International Journal of Hepatology最新文献

{"title":"Cirrhosis Is an Independent Risk Factor for Mortality in Ischemic Stroke-A Nationwide Analysis.","authors":"Kayode E Ogunniyi, Habib Olatunji Alagbo, Oluwaremilekun Zeth Tolu-Akinnawo, Selimat Ibrahim, Oluwaseun Dorcas Adeleke, Arun Mahtani, Derek Fan Ugwendum, Indebir Padda, Meena Farid, Toluwalase Awoyemi","doi":"10.1155/ijh/9250819","DOIUrl":"10.1155/ijh/9250819","url":null,"abstract":"<p><p><b>Background and Aims:</b> Ischemic stroke remains a leading cause of preventable cardiovascular mortality worldwide, with emerging evidence suggesting an association between liver cirrhosis and both stroke occurrence and severity. However, the specific impact of cirrhosis on stroke-related mortality remains incompletely understood. Elucidating this relationship is crucial for improving risk stratification and early recognition of high-risk individuals. <b>Methods</b>: We conducted a retrospective cohort study comparing ischemic stroke patients with cirrhosis to those without, using the National Inpatient Sample database for 2021. Univariate and multivariate logistic regression analyses were performed to compare various outcomes. <b>Results:</b> A total of 536,199 discharges for ischemic stroke were included, among which 4464 had a documented history of liver cirrhosis. Discharges with cirrhosis were predominantly male (58.2%) with a mean age of 67 years, which was 2.17 years younger than those without cirrhosis. In-hospital mortality was 7% (95% CI: 5.5%-8.99%) among discharges with cirrhosis versus 4.2% (95% CI: 4.0%-4.33%) in those without.. After adjusting for cofounders in multivariate logistic regression, it was revealed that cirrhosis is associated with 69% higher mortality risk in stroke discharges (OR = 1.69, 95% CI: 1.27-2.25, <i>p</i> < 0.001). <b>Conclusions:</b> Our study identifies liver cirrhosis as an independent risk factor for mortality among patients hospitalized with ischemic stroke. These findings underscore the necessity of incorporating proactive management strategies for liver cirrhosis into stroke care and prevention protocols, potentially improving outcomes in this high-risk population.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2025 ","pages":"9250819"},"PeriodicalIF":1.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721989","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 Risk Factors of Refractory Adult-Onset Still's Disease.","authors":"Lin Cheng, Hexiang Zong, Dongxu Li, Yaqin Zhang, Long Qian","doi":"10.1155/ijh/6689086","DOIUrl":"10.1155/ijh/6689086","url":null,"abstract":"<p><p><b>Background:</b> Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology and pathogenesis. Some patients fail to respond to conventional glucocorticoids and immunosuppressant therapies, a condition known as refractory AOSD. The prognosis for patients with refractory AOSD is typically poor, significantly impacting their quality of life and overall health. This study retrospectively analyzes the predictive factors for refractory AOSD to provide new strategies and insights for clinical diagnosis and treatment. <b>Methods:</b> Overall, 105 AOSD patients hospitalized between January 2008 and October 2024 were selected, 41 of whom were classified as refractory. Multivariate logistic regression analysis was conducted to identify risk factors for refractory AOSD, and receiver operating characteristic (ROC) curves were used to evaluate the predictive power of these indicators. <b>Results:</b> Patients with refractory AOSD were more likely to develop splenomegaly and MAS. Additionally, the neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase, serum ferritin (SF) levels, and AOSD system score were higher in refractory cases than in nonrefractory cases, while lymphocyte count and platelet (PLT) count were lower in the refractory AOSD group (<i>p</i> < 0.05). Multivariate logistic regression analysis identified PLT, NLR, and AOSD system scores as independent risk factors for predicting refractory AOSD. ROC curve analysis revealed that the area under the curve for PLT, NLR, and AOSD system scores were 0.659, 0.661, and 0.660, respectively. The optimal cutoff values for PLT, NLR, and AOSD system score in predicting refractory AOSD were 314.5 × 10⁹/L, 10.555, and 5.5, respectively, with sensitivities of 80.5%, 53.7%, and 75.6% and specificities of 46.9%, 75.0%, and 50.0%, respectively. <b>Conclusion:</b> PLT < 314.5 × 10⁹/L, NLR > 10.555, or an AOSD system score of > 5.5 before treatment may serve as independent risk factors for predicting refractory AOSD, providing clinicians with an early warning to identify disease progression.