scholarly journals Peculiarities of Cirrhosis due to Nonalcoholic Steatohepatitis (NASH)

2019 ◽  
Vol 40 (01) ◽  
pp. 001-010
Author(s):  
Omar El-Sherif ◽  
M.J. Armstrong
Keyword(s):  
Hepatocellular Carcinoma ◽  
Nonalcoholic Steatohepatitis ◽  
Metabolic Diseases ◽  
Nutritional Assessment ◽  
The United States ◽  
Obesity And Diabetes ◽  
Noninvasive Assessment ◽  
New Challenges ◽  
Complications Of Cirrhosis ◽  
The Impact

AbstractThe prevalence of cirrhosis due to nonalcoholic steatohepatitis (NASH) has increased 2.5-fold in the United States in the last decade. These patients pose new challenges to hepatologists given their older age and higher frequency of coexisting metabolic diseases such as obesity and diabetes compared with other etiologies of liver disease. Patients with NASH cirrhosis are at higher risk for renal and cardiovascular disease, and the presence of these extrahepatic comorbidities has a significant impact on outcomes and survival. This review outlines how NASH cirrhosis differs from other etiologies of cirrhosis including natural history, noninvasive assessment, and the challenges in the management of the complications of cirrhosis including hepatic encephalopathy and hepatocellular carcinoma. Nutritional assessment and the impact of sarcopenic obesity and frailty in this population, and strategies to address the latter, are discussed. This review also addresses liver transplantation in patients with NASH cirrhosis in relation to assessment and posttransplant care.

scholarly journals Early Morning Food Intake as a Risk Factor for Metabolic Dysregulation

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 756
Author(s):  
Ellen R. Stothard ◽  
Hannah K. Ritchie ◽  
Brian R. Birks ◽  
Robert H. Eckel ◽  
Janine Higgins ◽  
...  
Keyword(s):  
Food Intake ◽  
Caloric Intake ◽  
The United States ◽  
Early Morning ◽  
Shift Workers ◽  
Wake Time ◽  
Metabolic Dysregulation ◽  
Obesity And Diabetes ◽  
Increased Risk ◽  
The Impact

Increased risk of obesity and diabetes in shift workers may be related to food intake at adverse circadian times. Early morning shiftwork represents the largest proportion of shift workers in the United States, yet little is known about the impact of food intake in the early morning on metabolism. Eighteen participants (9 female) completed a counterbalanced 16 day design with two conditions separated by ~1 week: 8 h sleep opportunity at habitual time and simulated early morning shiftwork with 6.5 h sleep opportunity starting ~1 h earlier than habitual time. After wake time, resting energy expenditure (REE) was measured and blood was sampled for melatonin and fasting glucose and insulin. Following breakfast, post-prandial blood samples were collected every 40 min for 2 h and the thermic effect of food (TEF) was assessed for 3.25 h. Total sleep time was decreased by ~85 min (p < 0.0001), melatonin levels were higher (p < 0.0001) and post-prandial glucose levels were higher (p < 0.05) after one day of simulated early morning shiftwork compared with habitual wake time. REE was lower after simulated early morning shiftwork; however, TEF after breakfast was similar to habitual wake time. Insufficient sleep and caloric intake during a circadian phase of high melatonin levels may contribute to metabolic dysregulation in early morning shift workers.

scholarly journals Could the beneficial effects of dietary calcium on obesity and diabetes control be mediated by changes in intestinal microbiota and integrity?

2015 ◽  
Vol 114 (11) ◽  
pp. 1756-1765 ◽  
Author(s):  
J. M. G. Gomes ◽  
J. A. Costa ◽  
R. C. Alfenas
Keyword(s):  
Gut Microbiota ◽  
Metabolic Diseases ◽  
Beneficial Effects ◽  
Body Weight Reduction ◽  
Intestinal Integrity ◽  
Obesity And Diabetes ◽  
Supplementation Period ◽  
Inflammatory State ◽  
The Impact

