Hepatology Research最新文献

{"title":"Association of liver fibrosis progression with non–liver-related mortality in metabolic dysfunction-associated steatotic liver disease","authors":"Toshifumi Tada,&nbsp;Takashi Kumada,&nbsp;Hidenori Toyoda,&nbsp;Satoshi Yasuda,&nbsp;Yuichi Koshiyama,&nbsp;Tomoyuki Akita,&nbsp;Yuzo Kodama,&nbsp;Junko Tanaka","doi":"10.1111/hepr.14164","DOIUrl":"https://doi.org/10.1111/hepr.14164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In patients with metabolic dysfunction-associated steatotic liver disease (MASLD), the prognosis and outcomes, particularly non–liver-related mortality, remain insufficiently elucidated. We investigated all-cause mortality in patients with MASLD to elucidate the association of the severity of liver fibrosis with liver-related and non–liver-related mortality in MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among 4528 participants with MASLD, we examined the causes of death and analyzed liver-related and non–liver-related mortality, stratified by the degree of fibrosis using the competing risk method. Fibrosis severity was assessed using the Fibrosis-4 (FIB-4) and FIB-3 indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median follow-up period was 11.7 years. Of the 4528 participants, 551 died during the follow-up period, with only 37 (6.7%) deaths attributable to liver-related diseases and 514 (93.3%) to non–liver-related causes. For the risk of hepatocellular carcinoma, the hazard ratios (HRs; 95% confidence interval [CI]) for FIB-4 were 5.67 (2.20–14.59) and 32.14 (12.40–83.35) and for FIB-3 were 5.43 (2.73–10.79) and 19.96 (10.50–37.93). For liver-related mortality, the HRs (95% CI) for FIB-4 were 6.32 (2.23–17.85) and 27.62 (9.74–78.37) and for FIB-3 were 7.15 (2.62–19.50) and 19.86 (8.12–48.55), respectively. In contrast, intermediate and high FIB-4 and FIB-3 indices were unassociated with non–liver-related mortality: HRs (95% CI) for FIB-4 were 0.85 (0.70–1.04) and 0.87 (0.64–1.18), and for FIB-3 were 0.96 (0.77–1.20) and 0.92 (95% CI, 0.64–1.31), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The progression of liver fibrosis was unassociated with mortality from non–liver-related causes in patients with MASLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 5","pages":"648-662"},"PeriodicalIF":3.9,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating two rechallenge strategies of immune checkpoint inhibitors: Durvalumab plus tremelimumab in advanced hepatocellular carcinoma","authors":"Takuya Yonemoto,&nbsp;Sadahisa Ogasawara,&nbsp;Naoya Kanogawa,&nbsp;Chihiro Miwa,&nbsp;Makoto Fujiya,&nbsp;Takahiro Tsuchiya,&nbsp;Midori Sawada,&nbsp;Teppei Akatsuka,&nbsp;Ryo Izai,&nbsp;Sae Yumita,&nbsp;Miyuki Nakagawa,&nbsp;Tomomi Okubo,&nbsp;Keisuke Koroki,&nbsp;Masanori Inoue,&nbsp;Masato Nakamura,&nbsp;Takayuki Kondo,&nbsp;Shingo Nakamoto,&nbsp;Norio Itokawa,&nbsp;Masanori Atsukawa,&nbsp;Ei Itobayashi,&nbsp;Michihisa Moriguchi,&nbsp;Naoya Kato","doi":"10.1111/hepr.14160","DOIUrl":"https://doi.org/10.1111/hepr.14160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate the safety and efficacy of durvalumab plus tremelimumab in patients with advanced hepatocellular carcinoma who have previously received atezolizumab plus bevacizumab (Atez/Bev). Additionally, it seeks to assess the feasibility of administering immunotherapy after the occurrence of immune-mediated adverse events (imAEs) in real-world clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed data from patients with advanced hepatocellular carcinoma treated with durvalumab plus tremelimumab at four Japanese institutions. Clinical outcomes, adverse events, tumor dynamics, and serum cytokine and chemokine levels were evaluated, with a focus on efficacy following prior Atez/Bev treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Durvalumab plus tremelimumab was administered to 68 patients. The objective response rate was 10.3%, and the disease control rate was 58.8%. Median progression-free survival was 3.1 months (95% confidence interval 2.0–4.9). imAEs occurred in 50.0% of patients, with colitis being the most