Browsing by Subject "nonalcoholic fatty liver disease"
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Item Advice Regarding Alcohol Use by Individuals With Nonalcoholic Fatty Liver Disease: Primum non nocere(Wiley, 2018) Dunn, Winston; Chalasani, Naga; Medicine, School of MedicineIndividuals with nonalcoholic fatty liver disease (NAFLD) often ask their health care providers about routinely consuming non‐heavy amounts of alcohol for pleasure and potential health benefits. According to the American Association for the Study of Liver Diseases (AASLD) Practice Guidance published in 2018, there are insufficient data to make a recommendation with regard to non‐heavy alcohol consumption by individuals with NAFLD.(1) Although several cross‐sectional studies have suggested that light alcohol consumption (on average, <1 drink per day) may have a beneficial effect on the presence and severity of NAFLD, a large meta‐regression analysis suggested that lower body mass index among light and moderate drinkers is a potential confounder and thus casts doubt on the rigor of those studies.Item Attribution of Nonalcoholic Steatohepatitis as an Etiology of Cirrhosis for Clinical Trials Eligibility: Recommendations from the Multi-stakeholder Liver Forum(Elsevier, 2020) Noureddin, Mazen; Chan, Jean L.; Barradas, Katherine; Dimick-Santos, Lara; Schabel, Elmer; Omokaro, Stephanie O.; Anania, Frank A.; Myers, Robert P.; Miller, Veronica; Sanyal, Arun J.; Chalasani, Naga; Medicine, School of MedicineItem Characteristics, aetiologies and trends of hepatocellular carcinoma in patients without cirrhosis: A United States multicentre study(Wiley, 2019-10) Gawrieh, Samer; Dakhoul, Lara; Miller, Ethan; Scanga, Andrew; deLemos, Andrew; Kettler, Carla; Burney, Heather; Liu, Hao; Abu-Sbeih, Hamzah; Chalasani, Naga; Wattacheril, Julia; Medicine, School of MedicineBackground Limited data exist on the burden and features of non‐cirrhotic hepatocellular carcinoma (HCC) in the United States. Aim To evaluate characteristics, aetiologies, trends and outcomes of non‐cirrhotic HCC from 2000 to 2014 at five large US centres Methods Patient, tumour and liver disease aetiology data were collected. The presence of underlying cirrhosis was assessed based on published criteria. Results Of 5144 eligible patients with HCC, 11.7% had no underlying cirrhosis. Non‐cirrhotic patients were older (64.1 vs 61.2 years), more frequently females (33.9% vs 20.8%) and less frequently black (8.3% vs 12.4%) (P < .001 for all). Among non‐cirrhotic patients, non‐alcoholic fatty liver disease (NAFLD) was the most common liver disease (26.3%), followed by hepatitis C virus (HCV) (12.1%) and hepatitis B virus (HBV) (10%) infections. As of 2014, there was increased percentage of cirrhotic HCC and a decline in non‐cirrhotic HCC mainly due to significant annual increases in cirrhotic HCC due to HCV (0.96% [P < .0001]) and NAFLD (0.66% [P = .003]). Patients with non‐cirrhotic HCC had larger tumours (8.9 vs 5.3 cm), were less frequently within Milan criteria (15% vs 39%), more frequently underwent resection (43.6% vs 8%) (P < .001 for all) and had better overall survival than cirrhotic HCC patients (median 1.8 vs 1.3 years, P = .004). Conclusions Nearly 12% of HCCs occurred in patients without underlying cirrhosis. NAFLD was the most common liver disease in these patients. During the study, the frequency of non‐cirrhotic HCC decreased, whereas that of cirrhotic HCC increased. Although non‐cirrhotic patients presented with more advanced HCC, their survival was better.Item The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases(Wiley, 2017) Chalasani, Naga; Younossi, Zobair; Lavine, Joel E.; Charlton, Michael; Cusi, Kenneth; Rinella, Mary; Harrison, Stephen A.; Brunt, Elizabeth M.; Sanyal, Arun J.; Department of Medicine, School of MedicineThis guidance provides a data-supported approach to the diagnostic, therapeutic, and preventive aspects of NAFLD care. A “Guidance” document