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同型半胱氨酸与非酒精性脂肪性肝病相关性Meta分析 预览
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作者 付晓枝 温志立 +1 位作者 杨茜 连玲艳 《中国肝脏病杂志(电子版)》 CAS 2019年第1期23-29,共7页
目的通过Meta分析评估非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)以及其疾病谱[包括单纯非酒精性脂肪肝(simple non-alcoholic fatty liver,NAFL)、非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)]与健康... 目的通过Meta分析评估非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)以及其疾病谱[包括单纯非酒精性脂肪肝(simple non-alcoholic fatty liver,NAFL)、非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)]与健康对照组间血清同型半胱氨酸(homocysteine,Hcy)水平的差异,为NAFLD的诊断和治疗提供参考。方法从PubMed、Web of Science、CNKI、万方数据和维普数据库中检索有关NAFLD与Hcy相关性的文献并提取数据,截止时间为2018年7月,采用Newcastle Ottawa Scale(NOS)评估纳入文献的质量,采用RevMan5.3对数据进行合并统计分析。结果与对照组相比,NAFLD组(14篇文献)、NAFL组(4篇文献)及NASH组(6篇文献)患者Hcy水平差异均有统计学意义(P均<0.05)。NASH组和NAFL组患者Hcy水平差异无统计学意义(4篇文献,SMD=0.53,95%CI:-0.60~1.66,P=0.36)。结论NAFLD及其疾病谱(NAFL、NASH)Hcy水平显著高于健康对照组,而NASH组与NAFL组Hcy水平基本相同。高同型半胱氨酸血症(Hyperhomocysteinemia,HHCY)可能是NAFLD发病的重要危险因素,其或许可成为诊断NAFLD的非侵入性标志物。然而尚不可以Hcy水平推断NAFLD病程是否从NAFL进展至NASH。 展开更多
关键词 脂肪肝 非酒精性 单纯性非酒精性脂肪肝 脂肪性肝炎 非酒精性 同型半胱氨酸 META分析
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Bariatric surgery in patients with non-alcoholic fatty liver disease-from pathophysiology to clinical effects 预览
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作者 Tea L Laursen Christoffer A Hagemann +4 位作者 Chunshan Wei Konstantin Kazankov Karen L Thomsen Filip K Knop Henning Grφb?k 《世界肝病学杂志:英文版(电子版)》 2019年第2期138-149,共12页
Non-alcoholic fatty liver disease(NAFLD)is increasingly recognized as a significant liver disease,and it covers the disease spectrum from simple steatosis with a risk of development of non-alcoholic steatohepatitis(NA... Non-alcoholic fatty liver disease(NAFLD)is increasingly recognized as a significant liver disease,and it covers the disease spectrum from simple steatosis with a risk of development of non-alcoholic steatohepatitis(NASH)to fibrosis,subsequent cirrhosis,end-stage liver failure,and liver cancer with a potential need for liver transplantation.NAFLD and NASH are closely related to obesity,metabolic syndrome,and type 2 diabetes(T2D).The role of gut hormones,especially glucagon-like peptide 1(GLP-1),is important in NAFLD.Bariatric surgery has the potential for inducing great weight loss and may improve the symptoms of metabolic syndrome and T2D.Recent data demonstrated significant effects of bariatric surgery on GLP-1 and other gut hormones and important lipid metabolic and inflammatory abnormalities in the pathophysiology of NAFLD.Therefore,bariatric surgery may reverse the pathological liver changes in NAFLD and NASH patients.In the present review,we describe NAFLD and NASH pathophysiology and the primary effects of bariatric surgery on metabolic pathways.We performed a systematic review of the beneficial and harmful effects and focused on changes in liver disease severity in NAFLD and NASH patients.The specific focus was liver histopathology as assessed by the invasive liver biopsy.Additionally,we reviewed several non-invasive methods used for the assessment of liver disease severity following bariatric surgery. 展开更多
