Background of the FIB-4 Index in Japanese Non-Alcoholic Fatty Liver Disease
|
|
- Nathan Lynch
- 5 years ago
- Views:
Transcription
1 ORIGINAL ARTICLE Background of the FIB-4 Index in Japanese Non-Alcoholic Fatty Liver Disease Takashi Wada and Mikio Zeniya Abstract Objective We investigated the distribution and characteristics of the FIB-4 index of liver fibrosis in 1,441 Japanese men (age 50.7±10.2 years) and 304 women (age 53.9±10.3 years) who underwent comprehensive general health checkups and were identified as having non-alcoholic fatty liver disease. With respect to the FIB-4 index, differences according to sex, metabolic indices, and ultrasonic findings were investigated. Methods Among 9,255 individuals who underwent comprehensive general health checkups, 2,750 (29.8%) were found to have mild fatty liver or fatty liver based on ultrasound findings. After excluding patients who consumed 150 g alcohol/week (818 individuals), those testing positive for hepatitis B surface antigens or hepatitis C virus antibody (184 individuals), and those for whom data were insufficient (three individuals), we investigated the FIB-4 indices in the remaining 1,745 subjects. Results There were no sex differences in the FIB-4 index. A total of 1,370 patients (78.5%) exhibited a low cut-off index (COI) (<1.30), 357 (20.5%), exhibited an indeterminate COI ( ), and 18 (1.0%) exhibited a high COI (>2.67). There were no associations between the FIB-4 index and the constituent factors of metabolic syndrome. In contrast, there was a significant difference in the ln FIB-4 index between the patients with and without mild fatty liver or fatty liver on ultrasound among men (0.006±0.43 and ±0.39, p<0.001), but not women. Conclusion The FIB-4 index was is significantly lower in men, but not women, with fatty liver. The FIB-4 index must be calculated separately during medical checkups and evaluated in conjunction with ultrasound findings. Key words: liver fibrosis, non-alcoholic fatty liver disease, ultrasound, general health checkup, sex difference () () Introduction Fatty liver disease occurs when fat is deposited in hepatocytes, thereby causing liver damage. This condition is defined as the presence of fat droplets in 30% of hepatocytes in liver tissue, and is clinically diagnosed based on ultrasound findings. Previously, cases of fatty liver were most frequently caused by alcohol consumption; however the disease currently develops as a manifestation of lifestyle-related diseases, such as diabetes mellitus and obesity. Nonalcoholic fatty liver disease (NAFLD) involves fat-induced liver damage resembling that caused by alcohol-related liver damage in the absence of a history of alcohol consumption. According to Eguchi et al. (1), the incidence of NAFLD among non-drinkers is 41% in adult men and 18% in adult women. The ideal modality for diagnosing NAFLD is a liver biopsy, although it is highly invasive (2, 3). The actual incidence of patients who require a liver biopsy is therefore unknown, and clear indication criteria for the procedure are lacking. A number of non-invasive indices have been proposed to identify candidates for liver biopsy, including the NAFLD fibrosis score (NFS) (4), BARD score (5), and FIB- 4 index (6). However, these liver fibrosis indices are not listed in the standard protocol for general medical checkups in the the United States or Europe. Nevertheless, the FIB-4 index is reported to be the most useful parameter (6, 7); it can be calculated from the platelet count, and aspartate Health-Care Center, The Jikei University School of Medicine, Japan Received for publication April 16, 2014; Accepted for publication May 21, 2014 Correspondence to Dr. Takashi Wada, t_wada@jikei.ac.jp 127
2 person Figure 1. FIB-4 index distribution. Table 1. Subject Attributes Men Women n=1,441 n=304 Age (y) 50.7± ±10.3 BMI(kg/m 2 ) 25.6± ±3.8 Waist circumference (cm) 89.5± ±8.9 Platelet count ( 10 3 /mm 3 ) 232±48 257±58 AST(U/L) 26.1± ±10.5 ALT(U/L) 37.1± ±18.6 FIB-4 index 1.04± ±0.50 Mild fatty liver/ fatty liver 575/ /158 BMI: body mass index, AST: aspartate transaminase, ALT: alanine transaminase aminotransferase (AST) and alanine aminotransferase (ALT) levels, variables that are readily obtainable during comprehensive general health checkups (Ningen Dock) and in everyday clinical practice. Therefore, simplicity is a major advantage of this index. To date, there have been no studies of sex differences in the FIB-4 index, at least among Japanese subjects. Although an association between NAFLD and metabolic syndrome has been suggested, no previous studies have investigated the effects of blood pressure, an assessment of which is required for the diagnosis of metabolic syndrome. Nor haves any studies evaluated differences between mild fatty liver and fatty liver, as evidenced on ultrasound. In addition, the FIB- 4 index exhibits a log-normal distribution rather than a normal distribution, although there have been no previous analysis of this issue. We therefore investigated the distribution of the FIB-4 index among patients diagnosed with NAFLD during comprehensive general health checkup, and investigated the association between the FIB-4 index and the constituent factors of metabolic syndrome. Materials and Methods Of the 9,255 individuals who underwent comprehensive general health checkups at the Shimbashi Medical Checkup Office, Jikei University Hospital, during the one-year period between April 2010 and March 2011, 2,750 were identified as having mild fatty liver or fatty liver, based on ultrasound findings. Fatty liver was categorized as either mild fatty liver, in which hepatorenal contrast was equivalent or better, or moderate or worse fatty liver, in which the difference was clear. The diagnosis was made by two experienced ultrasound technicians, and the ultrasound device was a Xario TM XG (Toshiba, Tokyo, Japan) 3.5-MHz convex probe. After excluding 818 individuals with a weekly ethanol intake of >150 g, three individuals with insufficient data, and 184 individuals who tested positive for either hepatitis B surface antigens (HBsAg) or hepatitis C virus antibody (HCVAb), the remaining 1,745 subjects were assessed including 1,441 men (age 50.7±10.2 years) and 304 women (age 53.9±10.3 years). The FIB-4 index was calculated as AST age/(platelet count ALT), and the subjects were categorized into three groups according to the cut-off index (COI) values proposed by Shah et al. (3): low COI (<1.30), indeterminate COI ( ), or high COI (>2.67). The study protocol was approved by the Ethics Committee of the Jikei University School of Medicine. Statistical analysis The StatView 4.0 (SAS Institute, Cary, USA) software program was used for the statistical analysis. An analysis of variance (ANOVA) was performed according to Scheffe s method, and a regression analysis was performed using the stepwise technique. A p value