The lancet. Gastroenterology & hepatology最新文献

{"title":"The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis.","authors":"Kiarash Riazi,&nbsp;Hassan Azhari,&nbsp;Jacob H Charette,&nbsp;Fox E Underwood,&nbsp;James A King,&nbsp;Elnaz Ehteshami Afshar,&nbsp;Mark G Swain,&nbsp;Stephen E Congly,&nbsp;Gilaad G Kaplan,&nbsp;Abdel-Aziz Shaheen","doi":"10.1016/S2468-1253(22)00165-0","DOIUrl":"https://doi.org/10.1016/S2468-1253(22)00165-0","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide and the leading cause of liver-related morbidity and mortality. We aimed to predict the burden of NAFLD by examining and estimating the temporal trends of its worldwide prevalence and incidence.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, we searched MEDLINE, EMBASE, Scopus, and Web of Science without language restrictions for reports published between date of database inception and May 25, 2021. We included observational cross-sectional or longitudinal studies done in study populations representative of the general adult population, in whom NAFLD was diagnosed using an imaging method in the absence of excessive alcohol consumption and viral hepatitis. Studies were excluded if conducted in paediatric populations (aged <18 years) or subgroups of the general population. Summary estimates were extracted from included reports by KR and independently verified by HA using the population, intervention, comparison, and outcomes framework. Primary outcomes were the prevalence and incidence of NAFLD. A random-effects meta-analysis was used to calculate overall and sex-specific pooled effect estimates and 95% CIs.</p><p><strong>Findings: </strong>The search identified 28 557 records, of which 13 577 records were screened; 299 records were also identified via other methods. In total, 72 publications with a sample population of 1 030 160 individuals from 17 countries were included in the prevalence analysis, and 16 publications with a sample population of 381 765 individuals from five countries were included in the incidence analysis. The overall prevalence of NAFLD worldwide was estimated to be 32·4% (95% CI 29·9-34·9). Prevalence increased significantly over time, from 25·5% (20·1-31·0) in or before 2005 to 37·8% (32·4-43·3) in 2016 or later (p=0·013). Overall prevalence of NAFLD was significantly higher in men than in women (39·7% [36·6-42·8] vs 25·6% [22·3-28·8]; p<0·0001). The overall incidence of NAFLD was estimated to be 46·9 cases per 1000 person-years (36·4-57·5); 70·8 cases per 1000 person-years (48·7-92·8) in men and 29·6 cases per 1000 person-years (20·2-38·9) in women (p<0·0001). There was considerable heterogeneity between studies of both NAFLD prevalence (I²=99·9%) and NAFLD incidence (I²=99·9%).</p><p><strong>Interpretation: </strong>Worldwide prevalence of NAFLD is considerably higher than previously estimated and is continuing to increase at an alarming rate. Incidence and prevalence of NAFLD are significantly higher among men than among women. Greater awareness of NAFLD and the development of cost-effective risk stratification strategies are warranted to address the growing burden of NAFLD.</p><p><strong>Funding: </strong>Canadian Institutes of Health.</p>","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":" ","pages":"851-861"},"PeriodicalIF":35.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40571138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory leg nodules following acute pancreatitis.","authors":"Margot Lehericey,&nbsp;Aurélie Baldolli,&nbsp;Renaud Verdon","doi":"10.1016/S2468-1253(22)00176-5","DOIUrl":"https://doi.org/10.1016/S2468-1253(22)00176-5","url":null,"abstract":"","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":" ","pages":"894"},"PeriodicalIF":35.