Clinico-biochemical and morphological mapping in chronic liver diseases in patients of the senior age group

Diagnosis of chronic liver diseases in elderly patients has its own features due to polymorbidity, multiple organ failure, being subtle the course of the disease. The purpose of the study was to identify correlations of inflammation biochemical parameters and hepatocellular failure with histology in chronic hepatitis (CH) and liver cirrhosis (LC) in elderly patients. Materials and methods. The study included medical records of patients with chronic liver disease (CLD) who died in the Clinical Hospital for War Veterans of Saint Petersburg between 2009 and 2015 (with the average age of 81 year). The diagnosis of chronic hepatitis (45 cases) and chronic cirrhosis (54 cases) was confirmed by postmortem examination. Morphological changes in the liver were described according to Knodell creteria. The degree of inflammatory activity in the liver was evaluated in points (0.1 to 3.0) depending on the level of AST, ALT, -globulin, alkaline phosphatase, -GTP, bilirubin. For similar scoring severity hepatocellular insufficiency (0.13.0) considered total protein, albumin, prothrombin index, fibrinogen. For cirrhotic patients the Child-Pugh criteria were also used. Results. Chronic liver disease (CLD) hepatitis and cirrhosis of the elderly is detected in 1,5% of cases. In most cases, CLD develop secondary to diseases of the cardiovascular system, and are accompanied by subtle symptoms, which limits their life-time diagnosis. The integral evaluation of the process activity degree according to biochemical indices was significantly higher in the group of chronic hepatitis than in the group of liver cirrhosis. Correlations of the inflammation bichemical parameters (AST and / or ALT, -globulin, alkaline phosphatase, -GTP) having a degree of Knodell Histological Activity Group chronic hepatitis and cirrhosis have not been established. The study established correlation of histological activity with total bilirubin levels in both groups of CLD. Integral assessment of hepatocellular deficiency by biochemical indicators of liver cirrhosis group was higher than in the group of chronic hepatitis.

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A quality of life assessment and the correlation between generic and disease-specific questionnaires scores in outpatients with chronic liver disease-pilot study

Romanian Journal of Internal Medicine ◽

10.1515/rjim-2017-0014 ◽

2017 ◽

Vol 55 (3) ◽

pp. 129-137 ◽

Cited By ~ 2

Author(s):

Milica Obradovic ◽

Zoran Gluvic ◽

Nina Petrovic ◽

Milan Obradovic ◽

Ratko Tomasevic ◽

...

Keyword(s):

Liver Cirrhosis ◽

Chronic Hepatitis ◽

Liver Disease ◽

Pilot Study ◽

Liver Diseases ◽

Alcoholic Hepatitis ◽

Chronic Liver ◽

Control Group ◽

Chronic Liver Diseases ◽

Healthy Control

Abstract Introduction. Chronic liver diseases (CLD) are an important cause of morbidity and mortality in general population. The aim of this study was to analyze potential differences between patients with CLD and healthy control group, and to estimate the severity of CLD by using simple questionnaires: general health questionnaire (GHQ-12) and chronic liver disease questionnaire (CLDQ). Methods. A cross-sectional pilot study was performed in Zemun Clinical Hospital during years 2014 and 2015. Sixty participants were divided into 4 groups (15 per group): chronic alcoholic hepatitis, other chronic hepatitis, liver cirrhosis, and healthy control group. Entire study population chose one of four offered answers of structured questionnaires GHQ-12 and CLDQ, based on which mean model of end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores were calculated. Results. Mean GHQ12 and CLDQ scores were 10.5 and 5.21 ± 1.11 respectively. Regarding certain CLDQ domain scores, a significant difference between alcoholic and non-alcoholic hepatitis groups in the worry domain was observed. Mean MELD score was 7.42 ± 2.89 and did not differ between chronic hepatitis groups, while mean CTP score was 5.73 ± 0.88. A statistically significant correlation was observed between GHQ12 and CLDQ scores (ρ = -0.404, p < 0.01), but not between subjective and objective scores. Conclusions. Mean GHQ12 and CLDQ scores pointed out to general psychological no-distress condition of the studied participants, as well as scarcely expressed CLD-specific complaints. Mean MELD and CTP scores indicated stable chronic liver diseases, with low three-month mortality rates in the cases of chronic hepatitis, as well as determination to Child A group in the case of liver cirrhosis.

