disease nafld – Rogalevich http://rogalevich.org/ Sat, 26 Mar 2022 12:35:19 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://rogalevich.org/wp-content/uploads/2021/10/icon-120x120.png disease nafld – Rogalevich http://rogalevich.org/ 32 32 Mice experiments reveal females produce more than one protein that helps prevent non-alcoholic fatty liver disease https://rogalevich.org/mice-experiments-reveal-females-produce-more-than-one-protein-that-helps-prevent-non-alcoholic-fatty-liver-disease/ Thu, 17 Mar 2022 16:49:32 +0000 https://rogalevich.org/mice-experiments-reveal-females-produce-more-than-one-protein-that-helps-prevent-non-alcoholic-fatty-liver-disease/ One of the most common disorders in the world, non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of death worldwide. Its progressive form, called “non-alcoholic steatohepatitis” (NASH), affects around 30% of all NAFLD patients, and can lead to cirrhosis and liver cancer. Despite numerous research efforts, we still do not understand the […]]]>

One of the most common disorders in the world, non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of death worldwide. Its progressive form, called “non-alcoholic steatohepatitis” (NASH), affects around 30% of all NAFLD patients, and can lead to cirrhosis and liver cancer. Despite numerous research efforts, we still do not understand the underlying mechanisms of NAFLD/NASH and therefore lack an effective treatment.

One thing we do know, however, is that it seems to be more common in men than in women, especially premenopausal women. Why this is so is not entirely clear, but current evidence suggests that estrogen, a sex hormone, plays a protective role. On the other hand, the formyl-peptide protein receptor 2 (FPR2) is known to play an important role in mediating inflammatory responses in several organs. However, no studies to date have determined its role in the liver. Could FPR2 be implicated in sex-related differences in NAFLD prevalence and severity?

Addressing this question, a research team led by Prof. Youngmi Jung from Pusan ​​National University, Korea, recently conducted a study using a mouse model, shedding light on the role of FPR2 in NAFLD/NASH and its relationship to observed sex-based differences. This work is among the very few studies of NAFLD that rely on gender-balanced animal experiments rather than the more common male-only designs. This article was posted on January 31, 2022 and was published in Volume 13, Number 578, of the journal Nature Communication on January 31, 2022.

The researchers first found that Fpr2 was highly expressed in the healthy liver of female mice. Moreover, it was expressed differently in the liver of male and female mice fed a special NAFLD-inducing diet. Silence the Fpr2 The gene made male and female mice equally vulnerable to NAFLD, suggesting that FPR2 has a protective effect on the liver.

Interestingly, the researchers also found that the production of FPR2 in the liver is mediated by estrogen. Males supplemented with external estrogen produced more Fpr2 and were more resistant to NAFLD, while females whose ovaries had been removed had reduced liver Fpr2 levels. “Taken together, our results suggest that FPR2 is a potential therapeutic target for the development of pharmacological agents to treat NAFLD/NASH,” says Professor Jung. “Furthermore, our results could aid in the development of gender-based therapies for NASH.”

This unprecedented discovery of female-specific FPR2 production in the liver and its role in NAFLD/NASH resistance will hopefully pave the way not only for new treatments, but also for a more comprehensive and gender sensitive during scientific research. In this regard, Professor Jung remarks: “Our research highlights the pressing need to design and develop better gender-balanced animal experiments, given that sex-specific expression of FPR2 in the liver had been completely overlooked. in previous studies.

Hopefully this marks the beginning of a deeper understanding of NAFLD/NASH and the first steps towards effective sex-based therapies.

Source of the story:

Materials provided by Pusan ​​National University. Original written by Na-hyun Lee. Note: Content may be edited for style and length.

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Hepatocellular carcinoma (HCC) related to non-alcoholic fatty liver disease differs clinically from HCC due to other causes https://rogalevich.org/hepatocellular-carcinoma-hcc-related-to-non-alcoholic-fatty-liver-disease-differs-clinically-from-hcc-due-to-other-causes/ Tue, 15 Mar 2022 07:26:38 +0000 https://rogalevich.org/hepatocellular-carcinoma-hcc-related-to-non-alcoholic-fatty-liver-disease-differs-clinically-from-hcc-due-to-other-causes/ 1. Patients with NAFLD-related HCC have longer disease-free survival than those with HCC from other causes. 2. Tumors from patients with HCC related to NAFLD were often larger in diameter than patients with HCC from other causes. Level of evidence assessment: 1 (Excellent) Summary of the study: This systematic review and meta-analysis aimed to compare […]]]>

1. Patients with NAFLD-related HCC have longer disease-free survival than those with HCC from other causes.

2. Tumors from patients with HCC related to NAFLD were often larger in diameter than patients with HCC from other causes.