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40588956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The International Liver Congress 2022.","authors":"R. Brierley, Hugh Thomas","doi":"10.1016/s2468-1253(22)00244-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(22)00244-8","url":null,"abstract":"","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":"7 9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129489728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of pouch neoplasia: consensus guidelines from the International Ileal Pouch Consortium.","authors":"Ravi P Kiran,&nbsp;Gursimran S Kochhar,&nbsp;Revital Kariv,&nbsp;Douglas K Rex,&nbsp;Akira Sugita,&nbsp;David T Rubin,&nbsp;Udayakumar Navaneethan,&nbsp;Tracy L Hull,&nbsp;Huaibin Mabel Ko,&nbsp;Xiuli Liu,&nbsp;Lisa A Kachnic,&nbsp;Scott Strong,&nbsp;Marietta Iacucci,&nbsp;Willem Bemelman,&nbsp;Philip Fleshner,&nbsp;Rachael A Safyan,&nbsp;Paulo G Kotze,&nbsp;André D'Hoore,&nbsp;Omar Faiz,&nbsp;Simon Lo,&nbsp;Jean H Ashburn,&nbsp;Antonino Spinelli,&nbsp;Charles N Bernstein,&nbsp;Sunanda V Kane,&nbsp;Raymond K Cross,&nbsp;Jason Schairer,&nbsp;James T McCormick,&nbsp;Francis A Farraye,&nbsp;Shannon Chang,&nbsp;Ellen J Scherl,&nbsp;David A Schwartz,&nbsp;David H Bruining,&nbsp;Jessica Philpott,&nbsp;Stuart Bentley-Hibbert,&nbsp;Dino Tarabar,&nbsp;Sandra El-Hachem,&nbsp;William J Sandborn,&nbsp;Mark S Silverberg,&nbsp;Darrell S Pardi,&nbsp;James M Church,&nbsp;Bo Shen","doi":"10.1016/S2468-1253(22)00039-5","DOIUrl":"https://doi.org/10.1016/S2468-1253(22)00039-5","url":null,"abstract":"<p><p>Surveillance pouchoscopy is recommended for patients with restorative proctocolectomy with ileal pouch-anal anastomosis in ulcerative colitis or familial adenomatous polyposis, with the surveillance interval depending on the risk of neoplasia. Neoplasia in patients with ileal pouches mainly have a glandular source and less often are of squamous cell origin. Various grades of neoplasia can occur in the prepouch ileum, pouch body, rectal cuff, anal transition zone, anus, or perianal skin. The main treatment modalities are endoscopic polypectomy, endoscopic ablation, endoscopic mucosal resection, endoscopic submucosal dissection, surgical local excision, surgical circumferential resection and re-anastomosis, and pouch excision. The choice of the treatment modality is determined by the grade, location, size, and features of neoplastic lesions, along with patients' risk of neoplasia and comorbidities, and local endoscopic and surgical expertise.</p>","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":" ","pages":"871-893"},"PeriodicalIF":35.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40571140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical trial designs for artificial intelligence in gastrointestinal endoscopy.","authors":"Yuichi Mori,&nbsp;Michal F Kaminski,&nbsp;Cesare Hassan,&nbsp;Michael Bretthauer","doi":"10.1016/S2468-1253(22)00232-1","DOIUrl":"https://doi.org/10.1016/S2468-1253(22)00232-1","url":null,"abstract":"","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":" ","pages":"785-786"},"PeriodicalIF":35.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40588950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Odevixibat treatment in progressive familial intrahepatic cholestasis: a randomised, placebo-controlled, phase 3 trial.","authors":"Richard J Thompson,&nbsp;Henrik Arnell,&nbsp;Reha Artan,&nbsp;Ulrich Baumann,&nbsp;Pier Luigi Calvo,&nbsp;Piotr Czubkowski,&nbsp;Buket Dalgic,&nbsp;Lorenzo D'Antiga,&nbsp;Özlem Durmaz,&nbsp;Björn Fischler,&nbsp;Emmanuel Gonzalès,&nbsp;Tassos Grammatikopoulos,&nbsp;Girish Gupte,&nbsp;Winita Hardikar,&nbsp;Roderick H J Houwen,&nbsp;Binita M Kamath,&nbsp;Saul J Karpen,&nbsp;Lise Kjems,&nbsp;Florence Lacaille,&nbsp;Alain Lachaux,&nbsp;Elke Lainka,&nbsp;Cara L Mack,&nbsp;Jan P Mattsson,&nbsp;Patrick McKiernan,&nbsp;Hasan Özen,&nbsp;Sanjay R Rajwal,&nbsp;Bertrand Roquelaure,&nbsp;Mohammad Shagrani,&nbsp;Eyal Shteyer,&nbsp;Nisreen Soufi,&nbsp;Ekkehard Sturm,&nbsp;Mary Elizabeth Tessier,&nbsp;Henkjan J Verkade,&nbsp;Patrick Horn","doi":"10.1016/S2468-1253(22)00093-0","DOIUrl":"https://doi.org/10.1016/S2468-1253(22)00093-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Progressive familial intrahepatic cholestasis (PFIC) is a group of inherited paediatric liver diseases resulting from mutations in genes that impact bile secretion. We aimed to evaluate the effects of odevixibat, an ileal bile acid transporter inhibitor, versus placebo in children with PFIC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients eligible for this 24-week, randomised, double-blind, completed, phase 3 study were paediatric outpatients diagnosed with PFIC1 or PFIC2 who had pruritus and elevated serum bile acids at screening. Patients were randomly assigned (1:1:1) using an interactive web-based system to once a day oral