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The Role of the Gut Microbiome in Liver Cirrhosis Treatment

International Journal of Molecular Sciences ◽

10.3390/ijms22010199 ◽

2020 ◽

Vol 22 (1) ◽

pp. 199

Author(s):

Na Young Lee ◽

Ki Tae Suk

Keyword(s):

Liver Cirrhosis ◽

Liver Disease ◽

Liver Fibrosis ◽

Gut Microbiota ◽

Gut Microbiome ◽

Liver Diseases ◽

Sclerosing Cholangitis ◽

Chronic Liver ◽

Chronic Liver Diseases

Liver cirrhosis is one of the most prevalent chronic liver diseases worldwide. In addition to viral hepatitis, diseases such as steatohepatitis, autoimmune hepatitis, sclerosing cholangitis and Wilson’s disease can also lead to cirrhosis. Moreover, alcohol can cause cirrhosis on its own and exacerbate chronic liver disease of other causes. The treatment of cirrhosis can be divided into addressing the cause of cirrhosis and reversing liver fibrosis. To this date, there is still no clear consensus on the treatment of cirrhosis. Recently, there has been a lot of interest in potential treatments that modulate the gut microbiota and gut-liver axis for the treatment of cirrhosis. According to recent studies, modulation of the gut microbiome by probiotics ameliorates the progression of liver disease. The precise mechanism for relieving cirrhosis via gut microbial modulation has not been identified. This paper summarizes the role and effects of the gut microbiome in cirrhosis based on experimental and clinical studies on absorbable antibiotics, probiotics, prebiotics, and synbiotics. Moreover, it provides evidence of a relationship between the gut microbiome and liver fibrosis.

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Noninvasive, Accurate Diagnosis of Chronic Liver Diseases Using Whole-Transcriptome Profiling of Platelets

10.21203/rs.3.rs-103725/v1 ◽

2020 ◽

Author(s):

Huikun Wu ◽

Gang Chen ◽

Tianyuan Zhang ◽

Mingzhong Xiao ◽

Ye Xia ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cirrhosis ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Liver Diseases ◽

Chronic Liver ◽

Support Vector ◽

Rna Seq ◽

Chronic Liver Diseases

Abstract Background: Hepatocellular carcinoma (HCC) is the most serious tumor in the world. It generally undergoes a series of processes from HBV infection, chronic hepatitis, cirrhosis, and HCC from early to late stages. Patients could benefit from early detection of chronic liver diseases (CLD). Tumor-Educated Platelets play an important role in tumor progression, which maybe a potential biomarker for CLD early diagnosis. Here, we developed a noninvasive liquid biopsy technique using platelet RNA for the early screening of patients with liver diseases. Methods: This study included a total of 163 individuals, including 50 healthy individuals, 39 chronic hepatitis B (CHB) patients, 40 liver cirrhosis (LC) and 34 patients with HCC. Blood was collected before initiation of treatment. Platelet RNA-Seq combined with Support Vector Machine (SVM), was used for the first time to distinguish the different stages of CLD in Asian patients.Results: Developed diagnostic model could distinguished with 92.4% accuracy between 34 HCC and 50 healthy, 89.92% accuracy between 34 patients HCC and 129 non-cancer individuals, and 83.67% between 50 healthy and 113 CLD. Across four different individual types, the accuracy of distinction (healthy/chronic hepatitis B/liver cirrhosis/hepatocellular carcinoma) was 65.31%. This model was internally validated, resulting in optimism-corrected AUC's of 86.8%.Conclusions: Our data indicate that the developed platelet RNA-Seq is a valuable platform for the diagnosis of CLD, providing an effective solution for its diagnosis.