Level of evidence assessment: 1 (Excellent)

Summary of the study: This systematic review and meta-analysis aimed to compare the clinical presentation and outcome of hepatocellular carcinoma (HCC) due to non-alcoholic fatty liver disease (NAFLD) with HCC from other causes. Outcome measures of interest included: proportion of HCC secondary to NAFLD as well as a comparison of patient and tumor characteristics, overall survival (OS) and disease-free survival outcomes, and other measures between NAFLD-related HCC and HCC due to other causes. The proportion of HCC secondary to NAFLD was 15.1% and an increasing trend over time was noted. Patients who had HCC due to NAFLD were older with higher BMI and had a higher likelihood of comorbidities, including diabetes, hypertension, hyperlipidemia, or cardiovascular disease, compared to patients with HCC due to other causes. Patients with NAFLD-related HCC also had a higher likelihood of being non-cirrhotic. The tumors of patients with HCC due to NAFLD were larger in diameter and these patients had a higher likelihood of uninodular lesions. OS results did not differ between patients with HCC due to NAFLD and those with HCC from other causes, but disease-free survival was longer in patients with HCC due to NAFLD. Limitations of this study include those intrinsic to the meta-analyses, the exclusion of pediatric populations, and a smaller number of studies from the Southeast Asian and South American regions. Overall, the proportion of HCCs linked to NAFLD is increasing over time and an increase in surveillance strategies would be valuable for high-risk patients with NAFLD.

Click to read the study in The Lancet Oncology

Relevant reading: Hepatocellular carcinoma in patients with non-alcoholic fatty liver disease

In depth [systematic review and meta-analysis]: This systematic review and meta-analysis included 94,636 patients in 61 studies from many countries completed between January 1980 and May 2021. The proportion of HCC secondary to NAFLD was 15.1% (95% confidence interval (CI) , 11.9%-18.9%). Patients with HCC due to NAFLD had higher BMI (mean difference 2.99 kg/m^2, 95% CI 2.20 – 3.78 kg/m^2) and were older ( mean difference 5.62 years, 95% CI 4.63 – 6.61 years). Patients with NAFLD-related HCC had a higher likelihood of comorbidities, including diabetes (odds ratio (OR) 4.31, 95% CI 3.19, 5.80), hypertension (OR 2.84, 95% CI, 2.09 – 3.86), hyperlipidemia (OR 3.43, 95% CI, 2.39 – 4.95) or cardiovascular disease (OR 2.23, 95% CI, 1.43, 3.48) compared to patients with HCC due to other causes. Patients with NAFLD-related HCC also had a higher probability of being non-cirrhotic: 38.5% (95% CI, 27.9% – 50.2%) versus 14.6% (CI at 95%, 8.7% – 23.4%). NAFLD HCC patients often had larger diameter tumors (mean difference 0.67 cm, 95% CI 0.35 to 0.98 cm) and more often uninodular lesions (OR 1.36; CI at 95%, 1.19 to 1.56). Comparison of OS results revealed that there was no difference between the groups (risk ratio (HR) 1.05; 95% CI, 0.92, 1.20). However, patients with NAFLD-related HCC had increased disease-free survival (HR 0.79; 95%, 0.63-0.99).

Picture: PD

©2022 2 Minute Medicine, Inc. All rights reserved. No work may be reproduced without the express written consent of 2 Minute Medicine, Inc. Learn about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

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Supporting the 3rd leading cause of cancer-related death https://rogalevich.org/supporting-the-3rd-leading-cause-of-cancer-related-death/ Mon, 07 Mar 2022 15:18:52 +0000 https://rogalevich.org/supporting-the-3rd-leading-cause-of-cancer-related-death/ Liver cancer is the third leading cause of cancer-related death worldwide, and the incidence of primary liver cancer in the United States has tripled over the past four decades. While chronic viral hepatitis is the primary route to liver cancer in the United States, non-infectious causes such as morbid obesity, type 2 diabetes, non-alcoholic fatty […]]]>

Liver cancer is the third leading cause of cancer-related death worldwide, and the incidence of primary liver cancer in the United States has tripled over the past four decades. While chronic viral hepatitis is the primary route to liver cancer in the United States, non-infectious causes such as morbid obesity, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and non-infectious steatohepatitis associated alcoholism (NASH) increased rapidly. We will describe each of these pathways, starting with viral hepatitis (HCV and HBV) and alcoholic cirrhosis.


There is a morbid saying that cancer eventually affects us all, unless something else affects us first.

While some cancers currently have no accessible prevention, some can be effectively prevented. Hepatocellular carcinoma (HCC) is one of those that can be prevented, but once HCC is established and symptomatic, survival rates drop sharply. While liver cancer is the 8and location of cancer site by prevalence (Figure 1), this is the 3rd leading cause of death (Figure 2). HCC has a high mortality profile with a median survival after diagnosis of 6-20 months, and in the United States it has a 5-year survival rate of only 10% (Golabi, et al., 2017)

Figure 1. Top 10 cancer sites by case (Sung et al, 2021)

Top 10 cancer sites by death

Figure 2. Top 10 cancer sites by death (Sung et al, 2021)

The COVID-19 pandemic has rightly occupied the minds and efforts of nearly everyone in healthcare for the past two years, but HCC has not gone away and continues to cause daily damage. . HCC was on 4and leading cause of cancer-related death in 2019 (Yang et al., 2019), and has been steadily increasing – it has tripled in the United States (Rawla, Sunkara, Muralidharan & Raj, 2018).