placebo, odevixibat 40 μg/kg, or odevixibat 120 μg/kg. Randomisation was done in a block size of six and stratified by PFIC type and patient age; patients, clinicians, and study staff were blinded to treatment allocation. Patients were enrolled at one of 33 global sites. Two primary endpoints were evaluated: proportion of positive pruritus assessments (PPAs; ie, scratching score of ≤1 or ≥1-point decrease as assessed by caregivers using the Albireo observer-reported outcome [ObsRO] PRUCISION instrument) over 24 weeks, and proportion of patients with serum bile acid response (ie, serum bile acids reduced by ≥70% from baseline or concentrations of ≤70 μmol/L) at week 24. Efficacy and safety were analysed in randomly allocated patients who received one or more doses of study drug. This study is registered with ClinicalTrials.gov, NCT03566238.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between June 21, 2018, and Feb 10, 2020, 62 patients (median age 3·2 [range 0·5-15·9] years) were randomly allocated to placebo (n=20), odevixibat 40 μg/kg per day (n=23), or odevixibat 120 μg/kg per day (n=19). Model-adjusted (least squares) mean proportion of PPAs was significantly higher with odevixibat versus placebo (55% [SE 8] in the combined odevixibat group [58% in the 40 μg/kg per day group and 52% in the 120 μg/kg per day group] vs 30% [SE 9] in the placebo group; model-adjusted mean difference 25·0% [95% CI 8·5-41·5]; p=0·0038). The percentage of patients with serum bile acid response was also significantly higher with odevixibat versus placebo (14 [33%] of 42 patients in the combined odevixibat group [10 in the 40 μg/kg per day group and four in the 120 μg/kg per day group] vs none of 20 in the placebo group; adjusting for stratification factor [PFIC type], the proportion difference was 30·7% [95% CI 12·6-48·8; p=0·0030]). The most common treatment-emergent adverse events (TEAEs) were diarrhoea or frequent bowel movements (13 [31%] of 42 for odevixibat vs two [10%] of 20 for placebo) and fever (12 [29%] of 42 vs five [25%] of 20); serious TEAEs occurred in three (7%) of 42 odevixibat-treated patients and in five (25%) of 20 placebo-treated patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;In children with PFIC, odevixibat effectively reduced pruritus and serum bile acids versus placebo and was generally well tolerated. O","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":" ","pages":"830-842"},"PeriodicalIF":35.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40557394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardising early liver transplantation for severe alcohol-related hepatitis.","authors":"Gene Y Im","doi":"10.1016/S2468-1253(22)00171-6","DOIUrl":"https://doi.org/10.1016/S2468-1253(22)00171-6","url":null,"abstract":"","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":" ","pages":"698"},"PeriodicalIF":35.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40504492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Gastroenterol Hepatol 2022; 7: 736-46.","authors":"","doi":"10.1016/S2468-1253(22)00211-4","DOIUrl":"https://doi.org/10.1016/S2468-1253(22)00211-4","url":null,"abstract":"","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":" ","pages":"704"},"PeriodicalIF":35.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40504496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap to achieve viral hepatitis mortality targets.","authors":"Ericka Flores,&nbsp;Jessica Howell","doi":"10.1016/S2468-1253(22)00163-7","DOIUrl":"https://doi.org/10.1016/S2468-1253(22)00163-7","url":null,"abstract":"","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":" ","pages":"691-692"},"PeriodicalIF":35.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40487844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardising early liver transplantation for severe alcohol-related hepatitis - Authors' reply.","authors":"Philippe Mathurin,&nbsp;Sebastien Dharancy,&nbsp;Alexandre Louvet","doi":"10.1016/S2468-1253(22)00195-9","DOIUrl":"https://doi.org/10.1016/S2468-1253(22)00195-9","url":null,"abstract":"","PeriodicalId":114609,"journal":{"name":"The lancet. Gastroenterology & hepatology","volume":" ","pages":"698-699"},"PeriodicalIF":35.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40487845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}