Translational gastroenterology and hepatology最新文献

{"title":"Hepatic epithelioid hemangioendothelioma: how fast does it grow and which findings could have prevented diagnostic delay?-a case report.","authors":"Michele Costa de Oliveira Ribeiro,&nbsp;Juliana Viana Baião Lemos,&nbsp;Marcelo Padovani de Toledo Moraes,&nbsp;Felipe Aguera Oliver,&nbsp;Matheus Alvarez,&nbsp;Giovanni Faria Silva,&nbsp;Xingshun Qi,&nbsp;Fernando Gomes Romeiro","doi":"10.21037/tgh-22-48","DOIUrl":"https://doi.org/10.21037/tgh-22-48","url":null,"abstract":"<p><strong>Background: </strong>Hepatic epithelioid hemangioendothelioma (HEHE) is a rare neoplastic disease of varied presentation and unspecific radiological signs in the early stages. The diagnostic delay can lead to metastatic disease, thus increasing the tumor burden and reducing the treatment options. HEHE is usually deemed a slow-growing tumor, but its speed of growth is poorly reported and still unknown.</p><p><strong>Case description: </strong>In this case report, we documented a HEHE diagnosed in a young woman who had complaints of abdominal pain, weight loss and bloating for a long time. The typical findings observed in histological studies were not promptly recognized in the histological analyzes, even after two laparoscopic-guided liver biopsies, delaying the diagnosis until extrahepatic tumor spreading. Findings observed in computed tomography, magnetic resonance imaging and histological studies are presented. The coalescence of nodules and the rising of giant masses, occupying large parts of the liver in a specific time span, were registered and quantified. As opposed to prior reports, the results show that hepatic HEHE can grow rapidly, reinforcing the need of early diagnosis, thus avoiding the complications presented herein.</p><p><strong>Conclusions: </strong>The findings observed via radiological and histological imaging that could have avoided the diagnosis delay are depicted and discussed, showing that HEHE can rise faster than previously documented.</p>","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"12"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/ab/tgh-08-22-48.PMC9813661.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10628595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EoE behaves as a unique Th2 disease: a narrative review.","authors":"Simon S Rabinowitz,&nbsp;Liwei Yu,&nbsp;Patrick Geraghty","doi":"10.21037/tgh-22-15","DOIUrl":"https://doi.org/10.21037/tgh-22-15","url":null,"abstract":"<p><strong>Background and objective: </strong>To highlight and interpret two significant differences between eosinophilic esophagitis (EoE), a type 2 helper cell (Th2) disease, and three other representative Th2 diseases. EoE, asthma, atopic dermatitis (AD), chronic rhinosinusitis (CRS) and other Th2 diseases employ epithelial alarmins to recognize triggers, share a prototypical inflammatory cascade, and respond to glucocorticoids. However, EoE also has several distinguishing characteristics which may be explained by a distinct pathophysiologic mechanism.</p><p><strong>Methods: </strong>The following report consist of four related narrative reviews which combine comprehensive PubMed and Google searches. Two reviews were performed to identify and contrast all eligible studies describing serologic markers in EoE compared to asthma, AD, and CRS. Two additional reviews then compare the responses to parenteral biological therapies in EoE and in the same representative Th2 diseases.</p><p><strong>Key content and findings: </strong>Comprehensive literature searches definitively differentiate the absence of serologic markers in EoE compared to their identification in the other representative Th2 diseases. Similarly, a summary of therapeutic trials demonstrates that while EoE is unable to clinically respond to a variety of parenteral biological therapies, asthma, AD and CRS are very effectively treated with this same approach. A novel pathophysiology for EoE is proposed, and the emerging literature that support its existence is summarized.</p><p><strong>Conclusions: </strong>The fundamental properties described in this narrative regarding serologic signaling and response to parenteral therapy in EoE could be explained if EoE employs a unique application of the Th2 pathway. One potential mechanism consistent with these observations is that EoE employs exclusively esophageal mucosal constituents to initiate and generate the prototypical Th2 cascade and the fibrostenotic changes that follow.</p>","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"11"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/d9/tgh-08-22-15.PMC9813655.