Although your daily chance of encountering a patient with HCC is still small, it increases year by year and there is a serious risk of missing the window of opportunity to prevent full-blown HCC.

This blog will describe how to be alert to the causes and cases of HCC, and we will provide you with tools and resources to help you identify HCC, ways to connect your patient with appropriate specialists, and help you find appropriate studies and trials for your patient.

There are four main HCC risk factors:

  1. Hepatitis B (HBV)
  2. Hepatitis C (HCV)
  3. Excessive consumption of alcohol
  4. Non-alcoholic fatty liver disease (NAFLD) resulting in non-alcoholic steatohepatitis (NASH)

How likely are you to encounter hepatocellular carcinoma in patients?

In the near future, it is unlikely that any specific patient you see will already have HCC. That’s great, but it’s also a problem because you’re less likely to recognize it immediately. For HCC, delay is the killer.

However, you are very likely to see a patient who, regardless of their primary complaint, is already on one or more of the four main HCC pathways. The picture is also skewed when race is taken into account – while the overall rate of HBV infection has declined significantly since 1991, it remains a concern for the African American population. In 2017, non-Hispanic African Americans were 1.5 times more likely to die from viral hepatitis than whites, and almost twice as likely to die from HCV. (HHS-OMH”Hepatitis and African Americans”)

Anything you can do to increase HBV vaccination rates and prevent HCV infection will help steer your patients away from the viral pathway. It is therefore important to use screening tests for HBV and HCV and to strongly encourage HBV vaccination even if patients are not in high-risk categories. Likewise, addressing alcohol use and encouraging your patients to follow guidelines will help steer them away from alcohol’s path to HCC.

the NAFLD/NASH pathway talks about lifestyle changes that are inherently healthier and worth discussing. Discussing healthy eating, limiting portion sizes, and maintaining a healthy weight with your patients can help steer them away from this path.

Patient history that should raise your index of suspicion includes past unprotected sex, use of needles, binge drinking or binge drinking, or increasing obesity. However, it is important to keep in mind that many patients who had no obvious risk factors in their history nevertheless went on to have HCC. Although atypical, HCC can be the result of maternal HBV infection or HCV transmitted to children. For an example, see “Better off bald: a life in 147 days

How to discuss staging with patients

Discussing staging with patients can be difficult, and the literature is often either aimed at clinicians or contains misleading information. Blue Faery provides clinically accurate yet understandable materials to help you describe the staging and help the patient understand where they are on the spectrum.

These materials include:

  • The HCC patient education brochures is written in plain language and intended to be read by the patient.
  • The Blue Faery and Exelixis staging discussion pad contains anatomical graphics and easy-to-understand text. Each double-sided sheet allows the doctor to add notes that his patient can use after the appointment.
  • the Liver Cancer Patient Resource Guide is a 20-page booklet containing relevant explanations and resources for HCC patients and their caregivers.

Blue Faery will send these documents free of charge to any doctor who requests them.

How to Find Hepatocellular Carcinoma Specialists, Treatment Options and Clinical Trials

Treatment of HCC is best approached with a multidisciplinary team coordinated by a primary care physician. The most effective approach will likely require the expertise of multiple healthcare professionals, including the primary care physician, and may include an oncologist with experience in HCC, gastroenterologist, hepatologist, radiologist interventionist, a radiation oncologist, a surgical oncologist and a transplant surgeon.

Where to find clinical trials specific to hepatocellular carcinoma

To find all clinical trials, the best option is clinicaltrials.gov, but this website can be confusing and difficult to navigate. To help physicians guide their patients to relevant trials, Blue Faery has a custom HCC clinical trial browser.

Where can patients find community support?

Patient communities are very helpful in providing patients with practical guidance for their care journey and are often a source of emotional support from people who understand the experience.

the Blue Fairy Liver Cancer Community is a free, HIPAA-compliant online community where patients and caregivers are invited to join and seek or exchange relevant information about HCC care. Members ask questions, discuss concerns and find common ground along their cancer journey. Forum moderators include Community Ambassadors who were former caregivers of HCC patients.

For individual patient support, Blue Faery has partnered with Imerman Angels, a non-profit organization that provides peer-to-peer support services to the liver cancer community. Blue Faery and Imerman Angels believe that no one should face cancer alone.

Conclusion

With proper screening, testing and inoculation, the viral pathway to HCC can often be interrupted. Blue Faery provides free, patient-readable and clinically accurate materials to help physicians discuss their patients’ staging, options and resources.

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Long or irregular periods can put a woman’s liver at risk – Consumer Health News https://rogalevich.org/long-or-irregular-periods-can-put-a-womans-liver-at-risk-consumer-health-news/ Fri, 04 Mar 2022 12:44:36 +0000 https://rogalevich.org/long-or-irregular-periods-can-put-a-womans-liver-at-risk-consumer-health-news/ FRIDAY, March 4, 2022 (HealthDay News) — According to a new study, women with long or irregular periods are at an increased risk of contracting a serious condition called non-alcoholic fatty liver disease. Non-alcoholic fatty liver disease (NAFLD) is a chronic disease in which excess fat builds up in the liver. It affects about 24% […]]]>

FRIDAY, March 4, 2022 (HealthDay News) — According to a new study, women with long or irregular periods are at an increased risk of contracting a serious condition called non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) is a chronic disease in which excess fat builds up in the liver. It affects about 24% of American adults, according to the March 3 report in the Journal of Clinical Endocrinology and Metabolism.

