Alcoholic liver disease(ALD)and non-alcoholic fatty liver disease(NAFLD)are serious health problems worldwide.These two diseases have similar pathological spectra,ranging from simple steatosis to hepatitis to cirrhosi...Alcoholic liver disease(ALD)and non-alcoholic fatty liver disease(NAFLD)are serious health problems worldwide.These two diseases have similar pathological spectra,ranging from simple steatosis to hepatitis to cirrhosis and hepatocellular carcinoma.Although most people with excessive alcohol or calorie intake display abnormal fat accumulation in the liver(simple steatosis),a small percentage develops progressive liver disease.Despite extensive research on understanding the pathophysiology of both these diseases there are still no targeted therapies available.The treatment for ALD remains as it was 50 years ago:abstinence,nutritional support and corticosteroids(or pentoxifylline as an alternative if steroids are contraindicated).As for NAFLD,the treatment modality is mainly directed toward weight loss and co-morbidity management.Therefore,new pathophysiology directed therapies are urgently needed.However,the involvement of several inter-related pathways in the pathogenesis of these diseases suggests that a single therapeutic agent is unlikely to be an effective treatment strategy.Hence,a combination therapy towards multiple targets would eventually be required.In this review,we delineate the treatment options in ALD and NAFLD,including various new targeted therapies that are currently under investigation.We hope that soon we will be having an effective multi-therapeutic regimen for each disease.展开更多
Liver-gut communication is vital in fatty liver diseases,and gut microbes are the key regulators in maintaining liver homeostasis.Chronic alcohol abuse and persistent overnutrition create dysbiosis in gut ecology,whic...Liver-gut communication is vital in fatty liver diseases,and gut microbes are the key regulators in maintaining liver homeostasis.Chronic alcohol abuse and persistent overnutrition create dysbiosis in gut ecology,which can contribute to fatty liver disease.In this review,we discuss the gut microbial compositional changes that occur in alcoholic and nonalcoholic fatty liver diseases and how this gut microbial dysbiosis and its metabolic products are involved in fatty liver disease pathophysiology.We also summarize the new approaches related to gut microbes that might help in the diagnosis and treatment of fatty liver disease.展开更多
Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in ...Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)management requires sustainable lifestyle modifications.This study aimed to evaluate the effectiveness of the RESET care plan,a comprehensive program that is an integ...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)management requires sustainable lifestyle modifications.This study aimed to evaluate the effectiveness of the RESET care plan,a comprehensive program that is an integrated personalized diet,exercise,and cognitive behavior therapy,delivered via MyTatva’s digital health application enabled through a body composition analyzer(BCA)and smartwatch.AIM To evaluates the effectiveness of the comprehensive program delivered via My-Tatva’s digital health app enabled through internet of thing devices.METHODS This retrospective observational study analyzed deidentified data from 22 par-ticipants enrolled in the MyTatva RESET care program.Participants were divided into three groups:Group A,diet plan;Group B,diet+exercise plan;and Group C,diet+exercise+cognitive behavioral therapy plan.Participants were provided with a BCA and smartwatch for continuous monitoring of anthropometric para-meters.Statistical analysis,including one-way ANOVA and post-hoc Tukey’s Honest Significant Difference test,was conducted to compare mean changes in anthropometric parameters across the groups.INTRODUCTION Non-alcoholic fatty liver disease(NAFLD)has emerged as a global health burden,affecting approximately 1 in 4 in-dividuals worldwide.NAFLD ranges from simple steatosis(fat accumulation)to non-alcoholic steatohepatitis(NASH),and its global prevalence in the general population is estimated between 6.3%and 33%,with NASH affecting 3-5%[1,2].Obesity is a major risk factor of NAFLD,with studies showing that the likelihood of developing NAFLD increases 5-fold at a body mass index(BMI)of 30-32.5 kg/m²and up to 14-fold at BMI of 37.5-40 kg/m²compared to a BMI of 20-22.5 kg/m²[3,4].Effective NAFLD management requires both dietary and physical activity modifications.Healthy weight loss with sustained muscle mass plays a pivotal role,with a reduction of 3%-5%decreasing hepatic steatosis,5%-7%improving NASH conditions,and 10%or more needed to reverse hepatic fibrosis[5].Management also normalizes elevated liver enzymes(aspartate aminotransferase and alanine aminotransferase),enhances insulin sensitivity,and thereby reduces cardiovascular risk by improving endothelial function and increasing cardiorespiratory fitness[6].However,diet or exercise alone is often not as effective as a combined approach.Integrating both balanced dietary changes and increased physical activity yields more sustainable improvements in NAFLD and overall metabolic health[1,7].Traditional intervention methods usually involve in-person consultations,which often lack real-time and continuous patient monitoring.The recommendation of drastic changes in diet and exercise can also be overwhelming for patients,leading to low adherence rates.Many patients struggle to maintain these changes in the long-term due to a lack of con-tinuous motivational support[8,9].In recent years,the health ecosystem has witnessed a significant shift toward digital health platforms,which complement pharmacological treatments in chronic disease management,and increase scala-bility.These platforms provide continuous monitoring and personalized support,helping to bridge the gap between health care setups and patients[10].Recent digital advances enable internet of things(IoT)devices to be integrated into such management plans to track health metrics,to address the limitations of traditional methods[11,12].The MyTatva digital health application offers the RESET plan,a novel comprehensive approach for NAFLD mana-gement by integrating personalized support from nutrition,physiotherapy,and cognitive behavioral therapy(CBT)coaches.We aimed to evaluate the effectiveness of the RESET plan by analyzing the reduction in anthropometric para-meters across three different digital intervention groups.展开更多
Non-alcoholic fatty liver disease(NAFLD)is one of the most common chronic liver diseases worldwide.Gut microbiota and its metabolites alteration are closely related to NAFLD.Nootkatone is an edible flavorant derived f...Non-alcoholic fatty liver disease(NAFLD)is one of the most common chronic liver diseases worldwide.Gut microbiota and its metabolites alteration are closely related to NAFLD.Nootkatone is an edible flavorant derived from grapefruit which has a variety of biological activities.However,the precise mechanisms of nootkatone on NAFLD remains to be defined.Our results showed that nootkatone prevented body weight gain and decreased serum lipid level,hepatic lipogenesis,hepatic proinflammatory cytokines secretion in NAFLD mice.Also,nootkatone attenuated inflammatory response via inhibiting TLR4/NF-κB/NLRP3 pathway.Moreover,nootkatone restored intestinal barrier damage through increasing tight junction proteins and short chain fatty acids contents.Further 16S rRNA sequencing of colonic content suggested that nootkatone recovered the disturbed gut microbiota to improve NAFLD.Spearman correlation analysis between gut microbiota and NAFLD related parameters indicated that nootkatone regulated lipid metabolism and immunity via altering the gut microbiota.In conclusion,these findings revealed that nootkatone alleviated hepatic lipid homeostasis and inflammatory response in NAFLD mice,which associated with intestinal barrier integrity and the regulation of gut microbiota.This study provides new perspectives that nootkatone has efficacy on NAFLD via“gut-liver axis”,and nootkatone is expected to be developed as a functional food additive.展开更多
