Association Between Urinary Alpha1-Microglobulin Levels and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

Zhang, Juanwen; Zhang, Xu-Yao; Zhao, Ying; Lv, Guoliang

doi:10.1159/000484255

Cited by 8 publications

(4 citation statements)

References 48 publications

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“…A cross-sectional study demonstrated a significant correlation between urinary α1m levels and MAFLD, suggesting its potential as a non-invasive diagnostic biomarker and a screening tool for identifying advanced fibrosis. Furthermore, these findings indicated that urinary α1m could also contribute to the early detection of kidney injury beyond eGFR [79]. However, the current study did not find significant changes in α1m/Cr levels in MAFLD patients following an intervention aimed at reducing IFC.…”

Section: Discussioncontrasting

confidence: 74%

Effects of a Two-Year Lifestyle Intervention on Intrahepatic Fat Reduction and Renal Health: Mitigation of Inflammation and Oxidative Stress, a Randomized Trial

Quetglas-Llabrés,

Monserrat-Mesquida,

Bouzas

et al. 2024

Antioxidants

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Metabolic-associated fatty liver disease (MAFLD) is the most common chronic liver disease observed in clinical practice worldwide. This disorder has been independently associated with an increased risk of developing chronic kidney disease (CKD). The aim of this study was to evaluate whether a 2-year intervention based on a Mediterranean diet (MedDiet) and physical activity focussed on reducing intrahepatic fat contents (IFC) was associated with a decreased risk of CKD. Forty adults (50% women) residing in Mallorca, aged 48 to 60 years, diagnosed with MAFLD were recruited. Participants were divided into two groups based on whether they improved IFC measured by nuclear magnetic resonance. Anthropometric and clinical parameters improved in responders, including reduced weight, body mass index (BMI), and waist circumference. Only responders showed improvements in lipid profile and liver enzymes. Haematological parameters showed favourable changes in both groups. Oxidative stress and inflammatory biomarkers differed between groups. Responders had lower plasma interleukine-18 (IL-18) levels, but higher erythrocyte malonaldehyde (MDA) levels. Non-responders showed increased erythrocyte catalase and superoxide dismutase activity. After 2 years, non-responders had higher serum creatinine, Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) levels, while responders showed reductions in these parameters together with uric acid and urine albumin-to-creatinine ratio (UACR). Positive correlations were found between changes in IFC and kidney injury biomarkers, including MDRD and serum creatinine levels. In conclusion, a healthy diet based on the Mediterranean dietary pattern and lifestyle promotes significant improvements in parameters related to cardiovascular, hepatic, and renal health.

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Section: Discussioncontrasting

confidence: 74%

Effects of a Two-Year Lifestyle Intervention on Intrahepatic Fat Reduction and Renal Health: Mitigation of Inflammation and Oxidative Stress, a Randomized Trial

Quetglas-Llabrés,

Monserrat-Mesquida,

Bouzas

et al. 2024

Antioxidants

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“…α1-Microglobulin (A1M) is a 26 kDa plasma and tissue protein, which is mainly synthesized in the liver, but also in smaller amounts in peripheral organs [85][86][87]. A crosssectional study showed a significant association between urinary A1M-creatinine ratio and NAFLD [88]. Hakuno et al have identified A1M as an Akt-activating hepatokine by screening the effects of conditioned media on doxorubicinor hypoxia-induced cardiomyocytes stress in vitro, and the in vivo study also confirmed that A1M is produced by the liver rather than the heart [89].…”

Section: Hepatokines Link the Liver Tomentioning

confidence: 99%

Hepatocardiac or Cardiohepatic Interaction: From Traditional Chinese Medicine to Western Medicine

Zhang

Xian-ming

2021

Evidence-Based Complementary and Alternative Medicine

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There is a close relationship between the liver and heart based on “zang-xiang theory,” “five-element theory,” and “five-zang/five-viscus/five-organ correlation theory” in the theoretical system of Traditional Chinese Medicine (TCM). Moreover, with the development of molecular biology, genetics, immunology, and others, the Modern Medicine indicates the existence of the essential interorgan communication between the liver and heart (the heart and liver). Anatomically and physiologically, the liver and heart are connected with each other primarily via “blood circulation.” Pathologically, liver diseases can affect the heart; for example, patients with end-stage liver disease (liver failure/cirrhosis) may develop into “cirrhotic cardiomyopathy,” and nonalcoholic fatty liver disease (NAFLD) may promote the development of cardiovascular diseases via multiple molecular mechanisms. In contrast, heart diseases can affect the liver, heart failure may lead to cardiogenic hypoxic hepatitis and cardiac cirrhosis, and atrial fibrillation (AF) markedly alters the hepatic gene expression profile and induces AF-related hypercoagulation. The heart can also influence liver metabolism via certain nonsecretory cardiac gene-mediated multiple signals. Moreover, organokines are essential mediators of organ crosstalk, e.g., cardiomyokines link the heart to the liver, while hepatokines link the liver to the heart. Therefore, both TCM and Western Medicine, and both the basic research studies and the clinical practices, all indicate that there exist essential “heart-liver axes” and “liver-heart axes.” To investigate the organ interactions between the liver and heart (the heart and liver) will help us broaden and deepen our understanding of the pathogenesis of both liver and heart diseases, thus improving the strategies of prevention and treatment in the future.