AbstractEvidence from animal and human studies has associated gut microbiota, increased translocation of lipopolysaccharide (LPS) and reduced intestinal integrity (II) with the inflammatory state that occurs in obesity and type 2 diabetes mellitus (T2DM). Consumption of Ca may favour body weight reduction and glycaemic control, but its influence on II and gut microbiota is not well understood. Considering the impact of metabolic diseases on public health and the role of Ca on the pathophysiology of these diseases, this review critically discusses possible mechanisms by which high-Ca diets could affect gut microbiota and II. Published studies from 1993 to 2015 about this topic were searched and selected from Medline/PubMed, Scielo and Lilacs databases. High-Ca diets seem to favour the growth of lactobacilli, maintain II (especially in the colon), reduce translocation of LPS and regulate tight-junction gene expression. We conclude that dietary Ca might interfere with gut microbiota and II modulations and it can partly explain the effect of Ca on obesity and T2DM control. However, further research is required to define the supplementation period, the dose and the type of Ca supplement (milk or salt) required for more effective results. As Ca interacts with other components of the diet, these interactions must also be considered in future studies. We believe that more complex mechanisms involving extraintestinal disorders (hormones, cytokines and other biomarkers) also need to be studied.

scholarly journals The Impact of Liver Transplantation on Hepatocellular Carcinoma Mortality in the United States

2020 ◽  
pp. cebp.1188.2020
Author(s):  
Parag Mahale ◽  
Meredith S. Shiels ◽  
Charles F. Lynch ◽  
Srinath Chinnakotla ◽  
Linda L Wong ◽  
...  
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
The United States ◽  
The Impact

The Impact of NASH to Liver Transplantations with Hepatocellular Carcinoma in the United States

2021 ◽  
Author(s):  
Zobair M. Younossi ◽  
Michael Harring ◽  
Youssef Younossi ◽  
Janus P. Ong ◽  
Saleh A. AlQahtani ◽  
...  
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
The United States ◽  
Liver Transplantations ◽  
The Impact

Significantly Higher Mortality Following Liver Transplantation Among Patients Aged 70 Years and Older

2017 ◽  
Vol 27 (3) ◽  
pp. 225-231 ◽  
Author(s):  
Mokshya Sharma ◽  
Aijaz Ahmed ◽  
Robert J. Wong
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Hepatitis C ◽  
Proportional Hazards ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Using Data ◽  
The Impact

Introduction: The age of liver transplantation recipients in the United States is steadily increasing. However, the impact of age on liver transplant outcomes has demonstrated contradictory results. Research Questions: We aim to evaluate the impact of age on survival following liver transplantation among US adults. Design: Using data from the United Network for Organ Sharing registry, we retrospectively evaluated all adults undergoing liver transplantation from 2002 to 2012 stratified by age (aged 70 years and older vs aged <70 years), presence of hepatocellular carcinoma, and hepatitis C virus status. Overall survival was evaluated with Kaplan-Meier methods and multivariate Cox proportional hazards models. Results: Compared to patients aged <70 years, those aged 70 years and older had significantly lower 5-year survival following transplantation among all groups analyzed (hepatocellular carcinoma: 59.9% vs 68.6%, P < .01; nonhepatocellular carcinoma: 61.2% vs 74.2%, P < .001; hepatitis C: 60.7% vs 69.0%, P < .01; nonhepatitis C: 62.6% vs 78.5%, P < .001). On multivariate regression, patients aged 70 years and older at time of transplantation was associated with significantly higher mortality compared to those aged <70 years (hazards ratio: 1.67; 95% confidence interval: 1.48-1.87; P < .001). Conclusion: The age at the time of liver transplantation has continued to increase in the United States. However, patients aged 70 years and older had significantly higher mortality following liver transplantation. These observations are especially important given the aging cohort of patients with chronic liver disease in the United States.

