Menopausal hot flushes severity is associated with hepatic steatosis index values

Resumen La incidencia de la enfermedad del hígado graso asociada al metabolismo (MAFLD) ha aumentado en los últimos años debido al estilo de vida actual. La biopsia de hígado sigue siendo la herramienta estándar de oro para detectar y estadificar MAFLD. Por otro lado, se están desarrollando múltiples biomarcadores y pruebas no invasivas para superar las limitaciones de la biopsia hepática, incluidos el costo y la invasividad. Las pruebas no invasivas se centran principalmente en la esteatosis y, en particular, en la fibrosis hepática y se pueden clasificar en pruebas patentadas y no patentadas. Si bien hepatic steatosis index y fatty liver index son las pruebas más comunes utilizadas para la detección de esteatosis, Hepamet Fibrosis Score, NAFLD fibrosis score, FIB-4, OWLiver®, y ELF® son las más utilizadas para la fibrosis hepática. Sin embargo, las pruebas no invasivas también tienen limitaciones que conviene resaltar ya que sus resultados podrían verse afectados por la presencia de diabetes, obesidad o por edades extremas que podrían dar lugar a falsos positivos o negativos. Para maximizar la precisión de los tests no invasivos, se han propuesto diferentes combinaciones integradas en algoritmos escalonados. Esta revisión tiene como objetivo destacar las fortalezas y limitaciones de dichos tests para detectar y estadificar MAFLD.

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Role of vascular endothelial growth factor in the pathogenesis of hepatic steatosis and dyslipidemia

ZHurnal «Patologicheskaia fiziologiia i eksperimental`naia terapiia» ◽

10.25557/0031-2991.2020.04.31-36 ◽

2020 ◽

pp. 31-36

Author(s):

И.Л. Гуляева ◽

И.А. Булатова ◽

Л.Д. Пестренин

Keyword(s):

Metabolic Syndrome ◽

Fatty Liver ◽

Hepatic Steatosis ◽

Low Density Lipoproteins ◽

Control Group ◽

Low Density ◽

Very Low Density Lipoproteins ◽

Fatty Liver Index ◽

Nonalcoholic Hepatic Steatosis ◽

Hepatic Steatosis Index

Цель исследования - изучение роли васкулоэндотелиального фактора роста в патогенезе неалкогольного стеатоза печени и дислипидемии при метаболическом синдроме. Методика. Обследовано 35 пациентов с неалкогольным стеатозом печени, в том числе 22 женщины и 13 мужчин. Группу контроля составили 12 сопоставимых по полу и возрасту лиц без патологии печени и признаков метаболического синдрома. Наличие жирового гепатоза подтверждали методом ультразвукового исследования. У пациентов с патологией печени рассчитывали индексы-предикторы стеатоза: Fatty Liver Index (FLI) и Hepatic Steatosis Index (HSI). У всех участников исследования определяли уровни провоспалительных цитокинов и васкулоэндотелиального фактора роста (ВЭФР), оценивали также липидный спектр крови и функциональные печеночные пробы. Результаты. У пациентов со стеатозом печени наблюдалось значимое увеличение уровней провоспалительных цитокинов, ВЭФР, общего холестерина и липопротеинов низкой и очень низкой плотности. Индекс атерогенности также был значимо выше, чем в контрольной группе. Концентрация ВЭФР положительно коррелировала с показателями окружности талии, тимоловой пробы, уровнями общего холестерина, липопротеинов низкой плотности и индексом атерогенности. Чувствительность FLI составила 91,4%, HSI - 97,1%. При этом, значения FLI и HSI значимо коррелировали с уровнем ВЭФР. Заключение. Полученные данные позволяют предположить, что ВЭФР, один из основных маркеров эндотелиальной дисфункции, может играть немаловажную роль в патогенезе неалкогольного стеатоза печени и дислипидемии у пациентов с метаболическомим синдромом The aim of the study was to assess the role of vascular endothelial growth factor (VEGF) in the pathogenesis of nonalcoholic hepatic steatosis and dyslipidemia in patients with signs of metabolic syndrome. Methods. 35 patients with nonalcoholic fatty liver disease, including 22 women and 13 men, were evaluated. The sex- and age-matched control group consisted of 12 people without liver pathology and metabolic syndrome criteria. Presence of hepatic steatosis was confirmed by an ultrasound examination. The Fatty Liver Index (FLI) and the Hepatic Steatosis Index (HSI) were calculated for patients with hepatic steatosis. Concentrations of proinflammatory cytokines and VEGF were measured for all participants. Also, blood biochemistry, including the lipid profile and liver function tests, was analyzed. Results. In patients with hepatic steatosis, levels of proinflammatory cytokines and VEGF were significantly increased. Also, concentrations of total cholesterol, low-density lipoproteins, and very low-density lipoproteins were higher in patients with the liver pathology than in the control group. Atherogenic coefficient was increased in hepatic steatosis. Significant correlations were observed between VEGF and waist circumference, thymol test, total cholesterol, low-density lipoproteins, very low-density lipoproteins, and atherogenic coefficient. Sensitivity of FLI and HIS was 91.4% and 97.1%, respectively. Also, FLI significantly correlated with HSI and VEGF level. Conclusion. The study suggested that VEGF, of the main markers of endothelial dysfunction, plays an important role in the pathogenesis of nonalcoholic hepatic steatosis and dyslipidemia in patients with signs of metabolic syndrome.

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Hepatic Steatosis Index in Acromegaly: Correlation with Insulin Resistance Regardless of the Disease Control

International Journal of Endocrinology ◽

10.1155/2018/5421961 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Alessandro Ciresi ◽

Valentina Guarnotta ◽

Daniela Campo ◽

Carla Giordano

Keyword(s):

Insulin Resistance ◽

Insulin Sensitivity ◽

Hepatic Steatosis ◽

Somatostatin Receptor ◽

Receptor Ligands ◽

Noninvasive Methods ◽

Somatostatin Receptor Ligands ◽

Hepatic Steatosis Index ◽

Surrogate Index ◽

Gh Excess

Objective. In acromegaly, both lipotoxicity secondary to GH excess and insulin resistance have a significant impact on the liver. Ultrasonography has shown poor sensitivity in detecting hepatic steatosis and noninvasive methods have been proposed. We evaluated the hepatic steatosis index (HSI), a validated surrogate index of hepatic steatosis, and we correlated it with disease activity and insulin resistance. Design. Thirty-one patients with newly diagnosed acromegaly were studied at diagnosis and after 12 months of treatment with somatostatin receptor ligands. Methods. Glucose and insulin levels, surrogate estimates of insulin sensitivity, and hepatic steatosis through ultrasonography and HSI were evaluated. Results. At diagnosis, ultrasonography documented steatosis in 19 patients (61.2%) while 26 (83.8%) showed high HSI. After 12 months, both GH (p=0.033) and IGF-1 (p<0.001) significantly decreased and, overall, 58% of patients were classified as controlled. Ultrasonography documented steatosis in all the same initial 19 patients, while only 14 patients (45.1%) showed high HSI (p<0.001). A significant reduction in HOMA-IR (p=0.002) and HSI (p<0.001) and increased ISI Matsuda (p<0.001), was documented. The change of HSI from baseline to 12 months was found to be directly correlated with the change of ISI (Rho -0.611; p=0.004) while no correlation was found with the change of GH or IGF-1 levels and other parameters. Conclusions. In acromegaly, HSI is mainly related with insulin resistance and the reduction of GH and IGF-1 levels, and above all the improvement in insulin sensitivity leads to an improvement of this surrogate index of hepatic steatosis.

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