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10619503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of baseline abnormal liver enzymes in the outcome of COVID-19 infection.","authors":"João Pedro Farias,&nbsp;Liana Codes,&nbsp;Diana Vinhaes,&nbsp;Ana Paula Amorim,&nbsp;Ricardo Cruz D'Oliveira,&nbsp;Alberto Queiroz Farias,&nbsp;Paulo Lisboa Bittencourt","doi":"10.21037/tgh-22-41","DOIUrl":"https://doi.org/10.21037/tgh-22-41","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the significance of liver function tests (LFT) abnormalities in COVID-19 and their impact on disease outcomes. The aims of the study were to evaluate abnormalities of LFT in patients with COVID-19 and their impact on disease severity, mortality, and correlation with leukocyte markers of inflammation.</p><p><strong>Methods: </strong>All patients with COVID-19 admitted to the emergency department (ED) of a single reference center were retrospectively evaluated. Data were collected using an electronic medical database covering the following variables: demographics, baseline complete blood count (CBC) and ratios, neutrophil-lymphocyte (NLR) and monocyte-lymphocyte ratios (MLR), systemic immune-inflammation index (SII), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Disease severity was defined by the presence of organ failure (OF) or requirement for intensive care unit (ICU) support. Mortality was considered as patient death during hospitalization.</p><p><strong>Results: </strong>A total of 1,539 subjects (799 women, mean age 57±18 years) with COVID-19 were evaluated. Abnormal AST and/or ALT were seen in 50% of them, with a frequency and magnitude that significantly correlated with leukocyte count and ratios. Both LFT were significantly associated with requirement for hospital and ICU admission and mortality. High AST levels were significantly associated with the presence, number, and types of OFs and in-hospital length of stay (LOS). Elevated ALT was also significantly associated with the aforementioned variables, with the exception of OFs presence, circulatory failure and LOS.</p><p><strong>Conclusions: </strong>LFT abnormalities are frequently seen in COVID-19 patients, reflect SARS-CoV-2 associated inflammation and may predict adverse outcomes. LFT may be useful to aid decision-making in the ED for hospital admission or scheduled outpatient reevaluation.</p>","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"5"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/80/tgh-08-22-41.PMC9813650.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10619509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect modification of hepatitis B viral load on the association between metabolic risk factors and hepatic steatosis.","authors":"Michelle Y Shi,&nbsp;Christopher Wong,&nbsp;Tai-Ping Lee","doi":"10.21037/tgh-22-44","DOIUrl":"https://doi.org/10.21037/tgh-22-44","url":null,"abstract":"<p><strong>Background: </strong>It is not clear if chronic hepatitis B (CHB) infection potentiates the severity of hepatic steatosis (HS) in patients with metabolic risk factors. We tested for the effect modification of hepatitis B viral load on the association between metabolic risk factors and HS.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, we included adult subjects, who had non-cirrhotic nonalcoholic fatty liver disease and CHB infection with positive hepatitis B envelope antibody. We reported descriptive statistics, stratified by detectable and undetectable hepatitis B viral load, by Kruskal-Wallis Rank Sum Test and chi-square. We reported coefficients of two multivariate regression predicting odds of HS > stage 2, testing for interaction between metabolic risk factors and hepatitis B viral load.</p><p><strong>Results: </strong>When controlled for age, sex, and hepatitis B treatment, the odds of HS > stage 2 increased significantly by 77% for each additional metabolic risk factor [odds ratio (OR) 1.77, 95% confidence interval (CI): 1.20-2.69, P=0.005]. The odds of HS > stage 2 was not associated with detectable hepatitis B viral load (OR 1.00, 95% CI: 0.83-1.19, P=0.986). The association between the odds of HS > stage 2 and metabolic risk factors did not significantly change as hepatitis B viral load increased [ratio of odds ratio (ROR) 1.01, 95% CI: 0.94-1.08, P=0.839].</p><p><strong>Conclusions: </strong>Our study does not find evidence of effect modification of hepatitis B viral load on the association between metabolic risk factors and HS in non-cirrhotic and hepatitis B envelope antibody positive patients with CHB viral infection. It suggests that the odds of HS in CHB infected patients is affected by metabolic risk factors and not by hepatitis B viremia.