Hepatology Forum最新文献

{"title":"Proximal myopathy in an untreated case of Wilson's disease - A case report.","authors":"Arya James, Akash Bang, Shikha Jain, Prarthana Khare, Himali Meshram, Abhishek Madhura, Meenakshi Girish","doi":"10.14744/hf.2024.2024.0051","DOIUrl":"10.14744/hf.2024.2024.0051","url":null,"abstract":"<p><p>Wilson's disease (WD) is a genetic disease of autosomal recessive inheritance resulting in the mutation of the adenosine triphosphate 7B (ATP7B) gene. The estimated prevalence of WD is one in 30,000 to 100,000, with a wide age of presentation between 3 to 55 years. Initial manifestations of WD are mainly neurologic, hepatic, or a combination of both. Proximal myopathy, however, is a rare presenting feature, with only a limited number of cases described in the literature. Presenting features such as rhabdomyolysis, hypokalemic muscle paralysis, and spasmodic contractions have been documented, but, as per our knowledge, only one case of proximal myopathy as the initial complaint has been reported. The underlying mechanism of this phenomenon in untreated cases remains unclear and warrants further investigation. We report the case of a 9-year-old female who presented with difficulty in walking, difficulty standing from a sitting position, and jaundice, subsequently diagnosed as WD with proximal myopathy.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 3","pages":"118-120"},"PeriodicalIF":1.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive tests for resmetirom treatment fail to accurately define the target population: Evidence from a biopsy-proven MASLD cohort.","authors":"Eda Kaya, Sinem Aksoy, Nazlican Oruc, Cagla Tasdemir, Beyza Irem Cengiz, Caglayan Keklikkiran, Yusuf Yilmaz","doi":"10.14744/hf.2025.2025.0050","DOIUrl":"10.14744/hf.2025.2025.0050","url":null,"abstract":"<p><strong>Background and aim: </strong>Resmetirom received conditional Food and Drug Administration (FDA) approval in 2024 for metabolic dysfunction-associated steatotic liver disease (MASLD) based on its promising liver-targeted therapy. Clinical trials required a histological diagnosis of metabolic dysfunction-associated steatohepatitis (MASH) with F2-F3 fibrosis, excluding cirrhosis, while real-world prescribing relies on non-invasive tests (NITs). This study evaluates their efficacy in identifying the target population within a biopsy-proven Turkish MASLD cohort.</p><p><strong>Materials and methods: </strong>We analyzed 266 patients with biopsy-proven MASLD from the Turkish NAFLD Biobank. Inclusion required AST >17 U/L (females) or >20 U/L (males), and CAP ≥280 dB/m. Eligibility was defined by liver stiffness measurement (LSM) of 10-19.9 kPa (excluding cirrhosis or low platelet count) or a FAST score ≥0.67.</p><p><strong>Results: </strong>Among the study population, 130 patients (48.9%) had histologically confirmed MASH with F2-F3 fibrosis. Based on LSM criteria applied to histologically eligible patients, 81 patients (62.3%) were underdiagnosed, compared to 95 patients (73.1%) when using the FAST score. Additionally, among patients who corresponded to NIT, 34 patients (41.0%) were overprescribed using LSM, while 23 patients (39.7%) were overprescribed using the FAST score. The kappa value as a measure of agreement showed poor compatibility for both LSM and FAST with liver biopsy (0.128 and 0.101, respectively). When treatment decisions were guided by either of the NITs, 44 patients (44.0%) received unnecessary prescriptions, and 74 patients (44.6%) had missed diagnoses.</p><p><strong>Conclusion: </strong>The NITs defined for identifying the target population for resmetirom demonstrated poor performance in accurately detecting or excluding eligible patients. Therefore, performing a liver biopsy before starting resmetirom treatment will prevent unnecessary increases in cost and significantly reduce the economic burden of the treatment.</p><p><strong>Keywords: </strong>Fibrosis; MASLD; MASH; non-invasive test; resmetirom.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 3","pages":"111-115"},"PeriodicalIF":1.