common (22.1%). Durvalumab was safely readministered to 14 patients after imAE resolution, although five experienced recurrence. Among 33 patients (48.5%) previously treated with Atez/Bev, improved responses were noted, including two partial responses. Tumor growth dynamics decreased in 60.0% of patients receiving sequential therapy. Common adverse events included elevated liver enzymes (aspartate aminotransferase 50.0%, alanine aminotransferase 48.5%), pruritus (45.6%), and rash (44.1%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Durvalumab plus tremelimumab therapy is feasible with proper imAE management and patient selection. Sequential treatment following Atez/Bev offers clinical benefit in advanced hepatocellular carcinoma, although some may experience rapid progression. Further biomarker research is needed to optimize immunotherapy strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 5","pages":"718-729"},"PeriodicalIF":3.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative circulating tumor cells predict the benefits of tyrosine kinase inhibitor for hepatocellular carcinoma after transplantation","authors":"De-Zhen Guo,&nbsp;Shi-Yu Zhang,&nbsp;Man Yang,&nbsp;Yang Xu,&nbsp;Peng-Xiang Wang,&nbsp;Wei Guo,&nbsp;Xiao-Wu Huang,&nbsp;Jia Fan,&nbsp;Jian Zhou,&nbsp;Xin-Rong Yang,&nbsp;Jian-Wen Cheng","doi":"10.1111/hepr.14154","DOIUrl":"https://doi.org/10.1111/hepr.14154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Circulating tumor cells (CTC) have shown promise in predicting the outcomes of adjuvant treatments for several malignancies. The clinical significance of CTC in predicting the efficacy of tyrosine kinase inhibitor (TKI) administration in patients with hepatocellular carcinoma (HCC) was unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 429 patients who underwent liver transplantation for HCC had provided 335 preoperative and 373 postoperative blood samples that could be used for CTC detection (pre-CTC and post-CTC). The association of the pre-CTC and post-CTC findings with the efficacy of TKI administration was assessed. Additionally, CTC surveillance was performed in 27 patients during TKI administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with detectable post-CTC, instead of pre-CTC, showed a significantly longer time to recurrence when receiving a TKI after liver transplantation for HCC (hazard ratio 0.57; <i>P</i> = 0.042). Whereas patients without detectable post-CTC did not benefit from the TKI administration (<i>P</i> = 0.270). Furthermore, we also found that patients who persistently harbored CTC during TKI administration showed significantly higher early recurrence rates (≤1 year; 40% vs. 5.9%, <i>P</i> &lt; 0.001) and a shorter time to recurrence (HR 7.03; <i>P</i> &lt; 0.001) than those whose CTC status switched from positive to negative. In addition, longitudinal CTC monitoring demonstrated that CTC tended to reflect drug resistance during TKI administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The postoperative CTC level could predict the efficacy of TKI treatment for HCC patients after liver transplantation. Dynamic monitoring for CTC during treatment could sensitively reflect the response to the TKI, the development of drug resistance, and foresee tumor recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 4","pages":"588-599"},"PeriodicalIF":3.9,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver-to-spleen ratio obtained from gadoxetate disodium-enhanced magnetic resonance imaging predicts intrahepatic recurrence after curative resection of hepatocellular carcinoma","authors":"Tsuyoshi Notake,&nbsp;Akira Shimizu,&nbsp;Koji Kubota,&nbsp;Noriyuki Kitagawa,&nbsp;Shinsuke Sugenoya,&nbsp;Takahiro Yoshizawa,&nbsp;Hiroki Sakai,&nbsp;Hikaru Hayashi,&nbsp;Hidenori Tomida,&nbsp;Shiori Yamazaki,&nbsp;Shigeki Hayashi,&nbsp;Akira Yamada,&nbsp;Yasunari Fujinaga,&nbsp;Yuji Soejima","doi":"10.1111/hepr.14161","DOIUrl":"https://doi.org/10.1111/hepr.14161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate whether parameters obtained from gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) could