Arab Journal of Gastroenterology最新文献

{"title":"Dietary composition and its association with metabolic dysfunction-associated fatty liver disease among Chinese adults: A cross-sectional study","authors":"Zuohu Niu ,&nbsp;Jing Liu ,&nbsp;Hongye Peng ,&nbsp;Xuan Wu ,&nbsp;Xinzhuo Zheng ,&nbsp;Shukun Yao ,&nbsp;Chunjun Xu","doi":"10.1016/j.ajg.2024.02.003","DOIUrl":"10.1016/j.ajg.2024.02.003","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Metabolic dysfunction-associated fatty liver disease (MAFLD) has become the most common cause of chronic liver disease worldwide. Diet plays a critical role in the prevention and treatment of MAFLD. Our hypothesis was that the intake of some macronutrients, vitamins, or mineral elements is associated with MAFLD.</p></div><div><h3>Patients and methods</h3><p>Patients with MAFLD can be diagnosed based on the evidence of hepatic steatosis and if they meet any of the three additional criteria of overweight/obesity, diabetes mellitus, or metabolic dysregulation. Diets were recorded using photographs and diaries of meals for seven consecutive days. The consumed dietary composition was compared with the recommended intake according to the China Food Composition Tables (Standard Edition) version 2019 and the Chinese Dietary Reference Intakes version 2013, and its association with MAFLD was assessed by logistical regression analyses.</p></div><div><h3>Results</h3><p>A total of 229 MAFLD patients and 148 healthy controls were included in this study. MAFLD patients, compared with that by non-MAFLD participants, consumed more polyunsaturated fatty acids (PUFAs) (<em>p</em> &lt; 0.001), vitamin E (<em>p</em> &lt; 0.001), and iron (<em>p</em> = 0.008). The intake of PUFAs (OR = 1.070, 95 % CI: 1.017–1.127, <em>p</em> = 0.009) and vitamin E (OR = 1.100, 95 % CI: 1.018–1.190, <em>p</em> = 0.016) was positively associated with MAFLD. In addition, the percentages of individuals who consumed PUFAs (<em>p</em> = 0.006), vitamin E (<em>p</em> &lt; 0.001), or iron (<em>p</em> = 0.046) above the recommended intake were higher among the individuals with MAFLD. Daily intake of PUFAs &gt; 11 % (OR = 2.328, 95 % CI: 1.290–4.201, <em>p</em> = 0.005) and vitamin E &gt; 14 mg (OR = 2.189, 95 % CI: 1.153–4.158, <em>p</em> = 0.017) was positively correlated with MAFLD.</p></div><div><h3>Conclusions</h3><p>Patients with MAFLD consumed more PUFAs, vitamin E, and iron in their daily diet. Excessive consumption of PUFAs and vitamin E might be independent risk factors for the incidence of MAFLD.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1687197924000297/pdfft?md5=c6662739bc0865db19865d88bd86e270&pid=1-s2.0-S1687197924000297-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913804","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":"A risk model for parenteral nutrition-associated liver disease in patients with severe acute pancreatitis","authors":"Zheng Chang,&nbsp;Hao Zhang","doi":"10.1016/j.ajg.2024.01.005","DOIUrl":"10.1016/j.ajg.2024.01.005","url":null,"abstract":"<div><h3>Background and study aims</h3><p>The aim of this study is to explore the risk factors for parenteral nutrition-associated liver disease (PNALD) in patients with severe acute pancreatitis by establishing a verification risk model.</p></div><div><h3>Patients and methods</h3><p>A total of 176 patients with severe acute pancreatitis from January 2019 to August 2021, were assigned into the observation group (n = 88) and control group (n = 88) based on the diagnostic results of PNALD, randomly. Their clinical data were recorded. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and alkaline phosphatase (ALP), etc., were detected. The logistic model and desicion tree model were used to analyze the risk factors.</p></div><div><h3>Results</h3><p>Patients in the observation group had higher levels of ALT, AST, TBIL, and lower level of ALP than those of control group (P &lt; 0.05). Multivariate logistic regression analysis revealed that alcohol intake history, ALT ≥69.65 U/L, AST ≥71.27 U/L, TBIL ≥26.27 μmol/L and ALP ≤45.11 U/L were risk factors for PNALD. The levels of ALT and AST in observation group were two times as high as those in the control group, which conformed to the Danan’s criteria and accorded with the results of univariate analysis.