of <0.05 was considered to be statistically significant. Results Of a total of 9,255 individuals who underwent comprehensive general health checkups between April 2010 and March 2011, 2,750 (29.8% of the total population) were found to be suffering from mild fatty liver or fatty liver based on the ultrasound findings. In order to identify individuals with NAFLD, who consumed 22 g of ethanol per day, the amount contained in a serving (approximately 180 ml of Japanese sake, i.e., 150 g of alcohol per week; 818 individuals, 8.8%) were excluded. Also excluded were individuals who tested positive for HBsAg or HCVAb (184 individuals, 2.0%), and those with incomplete data (three individuals), leaving a total of 1,745 subjects with NAFLD. This group accounted for 18.9% of all patients who underwent the comprehensive general health checkups, and 63.5% of those diagnosed with mild fatty liver or fatty liver based on ultrasound findings. The mean FIB-4 index among the 1,745 study subjects was 1.04±0.49, with a median value of The data were confirmed to have a normal distribution after logarithmic conversion, as shown in Fig. 1. The mean FIB-4 index was 1.04±0.49 among men and 1.05±0.50 among women, with no significant sex differences (Table 1). The COI was low in 1,370 individuals (78.3%), high in 18 individuals (1.0%), and indeterminate in the remaining 128
3 2,750 people having fatty liver seen by ultrasound ethanol consumption 150g/week (n=818) incomplete data (n=3) HBsAg and/or HCVAb positive (n=184) 1,745 people diagnosed as having NAFLD FIB-4 index Low (<1.3) Indeterminate ( ) High (>2.67) (n=1370, 78.5%) (n=357, 20.5%) (n=18, 1.0%) Male (%) 1135 (82.8%) 293 (82.0%) 13 (72.2%) Age 48.4±8.8 y 61.6±8.1 y 66.6±7.7 y Figure 2. Selection of the subjects. Table 2. Test Results for Men with Different FIB-4 Indices Age (y) BMI (kg/m 2 ) Waist circumference (cm) Platelet count ( 10 3 /mm 3 ) AST (U/L) ALT (U/L) AST/ALT GGT (U/L) Albumin (g/dl) FPG(mg/dL) Neutral lipids (mg/dl) HDL-C (mg/dl) SBP (mmhg) Low (<1.3) Indeterminate ( ) High (>2.67) (n=1,135, 78.8%) (n=293, 20.3%) (n=13, 0.9%) 47.8± ±8.4 (p<0.001) 64.8±7.4 (p<0.001) 25.7± ± ± ± ± ± ±44 188±30 (p<0.001) 138±51 (p<0.001) 25.0± ±15.6 (p<0.001) 47.5±18.0 (p<0.001) 37.5± ± ± ± ±0.30 (p<0.001) 1.06±0.43 (p<0.001) 53.8± ± ± ± ±0.24 (p<0.001) 4.37± ± ±26.6 (p<0.001) 103±17 163± ±77 131± ± ± ± ±13 125±13 118±10 DBP(mmHg) 78±10 79±9 72±11 BMI: body mass index, AST: aspartate transaminase, ALT: alanine transaminase, GGT: gamma-glutamyl transferase, FPG: fasting plasma glucose, HDL-C: high density cholesterol, SBP: systolic blood pressure, DBP: diastolic blood pressure Statistical analysis; versus low group 357 individuals (20.5%) (Fig. 2). Table 2 shows the results for men according to the FIB-4 index, while Table 3 shows the results for women. In terms of associations with metabolic syndrome, the only item for which there was a difference between the groups with different FIB-4 index values in women was fasting plasma glucose, whereas no differences were evident in waist circumference, neutral lipids, high-density lipoprotein (HDL-C), systolic blood pressure, diastolic blood pressure, or fasting plasma glucose in men. There were also no significant differences in albumin or BMI, both of which are included in the prediction formula for the NFS (4), between any of the three FIB-4 index groups. Nor were there any significant differences between the three FIB-4 index groups in terms of plasma glucose, an element of the prediction formula for the BARD score (5). Table 4 shows the clinical findings for the patients diagnosed with mild fatty liver or fatty liver based on an ultrasound diagnosis. There were no significant differences between the two groups in most of the test items associated with metabolic syndrome. However, the FIB-4 index was significantly lower in men, but not women, with fatty liver (p<0.001). When only patients with liver cell injury, as indicated by an ALT level of 31, were investigated, the ln FIB- 4 index was found to be significantly different between men with mild fatty liver versus those with fatty liver (0.006± 0.43 vs ±0.39, p<0.001). The corresponding values for women were ±0.42 and 0.064±0.22, respectively; this difference was not significant. These findings suggest that it may not be possible to estimate the degree of fibrosis based on the severity of fatty liver on ultrasound. Discussion We herein investigated the distribution and characteristics of the FIB-4 index of liver fibrosis in healthy individuals, using patients with NAFLD as subjects, from the view point of clinical preventive medicine. In Japan, a non-alcoholic status refers to an intake of <20 g of ethanol per day (8). However, the ethanol content in a serving (approximately 180 ml) of Japanese sake is approximately g, while that of a medium bottle or long can of beer (500 ml) is
4 Table 3. Test Results for Women with Different FIB-4 Indices Low (<1.3) Indeterminate ( ) High (>2.67) (n=235, 77.3%) (n=64, 21.1%) (n=5, 1.6%) Age (y) 51.1± ±7.0 (p<0.001) ±7.0 (p<0.001) BMI (kg/m 2 ) 25.6± ± ±3.7 Waist circumference (cm) 87.9± ± ±9.1 Platelet count( 10 3 /mm 3 ) 273±53 206±36 (p<0.001) 149± 52 (p<0.001) AST (U/L) 21.6± ±14.1 (p<0.001) 50.2±24.2 (p<0.001) ALT (U/L) 26.0± ± ±38.3 (p=0.001) AST/ALT 0.95± ±0.29 (p<0.001) 0.91±0.27 GGT (U/L) 32.5± ± ±15.1 Albumin (g/dl) 4.20± ± ±0.28 FPG (mg/dl) 101± ±14.0 (p<0.001) 132±39.3 (p<0.001) Triglyceride (mg/dl) 124±69 110±53 115±56 HDL-C (mg/dl) 60.0± ± ±13.5 SBP (mmhg) 123±15 126±13 125±12 DBP (mmhg) 75±10 76±8 79±12 BMI: body mass index, AST: aspartate transaminase, ALT: alanine transaminase, GGT: gamma-glutamyl transferase, FPG: fasting plasma glucose, HDL-C: high density cholesterol, SBP: systolic blood pressure, DBP: diastolic blood pressure Statistical analysis; versus low group Table 4. Ultrasound Diagnostic Findings for Individuals with Mild Fatty Liver and Fatty Liver Men Women Mild fatty liver Fatty liver Mild fatty liver Fatty liver n=575 n=866 n=146 n=158 Age (y) 52.3± ±9.7*** 53.9± ±10.3 BMI (kg/m 2 ) 24.3± ±3.5*** 24.3± ±4.0*** WC (cm) 86.9± ±8.5*** 85.7± ±8.8*** Platelet count 228±48 234±49* 252±51 262±64* ( 10 3 /mm 3 ) AST (U/L) 23.6± ±8.7*** 20.2± ±12.8*** ALT (U/L) 29.5± ±26.5*** 20.0± ±22.7*** AST/ALT 0.90± ±0.21*** 1.09± ±0.28*** GGT (U/L) 47.5± ±51.3*** 25.3± ±29.1*** Albumin (g/dl) 4.34± ±0.22*** 4.19± ±0.23* FPG (mg/dl) 102± ±29*** 101± ±15.5* Triglecreide 143±99 166±105*** 111±57 131±73*** (mg/dl) HDL-C(mg/dL) 51.5± ±10.4*** 62.3± ±13.7 SBP (mmhg) 122± ±13.1* 120± ±14.6*** DBP (mmhg) 77±9.7 79±9.8*** 73±9.9 77±9.4*** Ln FIB-4 index 0.006± ±0.39*** ± ±0.22 BMI: body mass index, WC: waist circumference, AST: aspartate transaminase, ALT: alanine transaminase, GGT: gamma-glutamyl transferase, FPG: fasting plasma glucose, HDL-C: high density cholesterol, SBP: systolic blood pressure, DBP: diastolic blood