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2025 ","pages":"6689086"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711432","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":"Utilization of Contrast-Enhanced Ultrasound in Diagnosis of Focal Liver Lesions.","authors":"Fady Salama, Nimish Thakral, Christina Delacruz Leyson, Venkata Konjeti, Karim Benrajab, Gregory Hawk, Harrison Fouch, Roberto Gedaly, Aman Khurana","doi":"10.1155/2024/3879328","DOIUrl":"10.1155/2024/3879328","url":null,"abstract":"<p><p><b>Background and aims</b>: Focal liver lesions (FLL) are one of the most common indications for hepatology and hepatobiliary surgery consultation. In this retrospective study, we aim to assess if contrast-enhanced ultrasound (CEUS) can address diagnostic dilemmas in the evaluation of indeterminate liver lesions by identifying characteristics of indeterminate FLL on CEUS and correlating these with cross-sectional imaging and pathology findings. <b>Methods</b>: We retrospectively reviewed all patients who underwent CEUS evaluation for liver lesions over a 28-month period (Oct 2020 to Jan 2023) at the University of Kentucky. To assess the relationship between CEUS results and the corresponding CT, MRI, and/or pathologic findings, the McNemar-Bowker tests were performed. <b>Results</b>: Twenty-nine patients were included (after two exclusions from a total <i>n</i> of 31). Mean age was 54 years, 62% were female, and 48% had underlying cirrhosis. Of the 29 patients with initial cross-sectional imaging, the initial results showed malignancy or likely malignant lesion in 6 patients and benign or likely benign lesion in 6 patients. The remaining 17 patients had inconclusive/indeterminate results. CEUS clarified an \"indeterminate\" CT/MRI result 15 times out of 17 (88.2%), moving the diagnosis to \"benign\" 11 times while suggesting \"malignant\" only four times. When aggregating indeterminate cross-sectional results with either benign or malignant categories suggested by CEUS, CEUS never reversed a benign CT/MRI diagnosis but often reversed a malignant CT/MRI diagnosis. <b>Conclusion</b>: CEUS provided a definitive diagnosis of indeterminate liver lesions in approximately 90% of patients and avoided the need for biopsy in most patients. In cases where the liver lesions were biopsied, CEUS accurately distinguished malignant versus benign lesions as confirmed by biopsy findings. CEUS, therefore, has the potential to provide a precise diagnosis for the majority of indeterminate lesions.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"3879328"},"PeriodicalIF":1.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559113","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":"Anatomical Variations of the Gallbladder and Bile Ducts: An MRI Study.","authors":"Kigundu Yason, Kirum Gonzaga Gonza, Okello Michael, Buwembo William, Ian Munabi, Kawooya Michael","doi":"10.1155/2024/3877814","DOIUrl":"10.1155/2024/3877814","url":null,"abstract":"<p><p><b>Background:</b> The anatomy of the biliary tree is complex with anatomical variations which can be found in ~50% of the patients. <b>Purpose:</b> Existing research on these variations primarily stems from studies in developed countries, with uncertain applicability to the Ugandan population due to noted ethnic differences in incidence rates. <b>Objective:</b> The study was aimed at describing the anatomical variations of the gallbladder and bile ducts. <b>Methods:</b> This retrospective