Influence of Psychological Biomarkers on Therapeutic Adherence by Patients with Non-Alcoholic Fatty Liver Disease: A Moderated Mediation Model

Funuyet‐Salas, Jesús; Martín-Rodríguez, Agustín; Pérez-San-Gregorio, María Ángeles; Romero‐Gómez, Manuel

doi:10.3390/jcm10102208

Cited by 7 publications

(10 citation statements)

References 70 publications

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“…In the theory of traditional Chinese medicine, catharsis of liver Qi is helpful to inhibit the occurrence and development of depression. Indeed, a close correlation ship has been shown between depression and hepatic disorders, such as non-alcoholic fatty liver disease and liver transplantation ( Herzer et al, 2020 ; Funuyet-Salas et al, 2021 ). To verify the SX-1 protection of CUMS-induced depression-like behavior via inhibition of hepatic IL-6/JAK2/STAT3 signaling, we will repeat the present study in a mouse model of liver-specific knockout of IL-6 in the future.…”

Section: Discussionmentioning

confidence: 99%

Shuxie-1 Decoction Alleviated CUMS -Induced Liver Injury via IL-6/JAK2/STAT3 Signaling

Zhang

Huang

et al. 2022

Front. Pharmacol.

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Introduction: Chronic stress has been shown to cause liver damage in addition to psychological depression. Besides, drug-induced liver injury is frequently caused by antidepressants. Shuxie-1 decoction (SX-1) is a formula of traditional Chinese medicine commonly used in nourishing liver blood, and relieving depression. However, the underlying molecular mechanism remains unclear. Therefore, this study was designed to explore the effects and mechanisms of SX-1 in treating chronic stress-induced depression as well as liver injury.Methods: Chronic unpredictable mild stress (CUMS) was applied to male Wistar rats for 4 weeks, with or without administration of SX-1 at low-dose and high-dose for 6 weeks, using Fluoxetine (Flu) as a positive control. Body weight was monitored once every 2 weeks. In the sixth week, the sugar preference test and open field test were carried out to evaluate the depression status. After that, the serum and liver tissues were collected. The quality control of SX-1 decoctions and drug-containing serum was controlled by UHPLC-QE-MS. The cell viability was measured by Cell Counting Kit-8 (CCK8). Enzyme-linked immunosorbent assay (Elisa), Western Blot and immunohistochemistrical staining was obtained to detect the protein levels in the plasma and the hepatic tissues, respectively.Results: CUMS led to decreased 1) body weight, 2) the preference for sugar water, 3) the desire to explore in open field, and increased serum levels of corticosterone. All these factors were completely reversed by SX-1 treatment. Hematoxylin-eosin staining (HE) showed that SX-1 improved the hepatocyte vacuolization in CUMS treated rats, decreased the serum levels of alanine aminotransferase (ALT) and the deposition of type I collagen (Col I) in hepatocytes as well. CUMS increased the levels of hepatic Interleukin-6 (IL-6), and provoked the activation of Janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3), which was abrogated by SX-1 treatment. Cobalt chloride (CoCl2) increased the protein expression of IL-6 and p-STAT3 in AML12 cells. Besides, nuclear pyknosis was observed under electron microscope, which were recovered after rat SX serum.Conclusion: SX-1 effectively ameliorated CUMS-induced depression-like behaviors as well as hepatic injuries, probably by the blockade of hepatic IL-6/JAK2/STAT3 signaling.

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Section: Discussionmentioning

confidence: 99%

Shuxie-1 Decoction Alleviated CUMS -Induced Liver Injury via IL-6/JAK2/STAT3 Signaling

Zhang

Huang

et al. 2022

Front. Pharmacol.

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“…A study evaluating adherence to lifestyle modification recommendations for weight loss showed that depressive symptoms strongly impacted adherence to physical activity and diet recommendations. Depressive symptoms also mediated the relationship between physical quality of life, social support, and diet/exercise adherence 17 . Furthermore, those with NAFLD and stable MDD had improvement in liver enzymes after 48 weeks of standard of care compared with those with unstable MDD who had no improvement 18 .…”

Section: Impact Of Behavioral Health Care On Cld Outcomesmentioning

confidence: 94%

“…Depressive symptoms also mediated the relationship between physical quality of life, social support, and diet/exercise adherence. 17 Furthermore, those with NAFLD and stable MDD had improvement in liver enzymes after 48 weeks of standard of care compared with those with unstable MDD who had no improvement. 18 In another study, readiness to change after receiving nutritional education and guidance did not predict weight change, psychiatric symptoms did.…”

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confidence: 97%

Psychiatric Disorders and Their Treatment: Impact of Outcomes in Patients With Chronic Liver Disease

