0000000000236839
AUTHOR
Aurora Giannetti
Development and Validation of Hepamet Fibrosis Scoring System-A Simple, Noninvasive Test to Identify Patients With Nonalcoholic Fatty Liver Disease With Advanced Fibrosis.
HEPAmet Registry.
PNPLA3 Rs738409 C>G Variant Predicts Liver-Related Outcomes in Patients with Non-Alcoholic Fatty Liver Disease
Background: Patients with NAFLD are at higher risk of developing liver-related complications -liver decompensation(LD) and hepatocellular carcinoma (HCC), including death-. A single nucleotide polymorphism in PNPLA3 gene is associated with a higher prevalence of liver damage and HCC, but prospective date are not available. We aimed to assess whether the common rs738409 variant in PNPLA3 gene can predict the occurrence of liver-related events and death in a large cohort of NAFLD patients. Methods: We considered 471 consecutive Italian individuals with histological diagnosis of NAFLD or clinical diagnosis of compensated NAFLD-related cirrhosis, prospectively followed for at least 6 months. …
Biochemical biomarkers of NAFLD/NASH
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the Western world and the global epidemics of obesity and type 2 diabetes have led to a dramatic increase of its prevalence and incidence. Among NAFLD patients, those with nonalcoholic steatohepatitis (NASH) have a double risk of fibrosis progression, that is the main driver toward the evolution in cirrhosis and its complications, including hepatocellular carcinoma and hepatic decompensation. Furthermore, patients with NAFLD are also at risk for cardiovascular diseases and extrahepatic malignancies, that represent the first and the second cause of death, respectively. The availability of non-invasi…
Impact of Obesity and Alanine Aminotransferase Levels on the Diagnostic Accuracy for Advanced Liver Fibrosis of Noninvasive Tools in Patients with Nonalcoholic Fatty Liver Disease
Some evidence suggests an interference of obesity and alanine aminotransferase (ALT) levels on the diagnostic accuracy for advanced fibrosis of noninvasive tools such as liver stiffness measurement (LSM) by FibroScan, Fibrosis-4 (FIB-4), and nonalcoholic fatty liver disease fibrosis score (NFS). We assessed whether the diagnostic accuracy of LSM, Fibrosis-4 (FIB-4), and NFS and strategies based on the combination of these tools is affected by obesity and/or ALT levels.METHODS:We analyzed data from 968 patients with a histological diagnosis of nonalcoholic fatty liver disease. FIB-4, NFS, and LSM by FibroScan were measured.RESULTS:LSM was better than both FIB-4 and NFS for staging F3-F4 fibr…
Antidiabetic Drugs in NAFLD: The Accomplishment of Two Goals at Once?
Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver disease in Western countries, accounting for 20–30% of general population and reaching a prevalence of 55% in patients with type 2 diabetes mellitus (T2DM). Insulin resistance plays a key role in pathogenic mechanisms of NAFLD. Many drugs have been tested but no medications have yet been approved. Antidiabetic drugs could have a role in the progression reduction of the disease. The aim of this review is to summarize evidence on efficacy and safety of antidiabetic drugs in patients with NAFLD. Metformin, a biguanide, is the most frequently used drug in the treatment of T2DM. To date 15 randomized controlled t…
Endoscopic management of gastric outlet obstruction disease
Gastric outlet obstruction (GOO) is a clinical syndrome characterized by a variety of symptoms. It may be caused by motor disorders and by benign or malignant mechanical disease. Endoscopic management of benign disease is mainly based on balloon dilation, augmented by the use of covered self-expanding metal stents (SEMS) in refractory disease. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is increasingly used as an alternative method, although more studies with longer follow up are needed before it can be considered as a recommended therapy. Surgery remains the last resort. Endoscopic management of malignant GOO is based on SEMS placement as an alternative to palliative surgery, b…
Association Between PNPLA3 rs738409 C>G Variant and Liver-Related Outcomes in Patients with Non-alcoholic Fatty Liver Disease
Background & Aims Patients with nonalcoholic fatty liver disease (NAFLD) have an increased risk for liver-related complications, such as decompensation, hepatocellular carcinoma (HCC), and death; the severity of liver fibrosis and metabolic comorbidities are the main risk factors. A single nucleotide polymorphism in patatin-like phospholipase domain-containing-3 (PNPLA3) gene is associated with higher prevalence of liver damage and HCC, but there are no data from prospective studies of outcomes of patients with this polymorphism. We investigated whether the common rs738409 variant in PNPLA3 gene associates with the occurrence of liver-related events and death in a large cohort of patients w…
Non-invasive Diagnostic Approach to NASH: Biological Markers
Non-alcoholic fatty liver disease (NAFLD) prevalence and incidence are dramatically increasing in parallel with the epidemics of both obesity and type 2 diabetes, accounting for the most growing cause of chronic liver disease, of hepatocellular carcinoma and of end-stage liver disease leading to liver transplantation. Natural history studies clearly demonstrated that among NAFLD population, those with non-alcoholic steatohepatitis (NASH) have a double risk of fibrosis progression, and that the severity of liver fibrosis is the main driver of hepatic and extrahepatic prognosis. Consistently, the availability of non-invasive markers to be used in NAFLD patients represents a relevant medical n…