predict intrahepatic tumor recurrence in patients who underwent curative hepatectomy for hepatocellular carcinoma (HCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 208 patients who underwent EOB-MRI before hepatectomy for HCC. The mean signal intensity of the liver (L20) and spleen (S20) was obtained from preoperative EOB-MRI, and liver-to-spleen ratio (LSR) was calculated from these values as: LSR = L20/S20. The association of LSR value with intrahepatic recurrence of HCC after curative hepatectomy was analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Intrahepatic recurrence in the remnant liver developed in 111 (53%) patients during the median follow-up period of 52.0 (range, 7.0–134.9) months after hepatectomy. Cumulative incidence of intrahepatic recurrence was significantly higher in patients with low LSR (&lt;2.0) than in those with high LSR (≥2.0) (<i>p</i> &lt; 0.001). In multivariable analysis, low LSR was identified as an independent predictor of intrahepatic recurrence (hazard ratio, 1.83; 95% confidence interval [CI], 1.23–2.72; <i>p</i> = 0.002), together with multiple tumors, macroscopic vascular invasion, and high-grade fibrosis of the background liver. Subgroup analysis according to the time of recurrence (within 1 year or more) revealed that low LSR was significantly associated with late recurrence (hazard ratio, 2.35; 95% CI, 1.40–3.94; <i>p</i> = 0.001), but not with early recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Low LSR was an independent risk factor of intrahepatic recurrence after curative hepatectomy for HCC, and was especially associated with late recurrence developing more than 1 year after curative hepatectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 5","pages":"730-740"},"PeriodicalIF":3.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-infiltrating CD8+ T-cell numbers and serum C-reactive protein levels as a prognostic biomarker in hepatocellular carcinoma patients receiving atezolizumab plus bevacizumab","authors":"Akifumi Kuwano,&nbsp;Masayoshi Yada,&nbsp;Kosuke Tanaka,&nbsp;Junro Takahira,&nbsp;Hideo Suzuki,&nbsp;Yoshihiro Ohishi,&nbsp;Kenta Motomura","doi":"10.1111/hepr.14157","DOIUrl":"https://doi.org/10.1111/hepr.14157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Atezolizumab plus bevacizumab is an established first-line treatment for unresectable hepatocellular carcinoma (HCC). Our previous research identified CD8⁺ tumor-infiltrating lymphocytes (TILs) as a potential biomarker for predicting patient response to this therapy. However, not all HCC patients with CD8⁺ TILs respond favorably to atezolizumab and bevacizumab. Moreover, elevated serum C-reactive protein (CRP) levels have been associated with poor outcomes in patients treated with immune checkpoint inhibitors across various cancer types. The aim of this study was to determine whether CD8⁺ TIL numbers combined with serum CRP levels could collectively predict the response to atezolizumab and bevacizumab better than CD8⁺ TIL numbers alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 46 HCC patients who provided liver biopsy samples were included. CD8⁺ TIL numbers in liver tissue were measured using immunohistochemistry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A group of 13 patients (28.3%) with high CD8⁺ TIL numbers and low (≤0.54 mg/dl) serum CRP levels demonstrated the highest treatment response rate. Furthermore, this group had a significantly longer median overall survival and progression-free survival than the remaining 33 patients. Multivariate analysis revealed that high CD8⁺ TIL numbers with low CRP levels (HR 0.264; <i>p</i> = 0.037) and Child–Pugh class A (HR 0.277; <i>p</i> = 0.009) were associated with improved overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that the combination of CD8⁺ TIL numbers and serum CRP levels may serve as a useful biomarker for predicting the efficacy of atezolizumab plus bevacizumab in HCC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 4","pages":"600-610"},"PeriodicalIF":3.