</p>","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"6"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/57/f2/tgh-08-22-44.PMC9813647.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10625584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal carcinoma cuniculatum: a narrative review to understand this rare and commonly misdiagnosed variant of well-differentiated esophageal squamous cell carcinoma.","authors":"Ikponmwosa Enofe,&nbsp;Harish Venkataraj,&nbsp;Paul Hong,&nbsp;Xianzhong Ding,&nbsp;Abdul Haseeb","doi":"10.21037/tgh-22-37","DOIUrl":"https://doi.org/10.21037/tgh-22-37","url":null,"abstract":"<p><strong>Background and objective: </strong>Esophageal carcinoma cuniculatum (CC) is a rare variant of a well-differentiated squamous cell carcinoma (SCC). Unlike other forms of esophageal cancers, CC of the esophagus is difficult to diagnose on endoscopic biopsies. This can lead to a delay in the diagnosis and increases morbidity. We reviewed the available literature to shed light on the etiopathogenesis, diagnosis, treatment, and outcomes of this disease. Our aim is to create a better understanding of this rare disease entity and contribute to a timely diagnosis to reduce the associated morbidity and mortality.</p><p><strong>Methods: </strong>Extensive review of PubMed, Embase, Scopus, Google Scholar was conducted. We identified the published literature on Esophageal CC from inception till date. We report epidemiological trends, clinical presentation, diagnostic and treatment strategies to correctly identify the cases to reduce the likelihood of a missed diagnosis of esophageal CC.</p><p><strong>Key content and findings: </strong>Associated risk factors for esophageal CC are chronic reflux esophagitis, smoking, alcohol consumption, immunosuppression, and achalasia. Dysphagia is the most common presentation. Primary diagnostic modality is an esophagogastroduodenoscopy (EGD), but diagnosis can be easily missed. To favor an early diagnosis, a histological scoring system has been proposed by Chen <i>et al.</i> where authors describe specific histological features that appear to be common based on the numerous mucosal biopsies examined from patients with CC.</p><p><strong>Conclusions: </strong>A high clinical suspicion for the disease along with close endoscopic follow-up with repeat biopsies is needed for an early diagnosis. Surgery remains the gold standard for treatment and is associated with a favorable prognosis when the patients are diagnosed early.</p>","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"20"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/a6/tgh-08-22-37.PMC10184030.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating stress signals-XBP1 as a novel mediator of intercellular crosstalk in non-alcoholic steatohepatitis.","authors":"Junjie Yu,&nbsp;Utpal B Pajvani","doi":"10.21037/tgh-22-73","DOIUrl":"https://doi.org/10.21037/tgh-22-73","url":null,"abstract":"© Translational Gastroenterology and Hepatology. All rights reserved. Transl Gastroenterol Hepatol 2023;8:13 | https://dx.doi.org/10.21037/tgh-22-73 Non-alcoholic steatohepatitis (NASH), the most advanced form of non-alcoholic fatty liver disease (NAFLD), is the most common chronic liver disease and will soon be the most common reason for liver transplantation as NASH has no approved pharmacotherapy. This unmet need is due in part to an incomplete understanding of mechanistic determinants of various aspects of NASH pathogenesis, and uncertain progression between a prevalent pre-NASH state (lipid accumulation) to the hepatocyte injury, inflammation and fibrosis that defines NASH (1). NASH develops in the context of obesity, but people of similar body weight and adiposity do not have identical risk of NASH development. This discordance highlights a genetic component to the disease, well-established for hepatic lipid accumulation from genome-wide association studies (GWAS), but less so for liver inflammation and fibrosis. One possibility is that heterogeneity in NASH arises from altered transcriptional regulation that may not be easily uncovered by GWAS, as multiple metabolic and developmental signaling pathways are preferentially dysregulated in NASH but not pre-NASH states (2). These and other studies have suggested that two or more “hits” are necessary for NASH development (3,4). In this conceptual framework, lipid accumulation in hepatocytes, termed steatosis, may (but not necessarily) prompt a second hit, for example, oxidative stress, which will trigger hepatocyte death, immune cell activation, and eventually, the deposition of collagen fibrils by activated hepatic stellate cells (HSCs). Other work suggests that NASH