is different from a “Guideline.” Guidelines are developed by a multidisciplinary panel of experts and rate the quality (level) of the evidence and the strength of each recommendation using the Grading of Recommendations, Assessment Development, and Evaluation (GRADE) system. A guidance document is developed by a panel of experts in the topic, and guidance statements, not recommendations, are put forward to help clinicians understand and implement the most recent evidence.Item Effects of knee loading on obesity‐related nonalcoholic fatty liver disease in an ovariectomized mouse model with high fat diet(Wiley, 2018) Tan, Nian; Li, Xinle; Zhai, Lidong; Liu, Daquan; Li, Jie; Yokota, Hiroki; Zhang, Ping; Anatomy and Cell Biology, School of MedicineAim Hormonal and nutritional disorders are the main causes of obesity and nonalcoholic fatty liver disease, especially in the elderly and postmenopausal women. Although physical activity may alleviate these disorders, the elderly may often have difficulty in conducting physical exercise. The purpose of this study was to investigate the therapeutic effect of knee loading, a new form of physical stimulation, on the symptom of obesity and fatty liver. Methods Using ovariectomized mice with high fat diet, we evaluated the effect of knee loading that applies gentle cyclic loads to the knee. Female C57BL/6 mice were divided into five groups: control (SCD), high fat diet (HF), HF with loading (HF+L), HF with ovariectomy (HF+OVX), and HF+OVX with loading (HF+OVX+L). Except for SCD, mice underwent sham operation or ovariectomy and maintained on high fat diet. After 6 weeks, the mice in HF+L and HF+OVX+L were treated with 6‐week knee loading. Results Compared to the obesity groups (HF and HF+OVX), knee loading significantly decreased a gain in body weight, liver weight, and white adipose tissue (all P<0.01). It also reduced the lipid level in the serum (P<0.01) and histological severity of hepatic steatosis (P<0.01). Furthermore, knee loading downregulated biomarkers related to the endoplasmic reticulum stress (GRP78, p‐eIF2α and ATF4) and altered biomarkers in autophagy (LC3 and p62). Conclusions Knee loading suppressed obesity‐associated metabolic alterations and hepatic steatosis, the effect with knee loading might be associated with suppression of the ER stress and promotion of autophagy.Item Haptoglobin 2 Allele is Associated With Histologic Response to Vitamin E in Subjects With Nonalcoholic Steatohepatitis(Wolters Kluwer, 2020-11) Banini, Bubu A.; Cazanave, Sophie C.; Yates, Katherine P.; Asgharpour, Amon; Vincent, Robert; Mirshahi, Faridoddin; Le, Peter; Contos, Melissa J.; Tonascia, James; Chalasani, Naga P.; Kowdley, Kris V.; McCullough, Arthur J.; Behling, Cynthia A.; Schwimmer, Jeffrey B.; Lavine, Joel E.; Sanyal, Arun J.; Medicine, School of MedicineBackground: Haptoglobin (Hp) genotype has been linked to oxidative stress and response to vitamin E (VitE) in patients with dyslipidemia. Its effect on histological response to VitE in nonalcoholic steatohepatitis (NASH) is unknown. Goals: Our objective was to determine if Hp genotype associates with response to VitE in patients with NASH. Study: A post hoc analysis of 228 patients receiving VitE or placebo in two clinical trials was performed. Regression analysis was used to assess the effect of VitE versus placebo, by Hp genotype (1–1, 2–1, or 2–2), on histologic features and laboratory markers of liver disease, comparing baseline to end of treatment values. An interaction term was included in the regression models to assess differential treatment effect across Hp genotype. Results: Hp 2–2 patients treated with VitE versus placebo showed significant histologic improvement (51% versus 20%, OR=4·2, p=0·006), resolution of steatohepatitis (44% versus 12%, OR=6.2, p=0·009), decrease in NAFLD Activity Score (NAS) (−2·2 versus −0·6, p=0·001), and decrease in liver enzymes alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and