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does <i>Helicobacter pylori</i> infection affect indirect hepatic fibrosis tests?","authors":"Ali Cagatay Bozkina, Goksel Bengi, Suleyman Dolu, Anil Aysal, Mujde Soyturk, Ender Berat Ellidokuz, Omer Selahattin Topalak, Hale Akpınar, Mesut Akarsu","doi":"10.14744/hf.2024.2024.0067","DOIUrl":"10.14744/hf.2024.2024.0067","url":null,"abstract":"<p><strong>Background and aim: </strong>Early detection, accurate evaluation, and proper follow-up of fibrosis in chronic liver disease are crucial for improving disease prognosis. Indirect biochemical fibrosis tests, such as the AST-to-Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) score, have been developed, incorporating parameters like AST, ALT, and platelet count. However, the influence of factors such as <i>Helicobacter pylori</i> (<i>H. pylori</i>) on fibrosis tests such as APRI and FIB-4 remains unclear, and this study aimed to evaluate its impact.</p><p><strong>Materials and methods: </strong>This study included 190 patients (aged ≥18 years) who underwent gastric and liver biopsies at a tertiary center between 2006 and 2021. Patients were categorized into three groups based on liver histopathological findings: mild (F0-1), moderate (F2-3), and advanced (F4-6) fibrosis. Additionally, patients were grouped based on <i>H. pylori</i> presence as determined by gastric histopathology. Demographic, clinical, laboratory, imaging, and histopathological characteristics were analyzed and compared between groups.</p><p><strong>Results: </strong>Among the 190 patients, <i>H. pylori</i> was detected in 135 (71%) and was absent in 55 (29%). No significant differences were observed between <i>H. pylori</i>-positive and -negative groups in terms of AST, ALT, platelet count, INR, FIB-4, or APRI scores. For APRI, significant differences were found between mild-moderate and mild-advanced fibrosis groups (p<0.001), but not between moderate and advanced groups (p>0.05). For FIB-4, significant differences were observed across all fibrosis groups (p<0.001). The presence of <i>H. pylori</i> did not significantly affect the APRI or FIB-4 scores within any fibrosis group.</p><p><strong>Conclusion: </strong>The presence of <i>H. pylori</i> did not significantly impact APRI or FIB-4 scores. These indices can reliably assess liver fibrosis, regardless of <i>H. pylori</i> status.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 3","pages":"105-110"},"PeriodicalIF":1.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver disorders in substance abusers: Early identification.","authors":"Gianni Testino, Patrizia Balbinot","doi":"10.14744/hf.2025.2025.0032","DOIUrl":"10.14744/hf.2025.2025.0032","url":null,"abstract":"","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 3","pages":"139-140"},"PeriodicalIF":1.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting hepatocellular carcinoma development in advanced fibrosis or cirrhosis due to chronic hepatitis B: The role of glypican-3, heat shock protein 70, CD34, and glutamine synthetase.","authors":"Yusuf Ozturk, Tugrul Purnak, Halis Simsek, Cenk Sokmensuer","doi":"10.14744/hf.2025.2025.0002","DOIUrl":"10.14744/hf.2025.2025.0002","url":null,"abstract":"<p><strong>Background and aim: </strong>Numerous studies have demonstrated associations between hepatocellular carcinoma (HCC)-related features and markers such as glypican-3 (GPC3), heat shock protein 70 (HSP70), CD34, and glutamine synthetase (GS). In this study, we aimed to quantify these markers in the tissues of patients with cirrhosis or advanced fibrosis due to chronic hepatitis B (CHB).</p><p><strong>Materials and methods: </strong>A retrospective review was conducted on patients with CHB who developed pathologically confirmed HCC and underwent surgical resection between 2003 and 2013. A total of 24 patients who had paired malignant and surrounding cirrhotic tissue samples were included. Liver tissues were categorized as pre-HCC cirrhotic tissue, peritumoral cirrhotic tissue, and malignant HCC tissue. Non-cirrhotic liver samples from CHB patients served as controls.