Hepatology International最新文献

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Key considerations in portal vein thrombosis management. 门静脉血栓治疗的主要考虑因素。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-11-13 DOI: 10.1007/s12072-024-10746-7
Jianyu Lv, Chengfei Du, Junbin Yan
{"title":"Key considerations in portal vein thrombosis management.","authors":"Jianyu Lv, Chengfei Du, Junbin Yan","doi":"10.1007/s12072-024-10746-7","DOIUrl":"https://doi.org/10.1007/s12072-024-10746-7","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing the evaluation and management of MAFLD: a call for comprehensive assessments and social work integration. 加强对 MAFLD 的评估和管理:呼吁进行全面评估和社会工作整合。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-11-09 DOI: 10.1007/s12072-024-10735-w
Han Wang, Huanhuan Feng, Wenchao Zhou
{"title":"Enhancing the evaluation and management of MAFLD: a call for comprehensive assessments and social work integration.","authors":"Han Wang, Huanhuan Feng, Wenchao Zhou","doi":"10.1007/s12072-024-10735-w","DOIUrl":"https://doi.org/10.1007/s12072-024-10735-w","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimal threshold of portal pressure gradient for patients with ascites after covered TIPS: a multicentre cohort study. 覆盖式 TIPS 术后腹水患者门静脉压力梯度的最佳阈值:一项多中心队列研究。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-11-09 DOI: 10.1007/s12072-024-10742-x
Yifu Xia, Jun Tie, Guangchuan Wang, Hao Wu, Yuzheng Zhuge, Xulong Yuan, Guangjun Huang, Zhen Li, Linhao Zhang, Zihao Cai, Chengwei Tang, Chunqing Zhang
{"title":"Optimal threshold of portal pressure gradient for patients with ascites after covered TIPS: a multicentre cohort study.","authors":"Yifu Xia, Jun Tie, Guangchuan Wang, Hao Wu, Yuzheng Zhuge, Xulong Yuan, Guangjun Huang, Zhen Li, Linhao Zhang, Zihao Cai, Chengwei Tang, Chunqing Zhang","doi":"10.1007/s12072-024-10742-x","DOIUrl":"https://doi.org/10.1007/s12072-024-10742-x","url":null,"abstract":"<p><strong>Background: </strong>Transjugular intrahepatic portosystemic shunt (TIPS) is recommended for treating recurrent and refractory ascites. However, determining the target portal pressure gradient (PPG) has been inconclusive. This multicentre cohort study explored the post-TIPS PPG potential range associated with improving survival.</p><p><strong>Methods: </strong>The study enrolled 276 patients, all of whom underwent covered TIPS for ascites treatment across four medical centers. The cumulative incidences of clinical outcomes were compared among groups categorized by potential PPG thresholds.</p><p><strong>Results: </strong>During the whole follow-up period with a medium follow-up of 21.6 (7.5, 41.6) months, 122 (44.2%) experienced liver-related death, and 73 (26.4%) patients experienced a recurrence of ascites. Multivariable analysis revealed PPG < 7 mmHg (p = 0.007) and the recurrence of ascites (p = 0.033) are independent risk factors for survival, while the PPG ≥ 11 mmHg was an independent risk factor for the recurrence of ascites (p = 0.012). Patients with ≥ 7 mmHg had a lower rate of liver-related death than patients with post-TIPS PPG < 7 mmHg (51.0% vs 66.6%, p = 0.004), while those with post-TIPS PPG ≥ 11 mmHg exhibited a higher cumulative incidence of ascites compared to those with post-TIPS PPG < 11 mmHg (44.6% vs 33.7%, p = 0.023). The robustness of the results was confirmed.</p><p><strong>Conclusion: </strong>Our study highlighted the existence of an optimal post-TIPS PPG range in patients with recurrent and refractory ascites. Patients may experience improved survival and ascites control with a post-TIPS PPG of 7-11 mmHg.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of graft type on outcomes following liver transplantation for primary sclerosing cholangitis. 移植类型对原发性硬化性胆管炎肝移植术后疗效的影响。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-10-30 DOI: 10.1007/s12072-024-10733-y
Shiva Kumar, Songhua Lin, Jesse D Schold