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“…Patients with non-alcoholic fatty liver disease (NAFLD) tend to have high urinary α1MG levels. 9 NAFLD leads to liver complications, including non-alcoholic steatohepatitis, liver cirrhosis and hepatocellular carcinoma. 10 Metformin has benefits, such as inhibiting hepatic gluconeogenesis, modifying hepatic fatty acid metabolism and enhancing insulin sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with non‐alcoholic fatty liver disease (NAFLD) tend to have high urinary α1MG levels 9 . NAFLD leads to liver complications, including non‐alcoholic steatohepatitis, liver cirrhosis and hepatocellular carcinoma 10 .…”

Section: Discussionmentioning

confidence: 99%

Urinary α1 microglobulin level is useful for selecting sodium‐glucose transporter 2 inhibitor or metformin for visceral fat reduction in patients with type 2 diabetes

Koshizaka

Ishibashi

Ishikawa

et al. 2023

Diabetes Obesity Metabolism

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BACKGROUNDThe Japanese Diabetes Society has released an algorithm for pharmacotherapy for patients with type 2 diabetes (T2D). 1 It recommends metformin and sodium-glucose co-transporter 2 (SGLT2) inhibitors for patients with obesity. However, there is insufficient evidence to show which patients are more suitable for SGLT2 inhibitors or metformin among patients undergoing primary prevention.Visceral adipose tissue, accurately measured using computed tomography (CT), is an independent risk marker of cardiovascular and metabolic diseases, while visceral fat reduction ameliorates metabolic disorders. 2 Some studies reported that SGLT2 inhibitors significantly reduced visceral fat area (VFA) 3 and metformin reduced visceral fat. 4 We previously reported that the mean percentage reduction in the VFA was significantly greater in the ipragliflozin, an SGLT2 inhibitor, group than in the metformin group. 5 Therefore, a sub-analysis of a prospective, multicenter, blinded-endpoint, randomized controlled study 5 was conducted to identify responders to ipragliflozin and metformin in reducing VFA in patients with T2D. We analysed patient backgrounds between high-reduction responders and low-reduction non-responders, identifying contributing clinical factors. | METHODSThis main study evaluated the efficacy of treatment with ipragliflozin or metformin in reducing VFA in 103 patients with T2D. The study design has been previously described. 6 The study protocol was approved by the relevant ethics committees and conformed to the principles of the Declaration of Helsinki. Participants who provided written informed consent were registered between September 2014 and September 2016. The study was registered at http:// www.umin.ac.jp/ctr/, with registration ID UMIN-ID: UMIN 000015170.Patients with T2D with a body mass index (BMI) of ≥22 kg/m 2 and a glycated hemoglobin (HbA1c) level of ≥7% and <10% were included. The patients were randomized to receive ipragliflozin (50 mg/day) or metformin (1000-1500 mg/day). The primary outcome was the percentage change in the VFA measured using CT after 24 weeks of therapy. Two radiologists blinded to the information analysed the images. The secondary outcomes included changes in subcutaneous fat area; abdominal muscle volume measured using CT; body weight; BMI; waist circumference; HbA1c, fasting blood glucose, fasting insulin, triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, urinary

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Association Between Urinary Alpha1-Microglobulin Levels and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

Cited by 8 publications

References 48 publications

Effects of a Two-Year Lifestyle Intervention on Intrahepatic Fat Reduction and Renal Health: Mitigation of Inflammation and Oxidative Stress, a Randomized Trial

Effects of a Two-Year Lifestyle Intervention on Intrahepatic Fat Reduction and Renal Health: Mitigation of Inflammation and Oxidative Stress, a Randomized Trial

Hepatocardiac or Cardiohepatic Interaction: From Traditional Chinese Medicine to Western Medicine

Urinary α1 microglobulin level is useful for selecting sodium‐glucose transporter 2 inhibitor or metformin for visceral fat reduction in patients with type 2 diabetes

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