development is augmented by extrahepatic mechanisms, including gutand adipose tissue-derived proinflammatory factors, which may be synergetic. In fact, inflammation may theoretically precede or even provoke steatosis. Chronic endoplasmic reticulum (ER) stress is linked to pathogenesis of multiple diseases (5-7), including obesity-induced metabolic diseases such as type 2 diabetes (T2D) and NASH, suggesting a possible pathogenic role. ER stress is often associated with the accumulation of unfolded proteins in the ER, which bind to the binding immunoglobulin protein (BIP), and triggers three, parallel signaling pathways—inositol-requiring enzyme 1α (IRE1α), which activates c-Jun NH2-terminal kinase (JNK), causing apoptosis, and induces splicing of X-box binding protein 1 (XBP1), leading to transcriptional upregulation of genes involved in lipogenesis, folding and ER-associated degradation (ERAD); PKR-like ER kinase (PERK)-induced phosphorylation of eukaryotic translation initiation factor 2α (eIF2α), which leads to increased activating transcription factor (ATF4), and upregulated gene expression associated with amino acid metabolism, anti-oxidative stress and apoptosis; and activating transcription factor 6α (ATF6α), which is furthe","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"13"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/3e/tgh-08-22-73.PMC10184033.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9841116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative imaging tests for non-alcoholic fatty liver disease: which, when and why.","authors":"Andrea Dennis","doi":"10.21037/tgh-22-85","DOIUrl":"https://doi.org/10.21037/tgh-22-85","url":null,"abstract":"","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/37/tgh-08-22-85.PMC9813660.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10632884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes: endoscopic resection of duodenal ampullary lesions.","authors":"Stephanie M Woo,&nbsp;Mark J Real,&nbsp;Brett M Will,&nbsp;Eric J Kim,&nbsp;Jiling Chou,&nbsp;Ahmed A Alsaiari,&nbsp;Ahmad Nakshabandi,&nbsp;Walid M Chalhoub,&nbsp;Nadim G Haddad","doi":"10.21037/tgh-22-87","DOIUrl":"https://doi.org/10.21037/tgh-22-87","url":null,"abstract":"<p><strong>Background: </strong>Ampullary adenomas are lesions at the duodenum's major papilla commonly associated with familial adenomatous polyposis (FAP) but may also occur sporadically. Historically, ampullary adenomas were removed surgically, however endoscopic resection has become the preferred method of resection. Most of the literature on management of ampullary adenomas are small single-center retrospective reviews. The objective of this study is to describe endoscopic papillectomy outcomes to further refine management guidelines.</p><p><strong>Methods: </strong>This is a retrospective study of patients who underwent endoscopic papillectomy. Demographic data were included. Details regarding lesions and procedures were also collected, including endoscopic impression, size, resection method and adjunctive therapies. Chi-square, Kruskal-Wallis rank-sum, and <i>t-</i>tests were performed.</p><p><strong>Results: </strong>A total of 90 patients were included. 60% patients (54 of 90) had pathology-proven adenomas. 14.4% of all lesions (13 of 90) and 18.5% of adenomas (10 of 54) were treated with APC. Among APC-treated lesions, 36.4% developed recurrence (4 of 11) <i>vs</i>. 7.1% developed residual lesion (1 of 14) (P=0.019). 15.6% of all lesions (14 of 90) and 18.5% of adenomas (10 of 54) reported complications, and the most common was pancreatitis (11.1% and 5.6%). Median follow-up time was 8 months for all lesions and 14 months (range, 1-177 months) for adenomas, with time to recurrence 30 and 31 months (range, 1-137 months), respectively. Recurrence was observed in 16.7% of all lesions (15 of 90) and 20.4% of adenomas (11 of 54). Endoscopic success was observed in 69.2% of all lesions (54 of 78) and 71.4% of adenomas (35 of 49) after removing patients lost to follow-up.</p><p><strong>Conclusions: </strong>Endoscopic papillectomy is an effective method for managing duodenal adenomas. Pathology-proven adenoma should undergo surveillance for at least 31 months. Lesions treated with APC may require closer follow-up and for a prolonged period.</p>","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"15"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/44/tgh-08-22-87.PMC10184035.