{"title":"Impact of graft type on outcomes following liver transplantation for primary sclerosing cholangitis.","authors":"Shiva Kumar, Songhua Lin, Jesse D Schold","doi":"10.1007/s12072-024-10733-y","DOIUrl":"https://doi.org/10.1007/s12072-024-10733-y","url":null,"abstract":"<p><strong>Background: </strong>Limited data exists regarding impact of graft type on outcomes following liver transplantation (LT) in Primary Sclerosing Cholangitis (PSC). Our goal was to evaluate the impact of graft type on outcomes following LT in PSC and determine predictors of outcomes.</p><p><strong>Methods: </strong>Using the Scientific registry of transplant recipients (SRTR), retrospective cohorts were constructed of recipients with PSC over the time period 2010-2020, divided into 2 eras: 2010-2014, 2015-2020, stratified by graft type: living donor (LDLT), donation after circulatory death (DCD) and donation after brain death (DBD). Outcome measures evaluated were graft and patient survival. Survival comparison was performed using Kaplan-Meier method and multivariable analysis using Cox proportional hazard models.</p><p><strong>Results: </strong>2966 recipients underwent LT for PSC over the study period: LDLT-PSC 153 (5.2%), DCD-PSC 131 (4.4%) and DBD-PSC 2682 (90.4%). While LDLT utilization was higher in PSC (5.2% vs. 1.3%; p < 0.001), DCD use was lower (4.4% vs. 7.2%; p < 0.001) but increased over time (era 1 vs. era 2: 3.3% vs. 5.2%; p = 0.02). Outcomes following DCD-PSC were comparable to DBD and improved over time. Compared to DBD-PSC, there was a trend toward lower short-term graft survival following LDLT-PSC (1 Yr. 85.3 vs. 91.9; p = 0.07) with higher retransplant rate (LDLT-PSC vs. DCD-PSC vs. DBD-PSC: 15% vs 11% vs 7%; p < 0.001). Compared to recipients without PSC, long-term patient survival was superior in LDLT-PSC (5 Yr. 90.1 vs. 83.7%; p = 0.05) and DCD-PSC (93.3 vs. 79.7%, p = 0.01). On multivariable analysis, LDLT but not DCD graft type, was associated with inferior graft survival in PSC (adjusted hazard Ratio = 1.65 (1.16-2.34); p = 0.005).</p><p><strong>Conclusions: </strong>In PSC, utilization of LDLT is higher, while DCD use is lower but increased over time. Outcomes following DCD LT in PSC are comparable to DBD and superior to recipients without PSC. Reduced graft survival and higher re-transplant rate following LDLT in PSC warrants further study. Consideration of DCD could help expand the donor pool in PSC.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Metabolic (dysfunction)-associated fatty liver disease metrics and contributions to liver research. 代谢(功能障碍)相关脂肪肝指标和对肝脏研究的贡献。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-10-16 DOI: 10.1007/s12072-024-10731-0
Maito Suoh, Saeed Esmaili, Mohammed Eslam, Jacob George
{"title":"Metabolic (dysfunction)-associated fatty liver disease metrics and contributions to liver research.","authors":"Maito Suoh, Saeed Esmaili, Mohammed Eslam, Jacob George","doi":"10.1007/s12072-024-10731-0","DOIUrl":"https://doi.org/10.1007/s12072-024-10731-0","url":null,"abstract":"<p><strong>Background: </strong>The international consensus to revise non-alcoholic fatty liver disease to metabolic (dysfunction)-associated fatty liver disease (MAFLD) in 2020 attracted significant attention. The impact of the MAFLD definition on the research community has not been objectively assessed. We conducted an analysis of systematically collected literature on MAFLD to understand its research impact.</p><p><strong>Methods: </strong>From PubMed, Web of Science, and Scopus, the literature adopting MAFLD, written in English, and published from 2020 to 10 October 2023 was collected. The publication metrics, including publication counts, publishing journals, author countries, author keywords, and citation information, were analyzed to evaluate the research impact and key topics on MAFLD.</p><p><strong>Results: </strong>1469 MAFLD-related papers were published in 434 journals with a steady increase in the number. The intense publishing and citations activity on MAFLD indicates the large impact of the redefinition. Topic assessment with keyword and citation analysis revealed a transition from the proposal and discussion of the redefinition to clinical characterization of MAFLD with a focus on metabolic dysfunction. Moreover, the diagnostic criteria for MAFLD showed better performance in predicting hepatic and extrahepatic outcomes compared to NAFLD. The publications were from 99 countries with evidence of strong regional and global collaboration. Multiple international societies and stakeholders have endorsed MAFLD for its utility in clinical practice, improving patient management and promoting multidisciplinary care, while alleviating stigma.