“The results of our study show that long or irregular menstrual cycles may be associated with an increased risk of developing NAFLD, and this link was not explained by obesity,” said Dr. Seungho Ryu of the Kangbuk Samsung Hospital at Sungkyunkwan University Medical School in Seoul, South Korea.

“Previous studies have shown that long or irregular menstrual cycles are associated with type 2 diabetes and cardiovascular disease, but our study is the first to find a link between long or irregular menstrual cycles and NAFLD,” Ryu noted. in a press release.

NAFLD that is not caused by heavy alcohol consumption may progress to chronic liver damage and is associated with a higher risk of death. There are no approved drugs to treat the condition, so diet and exercise are the standard of care.

For the study, the researchers analyzed data from more than 72,000 women under the age of 40. About 28% of women had long or irregular menstrual cycles and 7% had NAFLD.

After four years of follow-up, new cases of NAFLD had been diagnosed in nearly 9% of women. The researchers concluded that there was an association between long or irregular menstrual cycles in young premenopausal women and an increased risk of NAFLD.

“Young women with long or irregular menstrual cycles may benefit from lifestyle changes to reduce the risk of NAFLD as well as other cardiometabolic diseases,” Ryu concluded.

More information

There’s more on NAFLD at the US National Institute of Diabetes and Digestive and Kidney Diseases.

THE SOURCE: Journal of Clinical Endocrinology and Metabolismpress release, March 3, 2022

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Fatty liver disease: four signs of the disease explained https://rogalevich.org/fatty-liver-disease-four-signs-of-the-disease-explained/ Thu, 03 Mar 2022 15:08:11 +0000 https://rogalevich.org/fatty-liver-disease-four-signs-of-the-disease-explained/ Warning signs that suggest you are at risk of developing fatty liver disease. Accumulation of fat in the liver can cause non-alcoholic fatty liver disease (NAFLD), a condition seen in overweight or obese people. NAFLD is not caused by alcohol, but if left untreated, it can lead to cirrhosis resembling liver damage caused by excessive […]]]>

Warning signs that suggest you are at risk of developing fatty liver disease.

Accumulation of fat in the liver can cause non-alcoholic fatty liver disease (NAFLD), a condition seen in overweight or obese people.

NAFLD is not caused by alcohol, but if left untreated, it can lead to cirrhosis resembling liver damage caused by excessive alcohol consumption.

However, foods and drinks containing alcohol or sugar can make the situation worse, so it is advisable to limit their consumption.

NAFLD is the most common liver disease in the world.

More than 90% of obese people, 60% of diabetics and 20% of people with a healthy weight suffer from this disease.

The human liver normally contains some fat, but when fat exceeds 5% of liver weight, fatty liver can develop.

In the early stages, NAFLD usually has no symptoms, but it can be detected by a liver function test from the blood sample.

The warning signs appear when it progresses to non-alcoholic steatohepatitis (NASH) or fibrosis in which the liver has become inflamed.

A person with NASH may experience:

  1. extremely tired,
  2. tiredness,
  3. pain in the upper right of the belly on the lower right side of the ribs,
  4. and lose weight for no reason.

Prolonged fibrosis and persistent inflammation will cause cirrhosis where the liver is severely scarred and damaged.

Permanent damage can lead to liver cancer, liver failure, and ultimately death.

Symptoms of cirrhosis can include:

  • itchy skin,
  • edema (swelling of the legs or stomach),
  • and jaundice (the skin and the whites of the eyes turn yellow).

We don’t know how mild fatty liver disease develops into serious disease such as non-alcoholic steatohepatitis and liver fibrosis.

To understand the process, the researchers performed a genetic analysis of hepatocytes, the main functional cells of the liver.

Professor Stephan Herzig, co-author of the study, said:

“Understanding the mechanism by which this condition becomes fatal is essential in our quest to find therapeutic solutions and preventive measures.”

The research team developed a method targeting particular nodes of the protein network to halt disease progression or even prevent fibrosis.

A network of proteins called “transcription factors” is involved in the process of hepatocyte reprogramming.

Failure of the process could lead to dysfunction of hepatocyte cells.

For example, during the development of NASH, hepatocyte cells lose their identity.

Dr Ana Alfaro, the first author of the study, said:

“These findings are important because they unravel the cellular mechanisms underlying non-alcoholic steatohepatitis.

Knowing the role of protein networks and the loss of hepatocyte identity gives us potential intervention targets for the development of effective therapies.

The study was published in the journal Cell metabolism (Loft et al., 2021).