pressure Statistical analysis; *p<0.05, ** p<0.01, *** p<0.001, versus mild fatty liver group 25 g, and some subjects do not drink every day. In the present study, we therefore used the definition of nonalcoholic as an ethanol intake of 150 g per week. Liver fibrosis is more advanced in elderly than in young patients. This time-dependent nature of the degree of fibrosis is believed to underlie the tendency for the FIB-4 index to increase with age (9). NAFLD is also thought to represent the hepatic expression of metabolic syndrome, due to insulin resistance caused by visceral obesity (10). In the present study, however, we found no associations between an elevated FIB-4 index and waist circumference or the values of neutral lipids, HDL-C or, systolic or diastolic blood pressure, all of which are diagnostic constituent factors for metabolic syndrome, with the exception of fasting plasma glucose. In addition, Yatsuji et al. (11) reported that diabetes mellitus has an effect on the incidence of NAFLD in women, consistent with the results of the present study. With respect to performing a comprehensive general health checkup, it is necessary to assess the state of the liver and identify the presence of fatty liver and/or liver dysfunction. It is necessary to identify patients who require liver biopsy from among those who exhibit fibrosis or a prefibrotic condition of NAFLD. Sumida et al. (12) diagnosed the state of fibrosis in liver biopsies of 576 Japanese patients with NAFLD, and investigated whether such staging could be evaluated with the FIB- 4 index and/or six other indices. The researchers regarded stages 3 and 4 disease as being severe, and found that there were 64 such cases (11%). Unlike that used in the present 130
5 study, the cut-off points for the FIB-4 index was categorized as low at <1.45, indeterminate at , and high at >3.25. Compared with other scoring systems, these values were found to be useful for distinguishing between mild and severe fibrosis, with a reported negative predictive value of 98% and positive predictive value of 53%. Of the 395 patients, 91% were classified into the group, indicating that assessing the FIB-4 index may render liver biopsy unnecessary in Japanese patients. Meanwhile, McPherson et al. (13) investigated whether the non-invasive indices of the AST/ALT ratio, AST-toplatelet-ratio index, FIB-4 index, NAFLD fibrosis score (4) and BARD score (5) could be used to evaluate the degree of fibrosis in 145 patients diagnosed with NAFLD based on the findings of a liver biopsy. The authors found that the FIB-4 index outperformed the other indices in terms of its capacity for diagnosing advanced fibrosis. Furthermore, Shah et al. (6) investigated whether the FIB- 4 and seven other indices could be used to assess the presence of fibrosis in 541 patients diagnosed with NAFLD and found a jackknife-validated area under the receiver operating characteristic curve of for the FIB-4 index [95% confidence interval (CI), ], which was superior to that for the other indices. From this viewpoint, Kakuta et al. (14) used the same method applied in the present study to validate the FIB-4 index in individuals undergoing health checkups. In the Kakuta study, the proportion of patients with a low FIB-4 index was 79% (78% in the present study), those with an indeterminate index was 20% (20% in the present study), and those with a high index was 0.9% (1% in the present study). The results of the present study were almost identical to these findings. In the present study, among patients diagnosed with mild fatty liver or fatty liver on an ultrasound diagnosis, the FIB- 4 index was significantly lower in men with fatty liver. However, this trend was not observed in women. This suggests that it is difficult to estimate the degree of fibrosis based on the severity of fatty liver on ultrasound. In this study, we used hepatorenal contrast, which exhibits a better capacity for obtaining an accurate diagnosis of fatty infiltration of the liver than the level of hepatic parenchymal brightness (15). This method was used to categorize fatty liver as either mild or as moderate or worse. The present study showed no differences in the proportions of patients with mild fatty liver and fatty liver among the subjects with an elevated FIB-4 index. The absence of differences in ultrasound findings may have been due to the fact that fatty metamorphosis resolves with the progression of fibrosis in patients with a high COI. This observation suggests that the FIB-4 index is useful for detecting the progression of fibrosis resulting from NAFLD. On comprehensive general health checkups, however, only 1% of patients are categorized as having a high level of fibrosis according to Shah s classification, and it is unclear whether this COI is appropriate for the Japanese population. Future studies are therefore required to verify the COI by reducing the lower limit for the high group, for example from 2.37 to 2.0, and performing liver biopsies in such patients. Ultrasound devices capable of measuring the degree of liver stiffness have recently been developed. In addition, Matsumoto et al. reported an association between liver stiffness and the FIB-4 index (16). That study found a good correlation between ultrasound measurements of liver stiffness and the FIB-4 index (R 2 =0.519, p<0.0001). However, the FIB-4 index, which can be calculated based on blood test results, is easier to apply when evaluating the degree of fibrosis in the liver and should not be replaced. A total of three million or more people a year undergo general medical checkups (Ningen Dock) in Japan. Assessments of liver fibrosis indices, such as the FIB-4 index, are not listed in the standard Ningen Dock program. However, beginning in April 2013, although not evaluated on comprehensive general health checkup records, the FIB-4 index is currently assessed on forms recording the doctor s opinion, and patients classified into the high group are carefully evaluated. One limitation associated with the present study is that the FIB-4 index may be overestimated in patients with a low platelet count compared to the liver function, such as those with pseudo-thrombocytopenia and idiopathic thrombocytopenia. Another limitation is that liver biopsies were not performed. Future studies involving stratified analysis including the presence of concomitant lifestyle-related diseases are required, as well as prospective studies of the association between the FIB-4 index and the long-term prognosis (mortality associated with liver disease). In conclusion, the proportions of patients with fibrosis categorized into three different grades of severity according to the FIB-4 index in the present study are similar to reported at other institutions. Differences in age, as well as the platelet count, and AST level, are evident among patients with a high FIB-4 index (indicating advanced fibrosis); these parameters are also included in the formula for calculating the FIB-4 index. However, in the present study, there was were no differences in the FIB-4 index between the patients with mild fatty liver and fatty liver as detected on ultrasound, and diagnosing fibrosis was problematic. Subjects who exhibit a high COI on general health checkups may need to undergo liver biopsies, although prospective studies are required to clarify this issue. The authors state that they have no Conflict of Interest (COI). References 1. Eguchi Y, Hyogo H, Ono M, et al.; JSG-NAFLD. Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2009 to 2010 in Japan: a multicenter large retrospective study. J Gastroenterol 47: , Vuppalanchi R, Chalasani N. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: selected practical issues in their 131