关键词 Non-alcoholic fatty liver disease Non-alcoholic STEATOHEPATITIS BARIATRIC surgery Insulin resistance Gut hormones Glucagon-like peptide 1 STEATOSIS Inflammation Fibrosis
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应对非酒精性脂肪性肝炎癌变的来袭
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作者 刘雪静 吴健 《中华肝脏病杂志》 CAS CSCD 北大核心 2019年第3期227-231,共5页
非酒精性脂肪性肝炎可进展为终末期肝病。部分非酒精性脂肪性肝炎在进展至肝硬化前即可发生肝细胞癌。非酒精性脂肪性肝炎如何发生肝癌的分子基础目前知之甚少,逐渐得到肝病领域的重视。现概述非酒精性脂肪性肝炎相关肝细胞癌临床及基... 非酒精性脂肪性肝炎可进展为终末期肝病。部分非酒精性脂肪性肝炎在进展至肝硬化前即可发生肝细胞癌。非酒精性脂肪性肝炎如何发生肝癌的分子基础目前知之甚少,逐渐得到肝病领域的重视。现概述非酒精性脂肪性肝炎相关肝细胞癌临床及基础研究,介绍对非酒精性脂肪性肝炎相关肝细胞癌现有的认识、遇到的困境、常用的方法及急需的对策。 展开更多
关键词 脂肪肝 非酒精性 肝细胞 非酒精性脂肪性肝炎
Nonalcoholic fatty liver disease prevalence in an Italian cohort of patients with hidradenitis suppurativa: A multi-center retrospective analysis 预览
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作者 Giovanni Damiani Sebastiano Leone +11 位作者 Kristen Fajgenbaum Nicola L Bragazzi Alessia Pacifico Rosalynn RZ Conic Paolo DM Pigatto Carlo Maiorana Pierpaolo Poli Emilio Berti Maria C Pace Piergiorgio Malagoli Vincenzo Bettoli Marco Fiore 《世界肝病学杂志:英文版(电子版)》 2019年第4期391-401,共11页
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) includes two distinct conditions, with different histologic features and prognosis: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). Furthe... BACKGROUND Nonalcoholic fatty liver disease (NAFLD) includes two distinct conditions, with different histologic features and prognosis: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). Furthermore, NASH is the more aggressive necro-inflammatory form, which may accumulate fibrosis and result in End stage liver disease (ESLD). NAFLD is also linked to systemic inflammatory conditions such as psoriasis. NAFLD is currently the most common cause of ESLD in Western countries, becoming a serious public health concern. Hidradenitis suppurativa (HS) is a systemic inflammatory/autoinflammatory disease of the terminal follicular epithelium of the apocrine gland with a prevalence of 0.05% to 4.10%. Due to its systemic inflammatory behavior several comorbidities were recently associated, however liver ones were scarcely assessed. AIM To evaluate the prevalence and characteristics of NASH/NAFL in HS patients. METHODS This retrospective study is a sub-analysis of a larger study carried out in 4 Italian dermatological centers. In this cohort, there were 83 patients: 51 patients with HS only, 20 patients with HS/NAFL and 12 with HS/NASH. RESULTS Inflammatory comorbidities were present in 3.9% of HS only patients, 25% of HS/NAFL patients and 58.3% of HS/NASH patients (P < 0.001). Similarly, mean Autoinflammatory Disease Damage Index (ADDI) was significantly higher among patients with HS/NASH (5.3 ± 2.2, P < 0.001) compared to patients with HS/NAFL or HS only (2.8 ± 1.6 and 2.6 ± 1.4 respectively). Furthermore, ADDI correlates with IHS4 in HS, HS/NAFL and HS/NASH. Diabetic patients have higher Hurley score than not diabetic ones. Ultrasound examination was significantly different in the three groups. CONCLUSION HS patients displayed a high prevalence of NASH/NAFLD and ultrasound examination should be particularly addressed to patients that display high ADDI scores. 展开更多
