scholarly journals Posttransplant Metabolic Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
M. Shadab Siddiqui ◽  
Richard K. Sterling
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Transplant ◽  
Cardiovascular Mortality ◽  
Early Recognition ◽  
Health Concern ◽  
Rapid Progression ◽  
Factors Associated ◽  
Increased Risk

Metabolic syndrome (MS) is a cluster of metabolic derangements associated with insulin resistance and an increased risk of cardiovascular mortality. MS has become a major health concern worldwide and is considered to be the etiology of the current epidemic of diabetes and cardiovascular disease. In addition to cardiovascular disease, the presence of MS is also closely associated with other comorbidities including nonalcoholic fatty liver disease (NAFLD). The prevalence of MS in patients with cirrhosis and end-stage liver disease is not well established and difficult to ascertain. Following liver transplant, the prevalence of MS is estimated to be 44–58%. The main factors associated with posttransplant MS are posttransplant diabetes, obesity, dyslipidemia, and hypertension. In addition to developing NAFLD, posttransplant MS is associated with increased cardiovascular mortality that is 2.5 times that of the age- and sex-matched individuals. Additionally, the presence of posttransplant MS has been associated with rapid progression to fibrosis in individuals transplanted for HCV cirrhosis. There is an urgent need for well-designed prospective studies to fully delineate the natural history and risk factors associated with posttransplant MS. Until then, early recognition, prevention, and treatment of its components are vital in improving outcomes in liver transplant recipients.

scholarly journals Non-alcoholic fatty liver disease: the hepatic consequence of obesity and the metabolic syndrome

2010 ◽  
Vol 69 (2) ◽  
pp. 211-220 ◽  
Author(s):  
J. Bernadette Moore
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Response To Treatment ◽  
Health Concern ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is now the most common liver disease in both adults and children worldwide. As a disease spectrum, NAFLD may progress from simple steatosis to steatohepatitis, advanced fibrosis and cirrhosis. An estimated 20–35% of the general population has steatosis, 10% of whom will develop the more progressive non-alcoholic steatohepatitis associated with markedly increased risk of cardiovascular- and liver-related mortality. Development of NAFLD is strongly linked to components of the metabolic syndrome including obesity, insulin resistance, dyslipidaemia and type 2 diabetes. The recognition that NAFLD is an independent risk factor for CVD is a major public health concern. There is a great need for a sensitive non-invasive test for the early detection and assessment of the stage of NAFLD that could also be used to monitor response to treatment. The cellular and molecular aetiology of NAFLD is multi-factorial; genetic polymorphisms influencing NAFLD have been identified and nutrition is a modifiable environmental factor influencing NAFLD progression. Weight loss through diet and exercise is the primary recommendation in the clinical management of NAFLD. The application of systems biology to the identification of NAFLD biomarkers and factors involved in NAFLD progression is an area of promising research.

Nonalcoholic Fatty Liver Disease and Cardiovascular Disease: Overlapping Mechanisms

2021 ◽  
Author(s):  
Søren Møller ◽  
Nina Kimer ◽  
Thit Kronborg ◽  
Josephine Grandt ◽  
Jens Dahlgaard Hove ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Severe Form ◽  
Nonalcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Near Future

AbstractNonalcoholic fatty liver disease (NAFLD) denotes a condition with excess fat in the liver. The prevalence of NAFLD is increasing, averaging > 25% of the Western population. In 25% of the patients, NAFLD progresses to its more severe form: nonalcoholic steatohepatitis and >25% of these progress to cirrhosis following activation of inflammatory and fibrotic processes. NAFLD is associated with obesity, type 2 diabetes, and the metabolic syndrome and represents a considerable and increasing health burden. In the near future, NAFLD cirrhosis is expected to be the most common cause for liver transplantation. NAFLD patients have an increased risk of developing cardiovascular disease as well as liver-related morbidity. In addition, hepatic steatosis itself appears to represent an independent cardiovascular risk factor. In the present review, we provide an overview of the overlapping mechanisms and prevalence of NAFLD and cardiovascular disease.