</p></div><div><h3>Conclusion</h3><p>The regression model showed high consistency with the decision tree model in the prediction of risk factors. Alcohol intake history, ALT ≥69.65 U/L, AST ≥71.27 U/L, TBIL ≥26.27 μmol/L and ALP ≤45.11 U/L are risk factors for PNALD.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the efficacy of diltiazem versus fluoxetine in the treatment of distal esophageal spasm: A randomized-controlled-trial","authors":"Mojgan Forootan ,&nbsp;Mohsen Rajabnia ,&nbsp;Ahmad Ghorbanpoor Rassekh ,&nbsp;Saeed Abdi ,&nbsp;Mobin Fathi ,&nbsp;Mohamad Amin Pourhoseingholi ,&nbsp;Pardis Ketabi Moghadam","doi":"10.1016/j.ajg.2023.07.002","DOIUrl":"10.1016/j.ajg.2023.07.002","url":null,"abstract":"<div><h3>Background and study aim</h3><p><span>Distal esophageal spasm<span><span> is an uncommon esophageal motility disorder presenting with non-cardiac chest pain and </span>dysphagia<span><span>. The main goal of therapy is symptom relief with pharmacologic, endoscopic, and surgical therapies. Pharmacologic treatment is less invasive and is the preferred method of choice. The purpose of this study was to compare the effectiveness of </span>diltiazem versus </span></span></span>fluoxetine in the treatment of distal esophageal spasm.</p></div><div><h3>Patients and methods</h3><p>A total of 125 patients with distal esophageal spasm diagnosed using endoscopy<span><span>, barium esophagogram, and manometry<span> were evaluated. Patients were divided into diltiazem and fluoxetine groups and received a 2-month trial of diltiazem + omeprazole or fluoxetine + omeprazole, respectively. Of 125 patients, 55 were lost to follow up and 70 were eligible for final analysis. Clinical signs and </span></span>symptoms<span> were assessed before and after therapy using four validated questionnaires: Eckardt score, short form-36, heartburn<span> score, and the hospital anxiety and depression scale.</span></span></span></p></div><div><h3>Results</h3><p><span>Both regimens significantly relieved symptoms (a decrease in mean Eckardt score of 2.57 and 3.18 for diltiazem and fluoxetine groups, respectively; and a decrease in mean heartburn score by 0.89 and 1.03 for diltiazem and fluoxetine groups, respectively). Patients’ quality of life improved based on short form-36 (an increase in mean score of 2.37 and 3.95 for fluoxetine and diltiazem groups, respectively). There was no relationship between patients’ improvement and severity of symptoms. Psychological findings based on the hospital anxiety and depression scale were inconsistent (a decrease in mean of 0.143 and 0.57 for fluoxetine and diltiazem groups, respectively; </span><em>p</em> &gt; 0.05).</p></div><div><h3>Conclusion</h3><p>Fluoxetine and diltiazem were effective for clinical symptom relief in patients with distal esophageal spasm, but were not promising for improving psychological symptoms. Neither regimen was superior in terms of efficacy. Consequently, it is key to consider side effects and comorbidities when choosing a therapy.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TGF-β1 inhibitor P144 protects against benign restenosis after esophageal stenting through TGF-β1/Smads signaling pathway inhibition","authors":"Jun-Zheng Wu ,&nbsp;Chun Zhou ,&nbsp;Sheng Liu ,&nbsp;Jin-Xing Zhang ,&nbsp;Wei Yang ,&nbsp;Hai-Bin Shi ,&nbsp;Wei-Zhong Zhou","doi":"10.1016/j.ajg.2024.02.004","DOIUrl":"10.1016/j.ajg.2024.02.004","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Esophageal restenosis is a serious complication after esophageal stent placement, which influences the clinical prognosis of stent implantation and the patient's quality of life. TGF-β1/Smads signaling pathway plays an important role in the development of the eosinophilic esophagitis and scar repair after skin trauma. However, the role of TGF-β1/Smads in the development of esophageal restenosis after esophageal stent placement remains unknown. Our study aimed to investigate whether TGF-β1/Smads plays an important role in the development of esophageal restenosis after esophageal stent, and whether the exogenous TGF-β1 inhibitor supplement could ameliorate the esophageal restenosis after esophageal stent.