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Exercise reduces clotting risk in patients with non-alcoholic fatty liver disease https://rogalevich.org/exercise-reduces-clotting-risk-in-patients-with-non-alcoholic-fatty-liver-disease/ Tue, 01 Mar 2022 15:42:43 +0000 https://rogalevich.org/exercise-reduces-clotting-risk-in-patients-with-non-alcoholic-fatty-liver-disease/ Exercise may help some patients with non-alcoholic fatty liver disease (NAFLD) reduce their risk of developing blood clots, a new study finds Penn State College of Medicine researchers. While diet and physical activity have always been recommended treatments for these patients, the researchers said their findings confirm that exercise has a multitude of benefits, many […]]]>

Exercise may help some patients with non-alcoholic fatty liver disease (NAFLD) reduce their risk of developing blood clots, a new study finds Penn State College of Medicine researchers. While diet and physical activity have always been recommended treatments for these patients, the researchers said their findings confirm that exercise has a multitude of benefits, many of which extend beyond the liver, and should be included as part of NAFLD treatment.

The condition, NAFLD, where too much fat builds up in liver cells, affects almost a billion adults worldwide. Patients with NAFLD have an increased risk of heart disease, stroke, cancer, and blood clots. Currently, there are no approved drug treatments or cures for this common condition.

Dr Jonathan StineAssociate Professor of Medicine and Public Health Sciences at the Faculty of Medicine and Transplant Hepatologist at Penn State Health Milton S. Hershey Medical Center, conducted a clinical trial to study how exercise programs affect the health of patients with non-alcoholic steatohepatitis (NASH) – an aggressive form of NAFLD. Twenty-four patients completed the study, which required two-thirds of participants to complete a 20-week aerobic exercise program and dietary advice.

At the end of the trial, participants who completed the exercise program – which consisted of five 30-minute moderate-intensity exercise sessions per week – had a significantly reduced amount of activator inhibitor. plasminogen 1 (PAI-1), a protein that helps blood clots stay formed, compared to control group participants who received standard clinical care.

“NAFLD and NASH patients have an increased risk of developing blood clots in the veins of the legs, lungs, or liver,” said Stine, who noted that blood clots affect nearly 900,000 Americans each year. “If these occur, they can have serious consequences, including an increased risk of hospitalization or death. The results of our study illustrate the importance of prescribing physical activity to NAFLD and NASH patients as a means of improving their general state of health.

In addition to measuring the risk of clotting, the researchers also found that exercise led to a greater decrease in liver fat, a greater increase in the body’s ability to deliver oxygen to skeletal muscles during exercise. (cardiorespiratory fitness), changes in blood sugar and insulin levels, reduced body fat and improved quality of life. The research team noted that these benefits appeared to be independent of weight loss or dietary changes. the results were published in Hepatology.

To build on the findings, Stine, a Penn State Cancer Institute researcher, is conducting another clinical trial, sponsored by the National Institutes of Health, to study how different “doses” of exercise affect the metabolic function and health of NAFLD patients. Stine plans to launch the trial in May 2022.

“There is no cure or effective drug therapies for NAFLD,” Stine said. “Through this research, we hope to develop additional guidance for clinicians on the optimal amount of exercise for these patients and explore the biology that explains why physical activity is an effective therapy.”

Ian Schreibman, Alison Faust, Jessica DahmusBenajmin Stern, Christopher Soriano, Gloriany Rivas, Breianna Hummer, Scottish KimballNate Geyer, Vernon Chinchilli, Catherine Schmitz and Christophe Sciamanna from Penn State College of Medicine; and Rohit Loomba of the University of California, San Diego also contributed to this research. Information on conflicts of interest can be found in the manuscript.

This study was supported by funds from the National Institutes of Health and in part by a grant from the Pennsylvania Department of Health using Tobacco CURE funds. This project was also supported by Penn State Institute for Clinical and Translational Sciences through the National Center for Advancing Translational Sciences of the National Institutes of Health (grant numbers UL1 TR002014).

Learn more about liver disease research at Penn State College of Medicine.

Learn more about the hepatology study.

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Women with irregular periods may be at risk for liver disease https://rogalevich.org/women-with-irregular-periods-may-be-at-risk-for-liver-disease/ Tue, 01 Mar 2022 14:00:00 +0000 https://rogalevich.org/women-with-irregular-periods-may-be-at-risk-for-liver-disease/ News – WASHINGTON –Women with long or irregular periods are known to have a higher risk of type 2 diabetes and heart disease, but researchers have found that these women may also be at risk for non-alcoholic fatty liver disease (NAFLD), according to a study. new study published in the Endocrine Society’s Journal of Clinical […]]]>

News – WASHINGTON –Women with long or irregular periods are known to have a higher risk of type 2 diabetes and heart disease, but researchers have found that these women may also be at risk for non-alcoholic fatty liver disease (NAFLD), according to a study. new study published in the Endocrine Society’s Journal of Clinical Endocrinology and Metabolism.

About 24% of American adults have NAFLD, a chronic disease in which excess fat builds up in the liver. This fat accumulation is not caused by heavy alcohol consumption. NAFLD can progress to chronic liver damage and is associated with a higher risk of death. Diet and exercise are the standard of care for NAFLD because no drugs have been approved to treat the disease.

“The results of our study show that long or irregular menstrual cycles may be associated with an increased risk of developing NAFLD, and this link was not explained by obesity,” said Seungho Ryu, MD, Ph. D., from the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine in Seoul, South Korea. “Previous studies have shown that long or irregular menstrual cycles are associated with type 2 diabetes and cardiovascular disease, but our study is the first to find a link between long or irregular menstrual cycles and NAFLD.”