scholarly journals Drug Induced Steatohepatitis: An Uncommon Culprit of a Common Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
Author(s):  
Liane Rabinowich ◽  
Oren Shibolet
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Injury ◽  
Hepatic Steatosis ◽  
Early Recognition ◽  
Developed Countries ◽  
Common Disease ◽  
Drug Induced ◽  
Altered Expression ◽  
The Metabolic Syndrome

Nonalcoholic fatty liver disease (NAFLD) is a leading cause of liver disease in developed countries. Its frequency is increasing in the general population mostly due to the widespread occurrence of obesity and the metabolic syndrome. Although drugs and dietary supplements are viewed as a major cause of acute liver injury, drug induced steatosis and steatohepatitis are considered a rare form of drug induced liver injury (DILI). The complex mechanism leading to hepatic steatosis caused by commonly used drugs such as amiodarone, methotrexate, tamoxifen, valproic acid, glucocorticoids, and others is not fully understood. It relates not only to induction of the metabolic syndrome by some drugs but also to their impact on important molecular pathways including increased hepatocytes lipogenesis, decreased secretion of fatty acids, and interruption of mitochondrialβ-oxidation as well as altered expression of genes responsible for drug metabolism. Better familiarity with this type of liver injury is important for early recognition of drug hepatotoxicity and crucial for preventing severe forms of liver injury and cirrhosis. Moreover, understanding the mechanisms leading to drug induced hepatic steatosis may provide much needed clues to the mechanism and potential prevention of the more common form of metabolic steatohepatitis.

scholarly journals Increased liver stiffness in patients with severe sleep apnoea and metabolic comorbidities

2018 ◽  
Vol 51 (6) ◽  
pp. 1800601 ◽  
Author(s):  
Wojciech Trzepizur ◽  
Jérôme Boursier ◽  
Marc Le Vaillant ◽  
Pierre-Henri Ducluzeau ◽  
Séverine Dubois ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Stiffness ◽  
Sleep Apnoea ◽  
Screening Tools ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Metabolic Comorbidities

The goal of this study was to assess the relationship between the severity of obstructive sleep apnoea (OSA) and liver stiffness measurement (LSM), one of the most accurate noninvasive screening tools for liver fibrosis in nonalcoholic fatty liver disease.The study included 147 patients with at least one criterion for the metabolic syndrome, assessed by polysomnography for suspected OSA. LSM was performed using transient elastography (FibroScan). Significant liver disease and advanced liver fibrosis were defined as LSM ≥7.3 and ≥9.6 kPa, respectively.23 patients were excluded because of unreliable LSM. Among 124 patients, 34 (27.4%) had mild OSA, 38 (30.6%) had moderate OSA and 52 (42.0%) had severe OSA. LSM values were 7.3– <9.6 kPa in 18 (14.5%) patients and ≥9.6 kPa in 15 (12.1%) patients. A dose–response relationship was observed between OSA severity and LSM values (p=0.004). After adjustment for age, sex, metabolic syndrome and insulin resistance, severe OSA was associated with an increased risk of LSM ≥7.3 kPa (OR 7.17, 95% CI 2.51–20.50) and LSM ≥9.6 kPa (OR 4.73, 95% CI 1.25–17.88).In patients with metabolic comorbidities, severe OSA is independently associated with increased liver stiffness, which may predispose to a higher risk of significant liver disease and poorer prognosis.