</p><p><strong>Results: </strong>GPC3 staining was observed to be strong in 80% of HCC tissues and was positive in 70% of cirrhotic tissue surrounding HCC. In cirrhotic tissue 44 months prior to HCC development, 60% of cases were GPC3 positive. In non-cirrhotic chronic viral hepatitis, 20% of cases were GPC3 positive. GPC3, CD34, and GS showed significantly stronger staining in malignant versus control tissue (p<0.05). CD34 showed the highest discriminatory performance for malignant versus cirrhotic tissue (sensitivity=91.7%, specificity=91.7%), while GPC3 had the highest sensitivity (83.4%) in differentiating malignant from non-cirrhotic tissue.</p><p><strong>Conclusion: </strong>GPC3 expression may be a predictive marker for HCC development in patients with CHB-related cirrhosis. CD34 also has considerable accuracy in differentiating HCC from cirrhotic and non-cirrhotic tissues, supporting a role for use in HCC detection.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 3","pages":"99-104"},"PeriodicalIF":1.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triglyceride-glucose index associated with anthropometric parameters: Early markers in the progression of nonalcoholic fatty liver disease.","authors":"Eduardo Sttocco da Silva, Claudriana Locatelli","doi":"10.14744/hf.2025.2025.0005","DOIUrl":"10.14744/hf.2025.2025.0005","url":null,"abstract":"","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 3","pages":"137-138"},"PeriodicalIF":1.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive tests fail to ensure therapeutic precision for resmetirom in MASLD.","authors":"Gupse Adali, Remzi Adnan Akdogan","doi":"10.14744/hf.2025.2025.0055","DOIUrl":"10.14744/hf.2025.2025.0055","url":null,"abstract":"","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 3","pages":"89-90"},"PeriodicalIF":1.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of orlistat for the treatment of metabolic dysfunction-associated steatotic liver disease patients: A systematic review and meta-analysis.","authors":"Ariyan Ayati, Iman Elahi Vahed, Yasaman Rahimi, Shima Karbasi, Ali Safdari, Mahkameh Razaghi, Aida Bazrgar, Melika Arab Bafrani, Mohammad Mehdi Mousavi Nasab, Masoud Noroozi, Shokoofeh Noori, Mohammad Rahmanian","doi":"10.14744/hf.2024.2024.0047","DOIUrl":"10.14744/hf.2024.2024.0047","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a persistent hepatic condition linked with cardiovascular disorders and metabolic disturbances. Characterized by inflammation, fat accumulation, and fibrosis within the liver, MASLD can develop into liver cancer and cirrhosis. With a global prevalence of 32.4%, the condition parallels rising obesity rates. Orlistat inhibits lipase enzymes and, therefore, reduces dietary fat absorption, which may benefit MASLD patients. The present systematic review and meta-analysis were performed in accordance with PRISMA guidelines. Searches of PubMed, Scopus, Web of Science, and Embase up to January 2025 were performed using specific keywords and MeSH terms. Bias assessment and data extraction were conducted using Joanna Briggs Institute (JBI) tools independently by two researchers. Statistical analyses were performed with Stata version 14, calculating standardized mean differences, 95% confidence intervals (CI), and heterogeneity (by performing Cochran's Q test and I² index). Moreover, meta-regression, subgroup analyses, and sensitivity analyses were conducted. Eleven studies featuring 582 participants were included. Orlistat treatment induced a significant reduction in levels of alanine transaminase (ALT) (SMD = -26.23; 95% CI = -34.70 to -17.76) and aspartate aminotransferase (AST) (SMD = -19.62; 95% CI = -28.33 to -10.92). Furthermore, reductions in HOMA-IR, body mass index, cholesterol, insulin, and waist circumference were observed. The included studies exhibited low to moderate heterogeneity for most outcomes, indicating consistent results across trials. Orlistat significantly improved AST, ALT, and some other metabolic parameters in MASLD patients, suggesting its potential as an additional treatment option. However, the outcome must be interpreted cautiously, considering study heterogeneity. Further high-quality, multicenter research is necessary to confirm these results.