Non-alcoholic fatty liver disease(NAFLD)has emerged as a significant health challenge,characterized by its widespread prevalence,intricate natural progression and multifaceted pathogenesis.Although NAFLD initially pre...Non-alcoholic fatty liver disease(NAFLD)has emerged as a significant health challenge,characterized by its widespread prevalence,intricate natural progression and multifaceted pathogenesis.Although NAFLD initially presents as benign fat accumulation,it may progress to steatosis,non-alcoholic steatohepatitis,cirrhosis,and hepatocellular carcinoma.Mesenchymal stem cells(MSCs)are recognized for their intrinsic self-renewal,superior biocompatibility,and minimal immunogenicity,positioning them as a therapeutic innovation for liver diseases.Therefore,this review aims to elucidate the potential roles of MSCs in alleviating the progression of NAFLD by alteration of underlying molecular pathways,including glycolipid metabolism,inflammation,oxidative stress,endoplasmic reticulum stress,and fibrosis.The insights are expected to provide further understanding of the potential of MSCs in NAFLD therapeutics,and support the development of MSC-based therapy in the treatment of NAFLD.展开更多
This editorial comments on an article published in a recent issue of World Journal of Gastroenterology,entitled“Association of low muscle strength with metabolic dysfunction-associated fatty liver disease:A nationwid...This editorial comments on an article published in a recent issue of World Journal of Gastroenterology,entitled“Association of low muscle strength with metabolic dysfunction-associated fatty liver disease:A nationwide study”.We focused on the association between muscle strength and the incidence of non-alcoholic fatty liver disease(NAFLD)and metabolic-associated fatty liver disease(MAFLD),as well as the mechanisms underlying the correlation and related clinical applications.NAFLD,which is now redefined as MAFLD,is one of the most common chronic liver diseases globally with an increasing prevalence and is characterized by malnutrition,which may contribute to decreased muscle strength.Reduction of muscle strength reportedly has a pathogenesis similar to that of NAFLD/MAFLD,including insulin resistance,inflammation,sedentary behavior,as well as insufficient vitamin D.Multiple studies have focused on the relationship between sarcopenia or muscle strength and NAFLD.However,studies investigating the relationship between muscle strength and MAFLD are limited.Owing to the shortage of specific medications for NAFLD/MAFLD treatment,early detection is essential.Furthermore,the relationship between muscle strength and NAFLD/MAFLD suggests that improvements in muscle strength may have an impact on disease prevention and may provide novel insights into treatments including dietary therapy,as well as tailored physical activity.展开更多
Non-alcoholic fatty liver disease(NAFLD)has emerged as the commonest cause of chronic liver disease worldwide in recent years.With time,our understanding of NAFLD has evolved from an isolated liver condition to a syst...Non-alcoholic fatty liver disease(NAFLD)has emerged as the commonest cause of chronic liver disease worldwide in recent years.With time,our understanding of NAFLD has evolved from an isolated liver condition to a systemic disease with significant manifestations beyond the liver.Amongst them,cardiovascular diseases(CVDs)are the most important and clinically relevant.Recent research supports a strong independent link between NALFD and CVD beyond the shared risk factors and pathophysiology.Female sex hormones are well known to not only protect against CVD in pre-menopausal females,but also contribute to improved adipose tissue function and preventing its systemic deposition.Recent research highlights the increased risk of major adverse cardiovascular-cerebral events(MACCE)amongst male with NAFLD compared to females.Further,racial variation was observed in MACCE outcomes in NAFLD,with excess mortality in the Native Americans and Asian Pacific Islanders compared to the other races.展开更多
Non-alcoholic fatty liver disease(NAFLD)is associated with mutations in lipopolysaccharide-binding protein(LBP),but the underlying epigenetic mechanisms remain understudied.Herein,LBP^(-/-)rats with NAFLD were establi...Non-alcoholic fatty liver disease(NAFLD)is associated with mutations in lipopolysaccharide-binding protein(LBP),but the underlying epigenetic mechanisms remain understudied.Herein,LBP^(-/-)rats with NAFLD were established and used to conduct integrative targetingactive enhancer histone H3 lysine 27 acetylation(H3K27ac)chromatin immunoprecipitation coupled with high-throughput and transcriptomic sequencing analysis to explore the potential epigenetic pathomechanisms of active enhancers of NAFLD exacerbation upon LBP deficiency.Notably,LBP^(-/-)reduced the inflammatory response but markedly aggravated high-fat diet(HFD)-induced NAFLD in rats,with pronounced alterations in the histone acetylome and regulatory transcriptome.In total,1128 differential enhancer-target genes significantly enriched in cholesterol and fatty acid metabolism were identified between wild-type(WT)and LBP^(-/-)NAFLD rats.Based on integrative analysis,CCAAT/enhancer-binding proteinβ(C/EBPβ)was identified as a pivotal transcription factor(TF)and contributor to dysregulated histone acetylome H3K27ac,and the lipid metabolism gene SCD was identified as a downstream effector exacerbating NAFLD.This study not only broadens our understanding of the essential role of LBP in the pathogenesis of NAFLD from an epigenetics perspective but also identifies key TF C/EBPβand functional gene SCD as potential regulators and therapeutic targets.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk factors.However,large-scale cardiovascular sex and race differences are poorly understood.AIM To ...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk factors.However,large-scale cardiovascular sex and race differences are poorly understood.AIM To investigate the relationship between NAFLD and major cardiovascular and cerebrovascular events(MACCE)in subgroups using a nationally representative United States inpatient sample.METHODS We examined National Inpatient Sample(2019)to identify adult hospitalizations with NAFLD by age,sex,and race using ICD-10-CM codes.Clinical and demographic characteristics,comorbidities,and MACCE-related mortality,acute myocardial infarction(AMI),cardiac arrest,and stroke were compared in NAFLD cohorts by sex and race.Multivariable regression analyses were adjusted for sociodemographic characteristics,hospitalization features,and comorbidities.RESULTS We examined 409130 hospitalizations[median 55(IQR 43-66)years]with NFALD.NAFLD was more common in females(1.2%),Hispanics(2%),and Native Americans(1.9%)than whites.Females often reported non-elective admissions,Medicare enrolment,the median age of 55(IQR 42-67),and poor income.Females had higher obesity and uncomplicated diabetes but lower hypertension,hyperlipidemia,and complicated diabetes than males.Hispanics had a median age of 48(IQR 37-60),were Medicaid enrollees,and had non-elective admissions.Hispanics had greater diabetes and obesity rates than whites but lower hypertension and hyperlipidemia.MACCE,all-cause mortality,AMI,cardiac arrest,and stroke were all greater in elderly individuals(P<0.001).MACCE,AMI,and cardiac arrest were more common in men(P<0.001).Native Americans(aOR 1.64)and Asian Pacific Islanders(aOR 1.18)had higher all-cause death risks than whites.CONCLUSION Increasing age and male sex link NAFLD with adverse MACCE outcomes;Native Americans and Asian Pacific Islanders face higher mortality,highlighting a need for tailored interventions and care.展开更多