cross-sectional study conducted at Kampala MRI Centre from January 2017 to December 2022 analyzed MRCP images and reports from 231 patients to document gallbladder and bile duct variations. <b>Results:</b> 53.2% of patients exhibited typical cystic duct anatomy, and 51% had Type 1 variations in intrahepatic ducts. Importantly, the study identified a significant correlation between age and common bile duct diameter. <b>Conclusion:</b> The findings showed various anatomical variations that were slightly higher in the study population than those reported in the literature. This study emphasizes the critical need for comprehensive knowledge to enhance surgical safety, minimize iatrogenic trauma, and improve the accuracy of diagnostic imaging and hepatobiliary procedures.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"3877814"},"PeriodicalIF":1.5,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510162","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 Role of Gut Microbiota Modification in Nonalcoholic Fatty Liver Disease Treatment Strategies.","authors":"Hessam Yaghmaei, Amirhossein Bahanesteh, Masood Soltanipur, Sobhan Takaloo, Mahdi Rezaei, Seyed Davar Siadat","doi":"10.1155/2024/4183880","DOIUrl":"https://doi.org/10.1155/2024/4183880","url":null,"abstract":"<p><p>One of the most common chronic liver diseases is nonalcoholic fatty liver disease (NAFLD), which affects many people around the world. Gut microbiota (GM) dysbiosis seems to be an influential factor in the pathophysiology of NAFLD because changes in GM lead to fundamental changes in host metabolism. Therefore, the study of the effect of dysbiosis on the pathogenicity of NAFLD is important. European clinical guidelines state that the best advice for people with NAFLD is to lose weight and improve their lifestyle, but only 40% of people can achieve this goal. Accordingly, it is necessary to provide new treatment approaches for prevention and treatment. In addition to dietary interventions and lifestyle modifications, GM modification-based therapies are of interest. These therapies include probiotics, synbiotics, fecal microbiota transplantation (FMT), and next-generation probiotics. All of these treatments have had promising results in animal studies, and it can be imagined that acceptable results will be obtained in human studies as well. However, further investigations are required to generalize the outcomes of animal studies to humans.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"4183880"},"PeriodicalIF":1.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510163","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":"Evaluation of Noninvasive Tools for Predicting Esophageal Varices in Patients With Cirrhosis at Tygerberg Hospital, Cape Town.","authors":"Lawrence Kwape, Shiraaz Gabriel, Ahmad Abdelsalem, Penelope Rose, Lefika Bathobakae, Dale Peterson, Desiree Moodley, Mohammed Parker, Saadiq Moolla, Arifa Parker, Keatlaretse Siamisang, Christoffel Van Rensburg, Ernst Fredericks","doi":"10.1155/2024/9952610","DOIUrl":"https://doi.org/10.1155/2024/9952610","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; In patients with cirrhosis, esophageal variceal hemorrhage (EVH) is a devastating consequence of portal hypertension (PH). Upper endoscopy is considered the gold standard for the detection and diagnosis of esophageal varices (EVs), despite being invasive and costly. This study was aimed at identifying and evaluating the diagnostic accuracy of noninvasive tools in predicting EVs in patients with compensated cirrhosis. &lt;b&gt;Methods:&lt;/b&gt; This cross-sectional study included 50 patients with compensated cirrhosis at the Tygerberg Hospital Gastroenterology Clinic in Cape Town between November 2022 and May 2023. We collected clinical, anthropometric, and laboratory data from patients' physical and electronic charts. All patients underwent an abdominal ultrasound, vibration-controlled transient elastography (VCTE) to assess liver and splenic stiffness, and upper endoscopy. In this comparative study, we evaluated the