scholarly journals Increased burden of cardiovascular disease in people with liver disease: unequal geographical variations, risk factors and excess years of life lost

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Wai Hoong Chang ◽  
Stefanie H. Mueller ◽  
Sheng-Chia Chung ◽  
Graham R. Foster ◽  
Alvina G. Lai
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Hepatitis ◽  
Liver Disease ◽  
Kidney Disease ◽  
Incidence Rate ◽  
Liver Diseases ◽  
Autoimmune Liver Disease ◽  
Years Of Life Lost ◽  
Geographical Variations ◽  
Wide Range

Abstract Background People with liver disease are at increased risk of developing cardiovascular disease (CVD), however, there has yet been an investigation of incidence burden, risk, and premature mortality across a wide range of liver conditions and cardiovascular outcomes. Methods We employed population-wide electronic health records (EHRs; from 1998 to 2020) consisting of almost 4 million adults to assess regional variations in disease burden of five liver conditions, alcoholic liver disease (ALD), autoimmune liver disease, chronic hepatitis B infection (HBV), chronic hepatitis C infection (HCV) and NAFLD, in England. We analysed regional differences in incidence rates for 17 manifestations of CVD in people with or without liver disease. The associations between biomarkers and comorbidities and risk of CVD in patients with liver disease were estimated using Cox models. For each liver condition, we estimated excess years of life lost (YLL) attributable to CVD (i.e., difference in YLL between people with or without CVD). Results The age-standardised incidence rate for any liver disease was 114.5 per 100,000 person years. The highest incidence was observed in NAFLD (85.5), followed by ALD (24.7), HCV (6.0), HBV (4.1) and autoimmune liver disease (3.7). Regionally, the North West and North East regions consistently exhibited high incidence burden. Age-specific incidence rate analyses revealed that the peak incidence for liver disease of non-viral aetiology is reached in individuals aged 50–59 years. Patients with liver disease had a two-fold higher incidence burden of CVD (2634.6 per 100,000 persons) compared to individuals without liver disease (1339.7 per 100,000 persons). When comparing across liver diseases, atrial fibrillation was the most common initial CVD presentation while hypertrophic cardiomyopathy was the least common. We noted strong positive associations between body mass index and current smoking and risk of CVD. Patients who also had diabetes, hypertension, proteinuric kidney disease, chronic kidney disease, diverticular disease and gastro-oesophageal reflex disorders had a higher risk of CVD, as do patients with low albumin, raised C-reactive protein and raised International Normalized Ratio levels. All types of CVD were associated with shorter life expectancies. When evaluating excess YLLs by age of CVD onset and by liver disease type, differences in YLLs, when comparing across CVD types, were more pronounced at younger ages. Conclusions We developed a public online app (https://lailab.shinyapps.io/cvd_in_liver_disease/) to showcase results interactively. We provide a blueprint that revealed previously underappreciated clinical factors related to the risk of CVD, which differed in the magnitude of effects across liver diseases. We found significant geographical variations in the burden of liver disease and CVD, highlighting the need to devise local solutions. Targeted policies and regional initiatives addressing underserved communities might help improve equity of access to CVD screening and treatment.

scholarly journals Increased burden of cardiovascular disease in people with liver disease: unequal geographical variations, risk factors and excess years of life lost

2021 ◽  
Author(s):  
Wai Hoong Chang ◽  
Stefanie Mueller ◽  
Sheng-Chia Chung ◽  
Graham R Foster ◽  
Alvina G Lai
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Hepatitis ◽  
Liver Disease ◽  
Kidney Disease ◽  
Incidence Rate ◽  
Liver Diseases ◽  
Autoimmune Liver Disease ◽  
Years Of Life Lost ◽  
Geographical Variations ◽  
Wide Range