The researchers studied a dataset of 72,092 women under the age of 40. About 28% of these women had long or irregular menstrual cycles and 7% had NAFLD. Researchers followed up four years later and found that new cases of NAFLD occurred in nearly 9% of women. The researchers concluded that there was an association between long or irregular menstrual cycles in young premenopausal women and an increased risk of NAFLD.

“Young women with long or irregular menstrual cycles may benefit from lifestyle changes to reduce the risk of NAFLD as well as other cardiometabolic diseases,” Ryu said.

Other authors of this study include: In Young Cho, Yoosoo Chang, Jae-Heon Kang, Yejin Kim, Eunju Sung, and Hocheol Shin of Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine in Seoul, South Korea; Sarah Wild from the University of Edinburgh in Edinburgh, UK; and Christopher Byrne of the University of Southampton and University Hospital of Southampton in Southampton, UK

The study received funding from Sungkyunkwan University and the NIHR Center for Biomedical Research in Southampton.

The manuscript, “Long or Irregular Menstrual Cycles and Risk of Prevalent and Incident Non-Alcoholic Fatty Liver Disease”, was published online, ahead of print.

# # #

Endocrinologists are at the heart of solving the most pressing health issues of our time, from diabetes and obesity to infertility, bone health and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists dedicated to hormone research and physicians who care for people with hormone-related diseases.

The Society has more than 18,000 members, including scientists, doctors, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site atwww.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

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Physical activity reduces the risk of clotting in patients with non-alcoholic fatty liver disease https://rogalevich.org/physical-activity-reduces-the-risk-of-clotting-in-patients-with-non-alcoholic-fatty-liver-disease/ Mon, 28 Feb 2022 13:00:38 +0000 https://rogalevich.org/physical-activity-reduces-the-risk-of-clotting-in-patients-with-non-alcoholic-fatty-liver-disease/ Exercise may help some patients with non-alcoholic fatty liver disease (NAFLD) reduce their risk of developing blood clots, a new study finds Penn State College of Medicine researchers. While diet and physical activity have always been recommended treatments for these patients, the researchers said their findings confirm that exercise has a multitude of benefits, many […]]]>

Exercise may help some patients with non-alcoholic fatty liver disease (NAFLD) reduce their risk of developing blood clots, a new study finds Penn State College of Medicine researchers. While diet and physical activity have always been recommended treatments for these patients, the researchers said their findings confirm that exercise has a multitude of benefits, many of which extend beyond the liver, and should be included as part of NAFLD treatment.

February 28, 2022Penn State College of Medicine News

The condition, NAFLD, where too much fat builds up in liver cells, affects almost a billion adults worldwide. Patients with NAFLD have an increased risk of heart disease, stroke, cancer, and blood clots. Currently, there is no approved drug treatment or cure for this common condition.

Dr Jonathan StineAssociate Professor of Medicine and Public Health Sciences at the Faculty of Medicine and Transplant Hepatologist at Penn State Health Milton S. Hershey Medical Center, conducted a clinical trial to study how exercise programs affect the health of patients with non-alcoholic steatohepatitis (NASH) – an aggressive form of NAFLD. Twenty-four patients completed the study, which required two-thirds of participants to complete a 20-week aerobic exercise program and dietary advice.

At the end of the trial, participants who completed the exercise program – which consisted of five 30-minute moderate-intensity exercise sessions per week – had a significantly reduced amount of activator inhibitor. plasminogen 1 (PAI-1), a protein that helps blood clots stay formed, compared to control group participants who received standard clinical care.

“NAFLD and NASH patients have an increased risk of developing blood clots in the veins of the legs, lungs, or liver,” said Stine, who noted that blood clots affect nearly 900,000 Americans each year. “If these occur, they can have serious consequences, including an increased risk of hospitalization or death. The results of our study illustrate the importance of prescribing physical activity to NAFLD and NASH patients as a means of improving their general state of health.

In addition to measuring the risk of clotting, the researchers also found that exercise led to a greater decrease in liver fat, a greater increase in the body’s ability to deliver oxygen to skeletal muscles during exercise. (cardiorespiratory fitness), changes in blood sugar and insulin levels, reduced body fat and improved quality of life. The research team noted that these benefits appeared to be independent of weight loss or dietary changes. the results were published in Hepatology.

To build on the findings, Stine, a Penn State Cancer Institute researcher, is conducting another clinical trial, sponsored by the National Institutes of Health, to study how different “doses” of exercise affect the metabolic function and health of NAFLD patients. Stine plans to launch the trial in May 2022.

“There is no cure or effective drug therapies for NAFLD,” Stine said. “Through this research, we hope to develop additional guidance for clinicians on the optimal amount of exercise for these patients and explore the biology that explains why physical activity is an effective therapy.”