745 The Impact of Hepatocellular Carcinoma (HCC) in the United States (U.S.) From 2005 to 2009

2012 ◽  
Vol 142 (5) ◽  
pp. S-928
Author(s):  
Alita Mishra ◽  
Munkhzul Otgonsuren ◽  
Chapy Venkatesan ◽  
Mariam Afendy ◽  
Madeline Erario ◽  
...  
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
The United States ◽  
The Impact

scholarly journals High Rates of Liver Cirrhosis and Hepatocellular Carcinoma in Chronic Hepatitis B Patients with Metabolic and Cardiovascular Comorbidities

2021 ◽  
Vol 9 (5) ◽  
pp. 968
Author(s):  
Jan-Hendrik Bockmann ◽  
Matin Kohsar ◽  
John M. Murray ◽  
Vanessa Hamed ◽  
Maura Dandri ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Disease Surveillance ◽  
Metabolic Diseases ◽  
Cardiovascular Comorbidities ◽  
The Impact

Background: The prevalence of metabolic and cardiovascular diseases is rising worldwide. However, little is known about the impact of such disorders on hepatic disease progression in chronic hepatitis B (CHB) during the era of potent nucleo(s)tide analogues (NAs). Methods: We retrospectively analyzed a single-center cohort of 602 CHB patients, comparing the frequency of liver cirrhosis at baseline and incidences of liver-related events during follow-up (hepatocellular carcinoma, liver transplantation and liver-related death) between CHB patients with a history of diabetes, obesity, hypertension or coronary heart disease (CHD). Results: Rates of cirrhosis at baseline and liver-related events during follow-up (median follow-up time: 2.51 years; NA-treated: 37%) were substantially higher in CHB patients with diabetes (11/23; 3/23), obesity (6/13; 2/13), CHD (7/11; 2/11) or hypertension (15/43; 4/43) compared to CHB patients without the indicated comorbidities (26/509; 6/509). Multivariate analysis identified diabetes as the most significant predictor for cirrhosis (p = 0.0105), while comorbidities did not correlate with liver-related events in pre-existing cirrhosis. Conclusion: The combination of metabolic diseases and CHB is associated with substantially increased rates of liver cirrhosis and secondary liver-related events compared to CHB alone, indicating that hepatitis B patients with metabolic comorbidities warrant particular attention in disease surveillance and evaluation of treatment indication.

scholarly journals The impact of obesity and diabetes mellitus on the risk of hepatocellular carcinoma

2009 ◽  
Vol 20 (2) ◽  
pp. 353-357 ◽  
Author(s):  
J. Polesel ◽  
A. Zucchetto ◽  
M. Montella ◽  
L. Dal Maso ◽  
A. Crispo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hepatocellular Carcinoma ◽  
Obesity And Diabetes ◽  
The Impact

Hepatocellular Carcinoma in Nonalcoholic Steatohepatitis

2017 ◽  
Vol 01 (02) ◽  
pp. 066-073
Author(s):  
Sean Koppe ◽  
Hafiz Arshad
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Nonalcoholic Steatohepatitis ◽  
The United States ◽  
Nuclear Factor ◽  
Obese Patients ◽  
Nonalcoholic Fatty Liver ◽  
Potential Risk Factors ◽  
Factor Α ◽  
Necrosis Factor

AbstractNonalcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease in the United States. Approximately 10 to 20% of patients with NAFLD progress to nonalcoholic steatohepatitis (NASH). NASH can progress to cirrhosis, which, in turn, can lead to hepatocellular carcinoma (HCC). However, evidence also supports that HCC can develop in patients with NASH who do not have cirrhosis or advanced fibrosis. Obesity, diabetes mellitus, hepatic iron deposition, and insulin resistance are potential risk factors for HCC in NASH. Mechanisms proposed include a role for tumor necrosis factor-α, interleukin-6, insulinlike growth factor, and nuclear factor κβ activation in progression of NASH to HCC. Polymorphisms in patatin-like phospholipase domain-containing 3 also support a genetic influence in NASH-related HCC. Surgical resection, liver directed therapy, and liver transplant remain the mainstay of therapy. Ultrasound has reduced sensitivity for surveillance of HCC in obese patients and alpha fetoprotein may have more value for HCC surveillance in the NASH patient as compared with the HCV patient. Although HCC can develop in noncirrhotic NASH, currently there are no guidelines to recommend surveillance in noncirrhotic NASH patients.

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