6 evaluation and management. Hepatology 46: , Wieckowska A, McCullough AJ, Feldstein AE. Noninvasive diagnosis and monitoring of nonalcoholic steatohepatitis: present and future. Hepatology 49: , Angulo P, Hui JM, Marchesini G, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 45: , Harrison SA, Oliver D, Arnold HL, Gogia S, Neuschwander-Tetri BA. Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease. Gut 57: , Shah AG, Lydecker A, Murray K, Tetri BN, Contos MJ, Sanyal AJ; Nash Clinical Research Network. Collaborators (114). Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 7: , McPherson S, Stewart SF, Henderson E, Burt AD, Day CP. Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease. Gut 59: , Okanoue T, Saibara T, Nono M, Sumida Y, Hashimoto E, Tamura S, et al. JSH Consensus Kobe 2009; Diagnosis and treatment of NASH. Kanzo 50: , 2009 (in Japanese). 9. Angulo P, Keach JC, Batts KP, Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatology 30: , Watanabe S, Yaginuma R, Ikejima K, Miyazaki A. Liver diseases and metabolic syndrome. J Gastroenterol 43: , Yatsuji S, Hashimoto E, Tobari M, Tokushige K, Shiratori K. Influence of age and gender in Japanese patients with non-alcololic steatohepatitis. Hepatol Res 37: , Sumida Y, Yoneda M, Hyogo H, et al.; Japan Study Group of Nonalcoholic Fatty Liver Disease. Validation of the FIB4 index in a Japanese nonalcoholic fatty liver disease population. BMC Gastroenterol 12: 2, McPherson S, Stewart SF, Henderson E, Burt AD, Day CP. Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease. Gut 59: , Kakuta Y, Sakuragi S, Ohno T, Sakai K, Kanemasa K. The distribution of FIB-4 index in Japanese subjects undergoing a health checkup who are diagnosed as having nonalcoholic fatty liver disease. Kanzo 52: , 2011 (in Japanese, Abstract in English). 15. Sanyal AJ; American Gastroenterological Association. AGA technical review on nonalcoholic fatty liver disease. Gastroenterology 123: , Matsumoto T, Sohda T, Nishizawa S, et al. Non-invasive evaluation of liver fibrosis in patients with chronic liver diseases. Med Bull Fukuoka Univ 38: 1-6, The Japanese Society of Internal Medicine 132
/ FIB4 Index , simple steatosis. FIB4 Index. FIB4 Index. FIB4 Index FIB4 Index. Sterling FIB4 Index. FIB4 Index AST AST ALT
原 著 29 34-41, 2014 FIB4 Index 1 1 1 1 2 1 1 FIB4 Index FIB4 Index cut off 2.67 2.67 12,059 FIB4 IndexFIB4 Index 2.67 / FIB4 Index AST ALT FIB4 Index 2.67 161 1.3% FIB4 Index 5 FIB4 Index 1.1 5 1.6 FIB4
More informationHEP DART 2017, Kona, Hawaii
HEP DART 2017, Kona, Hawaii Rong Yu 1, Ke Xu 1, Jing Li 1, Tong Sun 1, Shengjiang Zhang 2, Jinhua Shao 2, Jin Sun 2, Qiong He 3, Jianwen Luo 3, Cheng Wang 4, Yudong Wang 4, Jing Chen 4, Vanessa Wu 4, George
More informationThe role of non-invasivemethods in evaluating liver fibrosis of patients with non-alcoholic steatohepatitis
The role of non-invasivemethods in evaluating liver fibrosis of patients with non-alcoholic steatohepatitis Objectives: Liver biopsy is the gold standard for diagnosing the extent of fibrosis in NAFLD/NASH;
More informationALT and aspartate aminotransferase (AST) levels were measured using the α-ketoglutarate reaction (Roche,
Supplemental Methods Analytical determinations ALT and aspartate aminotransferase (AST) levels were measured using the α-ketoglutarate reaction (Roche, Basel, Switzerland). Glucose, triglyceride, total
More informationNONALCOHOLIC FATTY LIVER DISEASE. Non-Alcoholic Fatty Liver Disease (NAFLD) Primary NAFLD. April 13, 2012
NONALCOHOLIC FATTY LIVER DISEASE Kiran Bambha, MD University of Colorado Denver April 13, 2012 Non-Alcoholic Fatty Liver Disease (NAFLD) Primary NAFLD Simple Steatosis Fatty hepatocytes Intracellular fat
More informationAt Least 1 in 5 Patients in Your Practice Have Fatty Liver
At Least 1 in 5 Patients in Your Practice Have Fatty Liver What Can You Tell Your Patients Magnus McLeod MD FRCPC Assistant Professor Dalhousie University 30-NOV-2017 NAFLD Non-Alcoholic Fatty Liver Disease
More informationInternal and Emergency Medicine Official Journal of the Italian Society of Internal Medicine. ISSN Volume 8 Number 3
Hepatic Steatosis Index and Lipid Accumulation Product as middle-term predictors of incident metabolic syndrome in a large population sample: data from the Brisighella Heart Study Arrigo F. G. Cicero,
More informationNonalcoholic Fatty Liver Disease: Definitions, Risk Factors, and Workup
REVIEW REVIEW Nonalcoholic Fatty Liver Disease: Definitions, Risk Factors, and Workup Puneet Puri, M.B.B.S., M.D. and Arun J. Sanyal, M.B.B.S., M.D. Nonalcoholic fatty liver disease (NAFLD) is defined
More informationNew Discriminant Method for Identifying the Aggressive Disease Phenotype of Non-alcoholic Fatty Liver Disease
ORIGINAL ARTICLE New Discriminant Method for Identifying the Aggressive Disease Phenotype of Non-alcoholic Fatty Liver Disease Yusuke Kawamura 1,2, Kenji Ikeda 1,2, Yasuji Arase 1,2, Shunichiro Fujiyama
More informationORIGINAL ARTICLE. Abstract. Introduction
ORIGINAL ARTICLE Prognostic Factors for Regression from Impaired Glucose Tolerance to Normal Glucose Regulation in Japanese Patients with Nonalcoholic Fatty Liver Disease Chie Ogata, Yuki Ohmoto-Sekine,
More informationAmerican Journal of Oral Medicine and Radiology
American Journal of Oral Medicine and Radiology e - ISSN - XXXX-XXXX ISSN - 2394-7721 Journal homepage: www.mcmed.us/journal/ajomr PREVALENCE OF NONALCOHOLIC FATTY LIVER DISEASE AMONG TYPE 2 DIABETIC POPULATION
More informationDevelopment and validation of a simple index system to predict nonalcoholic fatty liver disease
The Korean Journal of Hepatology 2011;17:19-26 DOI: 10.3350/kjhep.2011.17.1.19 Original Article Development and validation of a simple index system to predict nonalcoholic fatty liver disease Young Jin
More informationEFFECT OF ORAL SUPPLEMENTATION OF WHEY PROTEIN ISOLATE ON NON-ALCOHOLIC STEATOHEPATITIS PATIENTS
42 EFFECT OF ORAL SUPPLEMENTATION OF WHEY PROTEIN ISOLATE ON NON-ALCOHOLIC STEATOHEPATITIS PATIENTS Prasong Tienboon MD, PhD. 1, Taned Chitapanarux MD. 2, Suwalee Pojchamarnwiputh MD. 3, Donrawee Leelarungrayub