Ian Schreibman, Alison Faust, Jessica DahmusBenajmin Stern, Christopher Soriano, Gloriany Rivas, Breianna Hummer, Scottish KimballNate Geyer, Vernon Chinchilli, Catherine Schmitz and Christophe Sciamanna from Penn State College of Medicine; and Rohit Loomba of the University of California, San Diego also contributed to this research. Information on conflicts of interest can be found in the manuscript.

This study was supported by funds from the National Institutes of Health and in part by a grant from the Pennsylvania Department of Health using Tobacco CURE funds. This project was also supported by Penn State Institute for Clinical and Translational Sciences through the National Center for Advancing Translational Sciences of the National Institutes of Health (grant numbers UL1 TR002014).

Learn more about liver disease research at Penn State College of Medicine.

Learn more about the hepatology study.

If you are having difficulty accessing this content, or would like it in an alternate format, please email Penn State Health Marketing & Communications.

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A comprehensive view of the interaction between non-alcoholic fatty liver disease and diabetes https://rogalevich.org/a-comprehensive-view-of-the-interaction-between-non-alcoholic-fatty-liver-disease-and-diabetes/ Sun, 20 Feb 2022 06:00:00 +0000 https://rogalevich.org/a-comprehensive-view-of-the-interaction-between-non-alcoholic-fatty-liver-disease-and-diabetes/ This article was originally published here Lancet Diabetes Endocrinol. February 17, 2022: S2213-8587(22)00003-1. doi: 10.1016/S2213-8587(22)00003-1. Online ahead of print. ABSTRACT Non-alcoholic fatty liver disease (NAFLD) has become an epidemic, as have other non-communicable diseases (NCDs), such as cancer, obesity, diabetes and cardiovascular disease. The pathophysiology of NAFLD, particularly involving insulin resistance and subclinical inflammation, is […]]]>

This article was originally published here

Lancet Diabetes Endocrinol. February 17, 2022: S2213-8587(22)00003-1. doi: 10.1016/S2213-8587(22)00003-1. Online ahead of print.

ABSTRACT

Non-alcoholic fatty liver disease (NAFLD) has become an epidemic, as have other non-communicable diseases (NCDs), such as cancer, obesity, diabetes and cardiovascular disease. The pathophysiology of NAFLD, particularly involving insulin resistance and subclinical inflammation, is not only closely linked to that of these NTMs, but also to a severe course of the communicable disease COVID-19. Genetics alone cannot explain the sharp increase in the prevalence of NAFLD over the past 2 decades and the projected increase for the next few decades. Impaired glucose and lipid metabolic pathways, which have been propelled by the global rise in the prevalence of obesity and type 2 diabetes, are most likely behind the rise in the number of people with NAFLD. As the prevalence of NAFLD varies among the subgroups of patients with diabetes and prediabetes identified by the cluster analyses, stratifying people with diabetes and prediabetes by major mechanistic disease pathways could improve the diagnosis of NAFLD and predicting its progress. In this review, we aim to understand how diabetes can affect the development of fatty liver disease and its progression to advanced liver injury. First, we highlight the extent to which NAFLD and diabetes occur together around the world. Second, we address the main mechanisms involved in the pathogenesis of NAFLD and type 2 diabetes, and discuss whether these mechanisms place NAFLD in an important position to better understand the pathogenesis of NCDs and communicable diseases. , such as COVID-19. Third, we examine whether this knowledge can be used for the personalized treatment of NAFLD in the future. Finally, we discuss current treatment strategies for people with type 2 diabetes and their effectiveness in treating the spectrum of liver disease, from simple steatosis to nonalcoholic steatohepatitis and liver fibrosis.

PMID:35183303 | DO I:10.1016/S2213-8587(22)00003-1

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Effective diagnostics for liver disease are urgently needed https://rogalevich.org/effective-diagnostics-for-liver-disease-are-urgently-needed/ Thu, 17 Feb 2022 16:56:16 +0000 https://rogalevich.org/effective-diagnostics-for-liver-disease-are-urgently-needed/ The following article is an opinion piece written by Dr. Tram Tran. The views and opinions expressed in this article are those of the author and do not necessarily reflect the official position of Technology Networks. Due to the increasing incidence of diabetes, obesity, and metabolic diseases in the United States, it is estimated that […]]]>

The following article is an opinion piece written by Dr. Tram Tran. The views and opinions expressed in this article are those of the author and do not necessarily reflect the official position of Technology Networks.

Due to the increasing incidence of diabetes, obesity, and metabolic diseases in the United States, it is estimated that one in four patients has some form of fatty liver disease. The impact of this on the healthcare system has been realized and is likely to increase over time.

As primary care physicians continue to see increasing numbers of patients with fatty liver disease, it is important for them to be able to effectively triage these patients to ensure the best care possible. For many patients with non-alcoholic fatty liver disease (NAFLD), primary care would focus on diet and exercise to reduce the risk of liver disease progression.

However, many patients with NAFLD have a more severe inflammatory form of fatty liver disease called non-alcoholic steatohepatitis (NASH) which, if left untreated, could lead to significant complications including cirrhosis, liver cancer or dead.

It is therefore important for physicians to diagnose NASH, assess patients for stage or severity, monitor liver disease progression, and identify risk factors to initiate appropriate intervention.