</p></div><div><h3>Material and methods</h3><p>We established the model of esophageal restenosis after esophageal stenting in rats, and determined the expression levels of TGF-β1/Smads signaling pathway and the relevant markers of fibroblast activation by immunochemistry (IHC), Western Blot and real time qPCR. Those all the indicators were also determined in esophageal fibroblast when exposed to rhTGF-β1 with or without TGF-β1 inhibitor P144.</p></div><div><h3>Results</h3><p>The serum level of IL-1β and TNFα were significantly increased in stent implantation group compared to blank control group, and obviously ameliorated when treated with P144. The TGF-β1/Smads signaling pathway and the relevant markers of fibroblast activation were significantly increased in stent implantation group compared to blank control group, and obviously ameliorated when treated with P144. Those all the indicators were significantly increased when exposed to rhTGF-β1, and obviously decreased when treated with P144.</p></div><div><h3>Conclusions</h3><p>TGF-β1 Inhibitor P144 could protect against benign restenosis after esophageal stenting by down-regulating the expression levels of relevant markers of fibroblast activation through TGF-β1/Smads signaling pathway inhibition, and may be used as a novel therapy for benign restenosis after esophageal stenting.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of lidocaine on postoperative analgesia of endoscopic rubber band ligation combined with injection sclerotherapy for treatment of internal hemorrhoids: A retrospective study (with video)","authors":"Wen Xu,&nbsp;Guili Xia,&nbsp;Ling Dong,&nbsp;Ying Zhu","doi":"10.1016/j.ajg.2024.01.007","DOIUrl":"10.1016/j.ajg.2024.01.007","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Endoscopic minimally invasive treatment of internal hemorrhoids may cause postoperative pain. The aim of the study is to investigate the analgesic effect of lidocaine plus lauromacrogol on postoperative pain caused by endoscopic rubber band ligation (ERBL) combined with injection sclerotherapy (IS) for internal hemorrhoids treatment.</p></div><div><h3>Patients and methods</h3><p>Clinical data of grade Ⅲ internal hemorrhoids patients who underwent ERBL combined with IS in department of Digestive Medicine, Shenzhen Hospital of Southern Medical University, were retrospectively analyzed. According to difference in the composition of sclerosing solution, the patients were divided into control group (lauromacrogol group, 46 patients) and study group (lidocaine plus lauromacrogol group, 20 patients). Postoperative pain (quantized by Visual Analogue Scale, VAS), pain relief time and postoperative adverse reactions were compared. The therapeutic effect was followed up 1 month after operation.</p></div><div><h3>Results</h3><p>VAS of postoperative pain was 0.80 ± 0.42 points and pain relief time was 0.90 ± 0.56 days in the study group, while VAS of postoperative pain was 4.11 ± 1.37 points and pain relief time was 2.57 ± 0.83 days in the control group, there was statistical difference between them (P &lt; 0.05). There was no significant difference in the incidence of postoperative adverse reactions and follow-up therapeutic effect between the control group and the study group.</p></div><div><h3>Conclusion</h3><p>Lidocaine plus lauromacrogol is useful for pain alleviation on ERBL combined with IS for internal hemorrhoids treatment because of its convenient procedure, low adverse reaction incidence and good therapeutic effect, which is worthy of promotion.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of artificial intelligence in gastrointestinal endoscopy","authors":"Fujia Guo,&nbsp;Hua Meng","doi":"10.1016/j.ajg.2023.12.010","DOIUrl":"10.1016/j.ajg.2023.12.010","url":null,"abstract":"<div><p>Endoscopy is an important method for diagnosing gastrointestinal (GI) diseases. In this study, we provide an overview of the advances in artificial intelligence (AI) technology in the field of GI endoscopy over recent years, including esophagus, stomach, large intestine, and capsule endoscopy (small intestine). AI-assisted endoscopy shows high accuracy, sensitivity, and specificity in the detection and diagnosis of GI diseases at all levels. Hence, AI will make a breakthrough in the field of GI endoscopy in the near future. However, AI technology currently has some limitations and is still in the preclinical stages.