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression patterns of hepatic Mac2-BP in the liver microenvironment","authors":"Tomoko Tadokoro","doi":"10.1111/hepr.14159","DOIUrl":"https://doi.org/10.1111/hepr.14159","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 2","pages":"166-167"},"PeriodicalIF":3.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in systemic therapies for unresectable hepatocellular carcinoma and their impact on clinical outcomes","authors":"Kyoko Oura","doi":"10.1111/hepr.14158","DOIUrl":"https://doi.org/10.1111/hepr.14158","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 2","pages":"163-165"},"PeriodicalIF":3.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steatotic liver index: An interpretable predictor of steatotic liver disease using machine learning with an enhanced shrinkage method","authors":"Akira Okada,&nbsp;Koji Oba,&nbsp;Takeshi Kimura,&nbsp;Yasuhiro Hagiwara,&nbsp;Sachiko Ono,&nbsp;Kayo Ikeda Kurakawa,&nbsp;Nobuaki Michihata,&nbsp;Toshimasa Yamauchi,&nbsp;Masaomi Nangaku,&nbsp;Yutaka Matsuyama,&nbsp;Takashi Kadowaki,&nbsp;Satoko Yamaguchi","doi":"10.1111/hepr.14156","DOIUrl":"https://doi.org/10.1111/hepr.14156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>While the Fatty Liver Index (FLI) has been the most prominent among interpretable predictors for steatotic liver disease (SLD), we aimed to prepare a novel diagnostic/prognostic index better than FLI for SLD using a non-black-box and modified parsimonious machine learning method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included individuals who participated in an annual health checkup in Tokyo, Japan, between January 2008 and December 2018. In the training set (randomly selected 80% of the sample), we developed a novel interpretable model, Steatotic Liver Index (SLI), using a modified method of least absolute shrinkage and selection operator regression focusing on parsimony and interpretability using as few variables as FLI, and confirming its superiority to FLI using the test set (the remaining 20%). The predictive performance of the constructed index was assessed for the diagnosis, development, and remission of SLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among ultrasound data of 92 968 participants at the first health checkup, 20 380 (21.9%) had SLD. Using a modified method of least absolute shrinkage and selection operator regression, SLI was constructed with four variables: body mass index, waist circumference, alanine aminotransferase, and triglycerides. The C-statistic of SLI for SLD diagnosis was superior to that of FLI (0.909 vs. 0.892, <i>p</i> &lt; 0.001). In participants without SLD, SLI was more accurate than FLI in predicting SLD development, whereas among those with SLD, SLI showed better accuracy in predicting SLD remission compared with FLI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We developed SLI, a novel interpretable and parsimonious index for diagnosing SLD, which demonstrates superior predictive capability compared with FLI. Further studies are necessary to validate the diagnostic ability outside Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 4","pages":"527-546"},"PeriodicalIF":3.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the impact of the Dietary Approaches to Stop Hypertension diet versus a calorie-restricted diet on metabolic dysfunction-associated steatotic liver disease: A meta-analysis of randomized controlled trials","authors":"Fariha Hasan,&nbsp;Avneet Singh,&nbsp;Alexander Garcia,&nbsp;Syeda Hafsa Qadri,&nbsp;Hina Sattar,&nbsp;Rimmel Ali,&nbsp;Hassam Ali,&nbsp;Tommy Nguyen,&nbsp;Babu P. Mohan,&nbsp;Krysta Contino","doi":"10.1111/hepr.14155","DOIUrl":"https://doi.org/10.1111/hepr.14155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) can lead to increased morbidity and mortality. Diets high in refined carbohydrates and saturated fats elevate MASLD risk. The Dietary Approaches to Stop Hypertension (DASH) diet has shown metabolic benefits. This meta-analysis evaluates the impact of the DASH diet on MASLD progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search from 2016 to 2023 across PubMed, Embase, Web of