Hormone replacement therapy in menopausal women: risk factor or protection to nonalcoholic fatty liver disease?

Florentino, Gesira Soares Assis; Cotrim, Helma Pinchemel; Florentino, Andre Vinicius de Assis; Padilha, Consuelo; Medeiros-Neto, Manoel; Bragagnoli, Gérson; Schwingel, Paulo Adriano

doi:10.1016/s1665-2681(19)31502-9

Cited by 11 publications

(2 citation statements)

References 11 publications

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“…11 Synthetic oestrogens can precipitate non-alcoholic steatohepatitis in genetically predisposed individuals; 12 however, it is unclear synthetic oestrogens can induce MS. Studies have inconsistently reported the beneficial effects of oestradiol on chronic liver disease, which are based on its antifibrogenic and wound-healing effects. 13,14 Here, we discuss these discordant arguments and explore the pathophysiological mechanisms underlying DIAIH and MS.…”

Section: What Is Known and Objectivementioning

confidence: 99%

A case of synthetic oestrogen-induced autoimmune hepatitis with microvesicular steatosis

et al. 2014

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Summary What is known and objective Drug‐induced liver injury (DILI) is a leading cause of acute liver failure in developed countries. Hepatotoxicity is a well‐recognized adverse effect associated with synthetic oestrogens, which can cause cholestasis. The current report describes ethinyloestradiol (EE2)‐associated highly unusual adverse effects of autoimmune hepatitis (AIH) and microvesicular steatosis (MS). DILI that fulfils the criteria for AIH is referred to as drug‐induced autoimmune hepatitis (DIAIH). MS is a potentially severe liver lesion that results from mitochondrial dysfunction. We explore the pathophysiological mechanisms underlying DIAIH and MS. Case summary A 51‐year‐old woman presented with jaundice, increased liver enzymes and IgG, and positive ANA. She had been taking EE2 for 3 years. Liver biopsy showed prominent interface hepatitis with MS. A drug‐lymphocyte stimulation test (DLST) using EE2 was positive. The liver biochemical parameters had normalized after the EE2 discontinuation; however, they exacerbated 5 months post‐onset. Repeated liver biopsy showed interface hepatitis with no MS. Considering EE2‐induced DIAIH, corticosteroids treatment was initiated. Then, all liver biochemical parameters had normalized, and the corticosteroids were successfully withdrawn. The patient continued to be in complete remission over the next 3 years. What is new and conclusion Five remarkable points should be emphasized: (i) a long latency interval, despite the acute presentation; (ii) exacerbation of liver biochemical parameters, even after drug cessation; (iii) the paired liver biopsies indicating continuing inflammation and disappearance of toxic features; (iv) a positive DLST and the absence of fibrosis consistent with DIAIH and not AIH; and (v) a rare histological feature of MS. Intense immunoallergic reactions were likely triggers of MS in the current case. A possibility of DIAIH should be considered in cases of DILI which exhibit overt jaundice, autoantibodies, intense histological inflammation and a long latency period.

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Section: What Is Known and Objectivementioning

confidence: 99%

A case of synthetic oestrogen-induced autoimmune hepatitis with microvesicular steatosis

et al. 2014

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“…Several studies have shown an association between menopause and NAFLD. 10 , 11 Furthermore, NAFLD is twice as common in postmenopausal women compared to premenopausal women. 12 The protective effect of estrogen against the development and progression of NAFLD has been suggested by studies using hormonal replacement therapy (HRT) on postmenopausal women.…”

Section: Introductionmentioning

confidence: 99%

Effects of three different formulae of Gamisoyosan on lipid accumulation induced by oleic acid in HepG2 cells

Ryuk

Hwang

et al. 2017

Integrative Medicine Research

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BackgroundGamisoyosan (GSS) is an herbal formula which has been used to treat women’s diseases for several hundred years in Korea. GSS is one of the three most common prescriptions among women and is used to treat menopausal symptoms. Fatty liver disease is also common in postmenopausal women and can precede more severe diseases, such as steatohepatitis. The present study compared the effects of GSS on fatty liver using three different formulae, Dongui-Bogam (KIOM A), Korean Pharmacopeia (KIOM B) and Korean National Health Insurance (KIOM C).MethodsIn oleic acid-induced HepG2 fatty liver cells, cellular lipid accumulation, triglycerides and total cholesterol were measured after treatment with three GSS formulae and simvastatin as a positive control. To investigate the phytoestrogen activity of GSS, MCF-7 cells were treated with GSS, and hormone levels were quantified. Also, qualitative analysis was performed with UPLC.ResultsAll types of GSS decreased cellular lipid accumulation. KIOM A was slightly less effective than the other two GSS formulae. KIOM B and KIOM C decreased cellular triglycerides more effective than simvastatin, but KIOM A did not affect cellular triglycerides. Cellular total cholesterol was decreased by all GSS and simvastatin. GSS showed phytoestrogen activity in MCF-7 cells. From the UPLC analysis data, geniposide, paeoniflorin and glycyrrhizin were detected form three GSS formulae.ConclusionThese results suggest that all GSS formulae have a beneficial effect on fatty liver disease during menopause and that differences of formula have no effect on the efficacy of the prescription.

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Advanced Glycation Endproducts (AGEs) and Chronic Complications in Diabetes

Vlassara¹,

Striker²

2017

Principles of Diabetes Mellitus

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Hormone replacement therapy in menopausal women: risk factor or protection to nonalcoholic fatty liver disease?

Cited by 11 publications

References 11 publications

A case of synthetic oestrogen-induced autoimmune hepatitis with microvesicular steatosis

A case of synthetic oestrogen-induced autoimmune hepatitis with microvesicular steatosis

Effects of three different formulae of Gamisoyosan on lipid accumulation induced by oleic acid in HepG2 cells

Advanced Glycation Endproducts (AGEs) and Chronic Complications in Diabetes

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