BACKGROUND A body of evidence has suggested bidirectional relationships among gallstone disease(GSD),non-alcoholic fatty liver disease(NAFLD),and kidney stone disease(KSD).However,the results are inconsistent,and stud...BACKGROUND A body of evidence has suggested bidirectional relationships among gallstone disease(GSD),non-alcoholic fatty liver disease(NAFLD),and kidney stone disease(KSD).However,the results are inconsistent,and studies on this topic in China are relatively few.Our goal is to explore the bidirectional associations among these three diseases through a multicenter study,systematic review,and meta-analysis.AIM To explore the bidirectional associations among these three diseases through a multicenter study,systematic review,and meta-analysis.The results may help to investigate the etiology of these diseases and shed light on the individualized prevention of these three diseases.METHODS Subjects who participated in physical examinations in Beijing,Tianjin,Chongqing in China were recruited.Multivariable logistic regression was employed to explore the bidirectional relationships among GSD,KSD,and NAFLD.Systematic review and meta-analysis were initiated to confirm the epidemiologic evidence from previous observational studies.Furthermore,trial sequential analysis(TSA)was conducted to evaluate whether the evidence was sufficient and conclusive.RESULTS Significant bidirectional associations were detected among the three diseases,independent of potential confounding factors.The pooled results of the systematic review and meta-analysis also corroborated the aforementioned results.The combined evidence from the multicenter study and meta-analysis was significant[pooled odds ratio(OR)=1.42,95%CI:1.16-1.75,KSD→GSD;pooled OR=1.48,95%CI:1.31-1.67,GSD→KSD;pooled OR=1.31,95%CI:1.17-1.47,GSD→NAFLD;pooled OR=1.37,95%CI:1.26-1.50,NAFLD→GSD;pooled OR=1.28,95%CI:1.08-1.51,NAFLD→KSD;pooled OR=1.21,95%CI:1.16-1.25,KSD→NAFLD].TSA indicated that the evidence was sufficient and conclusive.CONCLUSION The present study presents relatively sufficient evidence for the positive bidirectional associations among GSD,KSD,and NAFLD.The results may provide clues for investigating the etiology of these three diseases and offer a guideline for identifying high-risk patients.展开更多
In this editorial,we commented on a recently released manuscript by Zeng et al in the World Journal of Gastroenterology.We focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease(N...In this editorial,we commented on a recently released manuscript by Zeng et al in the World Journal of Gastroenterology.We focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease(NAFLD).NAFLD is a hepatic manifestation of the metabolic syndrome,which ultimately leads to advanced hepatic fibrosis,cirrhosis,and hepatocellular carcinoma and affects more than 25%of the population globally.Existing therapeutic strategies against NAFLD such as pharmacologic therapies focus on liver protection,anti-inflammation,and regulating disease-related metabolic disorder symptoms.Although several drugs are in late-stage development,potent drugs against the diseases are lacking.Additionally,existing surgical approaches such as bariatric surgery are not routinely used to treat NAFLD.Intervening in patients’unhealthy lifestyles,such as weight loss through dietary changes and exercises to ameliorate patientassociated metabolic disorders and metabolic syndrome,is the first-line treatment for patients with NAFLD.With sufficient intrinsic motivation and adherence,the management of unhealthy lifestyles can reduce the severity of the disease,improve the quality of life,and increase the survival expectancy of patients with NAFLD.展开更多
The population of non-alcoholic fatty liver disease(NAFLD)patients along with relevant advanced liver disease is projected to continue growing,because currently no medications are approved for treatment.Fecal microbio...The population of non-alcoholic fatty liver disease(NAFLD)patients along with relevant advanced liver disease is projected to continue growing,because currently no medications are approved for treatment.Fecal microbiota transplantation(FMT)is believed a novel and promising therapeutic approach based on the concept of the gut-liver axis in liver disease.There has been an increase in the number of pre-clinical and clinical studies evaluating FMT in NAFLD treatment,however,existing findings diverge on its effects.Herein,we briefly summarized the mechanism of FMT for NAFLD treatment,reviewed randomized controlled trials for evaluating its efficacy in NAFLD,and proposed the prospect of future trials on FMT.展开更多
Non-alcoholic fatty liver disease(NAFLD)is characterized by symptoms of excessive fat accumulation and steatosis in the liver without alcohol intake in patients.The associated pathogenic mechanism is not completely un...Non-alcoholic fatty liver disease(NAFLD)is characterized by symptoms of excessive fat accumulation and steatosis in the liver without alcohol intake in patients.The associated pathogenic mechanism is not completely understood and there are no specific drugs for patients with NAFLD.Exercise and diet adherence are the best options for the management of NAFLD patients.Questionnaire associated analysis models of adherence to these interventions are used to assess their effectiveness in the management of NAFLD patients using specificity,sensitivity,and so on.Studies have indicated that the relative ratio of NAFLD can be reduced by physical activity with diet control.In the future,the pathogenesis of NAFLD should be clarified with stratified efforts to develop appropriate drugs,and both exercise and diet adherence should be optimized using better questionnaire design and evaluation models for patients with NAFLD.展开更多
BACKGROUND There are limited studies investigating the association between type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD)in the region of Bihar,India.AIM To estimate the prevalence of NAFLD...BACKGROUND There are limited studies investigating the association between type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD)in the region of Bihar,India.AIM To estimate the prevalence of NAFLD in persons with newly diagnosed T2DM in the population of North Bihar,India.METHODS This single centre cross-sectional study was undertaken in the Research Centre for Diabetes Hypertension and Obesity,Samastipur,Bihar,India.Data were collected from persons newly diagnosed with T2DM or those diagnosed within 6 months of when the study was conducted between December 2022 to May 2023.RESULTS A total of 148 people with newly diagnosed T2DM were included(median age 47 years,46.6%female)and 109 patients with liver disease on ultrasound evaluation.The persons with liver disease consumed more fats and oils(88.1%vs 74.4%,P=0.042)and they had significantly greater body mass index(27.4 vs 23.0,P<0.001),waist circumference(37 vs 33,P<0.001),and waist-to-hip ratio(1.00 vs 0.70,P=0.025).Females were associated with greater liver disease[odds ratio(OR):3.09,95%confidence interval(CI):1.09-8.80,P=0.32].Waist circumference(OR:1.42,95%CI:1.22-1.66,P<0.001)and low-density lipoprotein cholesterol(OR:1.01,95%CI:1.01-1.02,P=0.048)were associated with any liver disease.The factors most associated with grade 2/3 liver disease was right upper quadrant pain or heaviness(OR:5.22,95%CI:1.40-19.41,P=0.14),greater income(OR:3.58,95%CI:1.28-10.04,P=0.015)and waist circumference(OR:1.31,95%CI:1.02-1.69,P=0.036).CONCLUSION NAFLD is common in new/recently diagnosed T2DM and disease burden is high and common among patients who are either high consumers of fats and oils or have obesity-associated markers.展开更多