γ-glutamyl transpeptidase. Hp 2–1 patients on VitE versus placebo showed improved resolution of steatohepatitis, NAS and liver enzymes. Hp 1–1 patients showed no significant improvement in histology or liver enzymes. VitE had no effect on fibrosis stage in any group. Regression analysis showed incremental benefit of having Hp 2–2 or 2–1 versus 1–1 for all liver enzymes. Conclusion: Hp 2 allele is associated with greater histological and biological improvement in NASH with VitE treatment compared to the Hp 1 allele.Item Is Fasting Necessary for Individuals With Nonalcoholic Fatty Liver Disease to Undergo Vibration-Controlled Transient Elastography?(Wolters Kluwer, 2019-06) Vuppalanchi, Raj; Weber, Regina; Russell, Sarah; Gawrieh, Samer; Samala, Niharika; Slaven, James E.; Harden, Lauren; Chalasani, Naga; Medicine, School of MedicineOBJECTIVES: To investigate the effect of meal intake on liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) in patients with biopsy-proven nonalcoholic fatty liver disease undergoing vibration-controlled transient elastography. METHODS: LSM and CAP were assessed at baseline and serially for 6 hours after meal intake in 24 patients. RESULTS: A significant increase in LSM was seen up to the 2-hour time point (26 ± 25%, P = 0.02). The CAP scores changed minimally with a maximal change of 3% (P > 0.1). CONCLUSIONS: Three hours of fasting is necessary before evaluation with vibration-controlled transient elastography.Item Patients With Chronic Liver Disease Suggestive of Nonalcoholic Fatty Liver Disease May Be at Higher Risk for Drug-Induced Liver Injury(Elsevier, 2019) Lammert, Craig; Imler, Timothy; Teal, Evgenia; Chalasani, Naga; Medicine, School of MedicineItem PNPLA3 rs738409 and Risk of Fibrosis in NAFLD: Exploring Mediation Pathways Through Intermediate Histological Features(Wiley, 2022) Vilar-Gomez, Eduardo; Pirola, Carlos J.; Sookoian, Silvia; Wilson, Laura A.; Liang, Tiebing; Chalasani, Naga; Medicine, School of MedicineBackground & Aims It is unclear whether rs738409 (p.I148M) missense variant in patatin-like phospholipase domain-containing 3 (PNPLA3) rs738409 promotes fibrosis development by triggering specific fibrogenic pathways or by creating an unfavorable microenvironment by promoting steatosis, inflammation, and ultimately fibrosis. We tested the hypothesis that intermediate histologic traits, including steatosis, lobular and portal inflammation, and ballooning may determine the effect of rs738409 on liver fibrosis among individuals with biopsy-proven NAFLD. Approach and Results Causal mediation models including multiple mediators in parallel or sequentially were performed to examine the effect of rs738409, by decomposing its total effect on fibrosis severity into direct and indirect effects, mediated by histology traits in 1153 Non-Hispanic White (NHW) patients. Total effect of rs738409 on fibrosis was β=0.19 (95% CI: 0.09-0.29). The direct effect of rs738409 on fibrosis upon removing mediators' effects was β=0.09 (95% CI: 0.01-0.17) and the indirect effect of rs738409 on fibrosis through all mediators' effects were β=0.010 (95% CI: 0.04-0.15). Among all mediators, the greatest estimated effect size was displayed by portal inflammation (β=0.09, 95% CI: 0.05-0.12). Among different sequential combinations of histology traits, the path including lobular inflammation followed by ballooning degeneration displayed the most significant indirect effect (β=0.023, 95% CI: 0.011-0.037). Mediation analysis in a separate group of 404 individuals with biopsy-proven NAFLD from other races and ethnicity showed similar results. Conclusions In NAFLD, nearly half of the total effect of the rs738409 G allele on fibrosis severity could be explained by a direct pathway, suggesting that rs738409 may promote fibrosis development by activating specific fibrogenic pathways. A large proportion of the indirect effect of rs738409 on fibrosis severity is mediated through portal inflammation.