4 index ≥1.3 and liver stiffness ≥8.07 kPa using shear wave elastography. Participants were classified as normal‐mild fibrosis (n = 1035) or advanced fibrosis (n = 120). Factors associated with advanced fibrosis were analyzed by logistic regression and decision‐tree analyses. Results Advanced fibrosis was observed in 10.4% of participants (120/1155). In the logistic regression analysis, independent factors for advanced fibrosis were age (≥75 years; OR 2.12, 95% CI 1.021–4.415; P = 0.0419) and the presence of metabolic syndrome (OR 2.51, 95% CI 1.416–4.462; P = 0.0017). The decision‐tree analysis showed two profiles associated with advanced fibrosis: profile 1 – individuals aged ≥65 years with metabolic syndrome and mild‐to‐moderate alcohol consumption (prevalence of advanced fibrosis 73.3%); and profile 2 – individuals without metabolic syndrome, aged ≥75 years, with no exercise habit (prevalence of advanced fibrosis 56.3%). Conclusions Advanced fibrosis was observed in 10.4% of health checkup examinees. Furthermore, we showed that aging, metabolic syndrome with mild‐to‐moderate alcohol consumption, and physical inactivity were associated with advanced fibrosis. Thus, prevention of metabolic syndrome and alcohol withdrawal, as well as exercise habits, might inhibit the progression of hepatic fibrosis.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Profiles of advanced hepatic fibrosis evaluated by FIB‐4 index and shear wave elastography in health checkup examinees

Yamamura

Kawaguchi

Nakano

et al. 2019

Hepatology Research

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Translation Reprogramming as a Novel Therapeutic Target in MAFLD

et al. 2022

Self Cite

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Approved pharmacotherapies for metabolic‐dysfunction‐associated fatty liver disease (MAFLD) are lacking. Novel approaches and therapeutic targets that are likely to translate to clinical benefit are required. Targeting components of the translation machinery hold promise as a novel therapeutic approach that can overcome the well‐known disease heterogeneity, as dysregulation of mRNA translation is a common feature independent of the MAFLD drivers. In this perspective, recent advances in understanding the role of mRNA translation in MAFLD are discussed, with a particular focus on the potential implications and challenges to “translate” these findings to the clinic, and an overview of similar recent efforts in other diseases is provided.

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Multidirectional facets of obesity management in the metabolic syndrome population after liver transplantation

Czarnecka

Tronina

et al. 2021

Immunity Inflam & Disease

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The obesity pandemic has resulted in an increasing demand for liver transplantation and has significantly altered the profile of liver transplant candidates in addition to affecting posttransplantation outcomes. In this review, we discuss a broad range of clinical approaches that warrant attention to provide comprehensive and patient-centred medical care to liver transplant recipients, and to be prepared to confront the rapidly changing clinical challenges and ensuing dilemmas. Adipose tissue is a complex and metabolically active organ. Visceral fat deposition is a key predictor of overall obesity-related morbidity and mortality. Limited pharmacological options are available for the treatment of obesity in the liver transplant population. Bariatric surgery may be an alternative in eligible patients. The rapidly increasing prevalence of nonalcoholic fatty liver disease (NAFLD) is a global concern; NAFLD affects both pre-and posttransplantation outcomes. Numerous studies have investigated pharmacological and nonpharmacological management of NAFLD and some of these have shown promising results. Liver transplant recipients are constantly exposed to numerous factors that result in intestinal microbiota alterations, which were linked to the development of obesity, diabetes type 2, metabolic syndrome (MS), NAFLD, and hepatocellular cancer. Microbiota modifications with probiotics and prebiotics bring gratifying results in the management of metabolic complications. Fecal microbiota transplantation (FMT) is successfully performed in many medical indications. However, the safety and efficacy profiles of FMT in immunocompromised patients remain unclear. Obesity together with immunosuppressive treatment, may affect the pharmacokinetic and/ or pharmacodynamic properties of coadministered medications. Individualized immunosuppressive regimens are recommended following liver transplantation to address possible metabolic concerns. Effective and comprehensive management of metabolic complications is shown to yield multiple beneficial results in the liver transplant population and may bring gratifying results in improving long-term survival rates.

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Metabolic syndrome and severity of fibrosis in nonalcoholic fatty liver disease: An age‐dependent risk profiling study

Cited by 48 publications

References 39 publications

Profiles of advanced hepatic fibrosis evaluated by FIB‐4 index and shear wave elastography in health checkup examinees

Profiles of advanced hepatic fibrosis evaluated by FIB‐4 index and shear wave elastography in health checkup examinees

Translation Reprogramming as a Novel Therapeutic Target in MAFLD

Multidirectional facets of obesity management in the metabolic syndrome population after liver transplantation

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