Many primary care physicians may see patients in the early stages of liver disease when symptoms may be mild or non-existent, and therefore may not recognize the potentially progressive nature of NASH. Hepatologists and specialists who work with patients with advanced liver disease are aware, however, that the increase in NASH cases is expanding the list of patients who manifest serious disease and who may eventually need medical attention. liver transplant.

According to the results of a 2021 study,1 NASH was the second leading indication for liver transplantation in the United States and the largest increase since 2002. This overall burden on our healthcare system will only continue to grow.

The best way to prevent progression to advanced liver disease is to intervene early. However, the ability to effectively assess liver disease is limited by the primary diagnostic tool: liver biopsy.

A liver biopsy is a procedure in which a needle is inserted into the liver to remove a small piece of it for microscopic analysis and diagnosis. As one can imagine, many patients are reluctant to undergo this procedure. It’s invasive, carries the risk of bleeding and pain, and requires careful attention to the surrounding logistics that come with a procedure — getting time off work, being driven home, etc.

The nature of liver biopsy presents clinicians with a significant challenge. How can we effectively diagnose, stage and monitor fatty liver disease when patients are reluctant to routinely undergo the procedure?

From there, larger questions begin to emerge. How can you effectively triage patients to the appropriate treatment path? How can you monitor a patient’s response to treatment?

Fortunately, these types of questions are asked by many experts in the field.

Researchers have recently focused on measuring the properties of active liver disease biology, which is considered more beneficial than studying a single biopsy sample of the diseased liver. Indeed, liver injury can be heterogeneous and patchy in nature, and a small liver sample (approximately 1/50,000and) of the organ – as collected from a biopsy – might not accurately reflect the degree of damage. A dynamic biological measurement would provide a more systemic snapshot of disease state.

At the most recent American Association for the Study of Liver Diseases (AASLD) conference, Dr. Arun Sanyal (Virginia Commonwealth University), in collaboration with scientists from Glympse, presented data demonstrating the high precision (AUC 0 .97) of a biosensor blood test in predicting NASH compared to healthy patients.2 We achieved this by measuring the enzymatic activity of proteins a fundamental biopathology of NASH.

The activity of certain proteases, or enzymes involved in the cleavage of proteins, varies depending on the state of disease in the liver. By exposing these proteases to a selection of small protein fragments (peptides), we can measure this activity. Also, because liver proteases circulate in the bloodstream, we can measure this from a routine blood test sample.

We are at the forefront of understanding biomarkers in this field, driven by the promise of what this data could mean for patients in need.

In addition, the NIMBLE group made another important presentation at the AASLD conference. NIMBLE (Non-Invasive Biomarkers of Metabolic Liver Disease) is a joint effort between industry, academia and government. The group presented important data evaluating the performance of five different non-invasive tests with the aim of reducing the need for liver biopsy in this patient population, hopefully paving the way for the future use of clinical biomarkers.3

Any accurate, non-invasive diagnosis would have important implications for patients. Not only would a simple blood test improve both the patient experience and clinicians’ ability to monitor disease progression, but it would also improve access to experimental treatments for NASH and NAFLD in clinical trials, because researchers could better determine the right patients for studies.

Having a reliable tool for diagnosing liver disease would ensure that patients can access these experimental drugs in a timely manner, paving the way for better therapies and interventions before the most serious outcomes, such as liver transplants, are not necessary.

For everyone involved in liver disease biomarker research, our overarching goal is to optimize best practices for patient care. Of course, we recognize the urgent need for the healthcare system to triage patients with liver disease more efficiently, as the need for liver transplants continues to dramatically outstrip available donor organs.

At the heart of this research, however, is the individual patient and the need to effectively diagnose, monitor and prevent the progression of liver disease. Research at Glympse and elsewhere gives hope that this need will soon be met.

The references

1. Younossi, ZM et al. Non-alcoholic steatohepatitis is the fastest growing indication for liver transplantation in the United States. Clin. Gastroenterol. Hepatol. 2021; 19:580–589. do I: 10.1016/j.cgh.2020.05.064

2. Sanyal, Arun. Accurate diagnosis of NASH using a new protease-based liquid biopsy. Glympse at AASLD 2021. Nov. 2021. https://glympsebio.com/presentation-accurate-diagnosis-of-nash-using-novel-protease/. Accessed January 2022.

3. Sanyal A, et. al. Main results of the NIMBLE stage 1-NASH CRN study of circulating biomarkers of nonalcoholic steatohepatitis and its activity and stage of fibrosis. Summary of the AASLD meeting. Nov 2021. https://fnih.org/sites/default/files/2021-11/CWS_NIMBLE_Abstract.pdf. Accessed January 2022.

About the Author

Tram Tran, MD is the Chief Medical Officer of Glympse. She is a renowned liver and virus specialist with over 20 years of academic and industrial experience as a physician-scientist. Prior to Glympse, Dr. Tran worked at Gilead Sciences and before that at Cedars-Sinai Medical Center. She has authored and co-authored over 150 abstracts, published manuscripts, and book chapters, and has been extensively involved in clinical trials and research funded by the National Institutes of Health (NIH). Dr. Tran received his MD from New York Medical College.

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