Studies have shown that non-alcoholic fatty liver disease(NAFLD)may be associated with sleep disorders.In order to explore the explicit relationship between the two,we systematically reviewed the effects of sleep diso...Studies have shown that non-alcoholic fatty liver disease(NAFLD)may be associated with sleep disorders.In order to explore the explicit relationship between the two,we systematically reviewed the effects of sleep disorders,especially obstructive sleep apnea(OSA),on the incidence of NAFLD,and analyzed the possible mechanisms after adjusting for confounding factors.NAFLD is independently associated with sleep disorders.Different sleep disorders may be the cause of the onset and aggravation of NAFLD.An excessive or insufficient sleep duration,poor sleep quality,insomnia,sleep-wake disorders,and OSA may increase the incidence of NAFLD.Despite that some research suggests a unidirectional causal link between the two,specifically,the onset of NAFLD is identified as a result of changes in sleep characteristics,and the reverse relationship does not hold true.Nevertheless,there is still a lack of specific research elucidating the reasons behind the higher risk of developing sleep disorders in individuals with NAFLD.Further research is needed to establish a clear relationship between NAFLD and sleep disorders.This will lay the groundwork for earlier identification of potential patients,which is crucial for earlier monitoring,diagnosis,effective prevention,and treatment of NAFLD.展开更多
Non-alcoholic fatty liver disease(NAFLD)was the term first used to describe hepatic steatosis in patients with the metabolic syndrome who did not consume excess amounts of alcohol.Alcoholic liver disease(ALD)has many ...Non-alcoholic fatty liver disease(NAFLD)was the term first used to describe hepatic steatosis in patients with the metabolic syndrome who did not consume excess amounts of alcohol.Alcoholic liver disease(ALD)has many similarities to NAFLD in both pathogenesis and histology.This entity is now the most prevalent chronic liver disease worldwide as a consequence of the epidemic of obesity.Attempts to incorporate the importance of the metabolic syndrome in the development of steatosis resulted in the renaming of NAFLD as metabolic-associated fatty liver disease.This new term,however,has the disadvantage of the use of terms that may be perceived as derogatory.The terms fatty and non-alcoholic have negative connotations in many cultures.In addition,non-alcoholic is not usually a term applicable to pediatric cases of hepatic steatosis.Recently,an international collaborative effort,with participants from 56 countries,after a global consultation process,recommended to change the nomenclature to steatotic liver disease-including metabolic dysfunction-associated steatotic liver disease,metabolic-associated steatohepatitis and metabolic dysfunction-associated ALD.The new terminology is consistent with most of the previously published epidemiological studies and will have a major impact on research into diagnosis,prognosis and treatment.展开更多
Nonalcoholic fatty liver disease(NAFLD)is a global epidemic,affecting more than half of the people living with type 2 diabetes(T2D).The relationship between NAFLD and T2D is bidirectional and the presence of one perpe...Nonalcoholic fatty liver disease(NAFLD)is a global epidemic,affecting more than half of the people living with type 2 diabetes(T2D).The relationship between NAFLD and T2D is bidirectional and the presence of one perpetuates the other,which significantly increases the hepatic as well as extrahepatic complications.Until recently,there was no approved pharmacological treatment for NAFLD/nonalcoholic steatohepatitits(NASH).However,there is evidence that drugs used for diabetes may have beneficial effects on NAFLD.Insulin sensitizers acting through peroxisome proliferator-activated receptor(PPAR)modulation act on multiple levels of NAFLD pathogenesis.Pioglitazone(PPARγ agonist)and saroglitazar(PPARα/γagonist)are particularly beneficial and recommended by several authoritative bodies for treating NAFLD in T2D,although data on biopsyproven NASH are lacking with the latter.Initial data on elafibanor(PPARα/δ agonist)and Lanifibranor(pan PPAR agonist)are promising.On the other hand,incretin therapies based on glucagon-like peptide-1(GLP-1)receptor agonists(GLP-1RA)and dual-and triple-hormone receptor co-agonists reported impressive weight loss and may have anti-inflammatory and antifibrotic properties.GLP-1 RAs have shown beneficial effects on NAFLD/NASH and more studies on potential direct effects on liver function by dual-and triple-agonists are required.Furthermore,the long-term safety of these therapies in NAFLD needs to be established.Collaborative efforts among healthcare providers such as primary care doctors,hepatologists,and endocrinologists are warranted for selecting patients for the best possible management of NAFLD in T2D.展开更多
BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pat...BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.展开更多
Eclipta prostrata L.has been used in traditional medicine and known for its liver-protective properties for centuries.Wedelolactone(WEL)and demethylwedelolactone(DWEL)are the major coumarins found in E.prostrata L.How...Eclipta prostrata L.has been used in traditional medicine and known for its liver-protective properties for centuries.Wedelolactone(WEL)and demethylwedelolactone(DWEL)are the major coumarins found in E.prostrata L.However,the comprehensive characterization of these two compounds on non-alcoholic fatty liver disease(NAFLD)still remains to be explored.Utilizing a well-established zebrafish model of thioacetamide(TAA)-induced liver injury,the present study sought to investigate the impacts and mechanisms of WEL and DWEL on NAFLD through integrative spatial metabolomics with liver-specific transcriptomics analysis.Our results showed that WEL and DWEL significantly improved liver function and reduced the accumulation of fat in the liver.The biodistributions and metabolism of these two compounds in whole-body zebrafish were successfully mapped,and the discriminatory endogenous metabolites reversely regulated by WEL and DWEL treatments were also characterized.Based on spatial metabolomics and transcriptomics,we identified that steroid biosynthesis and fatty acid metabolism are mainly involved in the hepatoprotective effects of WEL instead of DWEL.Our study unveils the distinct mechanism of WEL and DWEL in ameliorating NAFLD,and presents a“multi-omics”platform of spatial metabolomics and liver-specific transcriptomics to develop highly effective compounds for further improved therapy.展开更多
基金Supported by Merit Review grants BX001155 from the Department of Veterans Affairs,Office of Research and Development(Biomedical Laboratory Research and Development)to Kharbanda KK
文摘Alcoholic liver disease(ALD)and non-alcoholic fatty liver disease(NAFLD)are serious health problems worldwide.These two diseases have similar pathological spectra,ranging from simple steatosis to hepatitis to cirrhosis and hepatocellular carcinoma.Although most people with excessive alcohol or calorie intake display abnormal fat accumulation in the liver(simple steatosis),a small percentage develops progressive liver disease.Despite extensive research on understanding the pathophysiology of both these diseases there are still no targeted therapies available.The treatment for ALD remains as it was 50 years ago:abstinence,nutritional support and corticosteroids(or pentoxifylline as an alternative if steroids are contraindicated).As for NAFLD,the treatment modality is mainly directed toward weight loss and co-morbidity management.Therefore,new pathophysiology directed therapies are urgently needed.However,the involvement of several inter-related pathways in the pathogenesis of these diseases suggests that a single therapeutic agent is unlikely to be an effective treatment strategy.Hence,a combination therapy towards multiple targets would eventually be required.In this review,we delineate the treatment options in ALD and NAFLD,including various new targeted therapies that are currently under investigation.We hope that soon we will be having an effective multi-therapeutic regimen for each disease.