Abstract P189: Associations between Lactation and Maternal Measures of Total and Regional Adiposity 15 Years Postpartum: Results from the Study of Women’s Health Across the Nation

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Candace K McClure ◽  
Christina M Shay ◽  
Ping G Tepper ◽  
Molly B Conroy ◽  
Barbara Sternfeld ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Women’S Health ◽  
Women's Health ◽  
Menopausal Status ◽  
Lower Leg ◽  
Cross Sectional ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Regional Adiposity

Objective: It has been reported that mothers who do not breastfeed are at an increased risk of T2DM, metabolic syndrome, and CVD. We hypothesize that lactation may influence cardio-metabolic risk by altering maternal body composition. We examined the extent to which lactation was associated with regional and total adiposity in a sample of US women 15 years after their last birth. Study Design : Cross-sectional analysis of data provided by 1,268 women aged 45-58 who enrolled in the Study of Women’s Health Across the Nation (1996 -1997). Adiposity was assessed using dual-energy X-ray absorptiometry. History of lactation was self-reported and categorized into three groups: mothers who breastfed for ≥3 months after every birth, those who discontinued lactation within 3 months of some births, and those who never breastfed. Results: Compared with mothers who breastfed after every birth for at least 3 months, mothers who never breastfed had 0.87 kg greater trunk fat mass (FM), 1.3% greater % trunk FM, 1.3% lower % leg FM, and 0.075 greater trunk to leg FM ratio after adjustment for age, parity, height, years since last birth, race/ethnicity, socioeconomic, lifestyle, psychological, and family history variables, maximum gestational weight gain, and menopausal status. After additional adjustment for current BMI, women who never breastfed had 0.40 kg greater trunk FM and 0.053 greater trunk to leg FM ratio than mothers who breastfed every child for ≥3 months. Similarly, mothers who discontinued lactation within 3 months of some births had 0.28 kg greater trunk FM and 0.87% lower % leg FM than mothers who consistently breastfed. Conclusion : Women who did not breastfeed for at least 3 months after every birth exhibit less favorable body fat distributions 15 years postpartum. These results provide a potential physiologic basis for prior findings that women who do not breastfeed their children face increased risk of diabetes, the metabolic syndrome, and cardiovascular disease. Given existing disparities in rates of lactation, obesity and CVD, these findings have great clinical relevance and suggest the need for targeted lactation support for women at risk of cardiovascular disease.

Abstract P059: Utilizing Electronic Health Records to Evaluate Racial Disparities in Metabolic Syndrome

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Denise Danos ◽  
Maura Kepper ◽  
Tekeda Ferguson ◽  
Claudia Leonardi ◽  
Richard Scribner
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Racial Disparities ◽  
White Women ◽  
Research Network ◽  
Common Data Model ◽  
Patient Centered ◽  
Phenotype Definition ◽  
Increased Risk ◽  
Metabolic Conditions

Purpose: Metabolic syndrome is defined as a clustering of clinical metabolic conditions (increased blood pressure, high blood sugar, increased body fat, abnormal cholesterol or triglycerides) and has been associated with an increased risk for several chronic diseases, such as cardiovascular disease. The aim of this project was to identify individuals presenting with metabolic syndrome using a computational patient phenotype definition derived from electronic medical records (EHR) clinical outcomes data. Secondly, this project evaluated racial disparities in metabolic syndrome across Southeast Louisiana. Methods: Data was obtained through Research Action for Health Network (REACHnet). Using the National Patient-Centered Clinical Research Network Common Data Model, REACHnet has standardized and made usable EHR data for patient-centered research across Louisiana and Texas. The computational patient phenotype definition for metabolic syndrome was developed based on the National Cholesterol Education Program Expert Panel in Adult Treatment Panel III (NCEP III) guidelines. The presence of metabolic conditions was established using ICD9 Diagnosis codes, patient vitals and lab results that are routinely available in EHR data. Logistic regression models to assess racial disparities were executed using SAS 9.4. Results: We analyzed 18,664 patient EHRs for individuals 18 years or older with complete clinical data spanning the years 2013 to 2014. The sample was 43.28% male (n=8,077) and 29.35% black (n=5,477). Based on the patient phenotype definition, the prevalence of metabolic syndrome in the sample was 39.09%. Controlling for age, the odds of metabolic syndrome were twice as high for black women than for white women (OR= 2 (1.83, 2.18)), while the odds were 15% greater for black men than for white men (OR: 1.15 (1.04, 1.28)). Conclusion: We observed significant disparities in the prevalence of clinically evident metabolic syndrome in southeast Louisiana. Racial disparities were greatest among women. It has been increasingly recognized that differential exposure to chronic social and nutritive stress from living in a disadvantaged neighborhood may be contributing to racial health disparities. Further research in this sample will link ancillary sources of neighborhood data to the successfully developed metabolic syndrome phenotype to explore potential mechanisms for racial disparities in cardiovascular disease among a clinically-rich, state-wide sample.