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Withdrawal time in colonoscopy, past, present, and future, a narrative review.","authors":"Hossein Haghbin,&nbsp;Nuruddinkhodja Zakirkhodjaev,&nbsp;Muhammad Aziz","doi":"10.21037/tgh-23-8","DOIUrl":"https://doi.org/10.21037/tgh-23-8","url":null,"abstract":"<p><strong>Background and objective: </strong>Colonoscopy is a time proven, safe, and gold standard screening method for colorectal cancer (CRC). In order to achieve its objectives, quality markers have been defined for colonoscopy, including withdrawal time (WT). WT is defined as the time spent from reaching the cecum or terminal ileum till the end of procedure in colonoscopies without any additional interventions. This review aims to provide evidence on WT efficacy and future directions.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search of articles evaluating WT. Search was limited to English language articles from all peer-reviewed journals.</p><p><strong>Key content and findings: </strong>The seminal study by Barclay <i>et al.</i>, led to setting of a minimum WT of 6 minutes as the recommended amount for colonoscopy, per 2006 American College of Gastroenterology (ACG) taskforce. Since then, many observational studies have confirmed the efficacy of 6 minutes. Recently, multiple large multicenter trials suggest WT of 9 minutes as the alternative for better outcomes. Recently, novel Artificial Intelligence (AI) models have shown promise in improving WT and other outcomes and proved an exciting tool in the armamentarium of gastroenterologists. Some of these tools encourage the endoscopists to check the blind spots and clean the residual stool. This has shown to improve both WT and ADR. We recommend an improvement of these models to consider risk factors like adenoma detection in current and prior scopes to guide endoscopists spend time in each segment.</p><p><strong>Conclusions: </strong>In conclusion, new evidence demonstrates that WT of 9 minutes is better than 6 minutes. Future trends point toward an individualized AI-based approach combining real time and baseline data and guiding the endoscopist on how much time to spend in every segment of the colon in every colonoscopy procedure.</p>","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"19"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c8/4f/tgh-08-23-8.PMC10184034.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between body mass index and liver stiffness measurement using transient elastography in patients with non-alcoholic fatty liver disease in a hepatology clinic: a cross sectional study.","authors":"Harish Gopalakrishna,&nbsp;Oluwaseun E Fashanu,&nbsp;Gayatri B Nair,&nbsp;Natarajan Ravendhran","doi":"10.21037/tgh-22-1","DOIUrl":"https://doi.org/10.21037/tgh-22-1","url":null,"abstract":"<p><strong>Background: </strong>Transient elastography (TE) is an FDA approved, non-invasive tool to estimate liver stiffness measurement (LSM) in patients with non-alcoholic fatty liver disease (NAFLD). Our aim was to analyze if body mass index (BMI) would predict the severity of liver stiffness using TE scores.</p><p><strong>Methods: </strong>We performed a cross-sectional study of patients with NAFLD who presented to the hepatology clinic between January 2019 through January 2021. Fibrosis severity was divided into the following categories: F0 to F1 (2-7 kPa), F2 (>7 to 10 kPa), F3 (>10 to 14 kPa) and F4 (>14 kPa). We used ordered logistic regression models to determine the odds ratio (OR) and 95% confidence interval (CI) of having a higher LSM severity compared to lower associated with BMI. Models were adjusted for patient demographics and comorbidities.</p><p><strong>Results: </strong>Among 284 patients, 56.7% were females, and the median (interquartile range, IQR) age was 62 [51-68] years and BMI 31.9 (28.1, 36.2) kg/m²; 47% of patients were in the F0 to F1 stage, 24% F2, 16% F3, and 13% F4. The correlation between BMI and TE score was 0.31 (P<0.001). With 1 kg/m² increase in BMI there was 1.10 times higher odds of having a higher LSM severity (adjusted OR, 1.10; 95% CI: 1.05-1.14). Compared to patients with BMI <25 kg/m², the adjusted OR (95% CI) of having a higher fibrosis stage was 1.82 (0.61-5.44), 5.93 (2.05-17.13), and 8.56 (2.51-29.17) for patients with BMI of 25 to <30, 30 to <40, and ≥40 respectively.</p><p><strong>Conclusions: </strong>BMI correlates with the severity of LSM using TE scores in NAFLD patients even after adjusting for potential confounding variables. This suggests TE as an appreciable study for liver stiffness even in obese individuals.</p>","PeriodicalId":23267,"journal":{"name":"Translational gastroenterology and hepatology","volume":"8 ","pages":"10"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/5f/tgh-08-22-1.PMC9813648.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10619507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}