基金Supported by Basic Science Research Program(National Research Foundation of Korea),No.2020R1A6A1A03043026.
文摘Liver-gut communication is vital in fatty liver diseases,and gut microbes are the key regulators in maintaining liver homeostasis.Chronic alcohol abuse and persistent overnutrition create dysbiosis in gut ecology,which can contribute to fatty liver disease.In this review,we discuss the gut microbial compositional changes that occur in alcoholic and nonalcoholic fatty liver diseases and how this gut microbial dysbiosis and its metabolic products are involved in fatty liver disease pathophysiology.We also summarize the new approaches related to gut microbes that might help in the diagnosis and treatment of fatty liver disease.
文摘Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)management requires sustainable lifestyle modifications.This study aimed to evaluate the effectiveness of the RESET care plan,a comprehensive program that is an integrated personalized diet,exercise,and cognitive behavior therapy,delivered via MyTatva’s digital health application enabled through a body composition analyzer(BCA)and smartwatch.AIM To evaluates the effectiveness of the comprehensive program delivered via My-Tatva’s digital health app enabled through internet of thing devices.METHODS This retrospective observational study analyzed deidentified data from 22 par-ticipants enrolled in the MyTatva RESET care program.Participants were divided into three groups:Group A,diet plan;Group B,diet+exercise plan;and Group C,diet+exercise+cognitive behavioral therapy plan.Participants were provided with a BCA and smartwatch for continuous monitoring of anthropometric para-meters.Statistical analysis,including one-way ANOVA and post-hoc Tukey’s Honest Significant Difference test,was conducted to compare mean changes in anthropometric parameters across the groups.INTRODUCTION Non-alcoholic fatty liver disease(NAFLD)has emerged as a global health burden,affecting approximately 1 in 4 in-dividuals worldwide.NAFLD ranges from simple steatosis(fat accumulation)to non-alcoholic steatohepatitis(NASH),and its global prevalence in the general population is estimated between 6.3%and 33%,with NASH affecting 3-5%[1,2].Obesity is a major risk factor of NAFLD,with studies showing that the likelihood of developing NAFLD increases 5-fold at a body mass index(BMI)of 30-32.5 kg/m²and up to 14-fold at BMI of 37.5-40 kg/m²compared to a BMI of 20-22.5 kg/m²[3,4].Effective NAFLD management requires both dietary and physical activity modifications.Healthy weight loss with sustained muscle mass plays a pivotal role,with a reduction of 3%-5%decreasing hepatic steatosis,5%-7%improving NASH conditions,and 10%or more needed to reverse hepatic fibrosis[5].Management also normalizes elevated liver enzymes(aspartate aminotransferase and alanine aminotransferase),enhances insulin sensitivity,and thereby reduces cardiovascular risk by improving endothelial function and increasing cardiorespiratory fitness[6].However,diet or exercise alone is often not as effective as a combined approach.Integrating both balanced dietary changes and increased physical activity yields more sustainable improvements in NAFLD and overall metabolic health[1,7].Traditional intervention methods usually involve in-person consultations,which often lack real-time and continuous patient monitoring.The recommendation of drastic changes in diet and exercise can also be overwhelming for patients,leading to low adherence rates.Many patients struggle to maintain these changes in the long-term due to a lack of con-tinuous motivational support[8,9].In recent years,the health ecosystem has witnessed a significant shift toward digital health platforms,which complement pharmacological treatments in chronic disease management,and increase scala-bility.These platforms provide continuous monitoring and personalized support,helping to bridge the gap between health care setups and patients[10].Recent digital advances enable internet of things(IoT)devices to be integrated into such management plans to track health metrics,to address the limitations of traditional methods[11,12].The MyTatva digital health application offers the RESET plan,a novel comprehensive approach for NAFLD mana-gement by integrating personalized support from nutrition,physiotherapy,and cognitive behavioral therapy(CBT)coaches.We aimed to evaluate the effectiveness of the RESET plan by analyzing the reduction in anthropometric para-meters across three different digital intervention groups.
基金supported by grants from National Natural Science Foundation of China(82072709,81902441)Natural Science Foundation of Tianjin Municipal(23JCYBJC00850)+1 种基金China Postdoctoral Science Foundation(2022M712374)Tianjin“131”Innovative Talent Team Project(201926)。
文摘Non-alcoholic fatty liver disease(NAFLD)is one of the most common chronic liver diseases worldwide.Gut microbiota and its metabolites alteration are closely related to NAFLD.Nootkatone is an edible flavorant derived from grapefruit which has a variety of biological activities.However,the precise mechanisms of nootkatone on NAFLD remains to be defined.Our results showed that nootkatone prevented body weight gain and decreased serum lipid level,hepatic lipogenesis,hepatic proinflammatory cytokines secretion in NAFLD mice.Also,nootkatone attenuated inflammatory response via inhibiting TLR4/NF-κB/NLRP3 pathway.Moreover,nootkatone restored intestinal barrier damage through increasing tight junction proteins and short chain fatty acids contents.Further 16S rRNA sequencing of colonic content suggested that nootkatone recovered the disturbed gut microbiota to improve NAFLD.Spearman correlation analysis between gut microbiota and NAFLD related parameters indicated that nootkatone regulated lipid metabolism and immunity via altering the gut microbiota.In conclusion,these findings revealed that nootkatone alleviated hepatic lipid homeostasis and inflammatory response in NAFLD mice,which associated with intestinal barrier integrity and the regulation of gut microbiota.This study provides new perspectives that nootkatone has efficacy on NAFLD via“gut-liver axis”,and nootkatone is expected to be developed as a functional food additive.