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 3","pages":"129-136"},"PeriodicalIF":1.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of hepatocyte-specific MafF overexpression on FFA or ETOH induced hepatocyte steatosis and its underlying mechanism.","authors":"Jinhui Cai, Shen Wang, Yanmin Feng, Lin Zheng, Qiuting Liang, Yanqing Liang, Xiaoxia Ye","doi":"10.14744/hf.2024.2024.0030","DOIUrl":"10.14744/hf.2024.2024.0030","url":null,"abstract":"<p><strong>Background and aim: </strong>The transcription factor MafF is a novel regulator of adipogenesis, but its role in hepatic steatosis remains unclear. This study aimed to explore the impact of MafF on hepatocyte steatosis and its underlying mechanisms.</p><p><strong>Materials and methods: </strong>A stable MafF-overexpressing cell line was established using lentiviral infection. RT-qPCR and Western blot analysis confirmed MafF expression. Free fatty acid (FFA) or ethanol (ETOH) induction was used to simulate hepatocyte steatosis in non-alcoholic or alcoholic fatty liver disease (NAFLD or AFLD). Cell activity and lipid accumulation were assessed through the CCK-8 assay, Calcein-AM/PI staining, and Oil Red O staining. The changes in lipid metabolism-related gene expression before and after FFA or ETOH treatment were detected using RT-qPCR.</p><p><strong>Results: </strong>FFA or ETOH induced lipid accumulation in hepatocytes, and overexpression of MafF significantly ameliorated ETOH-induced hepatocyte steatosis but had little effect on FFA-induced hepatocyte steatosis. MafF overexpression significantly reduced the expression of peroxisome proliferator-activated receptor gamma (PPARG), acetyl-CoA carboxylase (ACC), and lipoprotein lipase (LPL) in hepatocytes. Upon FFA induction, control (NC) cells exhibited downregulation of these genes, whereas MafF-overexpressing cells upregulated LPL expression. In contrast, under ETOH treatment, NC cells upregulated these genes, while MafF-overexpressing cells showed downregulation.</p><p><strong>Conclusion: </strong>This study highlighted the regulation of lipid-related genes by MafF, including PPARG, ACC, and LPL, and its effect on FFA- and ETOH-induced hepatocellular lipid accumulation in distinct ways. MafF showed a more pronounced improvement in ETOH-induced hepatocyte steatosis, providing crucial insights into MafF's role in hepatic lipid metabolism and potential therapeutic strategies for NAFLD and AFLD.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 3","pages":"91-98"},"PeriodicalIF":1.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver transplantation for alcohol-associated liver disease: The changing landscape.","authors":"Eda Yildiz, Duha Zaffar, N Begum Ozturk, Merve Gurakar, A Eylul Donmez, Merih Deniz Toruner, Cem Simsek, Ahmet Gurakar","doi":"10.14744/hf.2024.2024.0057","DOIUrl":"https://doi.org/10.14744/hf.2024.2024.0057","url":null,"abstract":"<p><p>Alcoholic liver disease(ALD) is considered as a growing public health issue with universally increasing disease burden. Various genetic and environmental factors play role in its etiology. ALD recently has become the major indication for Liver Transplantation (LT). Most LT programs select their candidates by adhering to six months of alcohol abstinence policy. Nevertheless, early liver transplantation (ELT) has become a subject of research, both in Europe and the United States, as an effective and lifesaving option among highly selected severe alcohol-associated hepatitis (SAH) patients. ELT is a promising way in the management of ALD, perhaps changing clinical practice for carefully selected patient groups.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"6 2","pages":"77-86"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}