diagnostic accuracy of different noninvasive tools in detecting EVs in patients with compensated cirrhosis. &lt;b&gt;Results:&lt;/b&gt; Of the 50 patients included in the study, 30 (60%) were female and 20 (40%) were male. The patients' age ranged from 18 to 83, with a mean age of 46.6 years. Cirrhosis was mainly due to alcohol use (&lt;i&gt;n&lt;/i&gt; = 11, 22%), hepatitis B virus (HBV) infection (&lt;i&gt;n&lt;/i&gt; = 11, 22%), and autoimmune hepatitis (&lt;i&gt;n&lt;/i&gt; = 10, 20%). The patients included in the study were divided into two subgroups: with (&lt;i&gt;n&lt;/i&gt; = 34, 68%) or without (&lt;i&gt;n&lt;/i&gt; = 16, 32%) EVs. Statistically significant differences were detected between groups in platelet count (PC), liver stiffness measurement (LSM), spleen stiffness measurement (SSM), portal vein diameter (PVD), bipolar spleen diameter (SBD), aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 index (FIB-4), platelet/bipolar spleen diameter ratio (PSR), liver stiffness-spleen size-platelet ratio (LSPS), liver stiffness-spleen stiffness-platelet ratio score (LS&lt;sup&gt;3&lt;/sup&gt;PS), and spleen stiffness-spleen size-platelet ratio score (SSPS) (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). The highest diagnostic precision was observed with SSM (96%), SSPS (96%), LS&lt;sup&gt;3&lt;/sup&gt;PS (94%), LSPS (94%), PSR (94%), and PC (92%). SBD (88%), LSM (86%), APRI (82%), and FIB-4 (82%) had the lowest diagnostic accuracy. &lt;b&gt;Conclusion&lt;/b&gt;: SSM and SSPS have the highest diagnostic accuracy for predicting the presence of EVs in patients with compensated cirrhosis. LSPS, LS&lt;sup&gt;3&lt;/sup&gt;PS, and PSR come second at 94%. We recommend SSM and SSPS in institutions with transient elastography equipped with the software necessary to measure splenic stiffness. We introduce and propose LS&lt;sup&gt;3&lt;/sup&gt;PS as a novel composite score for predicting the presence of EVs in patients with compensated cirrhosis. Large-sample-size studies are needed to validate these prediction scores and to allow direct comparison with Baveno VII. These prediction tools can help clinicians avoid unnecessary endoscopic procedures in patients with ","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"9952610"},"PeriodicalIF":1.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298287","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":"Impact of Renal Replacement Therapy on Outcomes of Living Donor Liver Transplantation for Acute Liver Failure: A Cohort Study.","authors":"Abu Bakar Hafeez Bhatti, Nauman Ul Haq, Nayyer Mehmood, Danyal Hassan, Arsalan Ahmed, Wasim Tariq Malik, Haseeb Haider Zia, Mohammad Salih, Nusrat Yar Khan, Abid Ilyas, Nasir Ayub Khan","doi":"10.1155/2024/8422308","DOIUrl":"https://doi.org/10.1155/2024/8422308","url":null,"abstract":"<p><p>Despite the promising role of renal replacement therapy (RRT) in acute liver failure (ALF), high-risk patients need liver transplantation and remain at risk for death due to cerebral complications. The objective of this study was to report outcomes of living donor liver transplantation (LDLT) for ALF with perioperative RRT. This was a single-center retrospective cohort study. Out of 1167 LDLTs, 24 patients had ALF and met the King's College criteria for transplantation. They were categorized into no-RRT (<i>n</i> = 13) and RRT (<i>n</i> = 11) groups. We looked at 1-year posttransplant survival in these patients. The median serum ammonia level at the time of transplant in the no-RRT and RRT groups was 259.5 mcg/dL (222.7-398) and 70.6 mcg/dL (58.1-92.6) (<i>p</i> = 0.005). In the RRT group, serum ammonia level < 100 mcg/dL was achieved in all patients. Seven (53.8%) patients in the no-RRT group and 11/11 (100%) in the RRT group were extubated and regained full consciousness after LDLT (<i>p</i> = 0.013). The 90-day mortality was 6/13 (46.1%) and 2/11 (18.1%) (<i>p</i> = 0.211). There was no brainstem herniation-related mortality in the RRT group, that is, 5/13 (38.4%) and 0/11 (0%) (<i>p</i> = 0.030). The 1-year posttransplant survival was also significantly higher in the RRT group (<i>p</i> = 0.031). The use of RRT lowers serum ammonia levels and might reduce posttransplant mortality due to brainstem herniation.