Background People with liver disease are at increased risk of developing cardiovascular disease (CVD), however, there has yet been an investigation of incidence burden, risk, and premature mortality across a wide range of liver conditions and cardiovascular outcomes. Methods We employed population-wide electronic health records (EHRs; from 1998-2020) consisting of almost 4 million adults to assess regional variations in disease burden of five liver conditions, alcoholic liver disease (ALD), autoimmune liver disease, chronic hepatitis B infection (HBV), chronic hepatitis C infection (HCV) and NAFLD, in England. We analysed regional differences in incidence rates for 17 manifestations of CVD in people with or without liver disease. The associations between biomarkers and comorbidities and risk of CVD in patients with liver disease were estimated using Cox models. For each liver condition, we estimated excess years of life lost (YLL) attributable to CVD (i.e., difference in YLL between people with or without CVD). Results The age-standardised incidence rate for any liver disease was 114.5 per 100,000 person years. The highest incidence was observed in NAFLD (85.5), followed by ALD (24.7), HCV (6.0), HBV (4.1) and autoimmune liver disease (3.7). Regionally, the North West and North East regions consistently exhibited high incidence burden. Age-specific incidence rate analyses revealed that the peak incidence for liver disease of non-viral aetiology is reached in individuals aged 50-59 years. Patients with liver disease had a 2-fold higher incidence burden of CVD (2,634.6 per 100,000 persons) compared to individuals without liver disease (1,339.7 per 100,000 persons). When comparing across liver diseases, atrial fibrillation was the most common initial CVD presentation while hypertrophic cardiomyopathy was the least common. We noted strong positive associations between body mass index and current smoking and risk of CVD. Patients who also had diabetes, hypertension, proteinuric kidney disease, chronic kidney disease, diverticular disease and gastro-oesophageal reflex disorders had a higher risk of CVD, as do patients with low albumin, raised C-reactive protein and raised International Normalized Ratio levels. All types of CVD were associated with shorter life expectancies. When evaluating excess YLLs by age of CVD onset and by liver disease type, differences in YLLs, when comparing across CVD types, were more pronounced at younger ages. Conclusions We developed a public online app (https://lailab.shinyapps.io/cvd_in_liver_disease/) to showcase results interactively. We provide a blueprint that revealed previously underappreciated clinical factors related to the risk of CVD, which differed in the magnitude of effects across liver diseases. We found significant geographical variations in the burden of liver disease and CVD, highlighting the need to devise local solutions. Targeted policies and regional initiatives addressing underserved communities might help improve equity of access to CVD screening and treatment.

Liver disease

2019 ◽  
pp. 367-384
Author(s):  
Nina Vodošek Hojs ◽  
Aftab Ala ◽  
Debasish Banerjee
Keyword(s):  
Cardiovascular Disease ◽  
Liver Disease ◽  
Hepatitis C ◽  
Fatty Liver ◽  
Viral Hepatitis ◽  
Liver Dysfunction ◽  
Fatty Liver Disease ◽  
Liver Diseases ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Cardiovascular disease in patients with liver disease, previously uncommon, is rising because of an increasing incidence of non-alcoholic fatty liver disease and better survival of patients with viral hepatitis, particularly hepatitis C. Liver dysfunction alters the pharmacokinetics and pharmacodynamics of many drugs, and hence careful use and dose adjustments are necessary. This chapter describes common cardiovascular conditions and the pharmacotherapy in patients with different liver diseases.

scholarly journals Targeting Microbiota: What Do We Know about It at Present?

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 459 ◽  
Author(s):  
Aleksejs Derovs ◽  
Sniedze Laivacuma ◽  
Angelika Krumina
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
Liver Diseases ◽  
Intestinal Flora ◽  
Brain Health ◽  
Continuous Growth ◽  
Intestinal Dysbiosis ◽  
Inflammatory Changes ◽  
Blood Brain Barrier Integrity