文摘Non-alcoholic fatty liver disease(NAFLD)has emerged as a significant health challenge,characterized by its widespread prevalence,intricate natural progression and multifaceted pathogenesis.Although NAFLD initially presents as benign fat accumulation,it may progress to steatosis,non-alcoholic steatohepatitis,cirrhosis,and hepatocellular carcinoma.Mesenchymal stem cells(MSCs)are recognized for their intrinsic self-renewal,superior biocompatibility,and minimal immunogenicity,positioning them as a therapeutic innovation for liver diseases.Therefore,this review aims to elucidate the potential roles of MSCs in alleviating the progression of NAFLD by alteration of underlying molecular pathways,including glycolipid metabolism,inflammation,oxidative stress,endoplasmic reticulum stress,and fibrosis.The insights are expected to provide further understanding of the potential of MSCs in NAFLD therapeutics,and support the development of MSC-based therapy in the treatment of NAFLD.
基金Supported by National Natural Science Foundation of China,No.82000625the Doctoral Scientific Research Foundation of Liaoning Province,No.2020-BS-109.
文摘This editorial comments on an article published in a recent issue of World Journal of Gastroenterology,entitled“Association of low muscle strength with metabolic dysfunction-associated fatty liver disease:A nationwide study”.We focused on the association between muscle strength and the incidence of non-alcoholic fatty liver disease(NAFLD)and metabolic-associated fatty liver disease(MAFLD),as well as the mechanisms underlying the correlation and related clinical applications.NAFLD,which is now redefined as MAFLD,is one of the most common chronic liver diseases globally with an increasing prevalence and is characterized by malnutrition,which may contribute to decreased muscle strength.Reduction of muscle strength reportedly has a pathogenesis similar to that of NAFLD/MAFLD,including insulin resistance,inflammation,sedentary behavior,as well as insufficient vitamin D.Multiple studies have focused on the relationship between sarcopenia or muscle strength and NAFLD.However,studies investigating the relationship between muscle strength and MAFLD are limited.Owing to the shortage of specific medications for NAFLD/MAFLD treatment,early detection is essential.Furthermore,the relationship between muscle strength and NAFLD/MAFLD suggests that improvements in muscle strength may have an impact on disease prevention and may provide novel insights into treatments including dietary therapy,as well as tailored physical activity.
文摘Non-alcoholic fatty liver disease(NAFLD)has emerged as the commonest cause of chronic liver disease worldwide in recent years.With time,our understanding of NAFLD has evolved from an isolated liver condition to a systemic disease with significant manifestations beyond the liver.Amongst them,cardiovascular diseases(CVDs)are the most important and clinically relevant.Recent research supports a strong independent link between NALFD and CVD beyond the shared risk factors and pathophysiology.Female sex hormones are well known to not only protect against CVD in pre-menopausal females,but also contribute to improved adipose tissue function and preventing its systemic deposition.Recent research highlights the increased risk of major adverse cardiovascular-cerebral events(MACCE)amongst male with NAFLD compared to females.Further,racial variation was observed in MACCE outcomes in NAFLD,with excess mortality in the Native Americans and Asian Pacific Islanders compared to the other races.
基金supported by the National Natural Science Foundation of China(81971875,82300661)Natural Science Foundation of Anhui province(2308085QH246)+3 种基金Natural Science Foundation of the Anhui Higher Education Institutions(KJ2021A0205)Basic and Clinical Cooperative Research Program of Anhui Medical University(2019xkjT002,2019xkjT022,2022xkjT013)Talent Training Program,School of Basic Medical Sciences,Anhui Medical University(2022YPJH102)National College Students Innovation and Entrepreneurship Training Program of China(202210366024)。
文摘Non-alcoholic fatty liver disease(NAFLD)is associated with mutations in lipopolysaccharide-binding protein(LBP),but the underlying epigenetic mechanisms remain understudied.Herein,LBP^(-/-)rats with NAFLD were established and used to conduct integrative targetingactive enhancer histone H3 lysine 27 acetylation(H3K27ac)chromatin immunoprecipitation coupled with high-throughput and transcriptomic sequencing analysis to explore the potential epigenetic pathomechanisms of active enhancers of NAFLD exacerbation upon LBP deficiency.Notably,LBP^(-/-)reduced the inflammatory response but markedly aggravated high-fat diet(HFD)-induced NAFLD in rats,with pronounced alterations in the histone acetylome and regulatory transcriptome.In total,1128 differential enhancer-target genes significantly enriched in cholesterol and fatty acid metabolism were identified between wild-type(WT)and LBP^(-/-)NAFLD rats.Based on integrative analysis,CCAAT/enhancer-binding proteinβ(C/EBPβ)was identified as a pivotal transcription factor(TF)and contributor to dysregulated histone acetylome H3K27ac,and the lipid metabolism gene SCD was identified as a downstream effector exacerbating NAFLD.This study not only broadens our understanding of the essential role of LBP in the pathogenesis of NAFLD from an epigenetics perspective but also identifies key TF C/EBPβand functional gene SCD as potential regulators and therapeutic targets.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk factors.However,large-scale cardiovascular sex and race differences are poorly understood.AIM To investigate the relationship between NAFLD and major cardiovascular and cerebrovascular events(MACCE)in subgroups using a nationally representative United States inpatient sample.METHODS We examined National Inpatient Sample(2019)to identify adult hospitalizations with NAFLD by age,sex,and race using ICD-10-CM codes.Clinical and demographic characteristics,comorbidities,and MACCE-related mortality,acute myocardial infarction(AMI),cardiac arrest,and stroke were compared in NAFLD cohorts by sex and race.Multivariable regression analyses were adjusted for sociodemographic characteristics,hospitalization features,and comorbidities.RESULTS We examined 409130 hospitalizations[median 55(IQR 43-66)years]with NFALD.NAFLD was more common in females(1.2%),Hispanics(2%),and Native Americans(1.9%)than whites.Females often reported non-elective admissions,Medicare enrolment,the median age of 55(IQR 42-67),and poor income.Females had higher obesity and uncomplicated diabetes but lower hypertension,hyperlipidemia,and complicated diabetes than males.Hispanics had a median age of 48(IQR 37-60),were Medicaid enrollees,and had non-elective admissions.Hispanics had greater diabetes and obesity rates than whites but lower hypertension and hyperlipidemia.MACCE,all-cause mortality,AMI,cardiac arrest,and stroke were all greater in elderly individuals(P<0.001).MACCE,AMI,and cardiac arrest were more common in men(P<0.001).Native Americans(aOR 1.64)and Asian Pacific Islanders(aOR 1.18)had higher all-cause death risks than whites.CONCLUSION Increasing age and male sex link NAFLD with adverse MACCE outcomes;Native Americans and Asian Pacific Islanders face higher mortality,highlighting a need for tailored interventions and care.