More informationSimple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease
1 Liver Unit, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle upon Tyne, UK 2 Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne,
More informationThe role of ARFI and APRI in diagnosis of liver fibrosis on patients with common chronic liver diseases
RESEARCH ARTICLE The role of ARFI and APRI in diagnosis of liver fibrosis on patients with common chronic liver diseases Objective: This study aimed to investigate the value of liver fibrosis assessment
More informationThe classical metabolic work-up, approved by the Ethics Committee of the Antwerp
SUPPLEMENTARY MATERIALS METHODS Metabolic work-up The classical metabolic work-up, approved by the Ethics Committee of the Antwerp University Hospital and requiring written informed consent, included a
More informationRelationship between Alcohol Intake and Risk Factors for Metabolic Syndrome in Men
ORIGINAL ARTICLE Relationship between Alcohol Intake and Risk Factors for Metabolic Syndrome in Men Miharu Hirakawa, Yasuji Arase, Kazuhisa Amakawa, Yuki Ohmoto-Sekine, Makiko Ishihara, Masato Shiba, Kyoko
More informationPrevalence of non-alcoholic fatty liver disease in type 2 diabetes mellitus patients in a tertiary care hospital of Bihar
Original Research Article Prevalence of non-alcoholic fatty liver disease in type 2 diabetes mellitus patients in a tertiary care hospital of Bihar Naresh Kumar 1, Jyoti Kumar Dinkar 2*, Chandrakishore
More informationPrediction of Homeostasis Model Assessment of Insulin Resistance in Japanese Subjects
Tokai J Exp Clin Med., Vol. 37, No. 4, pp. 12-16, 212 Prediction of Homeostasis Model Assessment of Insulin Resistance in Japanese Subjects Masako NEGAMI, Eiko TAKAHASHI, Hiroki OTSUKA and Kengo MORIYAMA
More informationHigher non-hdl-cholesterol to HDLcholesterol ratio linked with increased nonalcoholic steatohepatitis
Wang et al. Lipids in Health and Disease (2018) 17:67 https://doi.org/10.1186/s12944-018-0720-x RESEARCH Open Access Higher non-hdl-cholesterol to HDLcholesterol ratio linked with increased nonalcoholic
More informationThe effect of aerobic exercise on serum level of liver enzymes and liver echogenicity in patients with non-alcoholic fatty liver disease
Gastroenterology and Hepatology From Bed to Bench. 2013 RIGLD, Research Institute for Gastroenterology and Liver Diseases ORIGINAL ARTICLE The effect of aerobic exercise on serum level of liver enzymes
More informationAssessment of Liver Stiffness by Transient Elastography in Diabetics with Fatty Liver A Single Center Cross Sectional observational Study
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 6 Ver. IV (June. 2017), PP 49-53 www.iosrjournals.org Assessment of Liver Stiffness by Transient
More informationTransient elastography in chronic liver diseases of other etiologies
4 Post Meeting A.I.S.F. Unmet Clinical Needs in Hepatology: New and upcoming diagnostic tools" Transient elastography in chronic liver diseases of other etiologies Dr. Vincenza Calvaruso Gastroenterologia
More informationAssociations between Bright Pancreas and Features of Metabolic Syndrome
Japan Society of Nigen Dock ORIGINAL ARTICLE Ningen Dock 2012 ; 26 : 935-943 Associations between Bright Pancreas and Features of Metabolic Syndrome Akihiro Obora 1,2), Takao Kojima 1,2), Takahiro Kato
More informationWhat is NAFLD?.NASH? Presenter Disclosure Information. Learning Objectives. Case 1: Rob. Questions Pertinent to Rob
Presenter Disclosure Information 5 6pm Nonalcoholic Fatty Liver Disease (NAFLD): Another Obesity-Related Epidemic SPEAKER Elliot Tapper, MD The following relationships exist related to this presentation:
More informationCASE REPORT. Abstract. Introduction
CASE REPORT A Customized Online Nutrition Guidance System Is Effective for Treating Patients with Nonalcoholic Fatty Liver Disease by Supporting Continuity of Diet Therapy at Home: A Pilot Study Tomonori
More informationEffect of lifetime alcohol consumption on the histological severity of non-alcoholic fatty liver disease
Liver International ISSN 1478-3223 METABOLIC AND STEATOHEPATITIS Effect of lifetime alcohol consumption on the histological severity of non-alcoholic fatty liver disease Hellan K. Kwon 1, Joel K. Greenson
More informationUpdate on Non-Alcoholic Fatty Liver Disease. Timothy R. Morgan, MD Chief, Hepatology, VA Long Beach Professor of Medicine, UCI
Update on Non-Alcoholic Fatty Liver Disease Timothy R. Morgan, MD Chief, Hepatology, VA Long Beach Professor of Medicine, UCI February 3, 2018 Disclosure Clinical trials: Genfit Speaker s Bureau: none
More informationPROGRESSION TO FIBROSIS IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) THE VALUE OF NONINVASIVE MARKERS
Supplement 1/2015, 4 th ISAA PROGRESSION TO FIBROSIS IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) THE VALUE OF NONINVASIVE MARKERS Denisa DOBRIN 1, Tiberiu Ioan NANEA 2, Cristian Mihai POMOHACI
More informationSogabe et al. BMC Gastroenterology (2016) 16:17 DOI /s
Sogabe et al. BMC Gastroenterology (2016) 16:17 DOI 10.1186/s12876-016-0431-6 RESEARCH ARTICLE Open Access Influence of light alcohol consumption on lifestyle-related diseases: a predictor of fatty liver
More informationIn Search of New Biomarkers for Nonalcoholic Fatty Liver Disease
REVIEW In Search of New Biomarkers for Nonalcoholic Fatty Liver Disease Ting-Ting Chan, M.R.C.P., and Vincent Wai-Sun Wong, M.D. Nonalcoholic fatty liver disease (NAFLD) affects 15% to 40% of the general
More informationIS LIVER BIOPSY NECESSARY IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE?
Rev. Med. Chir. Soc. Med. Nat., Iaşi 2016 vol. 120, no. 3 INTERNAL MEDICINE - PEDIATRICS UPDATES IS LIVER BIOPSY NECESSARY IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE? R. S. Gavril 1, Laura Mihalache
More informationLIVER, PANCREAS, AND BILIARY TRACT
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2012;10:1028 1033 LIVER, PANCREAS, AND BILIARY TRACT Prevalence and Indicators of Portal Hypertension in Patients With Nonalcoholic Fatty Liver Disease FLAVIA D.
More informationLiver Enzymes Concentrations Are Closely Related to Pre diabetes: Findings of the Shanghai Diabetes Study II (SHDS II) *
30 Biomed Environ Sci, 2012; 25(1): 30 37 Original Article Liver Enzymes Concentrations Are Closely Related to Pre diabetes: Findings of the Shanghai Diabetes Study II (SHDS II) * GAO Fei 1, PAN Jie Min
More informationThyroid Function and Risk of Non-Alcoholic Fatty Liver Disease in Euthyroid Subjects
Thyroid function and NAFLD., 2018; 17 (5): 779-788 ORIGINAL ARTICLE September-October, Vol. 17 No. 5, 2018: 779-788 779 The Official Journal of the Mexican Association of Hepatology, the Latin-American
More informationEASL EASD EASO Clinical practice guidelines for the management of nonalcoholic fatty liver disease.