The human microbiota is a variety of different microorganisms. The composition of microbiota varies from host to host, and it changes during the lifetime. It is known that microbiome may be changed because of a diet, bacteriophages and different processes for example, such as inflammation. Like all other areas of medicine, there is a continuous growth in the area of microbiology. Different microbes can reside in all sites of a human body, even in locations that were previously considered as sterile; for example, liver, pancreas, brain and adipose tissue. Presently one of the etiological factors for liver disease is considered to be pro-inflammatory changes in a host’s organism. There are lot of supporting data about intestinal dysbiosis and increased intestinal permeability and its effect on development of liver disease pointing to the gut–liver axis. The gut–liver axis affects pathogenesis of many liver diseases, such as chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, non-alcoholic liver disease, non-alcoholic steatohepatitis, liver cirrhosis and hepatocellular carcinoma. Gut microbiota has been implicated in the regulation of brain health, emphasizing the gut–brain axis. Also, experiments with mice showed that microorganisms have significant effects on the blood–brain barrier integrity. Microbiota can modulate a variety of mechanisms through the gut–liver axis and gut–brain axis. Normal intestinal flora impacts the health of a host in many positive ways, but there is now significant evidence that intestinal microbiota, especially altered, have the ability to impact the pathologies of many diseases through different inflammatory mechanisms. At this point, many of the pathophysiological reactions in case of microbial disbyosis are still unclear.

THU-012-Prevalence of autoimmune liver disease related autoantibodies in various non autoimmune liver diseases

2019 ◽  
Vol 70 (1) ◽  
pp. e165-e166
Author(s):  
Rakesh Kumar Jagdish ◽  
Shiv Kumar Sarin ◽  
Ashok Choudhury ◽  
Rakhi Maiwall ◽  
Manoj Kumar ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Diseases ◽  
Autoimmune Liver Disease ◽  
Autoimmune Liver Diseases

scholarly journals Coenzyme Q10 and Degenerative Disorders Affecting Longevity: An Overview

Antioxidants ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 44 ◽  
Author(s):  
David Mantle ◽  
Iain Hargreaves
Keyword(s):  
Cardiovascular Disease ◽  
Liver Disease ◽  
Kidney Disease ◽  
Coenzyme Q10 ◽  
Vascular Dysfunction ◽  
Alcoholic Fatty Liver ◽  
Degenerative Disorders ◽  
Coq10 Supplementation ◽  
Randomised Controlled

Longevity is determined by a number of factors, including genetic, environmental and lifestyle factors. A major factor affecting longevity is the development of degenerative disorders such as cardiovascular disease, diabetes, kidney disease and liver disease, particularly where these occur as co-morbidities. In this article, we review the potential role of supplementation with coenzyme Q10 (CoQ10) for the prevention or management of these disorders. Thus, randomised controlled clinical trials have shown supplementation with CoQ10 or CoQ10 plus selenium reduces mortality by approximately 50% in patients with cardiovascular disease, or in the normal elderly population, respectively. Similarly, CoQ10 supplementation improves glycaemic control and vascular dysfunction in type II diabetes, improves renal function in patients with chronic kidney disease, and reduces liver inflammation in patients with non-alcoholic fatty liver disease. The beneficial role of supplemental CoQ10 in the above disorders is considered to result from a combination of its roles in cellular energy generation, as an antioxidant and as an anti-inflammatory agent.

scholarly journals Burden of Liver Diseases: A Review from Iran

2019 ◽  
Vol 11 (4) ◽  
pp. 189-191
Author(s):  
Amir Anushiravani ◽  
Sadaf Ghajarieh Sepanlou
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Fatty Liver Disease ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