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ASSESMENT OF FATIGUE IN PATIENTS WITH CHRONIC LIVER DISEASES

Medical Journal ◽

10.51922/1818-426x.2021.3.49 ◽

2021 ◽

pp. 49-53

Author(s):

М.D. Golubeva ◽

◽

К.V. Darafeyeva ◽

D.E. Danilau ◽

D.V. Litvinchuk ◽

...

Keyword(s):

Liver Disease ◽

Chronic Liver Disease ◽

Liver Diseases ◽

Short Form ◽

Chronic Liver ◽

Assessment Scale ◽

Chronic Liver Diseases ◽

Fatigue Assessment ◽

Chronic Liver Disease Questionnaire ◽

Disease Questionnaire

To determine the most sensitive questionnaire for the detection of fatigue in patients with chronic liver diseases, 61 patients with chronic liver diseases were inpatient treatment at the City Infectious Diseases Clinical were interviewed. And 72 relatively healthy responses were interviewed using Chronic Liver Disease Questionnaire, the Short Form-36, the Fatigue Assessment Scale. The study was conducted between November 2019 and March 2020. The severity of fatigue and declining quality of life was correlated with the presence of chronic liver diseases, excess body weight, and female sex. The Short Form-36 questionnaire showed greater sensitivity for assessing fatigue in people with chronic liver diseases compared to the Chronic Liver Disease Questionnaire. The Fatigue Assessment Scale didn't reveal reliable differences between the groups being compared.

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LncRNAs Act as a Link between Chronic Liver Disease and Hepatocellular Carcinoma

International Journal of Molecular Sciences ◽

10.3390/ijms21082883 ◽

2020 ◽

Vol 21 (8) ◽

pp. 2883

Author(s):

Young-Ah Kim ◽

Kwan-Kyu Park ◽

Sun-Jae Lee

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Disease ◽

Chronic Liver Disease ◽

Hepatic Fibrosis ◽

Liver Diseases ◽

Molecular Mechanisms ◽

Chronic Liver ◽

Chronic Liver Diseases ◽

Nonalcoholic Fatty Liver ◽

Underlying Mechanisms

Long non-coding RNAs (lncRNAs) are emerging as important contributors to the biological processes underlying the pathophysiology of various human diseases, including hepatocellular carcinoma (HCC). However, the involvement of these molecules in chronic liver diseases, such as nonalcoholic fatty liver disease (NAFLD) and viral hepatitis, has only recently been considered in scientific research. While extensive studies on the pathogenesis of the development of HCC from hepatic fibrosis have been conducted, their regulatory molecular mechanisms are still only partially understood. The underlying mechanisms related to lncRNAs leading to HCC from chronic liver diseases and cirrhosis have not yet been entirely elucidated. Therefore, elucidating the functional roles of lncRNAs in chronic liver disease and HCC can contribute to a better understanding of the molecular mechanisms, and may help in developing novel diagnostic biomarkers and therapeutic targets for HCC, as well as in preventing the progression of chronic liver disease to HCC. Here, we comprehensively review and briefly summarize some lncRNAs that participate in both hepatic fibrosis and HCC.

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POS1385 AUTOIMMUNE DISEASES ASSOCIATED WITH CHRONIC LIVER DISEASES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4288 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 975.2-975

Author(s):

N. Trad ◽

G. Mohamed ◽

B. Ben Slimen ◽

K. Boughoula ◽

S. Bizid ◽

...

Keyword(s):