Science, and Cochrane databases was conducted to identify studies reporting on the role of the DASH diet in MASLD. Standard meta-analysis methods were employed using a random-effects model. Heterogeneity was assessed by <i>I</i>² statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified five randomized controlled trials meeting inclusion criteria, involving 280 participants (140 in the DASH group and 140 in the control group). Mean ages were approximately 41 years, and the proportions of women were similar between groups. Compared with controls, the DASH diet group had a significantly reduced risk of grade 0 and 1 liver fibrosis (RR 1.21, 95% CI 1.04–1.41, <i>p</i> = 0.01). They also showed lower levels of aspartate aminotransferase (MD −4.81, 95% CI −6.98 to −2.64, <i>p</i> &lt; 0.0001), alanine aminotransferase (MD −10.31, 95% CI −13.82 to −6.80, <i>p</i> &lt; 0.00001), body mass index (MD −0.74, 95% CI −1.45 to −0.03, <i>p</i> = 0.04), and cholesterol-to-high-density lipoprotein ratio (MD −0.40, 95% CI −0.68 to −0.11, <i>p</i> = 0.006). No significant differences were found for weight, waist and hip circumference, total cholesterol, low-density lipoprotein, or high-density lipoprotein levels. Heterogeneity was low for most outcomes (<i>I</i>² = 0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on our meta-analysis of five randomized controlled trials, the DASH diet may reduce MASLD progression. These findings suggest it could be an effective dietary intervention for MASLD management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 4","pages":"515-526"},"PeriodicalIF":3.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited use of FIB-4 index in patients under 65 years of age with type 2 diabetes mellitus","authors":"Mimi Kim,&nbsp;Eileen L. Yoon,&nbsp;Huiyul Park,&nbsp;Takanori Ito,&nbsp;Masatoshi Ishigami,&nbsp;Ae Jung Jo,&nbsp;Chul-Min Lee,&nbsp;Bo-Kyeong Kang,&nbsp;Hye-Lin Kim,&nbsp;Taeang Arai,&nbsp;Masanori Atsukawa,&nbsp;Miwa Kawanaka,&nbsp;Hidenori Toyoda,&nbsp;Ming-Lung Yu,&nbsp;Dae Won Jun,&nbsp;Mindie H. Nguyen","doi":"10.1111/hepr.14152","DOIUrl":"https://doi.org/10.1111/hepr.14152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Screening for liver fibrosis holds significant importance in patients with type 2 diabetes mellitus (T2DM) due to their elevated risk of advanced hepatic fibrosis. However, it is recognized that the diagnostic performance of the Fibrosis-4 (FIB-4) index is relatively low in T2DM patients. Our study aims to explore the potential and limitations of utilizing FIB-4 as a screening tool in patients with T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective biopsy cohort of 1906 patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease from South Korea, Japan, and Taiwan. Diagnostic performance according to T2DM was again compared after propensity score matching on age, sex, and body mass index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with T2DM were significantly older than those without. The area under the receiver operating characteristic curve (AUROC) of FIB-4 for ruling out advanced fibrosis in non-T2DM patients was significantly higher than that of T2DM (0.821 vs. 0.761, <i>p</i> = 0.044). However, the AUROCs of FIB-4 according to the same age groups showed no significant difference between patients with T2DM and without (all <i>p</i> &gt; 0.05). In the middle-aged group, the sensitivity of FIB-4 for ruling out advanced hepatic fibrosis was 77.1% for T2DM and did not differ with that of non-T2DM patients (73.0%) (<i>p</i> = 0.093). After propensity score matching of age, there was no statistically significant difference in the AUROCs of the T2DM and non-T2DM groups (0.860 vs. 0.761, <i>p</i> = 0.142).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the diagnostic performance of FIB-4 was found to be suboptimal in patients with T2DM, its limited use in individuals under 65 years of age with T2DM still holds value as a screening tool.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 4","pages":"505-514"},"PeriodicalIF":3.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}