Commentary. EASL EASD EASO Clinical practice guidelines for the management of nonalcoholic fatty liver disease. Christopher D. Byrne 1,2, Giovanni Targher 3 1 Nutrition and Metabolism, Faculty of Medicine,
More informationFree testosterone concentration is inversely associated with markers of liver fibrosis in men with type 2 diabetes mellitus
2017, 64 (12), 1137-1142 Original Free testosterone concentration is inversely associated with markers of liver fibrosis in men with type 2 diabetes mellitus Shozo Miyauchi 1), Teruki Miyake 2), Masumi
More informationNON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) AND NON- ALCOHOLIC STEATOHEPATITIS (NASH) IN ASIAN-PACIFIC REGION
SL 2-1 NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) AND NON- ALCOHOLIC STEATOHEPATITIS (NASH) IN ASIAN-PACIFIC REGION Mikio KAJIHARA 1,3, Yoshinori HORIE 2,3, Hiromasa ISHII 3 1 Tokyu Hospital, 2 Eiju General
More informationNon-alcoholic fatty liver disease (NAFLD) is a
Original Article / Liver Hepatobiliary & Pancreatic Diseases International The association of non-alcoholic fatty liver disease and metabolic syndrome in a Chinese population Shou-Wu Lee, Teng-Yu Lee,
More informationNON-ALCOHOLIC STEATOHEPATITIS AND NON-ALCOHOLIC FATTY LIVER DISEASES
NON-ALCOHOLIC STEATOHEPATITIS AND NON-ALCOHOLIC FATTY LIVER DISEASES Preface Zobair M. Younossi xiii Epidemiology and Natural History of NAFLD and NASH 1 Janus P. Ong and Zobair M. Younossi Understanding
More informationThe association between white blood cell subtypes and prevalence and incidence of nonalcoholic fatty liver disease
834477EJI0010.1177/2058739219834477European Journal of InflammationZhang et al. letter2019 Letter to the Editor The association between white blood cell subtypes and prevalence and incidence of nonalcoholic
More informationLaboratory analysis of the obese child recommendations and discussion. MacKenzi Hillard May 4, 2011
Laboratory analysis of the obese child recommendations and discussion MacKenzi Hillard May 4, 2011 aka: What to do with Fasting Labs The Obesity Epidemic The prevalence of obesity in adolescents has tripled
More informationNIH Public Access Author Manuscript Am J Med Sci. Author manuscript; available in PMC 2015 January 01.
NIH Public Access Author Manuscript Published in final edited form as: Am J Med Sci. 2014 January ; 347(1):. doi:10.1097/maj.0b013e31828b25a5. Association Between Metabolic Syndrome and Its Individual
More informationABNORMAL LIVER FUNCTION TESTS. Dr Uthayanan Chelvaratnam Hepatology Consultant North Bristol NHS Trust
ABNORMAL LIVER FUNCTION TESTS Dr Uthayanan Chelvaratnam Hepatology Consultant North Bristol NHS Trust INTRODUCTION Liver function tests Cases Non invasive fibrosis measurement Questions UK MORTALITY RATE
More informationNew discriminant score to predict the fibrotic stage of non-alcoholic steatohepatitis in Japan
Hepatol Int (215) 9:269 277 DOI 1.17/s1272-14-965-x ORIGINAL ARTICLE New discriminant score to predict the fibrotic stage of non-alcoholic steatohepatitis in Japan Yusuke Kawamura Kenji Ikeda Yasuji Arase
More informationCDHNF & NASPGHAN A Partnership for Research and Education for Children s Digestive and Nutritional Health
CDHNF & NASPGHAN A Partnership for Research and Education for Children s Digestive and Nutritional Health Obesity and NAFLD Definitions: Nonalcoholic steatohepatitis (NASH) and nonalcoholic fatty liver
More informationNAFLD fibrosis score: A prognostic predictor for mortality and liver complications among NAFLD patients
Online Submissions: http://www.wjgnet.com/esps/ wjg@wjgnet.com doi:10.3748/wjg.v19.i8.1219 World J Gastroenterol 2013 February 28; 19(8): 1219-1229 ISSN 1007-9327 (print) ISSN 2219-2840 (online) 2013 Baishideng.
More informationPancreatic exocrine insufficiency: a rare cause of nonalcoholic steatohepatitis
Pancreatic exocrine insufficiency: a rare cause of nonalcoholic steatohepatitis Naoki Tanaka 1, Akira Horiuchi 2, Takahide Yokoyama 3, Shigeyuki Kawa 1, and Kendo Kiyosawa 1 1 Department of Gastroenterology,
More informationNon alcoholic fatty liver disease and atherosclerosis Raul Santos, MD
Non alcoholic fatty liver disease and atherosclerosis Raul Santos, MD Sao Paulo Medical School Hospital Sao Paulo, Brazil Disclosure Honoraria received for consult and/or speaker : Astra Zeneca, Amgen,
More information«STEATOSI EPATICA ED EPATOPATIE METABOLICHE» Ester Vanni Division of Gastroenterology University of Turin
«STEATOSI EPATICA ED EPATOPATIE METABOLICHE» Ester Vanni Division of Gastroenterology University of Turin OUTLINE NAFLD overview NAFLD and menarche NAFLD and pregnancy NAFLD and menopause Other metabolic
More informationNAFLD and NASH: The Not-So-New Kids on the Block
NAFLD and NASH: The Not-So-New Kids on the Block Mary E. Rinella, MD Associate Professor of Medicine Feinberg School of Medicine Northwestern University Chicago, Illinois This program is supported by an
More informationPractical Diagnosis and Staging of Nonalcoholic Fatty Liver Disease: A Narrative Review
Practical Diagnosis and Staging of Nonalcoholic Fatty Liver Disease: A Narrative Review Authors: Jennifer Gallacher, 1 *Stuart McPherson 1,2 1. Liver Unit, Newcastle Upon Tyne Hospitals NHS Trust, Freeman
More informationNON-ALCOHOLIC FATTY LIVER DISEASE:
NON-ALCOHOLIC FATTY LIVER DISEASE: ROLE OF THE PRIMARY PROVIDER Archita P. Desai, MD Assistant Professor of Medicine University of Arizona 25 th Annual Southwestern Conference on Medicine Outline Pathophysiology
More informationAbnormality of risk factors for atherosclerotic disease among young Japanese aged years old: an evaluation of health checkup data
Environ Health Prev Med (2013) 18:165 170 DOI 10.1007/s12199-012-0289-3 SHORT COMMUNICATION Abnormality of risk factors for atherosclerotic disease among young Japanese aged 19 39 years old: an evaluation
More informationFatty Liver Disease. Mark Thursz. Imperial College
Fatty Liver Disease Mark Thursz Imperial College Non-Alcoholic Fatty Liver Disease UK adult obesity (BMI>30) 1980: 6% [M], 8% [F]. 1997: 17% [M], 20% [F]. By 2004, 23.6% of men and 23.8% of women were
More informationAbnormal serum alanine transaminase levels in adult patients with type 1 diabetes
Abnormal serum alanine transaminase levels in adult patients with type 1 diabetes Gautam Das 1 MD, MRCP (Diabetes and Endocrinology), FRCP, FACE (USA), Consultant in Endocrinology John Geen 2,3 MSc, PhD,
More informationFatty liver disease: What do we know?