Liver Disease ◽

Autoimmune Diseases ◽

Viral Infection ◽

Chronic Liver Disease ◽

Liver Diseases ◽

Female Gender ◽

Chronic Liver ◽

Primary Biliary Cholangitis ◽

Chronic Liver Diseases ◽

Systematic Screening

Background:Chronic liver diseases whatever their etiologies could be associated with immunological disturbances.Objectives:Our aim was to evaluate the prevalence and the characteristics of autoimmune diseases associated with chronic liver diseases.Methods:We performed a retrospective analysis of data from consecutive patients followed in our department for chronic liver diseases recruited from January 2010 to December 2019. Demographic, clinical, and paraclinical data were collected.Results:A total of 224 patients were included. The mean age was 61.02 ±13.2 years and the sex-ratio was 1.6. The main etiology of chronic liver diseases was viral infection C (32.1%) followed by viral infection B (22.8%) and non-alcoholic steatohepatitis (21.4%). The prevalence of autoimmune chronic liver diseases was 7.58%: autoimmune hepatitis (AIH) in four cases, primary biliary cholangitis (PBC) in huit cases, primary sclerosing cholangitis (PSC) in three cases and overlap syndrome (AIH-PBC) in two cases. Autoimmune diseases were noted in 31 cases (13.9%): autoimmune hemolytic anemia in 15 cases, autoimmune thyroiditis in 12 cases, one case of psoriasis, one case of CREST syndrome, one case of Sjögren’s syndrome and one case of autoimmune thrombocytopenia. Autoimmune pathologies were more associated with autoimmune chronic liver disease than other causes of chronic liver disease (47% vs 11.1%, p <0.001). Autoimmune pathologies were not statistically associated with female gender (p = 0.085) or young age (p = 0.483).Conclusion:In our study, the prevalence of autoimmune diseases during chronic liver diseases was 13.9%. This prevalence was higher in the case of autoimmune chronic liver diseases (47%), which would underline the importance of systematic screening for clinical and biological immune manifestations in those patients.Disclosure of Interests:None declared

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Serum Biomarkers of Liver Fibrosis Staging in the Era of the Concept “Compensated Advanced Chronic Liver Disease”

Journal of Clinical Medicine ◽

10.3390/jcm10153340 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3340

Author(s):

Koji Fujita ◽

Tsutomu Masaki

Keyword(s):

Liver Disease ◽

Liver Fibrosis ◽

Chronic Liver Disease ◽

Liver Diseases ◽

Serum Biomarkers ◽

Chronic Liver ◽

World Health ◽

Chronic Liver Diseases ◽

Fibrosis Staging ◽

Severe Fibrosis

Non-invasive indexes of liver fibrosis based on blood examinations have been developed for decades, partially replacing liver biopsy examinations. Recently, the concept of liver cirrhosis was revised and converted to “compensated advanced chronic liver diseases” since the Baveno VI consensus statement in 2015. The term “compensated advanced chronic liver diseases” was established based on the premise that serum biomarkers were not able to differentiate cirrhosis from severe fibrosis. The difficulty to histologically distinguish cirrhosis from severe fibrosis had been pointed out in 1977, when the definition and nomenclatures of cirrhosis had been determined by the World Health Organization. That was decades before serum biomarkers available at present were investigated. Though we are accustomed to differentiating the fibrosis stage as stage 1, 2, 3 (severe fibrosis), and 4 (cirrhosis), differentiation of cirrhosis from severe fibrosis is difficult even by histopathological examination. The current review will provide readers a framework to revise how to apply serum biomarkers on liver fibrosis staging in an era of the concept of “compensated advanced chronic liver disease”.

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Thrombin Generation in Chronic Liver Diseases—A Pilot Study

Healthcare ◽

10.3390/healthcare9050550 ◽

2021 ◽

Vol 9 (5) ◽

pp. 550

Author(s):

Liliana Vecerzan ◽

Ariela Olteanu ◽

Ionela Maniu ◽

Adrian Boicean ◽

Călin Remus Cipăian ◽

...