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"8422308"},"PeriodicalIF":1.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298288","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":"miRNA-221: A Potential Biomarker of Progressive Liver Injury in Chronic Liver Disease (CLD) due to Hepatitis B Virus (HBV) and Nonalcoholic Fatty Liver Disease (NAFLD).","authors":"Parthana Rani Sutradhar, Nahida Sultana, Afzalun Nessa","doi":"10.1155/2024/4221368","DOIUrl":"10.1155/2024/4221368","url":null,"abstract":"<p><p><b>Background:</b> Early detection of progressive liver damage in chronic liver disease (CLD) patients is crucial for better treatment response. Several studies have shown the association of microRNA (miRNA) in the progression of CLD in regulating cell proliferation, fibrosis, and apoptosis as well as in carcinogenesis. <b>Objectives:</b> The study was aimed at determining the expression of miRNA-221 among different stages of fibrosis in CLD patients due to hepatitis B virus (HBV) and nonalcoholic fatty liver disease (NAFLD) and thus evaluate its role as an early biomarker in CLD. <b>Methods:</b> A total of 100 participants (75 CLD patients and 25 healthy control) were recruited in this cross-sectional study and divided into four groups, of which 25 as healthy control, 25 in CLD without fibrosis, 25 were CLD with fibrosis, and 25 were CLD with cirrhosis. Total RNA was extracted from plasma followed by cDNA synthesis, and finally, the expression of miRNA-221 was analyzed for its diagnostic potential as a single biomarker using the qRT-PCR method. <b>Results:</b> The plasma level of miRNA-221 was significantly upregulated in different fibrosis stages of CLD (<i>p</i> < 0.05), and this upregulation was positively correlated with the progression of fibrosis (<i>p</i> < 0.05). Significantly increased expression of miRNA-221 was found in NAFLD patients compared to HBV patients in the CLD without fibrosis patient group (<i>p</i> < 0.05), while expression of miRNA-221 was significantly upregulated among HBV patients in the CLD with the fibrosis group. miRNA-221 showed high diagnostic accuracy in discriminating different stages of fibrosis from healthy control (<i>p</i> < 0.05). <b>Conclusion:</b> miRNA-221 may be used as a potential plasma biomarker for early prediction of fibrosis progression in CLD patients.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"4221368"},"PeriodicalIF":1.5,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056880","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":"Survival and Disease Progression in Older Adult Patients With Cirrhosis: A Retrospective Study.","authors":"Khaled Al-Smadi, Ammar Qureshi, Michelle Buitrago, Besher Ashouri, Zeid Kayali","doi":"10.1155/2024/5852680","DOIUrl":"10.1155/2024/5852680","url":null,"abstract":"<p><p><b>Background:</b> Cirrhosis incidence in older adult patients has been increasing with limited data on their survival. This study is aimed at investigating the survival and disease progression in older adult patients with cirrhosis compared to younger patients. <b>Methods:</b> This is a retrospective single-center study. Patients aged above 50 with a confirmed diagnosis of cirrhosis based on biopsy, FibroSure test, splenomegaly, and low platelets < 120 × 10⁹/L) or imaging findings including FibroScan were included. Patients with active substance abuse, transjugular intrahepatic portosystemic shunt (TIPS), prior spontaneous bacterial peritonitis (SBP), variceal hemorrhage, model for end-stage liver disease-Na (MELD - Na) ≥ 20, had liver transplantation, malignancy except for squamous cell carcinoma, and other comorbidities such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and end-stage kidney disease with glomerular filtration rate (GFR) < 30 were excluded. Patients' records from the liver clinic were reviewed and demographics, laboratory, and