</p><p><strong>Conclusion: </strong>This survey provides a quantitative measure of the considerable international impact and contributions of the MAFLD definition towards liver research and as part of the spectrum of cardiometabolic disorders.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adipokine/hepatokines profiling of fatty liver in adolescents and young adults: cross-sectional and prospective analyses of the BCAMS study. 青少年和年轻人脂肪肝的脂肪因子/肝脏因子分析:BCAMS 研究的横断面和前瞻性分析。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-10-14 DOI: 10.1007/s12072-024-10736-9
Xinghao Yi, Lanwen Han, Lianxia Li, Haoxue Zhu, Ming Li, Shan Gao
{"title":"Adipokine/hepatokines profiling of fatty liver in adolescents and young adults: cross-sectional and prospective analyses of the BCAMS study.","authors":"Xinghao Yi, Lanwen Han, Lianxia Li, Haoxue Zhu, Ming Li, Shan Gao","doi":"10.1007/s12072-024-10736-9","DOIUrl":"https://doi.org/10.1007/s12072-024-10736-9","url":null,"abstract":"<p><strong>Objective: </strong>The underlying connections between obesity and non-alcoholic fatty liver disease (NAFLD) are not fully understood. One potential link might be the imbalanced adipokines and hepatokines. We aimed to explore the associations between specific adipokines/hepatokines and NAFLD in Chinese youth and to determine how these biomarkers mediate the obesity-NAFLD relationship.</p><p><strong>Methods: </strong>We analyzed data from the 10-year follow-up visit of the Beijing Children and Adolescents Metabolic Syndrome (BCAMS) study (n = 509; mean age = 20.2 years) for a comprehensive metabolic risk assessment, including liver ultrasound and plasma measurements of adiponectin, leptin, fibroblast growth factor 21 (FGF21), retinol-binding protein 4 (RBP4), and angiopoietin-like protein 8 (ANGPTL8). Longitudinal analysis was performed on a subgroup (n = 307), with complete baseline (mean age = 12.2 years) and follow-up data. Mediation models assessed how obesity at baseline and follow-up influence NAFLD through these biomarkers.</p><p><strong>Results: </strong>Participants with NAFLD exhibited a high prevalence of central obesity (90.9%). Both cross-sectional and prospective analyses identified increased RBP4, FGF21, leptin, and decreased adiponectin levels as significant predictors of NAFLD. More adipokine/hepatokine abnormalities were linked to higher NAFLD risk. Furthermore, ratios reflecting adipokine/hepatokine imbalances, including leptin/adiponectin, FGF21/adiponectin, and RBP4/adiponectin, demonstrated stepwise changes correlating with NAFLD severity (all p < 0.05). Mediation analysis indicated that these four adipokines/hepatokines accounted for approximately 72.4% of the central obesity-NAFLD relationship and 80.1% in the subgroup analysis using baseline childhood data.</p><p><strong>Conclusions: </strong>Dysregulated adipokines/hepatokines may explain the onset or progression of obesity-related NAFLD in youths. Higher RBP4, FGF21 and leptin, alongside lower adiponectin, could serve as early biomarkers for NAFLD.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Appendicular skeletal muscle mass is associated with metabolic dysfunction-associated steatotic liver disease severity in young men: a cross-sectional and longitudinal study. 年轻男性骨骼肌质量与代谢功能障碍相关脂肪肝严重程度的关系:一项横断面和纵向研究。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-10-12 DOI: 10.1007/s12072-024-10737-8
Jaejun Lee, Jinson So, Chang In Han, Hyun Yang, Pil Soo Sung, Si Hyun Bae, Do Seon Song