Holmes

Patel

Desai

2022

Clinical Liver Disease

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Psychological and substance use disorders are highly prevalent in persons living with chronic liver disease (CLD). This review will summarize the mechanisms through which comorbid psychiatric and substance use disorders impact CLD-related outcomes. Furthermore, this review will summarize evidence supporting the treatment of comorbid psychiatric and substance use disorders to improve CLDrelated outcomes. PsYCHOlOGiCal DisOrDers/DisTress anD ClDIt has been established that psychological disorders and distress are related to a range of poor outcomes, including more severe liver symptoms, more advanced liver histological abnormalities, higher liver disease-related mortality, and poor compliance with medical treatment.Even in the modern era of hepatitis C (HCV) treatment, psychological disorders and distress reduce the odds of treatment success. 1 Depression and anxiety are the most prevalent psychological disorders that impact patients with liver disease, with anxiety impacting 25% to 45% of CLD patient populations and depression impacting 29% to 72%. 2 The rates of depression vary across liver diagnosis; patients with nonalcoholic fatty liver disease (NAFLD) and HCV diagnosis demonstrate increased rates of depression, and patients with hepatitis B report a similar rate of depression to the general population. 3 Most of these studies were single center or cross-sectional. 2 We should also note a lack of consensus on the definitions of "depression" and "anxiety" used in studies. For example, scales such as the hospital anxiety and depression scale and patient health questionnaire-9 measure anxiety and depressive symptoms, while instruments such as the structured Abbreviations: ADHD, attention deficit hyperactivity disorder; ADL, activities of daily living; ALD, alcoholic liver disease; CLD, chronic liver disease; GAD, generalized anxiety disorder; HCV, hepatitis C; HRQOL, health-related quality of life; IL, interleukin; MDD, major depressive disorder; miRNA, microRNA; NAFLD, nonalcoholic fatty liver disease; OH, alcohol; PNPLA3, patatin-like phospholipase domain-containing protein 3; PTSD, posttraumatic stress disorder; TNFα, tumor necrosis factorα.

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“…This behavioural change intervention is especially useful in motivating lifestyle modification for chronic disease management, disease prevention and addictions 10 11. Several studies have reported that psychological factors and readiness for behavioural change were related to the treatment outcome of NAFLD 11 12. Thus, when managing patients with NAFLD, more attention should be focused on patients’ psychological factors and readiness for behavioural change.…”

Section: Introductionmentioning

confidence: 99%

Stages of psychological change among patients with non-alcoholic fatty liver disease in China: a national cross-sectional study

et al. 2023

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ObjectivesNon-alcoholic fatty liver disease (NAFLD) is becoming the leading cause of chronic liver disease worldwide. However, treatment of NAFLD is potentially influenced by psychological conditions. Using the simplified version of the University of Rhode Island Change Assessment (URICA-SV) scale, this study aimed to evaluate the stage of psychological change as a prerequisite to refining implementation strategies for psychological change.DesignA multicentre cross-sectional survey.SettingNinety hospitals in China.Participants5181 patients with NAFLD were included in this study.Outcome measuresAll patients completed the URICA-SV questionnaire and were assigned to one of the three stages of change (precontemplation, contemplation or action) according to their readiness scores. A stepwise multivariate logistic regression analysis was used to identify independent factors associated with the stage of psychological change.ResultsA total of 4832 (93.3%) patients were included in the precontemplation stage and only 349 (6.7%) considered making a change or preparing to make one. There were significant differences in gender (Cohen’s d=0.039, p=0.005), age (Cohen’s d=−0.327, p<0.001), waist circumference (Cohen’s d=0.143, p=0.003), alanine transaminase (Cohen’s d=0.347, p=0.001), triglyceride (Cohen’s d=0.351, p=0.002), body mass index (BMI; Cohen’s d=0.056, p<0.001), proportion of hyperlipidaemia (Cohen’s d=0.068, p<0.001) and cardiovascular disease (Cohen’s d=0.032, p=0.029), therapeutic regimen (Cohen’s d=0.136, p<0.001), and Chronic Liver Disease Questionnaire-Non-Alcoholic Fatty Liver Disease overall score (Cohen’s d=−0.420, p<0.001) between patients with NAFLD in the precontemplation stage and those in the contemplation/action stage. Logistic regression identified BMI (HR 0.659, 95% CI 0.469 to 0.928, p=0.017), cardiovascular disease (HR 2.161, 95% CI 1.089 to 4.287, p=0.027) and triglyceride (HR 0.751, 95% CI 0.591 to 0.955, p=0.020) as independent factors predicting psychological change.ConclusionsThe results demonstrated that very few patients with NAFLD presented psychological condition in the stage of action. Psychological condition was found to be significantly related to BMI, cardiovascular disease and triglyceride factors. Integrated diversity considerations for evaluating psychological change are necessary.

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Influence of Psychological Biomarkers on Therapeutic Adherence by Patients with Non-Alcoholic Fatty Liver Disease: A Moderated Mediation Model

Cited by 7 publications

References 70 publications

Shuxie-1 Decoction Alleviated CUMS -Induced Liver Injury via IL-6/JAK2/STAT3 Signaling

Shuxie-1 Decoction Alleviated CUMS -Induced Liver Injury via IL-6/JAK2/STAT3 Signaling

Psychiatric Disorders and Their Treatment: Impact of Outcomes in Patients With Chronic Liver Disease

Stages of psychological change among patients with non-alcoholic fatty liver disease in China: a national cross-sectional study

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