compensation and decompensation status were collated. Patients were separated into two groups based on age 50-64 years and age ≥ 65. The primary endpoint was death, and the secondary endpoint was disease progression measured by the baseline to 12-month increase in MELD-Na score. The Kaplan-Meier analysis was conducted to compare the survival between the two groups. Cox regression analysis was performed to identify independent risk factors for poor survival. <b>Results:</b> A total of 191 patients diagnosed with cirrhosis met the inclusion and exclusion criteria. There were 80 patients aged 50-64 years and 111 patients aged ≥ 65 years. Significantly shorter survival times were seen among patients aged ≥ 65 years compared to those aged 50-64 years (73.3 ± 4.8 vs. 151.5 ± 22.7; <i>p</i> < .001). Age of diagnosis ≥ 65 years (<i>p</i> < 0.001), male gender (<i>p</i> = .013), body mass index (BMI) < 30 (<i>p</i> = 0.005), and decompensation (<i>p</i> = 0.008) were found to be independent risk factors for poor survival. MELD-Na scores increased significantly in 12 months of follow-up from baseline, but only in patients with decompensated cirrhosis (<i>p</i> = 0.013). <b>Conclusions:</b> Cirrhotic patients aged ≥ 65 years have significantly poor survival compared to younger patients. A prospective study is needed to further investigate the effect of age and obesity on survival and disease progression in older adult patients with cirrhosis.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"5852680"},"PeriodicalIF":1.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989184","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":"Acyl-CoA Thioesterase 1 Contributes to Transition of Steatosis to Metabolic-Associated Steatohepatitis.","authors":"Elisa Pasini, Cristina Baciu, Marc Angeli, Bianca Arendt, Diogo Pellegrina, Jüri Reimand, Keyur Patel, George Tomlinson, Mohammad T Mazhab-Jafari, Lakshmi P Kotra, Sandra Fischer, Johane P Allard, Atul Humar, Mamatha Bhat","doi":"10.1155/2024/5560676","DOIUrl":"https://doi.org/10.1155/2024/5560676","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatohepatitis (MASH) has become the leading cause of chronic liver disease, but there has been no approved pharmacotherapy to date.</p><p><strong>Methods: </strong>We used a network analysis approach to delineate protein-protein interactions that contribute to the transition from steatosis to MASH, in order to identify and target this transition as a potential pharmacotherapeutic strategy. Acyl-CoA thioesterase 1 (ACOT1) was identified as a critical node in the protein-protein interaction (PPI) network of the transition from steatosis to MASH in patient samples. ACOT1 overexpression and silencing effects were tested <i>in vivo</i> on C57BL/6 mice exposed to high-fat diet (HFD) and inoculated with an adenoviral system to modulate <i>ACOT1</i> expression. Transcriptomic and untargeted lipidomic profiles were performed on the mouse livers.</p><p><strong>Results: </strong>ACOT1 expression was 3-fold higher in MASH as compared to steatosis. In patient samples, <i>ACOT1</i> was significantly correlated with the severity of MASH as reflected by the nonalcoholic fatty liver disease score. Experimental validation showed that downregulation of ACOT1 resulted in decreased lipid accumulation and prevention of MASH <i>in vivo</i>. Conversely, upregulation of ACOT1 via an adenoviral vector resulted in development of MASH, whereas control mice only developed steatosis. Lipidomic analysis revealed glycerophospholipids to be especially abundant in MASH accelerated by ACOT1 upregulation.</p><p><strong>Conclusion: </strong>These results suggest that ACOT1 contributes to the transition from steatosis to MASH through modulation of glycerophospholipid accumulation and its potential as a novel therapeutic target in MASH. This trial is registered with NCT02148471.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"5560676"},"PeriodicalIF":1.5,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773494","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}