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S168719792300120X/pdfft?md5=4fd00ee36fb3b89463addfd04d1f8475&pid=1-s2.0-S168719792300120X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139470742","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":"Mucormycosis presenting as intestinal perforation: A pathologist perspective","authors":"Pallavi Saraf ,&nbsp;Jyotsna Naresh Bharti","doi":"10.1016/j.ajg.2023.12.011","DOIUrl":"10.1016/j.ajg.2023.12.011","url":null,"abstract":"<div><p>Mucormycosis is a life-threatening fungal infection mostly involving the ocular region, sinuses and brain. It is mostly seen in the immunocompromised host. Gastrointestinal (GI) mucormycosis is rare and mostly present as hematemesis, abdominal pain and melena. Here, we present a case of intestinal mucormycosis who presented as cecal perforation. Surgical resection was done, and the diagnosis was made by histopathology. Our case is unique in the way that GI mucormycosis is itself a rare entity and even rarer in an immunocompetent host.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronavirus disease 19 (Covid-19): A comparative study of pattern of liver injury in adult patients in different waves of Covid-19 infection","authors":"Zeinab Abdellatif ,&nbsp;Hanan Abdel-Haleem ,&nbsp;Rasha Ahmed Abdalaziz ,&nbsp;Ahmed Ramadan ,&nbsp;Aya Mohamed Al-sharif ,&nbsp;Reem Ibrahim Mohamed El-Korashy ,&nbsp;Youssef Mohamed Amin Soliman ,&nbsp;Sabah Ahmed Hussein ,&nbsp;Manal Mohamed Kamal ,&nbsp;Mona Mohsen Abdulsalam Abdullatif ,&nbsp;Mohammed Mustafa AbdelRazik ,&nbsp;Noha Mohamed Tarek Eldessouky ,&nbsp;Mira Atef","doi":"10.1016/j.ajg.2024.01.008","DOIUrl":"10.1016/j.ajg.2024.01.008","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Liver dysfunction is a common manifestation of the COVID-19 infection. We aimed to study transaminase abnormalities through different waves of COVID-19 and their relations to disease severity or mortality.</p></div><div><h3>Patients and Methods</h3><p>A retrospective study included 521 Egyptian patients diagnosed with COVID-19. Data was retrieved from the medical records of patients who were admitted from April 2020 to October 2021 in Kasr Al-Ainy Hospitals, Cairo University, with categorization according to disease severity in correspondence to the four waves.</p></div><div><h3>Results</h3><p>The median age was lower in the first wave compared to other waves, with male predominance across all waves. The most commonly encountered comorbidity overall was hypertension, followed by diabetes mellitus. White blood cells, ferritin, and interleukin-6 showed the highest median values in the second wave, with significantly higher median C–reactive protein on day 1 in the first wave. Forty percent of the patients showed elevated hepatic transaminases on admission in four waves, with no statistically significant difference between waves. On day 5, around half of the patients had elevated transaminases, with no significant difference between waves. Most CT findings were of moderate severity. Clinical severity was higher in the second wave. It was observed that the higher the disease severity, the greater the proportion of patients with elevated hepatic transaminases. The mortality rate was markedly high in cases who had elevated ALT or AST on day 5. The association between elevated enzymes on admission and mortality was seen in the first wave only, with a fatality rate of 22.5% in cases with increased baseline ALT and AST versus 5% in those with normal baseline enzymes.</p></div><div><h3>Conclusion</h3><p>There was no significant difference in transaminases between the four waves. Elevated transaminases were positively associated with increased mortality and severity, reflecting their prognostic value.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acyl ghrelin, desacyl ghrelin and their ratio affect hepatic steatosis via PPARγ signaling pathway","authors":"Emine Elibol ,&nbsp;Yasemin Akdevelioğlu ,&nbsp;Canan Yılmaz ,&nbsp;Belkıs Narlı ,&nbsp;Serkan Şen ,&nbsp;Gülnur Take Kaplanoğlu ,&nbsp;Cemile Merve Seymen","doi":"10.1016/j.ajg.2023.12.007","DOIUrl":"10.1016/j.ajg.2023.12.007","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Ghrelin is an appetite hormone-containing 28-amino acid and has 4 different forms in the body. Ghrelin forms have different physiological functions in the body. This study aims to analyze the effect of acyl and desacyl ghrelin hormone on hepatic steatosis and biochemical findings in 36 male Wistar rats.