Keyword(s):

Liver Disease ◽

Pilot Study ◽

Chronic Liver Disease ◽

Liver Diseases ◽

Thrombin Generation ◽

Chronic Liver ◽

Control Group ◽

Coagulation Disorders ◽

Chronic Liver Diseases ◽

Control Subjects

The knowledge about coagulation disorders in patients with chronic liver disease changed in the last decade. The aim of this study was to analyze the parameters of thrombin generation in patients with chronic liver disease, as they are the most appropriate biomarkers to explore coagulation. (1) Background: The knowledge about coagulation disorders in patients with chronic liver disease changed in the last decade. The study of thrombin generation in patients with chronic liver disease provides a much more accurate assessment of the coagulation cascade; (2) Methods: This study is a prospective observational pilot study on hospitalized patients with chronic liver diseases that analyzed thrombin generation performed from their platelet-poor plasma versus that of control subjects. We analyzed a group of 59 patients with chronic liver disease and 62 control subjects; (3) Results: Thrombin generation was lower in hepatitis and cirrhosis patients compared to controls and decreases as the disease progressed. Lag time was higher in ethanolic etiology compared to the control group. Peak thrombin and endogenous thrombin potential were shorter in all etiologies when compared to the control group. The velocity index was significantly lower in HCV hepatopathies, ethanolic, and mixed etiology when compared with normal individuals; (4) Conclusions: Given the variability of thrombin generation in patients with chronic liver disease, its assay could serve to identify patients with high thrombotic and hemorrhagic risk and establish personalized conduct toward them.

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Burden of Liver Diseases: A Review from Iran

Middle East Journal of Digestive Diseases ◽

10.15171/mejdd.2019.147 ◽

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.

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Alcohol drinking and risks of liver cancer and non-neoplastic chronic liver diseases in China: a 10-year prospective study of 0.5 million adults

BMC Medicine ◽

10.1186/s12916-021-02079-1 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Pek Kei Im ◽

Iona Y. Millwood ◽

Christiana Kartsonaki ◽

Yu Guo ◽

Yiping Chen ◽

...

Keyword(s):

Liver Cirrhosis ◽

Liver Disease ◽

Alcohol Consumption ◽

Liver Cancer ◽

Liver Diseases ◽

Alcohol Intake ◽

Chronic Liver ◽

Drinking Patterns ◽

Chronic Liver Diseases ◽

Alcoholic Fatty Liver

Abstract Background Alcohol consumption is an important risk factor for hepatic neoplastic and non-neoplastic diseases. Questions remain, however, about the relevance to disease risk of drinking patterns and alcohol tolerability, which differ appreciably between Chinese and Western populations. Methods The prospective China Kadoorie Biobank included 512,715 adults (41% men) aged 30–79 years recruited from ten areas during 2004–2008, recording alcohol intake, drinking patterns, and other characteristics. After median 10 years’ follow-up, 2531 incident liver cancer, 2040 liver cirrhosis, 260 alcoholic liver disease (ALD), and 1262 non-alcoholic fatty liver disease (NAFLD) cases were recorded among 492,643 participants without prior cancer or chronic liver disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HR) relating alcohol intake and drinking patterns to each disease. Results Overall, 33% of men and 2% of women drank alcohol regularly (i.e. at least weekly) at baseline. Among male current regular drinkers, alcohol consumption showed positive dose-response associations with risks of several major chronic liver diseases, with HRs per 280 g/week (i.e. around four drinks/day) higher usual alcohol intake of 1.44 (95% CI 1.23–1.69) for liver cancer (n = 547), 1.83 (1.60–2.09) for liver cirrhosis (n = 388), 2.01 (1.77–2.28) for ALD (n = 200), 1.71 (1.35–2.16) for NAFLD (n = 198), and 1.52 (1.40–1.64) for total liver disease (n = 1775). The association with ALD appeared stronger among men reporting flushing (i.e., with low alcohol tolerance). After adjustment for the total amount of weekly alcohol consumption, daily drinkers had significantly increased risk of ALD (2.15, 1.40–3.31) compared with non-daily drinkers, and drinking without meals was associated with significantly greater risks of liver cancer (1.32, 1.01–1.72), liver cirrhosis (1.37, 1.02–1.85), and ALD (1.60, 1.09–2.33) compared with drinking with meals. Female current regular drinkers had significantly higher risk of ALD, but not other liver diseases, than female abstainers. Conclusions In Chinese men, alcohol intake was associated with significantly increased risks of several major chronic liver diseases, and certain drinking patterns (e.g. drinking daily, drinking without meals) may further exacerbate the disease risks.

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