Fatty liver disease: What do we know? Prof. Dr. Claus Niederau Katholische Kliniken Oberhausen ggmbh St. Josef-Hospital Academic Teaching Hospital University of Duisburg-Essen NAFLD Non-Alcoholic Fatty
More informationFREQUENCY OF NON ALCOHOLIC FATTY LIVER DISEASE (NAFLD) AND ITS BIOCHEMICAL DERANGEMENTS IN TYPE II DIABETIC PATIENTS
FREQUENCY OF NON ALCOHOLIC FATTY LIVER DISEASE (NAFLD) AND ITS BIOCHEMICAL DERANGEMENTS IN TYPE II DIABETIC PATIENTS DR. ABDUL JABBAR, MBBS DR. ABDUL BASIT, MBBS DR. HAFIZ MUHAMMAD HANNAN AKBAR, MBBS ABSTRACT
More informationNonalcoholic Fatty Liver Disease in Children: Typical and Atypical
Nonalcoholic Fatty Liver Disease in Children: Typical and Atypical Disclosure Naim Alkhouri, MD discloses the following relationships with commercial companies: Membership in the Speakers Bureau for Alexion
More informationFatty Liver Disease A growing epidemic
Fatty Liver Disease A growing epidemic Updates in GIM for Primary Care Don C. Rockey March 9 th, 2018 Disclosures 2018 Research Funding (all to MUSC) NIH/NIDDK Actelion Pharmaceuticals Gilead Sciences
More informationAssociation between metabolic syndrome and the development of non-alcoholic fatty liver disease
EXPERIMENTAL AND THERAPEUTIC MEDICINE 6: 77-84, 2013 Association between metabolic syndrome and the development of non-alcoholic fatty liver disease YI WANG 1, YU YUAN LI 2, YU QIANG NIE 2, YONG JIAN ZHOU
More informationHepatocellular carcinoma is the most common liver-related complication in patients with histopathologically-confirmed NAFLD in Japan
Akuta et al. BMC Gastroenterology (2018) 18:165 https://doi.org/10.1186/s12876-018-0900-1 RESEARCH ARTICLE Open Access Hepatocellular carcinoma is the most common liver-related complication in patients
More informationNon-Alcoholic Fatty Liver Disease and Metabolic Syndrome in Type 2 Diabetes Mellitus Patients in Rajshahi Medical College Hospital
WELCOME Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome in Type 2 Diabetes Mellitus Patients in Rajshahi Medical College Hospital Presented by DR. PRABIR MOHAN BASAK ASSISTANT PROFESSOR DEPARTMENT
More informationDownloaded from zjrms.ir at 3: on Monday February 25th 2019 NAFLD BMI. Kg/m2 NAFLD
logistic regression Student s t-test P< BMI BMI P< ALT AST P< Email:mkhoshbaten@yahoo.com Kg/m2 NASH RUQ B C II Case-Control II Logistic Regression Chi-Square T-test P< Grade Model 1- A diffuse hyper echoic
More informationSerum uric acid and non-alcoholic fatty liver disease in non-obesity Chinese adults
Zheng et al. Lipids in Health and Disease (2017) 16:202 DOI 10.1186/s12944-017-0531-5 RESEARCH Open Access Serum uric acid and non-alcoholic fatty liver disease in non-obesity Chinese adults Xiaoya Zheng
More informationImproving Access to Quality Medical Care Webinar Series
Improving Access to Quality Medical Care Webinar Series Presented by The Arizona Telemedicine Program and the Southwest Telehealth Resource Center 2015 UA Board of Regents Welcome AZ, UT, CO, NM & NV FLEX
More informationUpdate on Nonalcoholic Fatty Liver Disease. Kathleen E Corey, MD, MPH, MMSc Director, Mass General Fatty Liver Clinic
Update on Nonalcoholic Fatty Liver Disease Kathleen E Corey, MD, MPH, MMSc Director, Mass General Fatty Liver Clinic Outline Defining the phenotypes of nonalcoholic fatty liver disease NAFLD Diagnostics
More informationShihui Fu 1,2, Ying Lin 2, Leiming Luo 1* and Ping Ye 1*
Fu et al. BMC Gastroenterology (2017) 17:49 DOI 10.1186/s12876-017-0607-8 RESEARCH ARTICLE Open Access The relationship of serum alanine aminotransferase normal-range levels to arterial stiffness and metabolic
More informationClinical profile of patients with non-alcoholic fatty liver disease and its association with metabolic syndrome
International Journal of Advances in Medicine Pande A et al. Int J Adv Med. 2017 Aug;4(4):1111-1116 http://www.ijmedicine.com pissn 2349-3925 eissn 2349-3933 Original Research Article DOI: http://dx.doi.org/10.18203/2349-3933.ijam20173242
More informationNonalcoholic Steatohepatitis National Digestive Diseases Information Clearinghouse
Nonalcoholic Steatohepatitis National Digestive Diseases Information Clearinghouse National Institute of Diabetes and Digestive and Kidney Diseases NATIONAL INSTITUTES OF HEALTH Nonalcoholic steatohepatitis
More information6/28/2017. Update in NAFLD. Key Points. NAFLD: Epidemiology. US Population: million. NALFD Prevalence 25% 80 million
Update in NAFLD PHILLIP K HENDERSON, DO ASSISTANT PROFESSOR OF MEDICINE UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE INSTRUCTOR OF SURGERY, DIVISION OF TRANSPLANT SURGERY UNIVERSITY OF ALABAMA AT BIRMINGHAM
More informationObesity, metabolic syndrome (MetS), and type 2 diabetes
Noninvasive Diagnosis of NASH and Liver Fibrosis Within the Spectrum of NAFLD Naim Alkhouri, MD, and Arthur J. McCullough, MD Dr. Alkhouri and Dr. McCullough are affiliated with the Department of Gastroenterology
More informationJMSCR Vol 06 Issue 12 Page December 2018
www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.63 Insulinemic Status and Nonalcoholic
More informationRisk of reduced platelet counts in patients with nonalcoholic fatty liver disease (NAFLD): a prospective cohort study
Liu et al. Lipids in Health and Disease (2018) 17:221 https://doi.org/10.1186/s12944-018-0865-7 RESEARCH Open Access Risk of reduced platelet counts in patients with nonalcoholic fatty liver disease (NAFLD):
More informationNAFLD & NASH. Naga Chalasani, MD, FACG Professor of Medicine and Cellular & Integrative Physiology Director, Division of GI and Hepatology
NAFLD & NASH Naga Chalasani, MD, FACG Professor of Medicine and Cellular & Integrative Physiology Director, Division of GI and Hepatology Indiana University School of Medicine ACG Midwest Regional Course,
More informationOcaliva (obeticholic acid tablets)
Ocaliva (obeticholic acid tablets) Policy Number: 5.01.619 Last Review: 11/2018 Origination: 11/2016 Next Review: 11/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage
More informationSupplementary Online Content
Supplementary Online Content Larsen JR, Vedtofte L, Jakobsen MSL, et al. Effect of liraglutide treatment on prediabetes and overweight or obesity in clozapine- or olanzapine-treated patients with schizophrenia
More informationDepok-Indonesia STEPS Survey 2003
The STEPS survey of chronic disease risk factors in Indonesia/Depok was carried out from February 2003 to March 2003. Indonesia/Depok carried out Step 1, Step 2 and Step 3. Socio demographic and behavioural
More informationHepatology for the Nonhepatologist
Hepatology for the Nonhepatologist Kenneth E. Sherman, MD, PhD Gould Professor of Medicine Director, Division of Digestive Diseases University of Cincinnati College of Medicine Cincinnati, Ohio Learning
More informationScreening cardiac patients for advanced liver disease
HKASLD 30 th ASM and International Symposium on Hepatology 2017 Screening cardiac patients for advanced liver disease 5 Nov 2017 Dr. Lau Yue Leung Joulen Pamela Youde Nethersole Eastern Hospital NAFLD
More informationAASLD Immune tolerant phase HBV NAFLD diagnostic HCC
AASLD 2016 Immune tolerant phase HBV NAFLD diagnostic HCC Immune tolerant 3 Modified from Chan HLY and Wong VWS. Hepatitis B. In Zakim and Boyers s Hepatology 2012 2015 AMERICAN ASSOCIATION FOR THE S1T6UDY
More informationUMHS-PUHSC JOINT INSTITUTE
Role of Visceral Adiposity in the Pathogenesis of Non-Alcoholic Fatty Liver Disease in Lean versus Obese Patients: A Comparative Study between Patients at UMHS versus PUHSC Lai WEI and Anna LOK W Zhang,
More informationJournal of Adolescent Health 42 (2008) Original article. Manuscript received September 5, 2007; manuscript accepted November 27, 2007
Journal of Adolescent Health 42 (2008) 543 548 Original article Presence of the Metabolic Syndrome in Obese Adolescents Predicts Impaired Glucose Tolerance and Nonalcoholic Fatty Liver Disease Kathy A.