</p></div><div><h3>Materials and methods</h3><p>Rats were split into 6 equal groups, consisting of control, acyl ghrelin, desacyl ghrelin, acyl/desacyl 3:1, acyl/desacyl 1:1, and acyl/desacyl 1:3 groups, and administered placebo or 200 ng/kg hormone subcutaneous twice a day for 14 days. Oral Glucose Tolerance Test (OGTT) was performed on Day 15, Insulin Tolerance Test (ITT) on Day 16, and scarification procedure on Day 17. Certain biochemical data and liver diacylglycerol (DAG), glycogen, protein kinase C and PPAR-γ levels were detected in the blood. Histological analyses were also conducted on the liver tissues.</p></div><div><h3>Results</h3><p>The highest plasma total cholesterol and VLDL-K levels were found in the acyl/desacyl 1:3 group, and lower insulin, and HOMA-IR levels were found in groups where acyl and desacyl were administered together (p &lt; 0.05). PPAR-γ gene expression level increased in acyl ghrelin and acyl/desacyl 1:3 groups compared to the control group. Protein kinase C gene expression was highest in the acyl/desacyl 1:3 group. The most severe degenerative findings compliant with steatosis in the liver were observed in the acyl ghrelin group (p &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>It was determined that administering rats acyl alone and acyl/desacyl by 1:3 caused the highest PPAR-γ gene expression, serum total cholesterol, HDL-K, and VLDL-K levels in the body. Besides, it is shown that desacyl ghrelin effectively regulates the blood glucose level when administered alone.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of L-ornithine L-aspartate for minimal hepatic encephalopathy in patients with cirrhosis: A meta-analysis of randomized controlled trials","authors":"Qiufeng He ,&nbsp;Chuangjie Mao ,&nbsp;Zhili Chen ,&nbsp;Yilan Zeng,&nbsp;Yang Deng,&nbsp;Rong Hu","doi":"10.1016/j.ajg.2024.01.006","DOIUrl":"10.1016/j.ajg.2024.01.006","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Minimal hepatic encephalopathy (MHE) is an early stage of hepatic encephalopathy (HE) and is highly prevalent. The efficacy of L-ornithine L-aspartate (LOLA) for the treatment of HE is well known but its role in MHE remains uncertain. The objectives of the current study were to evaluate the efficacy of LOLA for the treatment of MHE in patients with cirrhosis.</p></div><div><h3>Methods</h3><p>The Cochrane Library, PubMed, EMBASE, Web of Science and Ovid databases were searched. Only randomized controlled trials (RCTs) that compared the efficacy of LOLA with placebo or no intervention for the treatment of MHE in patients with cirrhosis were included from inception to January 2023. The primary outcomes were reversal of MHE and development of overt hepatic encephalopathy (OHE).</p></div><div><h3>Results</h3><p>Overall, six RCTs comprising 292 patients were included. Compared with placebo or no intervention, LOLA was more effective in reversing MHE (RR = 2.264, 95 % CI = 1.528, 3.352, P = 0.000, I² = 0.0 %) and preventing progression of OHE (RR = 0.220, 95 % CI = 0.076, 0.637, P = 0.005, I² = 0.0 %). Based on subgroup analyses, oral LOLA treatment appeared more likely to reverse MHE (RR = 2.648, 95 % CI = 1.593, 4.402, P = 0.000, I² = 0.0 %), intravenous LOLA treatment yielded a similar probability of reversing MHE (RR = 1.669, 95 % CI = 0.904, 3.084, P = 0.102, I² = 0.0 %). LOLA did not show a superior possibility in reducing mortality (RR = 0.422, 95 % CI = 0.064, 2.768, P = 0.368, I² = 0.0 %) and ammonia levels (SMD = 0.044, 95 % CI = -0.290, 0.379, P = 0.795, I² = 0.0 %) compared with placebo or no intervention.</p></div><div><h3>Conclusions</h3><p>LOLA has significant beneficial effects on reversal of MHE and prevention of OHE in patients with cirrhosis compared with placebo or no intervention.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1687197924000066/pdfft?md5=cfbe1b534640325d089a5ebf0b1c33c1&pid=1-s2.0-S1687197924000066-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974098","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}