{"title":"Appendicular skeletal muscle mass is associated with metabolic dysfunction-associated steatotic liver disease severity in young men: a cross-sectional and longitudinal study.","authors":"Jaejun Lee, Jinson So, Chang In Han, Hyun Yang, Pil Soo Sung, Si Hyun Bae, Do Seon Song","doi":"10.1007/s12072-024-10737-8","DOIUrl":"https://doi.org/10.1007/s12072-024-10737-8","url":null,"abstract":"<p><strong>Background and aim: </strong>Although appendicular skeletal muscle mass (ASM) has been linked to the severity of hepatic steatosis, investigations of its correlation among younger age groups are lacking. We aimed to elucidate the role of ASM in determining the severity of metabolic dysfunction-associated steatotic liver disease (MASLD) in younger patients.</p><p><strong>Methods: </strong>Retrospective data were collected from patients younger than 35 years who visited the Armed Forces Goyang Hospital between June 2022 and February 2024. Steatosis presence was determined by a controlled attenuation parameter score ≥ 250 dB/m, and significant fibrosis was identified with liver stiffness measurement > 8.0 kPa. ASM was measured using multifrequency bioelectrical impedance analysis (InBody 620).</p><p><strong>Results: </strong>Of 910 participants, 630 were diagnosed with MASLD. Patients with MASLD had lower ASM/fat mass (ASM/F) (1.02 vs. 1.91; p < 0.001), ASM/body mass index (BMI) (0.91 vs. 1.04/m<sup>2</sup>; p < 0.001), and ASM/body weight (ASM/W) (29.5% vs. 33.8%; p < 0.001) than non-MASLD patients. Additionally, ASM/F, ASM/BMI, and ASM/W significantly decreased with worsening steatosis severity and were notably lower in patients with significant fibrosis. Among 107 patients with MASLD who underwent two examinations with a median interval of 6.0 months, those with increased ASM/F showed a higher proportion of steatosis regression and a lower proportion of steatosis worsening than those with decreased ASM/F (steatosis regression, 43.1% vs. 22.9%; worsening, 11.1% vs. 28.6%; p = 0.031). All three ASM indices were significant factors in steatosis regression during the study period.</p><p><strong>Conclusions: </strong>ASM is associated with the severity of steatosis and significant fibrosis in MASLD in young adults < 35 years.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What is the truth: the roles of macrophages in EBV-LELCC. 真相是什么:巨噬细胞在 EBV-LELCC 中的作用。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-10-05 DOI: 10.1007/s12072-024-10738-7
Silan Huang, Lingli Huang, Guifang Guo
{"title":"What is the truth: the roles of macrophages in EBV-LELCC.","authors":"Silan Huang, Lingli Huang, Guifang Guo","doi":"10.1007/s12072-024-10738-7","DOIUrl":"https://doi.org/10.1007/s12072-024-10738-7","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of artificial liver support system on intestinal microbiota and serum bile acid profiles in patients with acute-on-chronic liver failure: a prospective cohort study. 人工肝支持系统对急性-慢性肝衰竭患者肠道微生物群和血清胆汁酸谱的影响:一项前瞻性队列研究。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-10-01 Epub Date: 2024-07-20 DOI: 10.1007/s12072-024-10712-3
Yuyu Zeng, Dakai Gan, Kaige Zhang, Tao Long, Yan He, Rui Zhou, Shuanglan Liu, Molong Xiong
{"title":"The impact of artificial liver support system on intestinal microbiota and serum bile acid profiles in patients with acute-on-chronic liver failure: a prospective cohort study.","authors":"Yuyu Zeng, Dakai Gan, Kaige Zhang, Tao Long, Yan He, Rui Zhou, Shuanglan Liu, Molong Xiong","doi":"10.1007/s12072-024-10712-3","DOIUrl":"10.1007/s12072-024-10712-3","url":null,"abstract":"<p><strong>Background: </strong>Acute-on-chronic liver failure (ACLF) patients exhibit an imbalance in intestinal microbiota, and bile acids (BAs) can affect the composition of intestinal microbiota. Although Artificial liver support system (ALSS) is a treatment for ACLF, the impact of ALSS on intestinal microbiota and serum BA profiles of ACLF patients remains unclear.</p><p><strong>Methods: </strong>A prospective study was conducted, which included 51 patients diagnosed with ACLF. These patients were stratified into two groups based on the utilization of an ALSS during their treatment period: a standard medical treatment group (SMT group), comprising 19 patients, and an ALSS combined with SMT group (ALSS group), comprising 32 patients. Blood and stool samples were collected from the patients on the day of admission and 14 days after treatment. Additionally, eight healthy controls were recruited, and their stool samples were also collected. The intestinal microbiota was sequenced using the 16S rRNA sequencing technique, while the serum BA profiles were determined using ultra-performance liquid chromatography/mass spectrometry.