The heterogeneity of metabolic syndrome presentation and challenges this causes in its pharmacological management: a narrative review focusing on principal risk modifiers

Lonardo, Amedeo

doi:10.1080/17512433.2023.2259306

Cited by 10 publications

(2 citation statements)

References 213 publications

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“…In conclusion, the study by Ebrahimi [28] adds another important piece to the complex puzzle of knowledge necessary for the successful implementation of precision medicine approaches eagerly anticipated in MFLS research and practice [45][46][47][48][49][50] . However, the above drawback of the study calls for additional investigations specifically addressing these limitations.…”

Section: Table 1 Insulin Resistance Nafld Advanced Hepatic Fibrosis A...mentioning

confidence: 99%

MASLD co-aggregates with HCC in families-names change, fa(c)ts remain

Lonardo

2023

Hepatoma Res

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My invited commentary discusses a recent paper published by Ebrahimi et al. [28 ]. To this end, the definitions of nonalcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated fatty liver disease (MAFLD), and the most recently proposed metabolic dysfunction-associated steatotic liver disease (MASLD) are reviewed. For brevity, the overarching definition of metabolic fatty liver syndromes (MFLS) is utilized to allude to NAFLD/MAFLD/MASLD collectively, although each nomenclature identifies different diagnostic criteria and identifies distinct patient populations. Ebrahimi and colleagues conducted an analysis using data from the National Swedish Multigeneration archive, involving 38,018 MASLD first-degree relatives (FDRs) and 9,381 MASLD spouses, alongside 197,303 comparator FDRs and 47,572 comparator spouses. They followed these groups for a median of 17.6 years and reported a definite familial aggregation of adverse liver-related events among families of MASLD individuals. These events comprise increased relative risks of hepatocellular carcinoma (HCC), major chronic liver disease, and mortality owing to hepatic causes. I comment on this study with reference to the ongoing changes in terminology describing MFLS and to sexual dimorphism exhibited by MFLS. It is concluded that the study by Ebrahimi adds another piece to the puzzle of knowledge requested to implement those precision medicine approaches that are eagerly awaited in the field of MFLS.

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Section: Table 1 Insulin Resistance Nafld Advanced Hepatic Fibrosis A...mentioning

confidence: 99%

MASLD co-aggregates with HCC in families-names change, fa(c)ts remain

Lonardo

2023

Hepatoma Res

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“…Various operational definitions of the Metabolic Syndrome (MetS) have been proposed between 1998 and 2009[ 8 ]. Conceptually, all maintain that the MetS is a cluster of cardio-metabolic factors.…”

Section: Introductionmentioning

confidence: 99%

Alanine aminotransferase predicts incident steatotic liver disease of metabolic etiology: Long life to the old biomarker!

Lonardo

2024

World J Gastroenterol

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Alanine aminotransferase (ALT) serum levels increase because of hepatocellular damage. Metabolic dysfunction-associated fatty liver disease (MAFLD), which identifies steatotic liver disease (SLD) associated with ≥ 2 metabolic abnormalities, has prominent sexual differences. The Metabolic Syndrome defines a cluster comprising abdominal obesity, altered glucose metabolism, dyslipidemia, and hypertension. Male sex, body mass index, glucose, lipids, ferritin, hypertension, and age independently predict ALT levels among blood donors. Over the last few decades, the reference range of ALT levels has been animatedly debated owing to attempts to update sex-specific reference ranges. With this backset, Chen et al have recently published a study which has two main findings. First, > 80% of individuals with MAFLD had normal ALT levels. Second, there was a linear increasing trend in the association between cumulative excess high-normal ALT levels and the rate of incident MAFLD. This study has biologically credible findings. However, it inaccurately considered sex differences in the MAFLD arena. Therefore, future studies on SLD owing to metabolic dysfunction should adopt locally determined and prospectively validated reference ranges of ALT and carefully consider sex differences in liver enzymes and MAFLD pathobiology.

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Does an Aspirin a Day Take the MASLD Away?

Lonardo,

Zheng

2024

Adv Ther

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The heterogeneity of metabolic syndrome presentation and challenges this causes in its pharmacological management: a narrative review focusing on principal risk modifiers

Cited by 10 publications

References 213 publications

MASLD co-aggregates with HCC in families-names change, fa(c)ts remain

MASLD co-aggregates with HCC in families-names change, fa(c)ts remain

Alanine aminotransferase predicts incident steatotic liver disease of metabolic etiology: Long life to the old biomarker!

Does an Aspirin a Day Take the MASLD Away?

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