基金Supported by National Natural Science Foundation of China,No.81802508 and No.81903398Chongqing Natural Science Foundation Program,No.CSTC2019JCYJ-MSXMX0466 and No.CSTB2022NSCQ-MSX0206+4 种基金The Research Start-up Fund for Introduction of Talents of Sichuan University,No.YJ2021112Medical Youth Innovation Research Project of Sichuan Province,No.Q21016Natural Science Foundation of Sichuan,No.2023NSFSC1927Sichuan Province Central Government Guide Local Science and Technology Development Project,No.2023ZYD0097"From 0 to 1"Innovation Project of Sichuan University,No.2023SCUH0026.
文摘BACKGROUND A body of evidence has suggested bidirectional relationships among gallstone disease(GSD),non-alcoholic fatty liver disease(NAFLD),and kidney stone disease(KSD).However,the results are inconsistent,and studies on this topic in China are relatively few.Our goal is to explore the bidirectional associations among these three diseases through a multicenter study,systematic review,and meta-analysis.AIM To explore the bidirectional associations among these three diseases through a multicenter study,systematic review,and meta-analysis.The results may help to investigate the etiology of these diseases and shed light on the individualized prevention of these three diseases.METHODS Subjects who participated in physical examinations in Beijing,Tianjin,Chongqing in China were recruited.Multivariable logistic regression was employed to explore the bidirectional relationships among GSD,KSD,and NAFLD.Systematic review and meta-analysis were initiated to confirm the epidemiologic evidence from previous observational studies.Furthermore,trial sequential analysis(TSA)was conducted to evaluate whether the evidence was sufficient and conclusive.RESULTS Significant bidirectional associations were detected among the three diseases,independent of potential confounding factors.The pooled results of the systematic review and meta-analysis also corroborated the aforementioned results.The combined evidence from the multicenter study and meta-analysis was significant[pooled odds ratio(OR)=1.42,95%CI:1.16-1.75,KSD→GSD;pooled OR=1.48,95%CI:1.31-1.67,GSD→KSD;pooled OR=1.31,95%CI:1.17-1.47,GSD→NAFLD;pooled OR=1.37,95%CI:1.26-1.50,NAFLD→GSD;pooled OR=1.28,95%CI:1.08-1.51,NAFLD→KSD;pooled OR=1.21,95%CI:1.16-1.25,KSD→NAFLD].TSA indicated that the evidence was sufficient and conclusive.CONCLUSION The present study presents relatively sufficient evidence for the positive bidirectional associations among GSD,KSD,and NAFLD.The results may provide clues for investigating the etiology of these three diseases and offer a guideline for identifying high-risk patients.
文摘In this editorial,we commented on a recently released manuscript by Zeng et al in the World Journal of Gastroenterology.We focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease(NAFLD).NAFLD is a hepatic manifestation of the metabolic syndrome,which ultimately leads to advanced hepatic fibrosis,cirrhosis,and hepatocellular carcinoma and affects more than 25%of the population globally.Existing therapeutic strategies against NAFLD such as pharmacologic therapies focus on liver protection,anti-inflammation,and regulating disease-related metabolic disorder symptoms.Although several drugs are in late-stage development,potent drugs against the diseases are lacking.Additionally,existing surgical approaches such as bariatric surgery are not routinely used to treat NAFLD.Intervening in patients’unhealthy lifestyles,such as weight loss through dietary changes and exercises to ameliorate patientassociated metabolic disorders and metabolic syndrome,is the first-line treatment for patients with NAFLD.With sufficient intrinsic motivation and adherence,the management of unhealthy lifestyles can reduce the severity of the disease,improve the quality of life,and increase the survival expectancy of patients with NAFLD.
基金the National Natural Science Foundation of China,No.82104525the Natural Science Foundation of the Jiangsu Higher Education Institutions of China,No.21KJB360009Health Commission of Zhejiang Province Scientific Research Foundation,No.2024KY247.
文摘The population of non-alcoholic fatty liver disease(NAFLD)patients along with relevant advanced liver disease is projected to continue growing,because currently no medications are approved for treatment.Fecal microbiota transplantation(FMT)is believed a novel and promising therapeutic approach based on the concept of the gut-liver axis in liver disease.There has been an increase in the number of pre-clinical and clinical studies evaluating FMT in NAFLD treatment,however,existing findings diverge on its effects.Herein,we briefly summarized the mechanism of FMT for NAFLD treatment,reviewed randomized controlled trials for evaluating its efficacy in NAFLD,and proposed the prospect of future trials on FMT.
基金Supported by Natural Science Foundation of Shanghai,No.17ZR1431400and National Key R&D Program of China,No.2017YFA0103902.
文摘Non-alcoholic fatty liver disease(NAFLD)is characterized by symptoms of excessive fat accumulation and steatosis in the liver without alcohol intake in patients.The associated pathogenic mechanism is not completely understood and there are no specific drugs for patients with NAFLD.Exercise and diet adherence are the best options for the management of NAFLD patients.Questionnaire associated analysis models of adherence to these interventions are used to assess their effectiveness in the management of NAFLD patients using specificity,sensitivity,and so on.Studies have indicated that the relative ratio of NAFLD can be reduced by physical activity with diet control.In the future,the pathogenesis of NAFLD should be clarified with stratified efforts to develop appropriate drugs,and both exercise and diet adherence should be optimized using better questionnaire design and evaluation models for patients with NAFLD.
文摘BACKGROUND There are limited studies investigating the association between type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD)in the region of Bihar,India.AIM To estimate the prevalence of NAFLD in persons with newly diagnosed T2DM in the population of North Bihar,India.METHODS This single centre cross-sectional study was undertaken in the Research Centre for Diabetes Hypertension and Obesity,Samastipur,Bihar,India.Data were collected from persons newly diagnosed with T2DM or those diagnosed within 6 months of when the study was conducted between December 2022 to May 2023.RESULTS A total of 148 people with newly diagnosed T2DM were included(median age 47 years,46.6%female)and 109 patients with liver disease on ultrasound evaluation.The persons with liver disease consumed more fats and oils(88.1%vs 74.4%,P=0.042)and they had significantly greater body mass index(27.4 vs 23.0,P<0.001),waist circumference(37 vs 33,P<0.001),and waist-to-hip ratio(1.00 vs 0.70,P=0.025).Females were associated with greater liver disease[odds ratio(OR):3.09,95%confidence interval(CI):1.09-8.80,P=0.32].Waist circumference(OR:1.42,95%CI:1.22-1.66,P<0.001)and low-density lipoprotein cholesterol(OR:1.01,95%CI:1.01-1.02,P=0.048)were associated with any liver disease.The factors most associated with grade 2/3 liver disease was right upper quadrant pain or heaviness(OR:5.22,95%CI:1.40-19.41,P=0.14),greater income(OR:3.58,95%CI:1.28-10.04,P=0.015)and waist circumference(OR:1.31,95%CI:1.02-1.69,P=0.036).CONCLUSION NAFLD is common in new/recently diagnosed T2DM and disease burden is high and common among patients who are either high consumers of fats and oils or have obesity-associated markers.