</p><p><strong>Results: </strong>ACLF patients exhibited imbalances in intestinal microbiota and abnormalities in BA profiles. Compared to SMT alone, the combined ALSS and SMT was more effective in regulating intestinal microbiota imbalance and increasing the concentrations of ursodeoxycholic acid and glycoursodeoxycholic acid. Correlation analysis revealed a significant correlation between intestinal microbiota and Bas. Furthermore, the preliminary correlation heatmap indicated that the Faecalibaculum, Gemmiger, and taurochenodeoxycholic acid were associated with clinical improvement.</p><p><strong>Conclusions: </strong>Our study identified the compositional characteristics of the intestinal microbiota and serum BA in ACLF patients, emphasizing the impact of ALSS on both intestinal microbiota and serum BA profiles.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1540-1554"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lifestyle intervention for metabolic dysfunction-associated fatty liver disease: a 24-h integrated behavior perspective. 代谢功能障碍相关脂肪肝的生活方式干预:24 小时综合行为视角。
IF 5.9 2区 医学
Hepatology International Pub Date : 2024-10-01 Epub Date: 2024-05-08 DOI: 10.1007/s12072-024-10663-9
Shelley E Keating, Yogesh Chawla, Arka De, Elena S George
{"title":"Lifestyle intervention for metabolic dysfunction-associated fatty liver disease: a 24-h integrated behavior perspective.","authors":"Shelley E Keating, Yogesh Chawla, Arka De, Elena S George","doi":"10.1007/s12072-024-10663-9","DOIUrl":"10.1007/s12072-024-10663-9","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence, health and socioeconomic burden of metabolic dysfunction-associated fatty liver disease (MAFLD) is growing, increasing the need for novel evidence-based lifestyle approaches. Lifestyle is the cornerstone for MAFLD management and co-existing cardiometabolic dysfunction. The aim of this review was to evaluate the evidence for lifestyle management of MAFLD, with a specific lens on 24-hour integrated behaviour and provide practical recommendations for implementation of the evidence.</p><p><strong>Results: </strong>Weight loss ≥ 7-10% is central to lifestyle management; however, liver and cardiometabolic benefits are attainable with improved diet quality and exercise even without weight loss. Lifestyle intervention for MAFLD should consider an integrated '24-h' approach that is cognisant of diet, physical activity/exercise, sedentary behavior, smoking, alcohol intake and sleep. Dietary management emphasises energy deficit and improved diet quality, especially the Mediterranean diet, although sociocultural adaptations to meet preferences should be considered. Increasing physical activity and reducing sedentary behavior can prevent MAFLD, with strongest evidence in MAFLD supporting regular structured moderate-vigorous aerobic exercise for 150-240 min/week. Resistance training in addition to aerobic exercise should be considered and prioritised for those who are losing body mass via diet and/or pharmacological approaches and those with sarcopenia, to minimise bone and lean mass loss. Limited evidence suggests that sleep is important for MAFLD prevention. Emerging novel approaches to diet and exercise may address some of the key barriers to behaviour change (e.g. lack of time, access to resources and social support).</p><p><strong>Future directions: </strong>Large-scale multidisciplinary trials in people with MAFLD with long-term follow-up, that can be scaled up into mainstream healthcare, are required. Future management guidelines should consider the heterogeneity of MAFLD and specialised models of care that coordinate the health workforce to manage the increased and growing MAFLD population.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"959-976"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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