scholarly journals Cardiovascular Risk in Non-Alcoholic Fatty Liver Disease: Mechanisms and Therapeutic Implications

2019 ◽  
Vol 16 (17) ◽  
pp. 3104 ◽  
Author(s):  
Claudio Tana ◽  
Stefano Ballestri ◽  
Fabrizio Ricci ◽  
Angelo Di Vincenzo ◽  
Andrea Ticinesi ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cardiovascular Events ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Alcoholic Fatty Liver Disease

New evidence suggests that non-alcoholic fatty liver disease (NAFLD) has a strong multifaceted relationship with diabetes and metabolic syndrome, and is associated with increased risk of cardiovascular events, regardless of traditional risk factors, such as hypertension, diabetes, dyslipidemia, and obesity. Given the pandemic-level rise of NAFLD—in parallel with the increasing prevalence of obesity and other components of the metabolic syndrome—and its association with poor cardiovascular outcomes, the question of how to manage NAFLD properly, in order to reduce the burden of associated incident cardiovascular events, is both timely and highly relevant. This review aims to summarize the current knowledge of the association between NAFLD and cardiovascular disease, and also to discuss possible clinical strategies for cardiovascular risk assessment, as well as the spectrum of available therapeutic strategies for the prevention and treatment of NAFLD and its downstream events.

scholarly journals Non alcoholic fatty liver disease is a predictor of subclinical Carotid Atherosclerosis in the presence of Metabolic Syndrome

2019 ◽  
Vol 16 (1) ◽  
pp. 39-45
Author(s):  
Cemal Kemaloglu ◽  
Melek Didem Kemaloglu
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Carotid Atherosclerosis ◽  
Controlled Study ◽  
Control Group ◽  
Alcoholic Fatty Liver ◽  
Increased Risk ◽  
Alcoholic Fatty Liver Disease

Objective: The aim of this study is to identify the relationship between carotid intima-media thickness (c-imt) and non-alcoholic fatty liver disease (NAFLD), and to determine whether NAFLD is an independent predictor for the progression of atherosclerosis.  Method: This is a prospective randomized controlled study. 103 NAFLD patients who have hepatosteatosis with grade II and above were enrolled in this study. Patients were divided into NAFLD with metabolic syndrome (MS) and NAFLD without MS groups and compared with 50 healthy people. Basal demographic characteristics and C-imt of all patients and control group were measured.  Results: C-imt and carotid cross sectional area rates in the NAFLD groups were significantly higher than those in the control group. The mean and max. c-imt levels were significantly higher in the NAFLD group with metabolic syndrome (p<0,001). Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR) levels were increased in the group with metabolic syndrome than those in the group without metabolic syndrome, with statistical significance (p<0.001). There was no difference in c-imt levels between HOMA-IR positive and negative groups (p=0.254) in patients with NAFLD and without metabolic syndrome. There was only a mild positive corelation between c-imt levels and high sensitive C-Reactive protein (hs-CRP) levels in metabolic syndrome positive group (p=0.026 r=0.30).  Conclusion: NAFLD was a significant predictor to determine the increased risk of carotid atherosclerosis. 

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