基金Supported by National Natural Science Foundation of China,No.82360880,and 82060661Jiangxi Provincial Natural Science Foundation of China,No.20232ACB206057+3 种基金Key project of Jiangxi Provincial Department of Education,No.GJJ218104Teaching reform research project of Jiangxi Province of China,No.JXJG-22-130-1National Natural Science Foundation of China,No.81660151Jiangxi Provincial Natural Science Foundation of China,No.20212BAB206092.
文摘Studies have shown that non-alcoholic fatty liver disease(NAFLD)may be associated with sleep disorders.In order to explore the explicit relationship between the two,we systematically reviewed the effects of sleep disorders,especially obstructive sleep apnea(OSA),on the incidence of NAFLD,and analyzed the possible mechanisms after adjusting for confounding factors.NAFLD is independently associated with sleep disorders.Different sleep disorders may be the cause of the onset and aggravation of NAFLD.An excessive or insufficient sleep duration,poor sleep quality,insomnia,sleep-wake disorders,and OSA may increase the incidence of NAFLD.Despite that some research suggests a unidirectional causal link between the two,specifically,the onset of NAFLD is identified as a result of changes in sleep characteristics,and the reverse relationship does not hold true.Nevertheless,there is still a lack of specific research elucidating the reasons behind the higher risk of developing sleep disorders in individuals with NAFLD.Further research is needed to establish a clear relationship between NAFLD and sleep disorders.This will lay the groundwork for earlier identification of potential patients,which is crucial for earlier monitoring,diagnosis,effective prevention,and treatment of NAFLD.
文摘Non-alcoholic fatty liver disease(NAFLD)was the term first used to describe hepatic steatosis in patients with the metabolic syndrome who did not consume excess amounts of alcohol.Alcoholic liver disease(ALD)has many similarities to NAFLD in both pathogenesis and histology.This entity is now the most prevalent chronic liver disease worldwide as a consequence of the epidemic of obesity.Attempts to incorporate the importance of the metabolic syndrome in the development of steatosis resulted in the renaming of NAFLD as metabolic-associated fatty liver disease.This new term,however,has the disadvantage of the use of terms that may be perceived as derogatory.The terms fatty and non-alcoholic have negative connotations in many cultures.In addition,non-alcoholic is not usually a term applicable to pediatric cases of hepatic steatosis.Recently,an international collaborative effort,with participants from 56 countries,after a global consultation process,recommended to change the nomenclature to steatotic liver disease-including metabolic dysfunction-associated steatotic liver disease,metabolic-associated steatohepatitis and metabolic dysfunction-associated ALD.The new terminology is consistent with most of the previously published epidemiological studies and will have a major impact on research into diagnosis,prognosis and treatment.
文摘Nonalcoholic fatty liver disease(NAFLD)is a global epidemic,affecting more than half of the people living with type 2 diabetes(T2D).The relationship between NAFLD and T2D is bidirectional and the presence of one perpetuates the other,which significantly increases the hepatic as well as extrahepatic complications.Until recently,there was no approved pharmacological treatment for NAFLD/nonalcoholic steatohepatitits(NASH).However,there is evidence that drugs used for diabetes may have beneficial effects on NAFLD.Insulin sensitizers acting through peroxisome proliferator-activated receptor(PPAR)modulation act on multiple levels of NAFLD pathogenesis.Pioglitazone(PPARγ agonist)and saroglitazar(PPARα/γagonist)are particularly beneficial and recommended by several authoritative bodies for treating NAFLD in T2D,although data on biopsyproven NASH are lacking with the latter.Initial data on elafibanor(PPARα/δ agonist)and Lanifibranor(pan PPAR agonist)are promising.On the other hand,incretin therapies based on glucagon-like peptide-1(GLP-1)receptor agonists(GLP-1RA)and dual-and triple-hormone receptor co-agonists reported impressive weight loss and may have anti-inflammatory and antifibrotic properties.GLP-1 RAs have shown beneficial effects on NAFLD/NASH and more studies on potential direct effects on liver function by dual-and triple-agonists are required.Furthermore,the long-term safety of these therapies in NAFLD needs to be established.Collaborative efforts among healthcare providers such as primary care doctors,hepatologists,and endocrinologists are warranted for selecting patients for the best possible management of NAFLD in T2D.
文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.
基金supported by the National Natural Science Foundation of China(Grant No.:82273888)Natural Science Foundation of Shandong Province(Grant Nos.ZR2022QH257,ZR2020YQ60)+2 种基金Shandong Major Technological Innovation Project(Project No.:2021CXGC010508)Taishan Scholars Program of Shandong Province(Program Nos.:tsqn202103096,tsqn202211204)Shandong Province Science and Technology Small and Medium Enterprises Innovation Ability Enhancement Project(Project No.:2022TSGC2210).
文摘Eclipta prostrata L.has been used in traditional medicine and known for its liver-protective properties for centuries.Wedelolactone(WEL)and demethylwedelolactone(DWEL)are the major coumarins found in E.prostrata L.However,the comprehensive characterization of these two compounds on non-alcoholic fatty liver disease(NAFLD)still remains to be explored.Utilizing a well-established zebrafish model of thioacetamide(TAA)-induced liver injury,the present study sought to investigate the impacts and mechanisms of WEL and DWEL on NAFLD through integrative spatial metabolomics with liver-specific transcriptomics analysis.Our results showed that WEL and DWEL significantly improved liver function and reduced the accumulation of fat in the liver.The biodistributions and metabolism of these two compounds in whole-body zebrafish were successfully mapped,and the discriminatory endogenous metabolites reversely regulated by WEL and DWEL treatments were also characterized.Based on spatial metabolomics and transcriptomics,we identified that steroid biosynthesis and fatty acid metabolism are mainly involved in the hepatoprotective effects of WEL instead of DWEL.Our study unveils the distinct mechanism of WEL and DWEL in ameliorating NAFLD,and presents a“multi-omics”platform of spatial metabolomics and liver-specific transcriptomics to develop highly effective compounds for further improved therapy.