More informationtage Percent Total & over Total & over Men Women Men Women
Paul Angulo, MD, FACG, AGAF Professor of Medicine, Section Chief of Hepatology Division i i of Digestive i Diseases and Nutrition i University of Kentucky Medical Center Lexington, KY Paul Angulo, MD University
More informationInvestigating general liver disease/transaminitis
BHIVA Autumn Conference London 14 October 2016 Investigating general liver disease/transaminitis Emmanuel A. Tsochatzis Senior Clinical Lecturer and Consultant Hepatologist Institute for Liver and Digestive
More informationCASE REPORT. Introduction. Case Report
doi: 10.2169/internalmedicine.8754-16 Intern Med Advance Publication http://internmed.jp CASE REPORT The Improvement of the Hepatic Histological Findings in a Patient with Non-alcoholic Steatohepatitis
More informationNAFLD & NASH: Russian perspective
NAFLD & NASH: Russian perspective Vasily Isakov, MD, PhD Professor, Chief, Department Gastroenterology & Hepatology, Federal Research Center of nutrition, biotechnology and food safety Disclosures Received
More informationSupplementary appendix
Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Harris R, Harman DJ, Card TR, Aithal GP, Guha
More informationNon-Alcoholic Steatohepatitis (NASH): What the Gastroenterologist Should Know
Non-Alcoholic Steatohepatitis (NASH): What the Gastroenterologist Should Know Naga P. Chalasani, MD, FACG Professor of Medicine and Cellular & Integrative Physiology Director, Division of GI and Hepatology
More informationEvaluating Obese Persons With Abnormal Liver Chemistries
Mary E. Rinella, MD, FAASLD Evaluating Obese Persons With Abnormal Liver Chemistries Postgraduate Course: Challenges in Management of Common Liver Diseases 275 1 25 year old obese Hispanic man with obesity,
More informationZhengtao Liu 1,2,3*, Shuping Que 4*, Lin Zhou 1,2,3 Author affiliation:
Dose-response Relationship of Serum Uric Acid with Metabolic Syndrome and Non-alcoholic Fatty Liver Disease Incidence: AMeta-analysis of Prospective Studies Zhengtao Liu 1,2,3*, Shuping Que 4*, Lin Zhou
More informationNonalcoholic fatty liver disease (NAFLD) and nonalcoholic. Noninvasive Assessment of Nonalcoholic Fatty Liver Disease in Obese or Overweight Patients
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2012;10:1162 1168 Noninvasive Assessment of Nonalcoholic Fatty Liver Disease in Obese or Overweight Patients SVEN M. A. FRANCQUE,* AN VERRIJKEN, ILSE MERTENS, GUY
More informationNon-alcoholic Fatty Liver Disease and Chronic Kidney Disease in Koreans Aged 50 Years or Older
. 2013;34:199-205 http://dx.doi.org/10.4082/kjfm.2013.34.3.199 Non-alcoholic Fatty Liver Disease and Chronic Kidney Disease in Koreans Aged 50 Years or Older Original Article Ah-Leum Ahn, Jae-Kyung Choi*,
More informationInvestigation of Ornithine Carbamoyltransferase as a Biomarker of Liver Cirrhosis
ORIGINAL ARTICLE Investigation of Ornithine Carbamoyltransferase as a Biomarker of Liver Cirrhosis Noriko Matsushita 1,2, Etsuko Hashimoto 1, Katsutoshi Tokushige 1, Kazuhisa Kodama 1, Maki Tobari 1, Tomomi
More informationPREVALENCE OF NON-ALCOHOLIC FATTY LIVER IN A HYPERCHOLESTEROLEMIC POPULATION OF NORTHWESTERN PENINSULAR MALAYSIA
PREVALENCE OF NON-ALCOHOLIC FATTY LIVER IN A HYPERCHOLESTEROLEMIC POPULATION OF NORTHWESTERN PENINSULAR MALAYSIA Enrico Magosso 1, Mukhtar Alam Ansari 2, Yogheswaran Gopalan 1, Mohamed Rizal Abu Bakar
More informationNONALCOHOLIC FATTY LIVER DISEASE
NONALCOHOLIC FATTY LIVER DISEASE Kiran Bambha, MD, MSc Hepatology and Liver Transplantation University of Colorado Denver April 13, 2012 Non-Alcoholic Fatty Liver Disease (NAFLD) Terminology Pathogenesis
More informationResponse of Liver Function Tests to Aerobic Exercise in Patients with Type 2 Diabetes Mellitus
Med. J. Cairo Univ., Vol. 78, No. 2, March: 91-95, 21 www.medicaljournalofcairouniversity.com Response of Liver Function Tests to Aerobic Exercise in Patients with Type 2 Diabetes Mellitus YASSER M. ABD
More informationNAFLD AND TYPE 2 DIABETES
NAFLD AND TYPE 2 DIABETES Sonia Caprio, MD STOPNASH Symposium on the Origin and Pathways of Nonalcoholic Steatohepatitis Washington 7, 215 Global Projection of Diabetes Hossain P et al. N Engl J Med 27;356:213
More informationAspartate aminotransferase-to-platelet ratio index in children with cholestatic liver diseases to assess liver fibrosis
The Turkish Journal of Pediatrics 2015; 57: 492-497 Original Aspartate aminotransferase-to-platelet ratio index in children with cholestatic liver diseases to assess liver fibrosis Aysel Ünlüsoy-Aksu 1,
More informationThe Egyptian Journal of Hospital Medicine (Apr. 2017) Vol. 67(1), Page
The Egyptian Journal of Hospital Medicine (Apr. 2017) Vol. 67(1), Page 415-424 Assessment of Left Ventricular Diastolic Function in Nonalcoholic Fatty Liver Disease Mohamed Elhussein Mohamed Ali Elnahas
More information