There has been an increase in the burden of liver diseases in Iran, with an increasing trend from communicable to non-communicable diseases. Almost 5400 deaths were due to chronic liver diseases in 2017. We aim to provide a concise update on the epidemiological trends of liver diseases in Iran. Estimations of deaths, disability-adjusted life years, prevalence of chronic liver diseases and cirrhosis in Iran with its common etiologies have been reported. We investigated the major causes of chronic liver diseases in Iran, we have reported our hepatology research centers, and also we have depicted the future of liver diseases in Iran. In 2017, there was a rising trend in chronic liver diseases in Iran. The most common etiologies for chronic liver disease were chronic hepatitis B, chronic hepatitis C, and non-alcoholic steatohepatitis with highest mortalities due to liver cancer and hepatitis C. The prevalence of HBV infection has decreased from 2.9% to 1.3% with effective vaccination, but new cases are still seen due to perinatal transmission. Treatment of HCV has dramatically changed with new drugs which are being produced by local pharmaceuticals at a low cost. The main obstacle in its elimination is finding patients and linkage to care. More than a third of our population have non-alcoholic fatty liver disease in which central obesity had a stronger association than weight itself. Iran has a high burden of liver diseases. The Ministry of Health has effectively controlled hepatitis B and is working towards the World Health WHO’s goals for hepatitis C by 2030. This being said, non-alcoholic fatty liver disease is becoming a major threat to our nation’s health and quality of life.

scholarly journals Extracellular Vesicles in Non-alcoholic Fatty Liver Disease and Alcoholic Liver Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Dongqing Wu ◽  
Huaqing Zhu ◽  
Hua Wang
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Extracellular Vesicles ◽  
Alcoholic Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Diseases ◽  
Solid Organ ◽  
Alcoholic Fatty Liver ◽  
Wide Range ◽  
Alcoholic Fatty Liver Disease

As the largest vital solid organ in the body, liver is consisting of multiple types of cells including hepatocytes, Kupffer cell, hepatic stellate cells (HSCs), liver sinusoidal endothelial cells (LSECs), and other immune cells. The communication between these cells is critical in maintaining liver function homeostasis, and dysregulation of such communication contributes to the pathogenesis of various liver diseases. Extracellular vesicles (EVs), including exosomes and ectosomes, act as important mediators of cell-to-cell communication. EVs can be produced and uptaken by a wide range of cells including all types of cells in the liver. Growing evidences show that EVs are involved in the development of liver diseases, especially non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD). In this review, we will summarize recent advance in how EVs production are altered in NAFLD and ALD and how the changes of EVs quantity and cargos influence the progression of these diseases. The therapeutic and diagnostic potential of EVs in NAFLD and ALD will be also discussed in this review.

scholarly journals SIX1/EYA1 are novel liver damage biomarkers in chronic hepatitis B and other liver diseases

2020 ◽  
Author(s):  
Baoyan Xu ◽  
Zhiqiao Zhang ◽  
Chong Zheng ◽  
Yingzi Tang ◽  
Zhaoxia Tan ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Liver Damage ◽  
Liver Diseases ◽  
Serum Levels ◽  
Immunofluorescent Staining ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls

Abstract Background: The aim of this study was to investigate the clinicopathological significance of SIX1/ EYA1 in chronic hepatitis B (CHB) and other liver diseases. Materials and methods: Both SIX1 and EYA1 levels were detected in human serum and liver tissues by enzyme linked immunosorbent assay (ELISA) and immunofluorescent staining, respectively. Results: Serum SIX1 and EYA1 levels were 7.24±0.11 ng/ml and 25.21±0.51 ng/ml, respectively, in 313 CHB patients, and these values were significantly higher than those in 33 healthy controls (2.84±0.15ng/ml and 13.11±1.01ng/ml, respectively; P < 0.05). Serum SIX1 and EYA1 were also significantly increased in patients with many other liver diseases including liver fibrosis, hepatocellular carcinoma, fatty liver disease, alcoholic liver disease, fulminant hepatic failure, autoimmune liver disease, and hepatitis C relative to healthy controls ( P < 0.05). Dynamic observation of these proteins over time in 35 selected CHB patients revealed that SIX1 and EYA1 serum levels increased over an interval. Immunofluorescent staining revealed that both SIX1 and EYA1 were only expressed in hepatic stellate cells (HSCs), and their increased expression was evident in CHB liver tissue. Conclusion: Both SIX1 and EYA1 are novel biomarkers of liver damage in CHB and other liver diseases, with potential clinical utility.

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