关键词 Non-alcoholic steatohepatitis Non-alcoholic FATTY LIVER Nonalcoholic FATTY LIVER DISEASE End stage LIVER DISEASE Hidradenitis suppurativa
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维生素D缺乏与非酒精性脂肪性肝病的关系及机制 预览
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作者 曾义岚 韩源平 +1 位作者 王丽 胡蓉 《中国肝脏病杂志(电子版)》 CAS 2019年第1期12-16,共5页
随着社会经济的快速发展及生活习惯的改变,肥胖、2型糖尿病和非酒精性脂肪性肝病(nonalcoholic fatty liver diseases,NAFLD)在国内流行。流行病学调查表明,中国成人不同程度肥胖、2型糖尿病及脂肪肝者占15%或更高。NAFLD是一类脂肪性... 随着社会经济的快速发展及生活习惯的改变,肥胖、2型糖尿病和非酒精性脂肪性肝病(nonalcoholic fatty liver diseases,NAFLD)在国内流行。流行病学调查表明,中国成人不同程度肥胖、2型糖尿病及脂肪肝者占15%或更高。NAFLD是一类脂肪性肝脏疾病的总称,与饮酒无关,其共性是甘油三酯在肝实质细胞的大量堆积。10%~20%NAFLD患者可能进展为非酒精性脂肪性肝炎(nonalcoholic steatohepatitis,NASH),后者中约20%可能进一步进展为肝硬化甚至肝细胞癌。Day等于1998年提出了“二次打击学说”来解释脂肪性肝炎的形成。大量调查显示,维生素D缺乏与脂肪肝和代谢综合征的发生密切相关,但作用机制尚未明确。维生素D受体(vitamin Dreceptor,VDR)在回肠帕内特细胞(Paneth cells)中大量表达,提示维生素D信号在小肠的先天性免疫及平衡肠道菌群方面发挥关键作用。近年来,动物模型研究发现充足的维生素D可促进帕内特细胞外分泌抗菌肽(alpha-defensins),平衡肠道菌群,减少内毒素入血,从而预防脂肪肝的形成。此外,有研究表明维生素D信号能够诱导调节性T细胞(regulatory T cells,Tregs),抑制Th1及Th17应答,维持机体免疫平衡。因此,开展大规模临床试验来验证维生素D对NAFLD的疗效及分子机制十分必要。 展开更多
关键词 脂肪肝 非酒精性 维生素D缺乏 临床干预 先天免疫 肠道菌群
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Hepatocellular carcinoma:Therapeutic advances in signaling,epigenetic and immune targets 预览
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作者 Daniel Neureiter Sebastian Stintzing +1 位作者 Tobias Kiesslich Matthias Ocker 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第25期3136-3150,共15页
Hepatocellular carcinoma(HCC)remains a global medical burden with rising incidence due to chronic viral hepatitis and non-alcoholic fatty liver diseases.Treatment of advanced disease stages is still unsatisfying.Besid... Hepatocellular carcinoma(HCC)remains a global medical burden with rising incidence due to chronic viral hepatitis and non-alcoholic fatty liver diseases.Treatment of advanced disease stages is still unsatisfying.Besides first and second generation tyrosine kinase inhibitors,immune checkpoint inhibitors have become central for the treatment of HCC.New modalities like epigenetic therapy using histone deacetylase inhibitors(HDACi)and cell therapy approaches with chimeric antigen receptor T cells(CAR-T cells)are currently under investigation in clinical trials.Development of such novel drugs is closely linked to the availability and improvement of novel preclinical and animal models and the identification of predictive biomarkers.The current status of treatment options for advanced HCC,emerging novel therapeutic approaches and different preclinical models for HCC drug discovery and development are reviewed here. 展开更多
关键词 Liver cancer IMMUNOTHERAPY CHECKPOINT inhibitors Targeted therapy Mouse model Biomarker Next-generation sequencing Non-alcoholic STEATOHEPATITIS Fibrosis Clinical trial
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Berberine Ameliorates High-Fat Diet-Induced Non-Alcoholic Fatty Liver Disease in Rats via Activation of SIRT3/AMPK/ACC Pathway 预览
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作者 Yu-pei ZHANG Yuan-jun DENG +8 位作者 Kai-rui TANG Run-sen CHEN Shu LIANG Yin-ji LIANG Li HAN Ling JIN Zi-en LIANG Yan-ning CHEN Qin-he YANG 《当代医学科学(英文)》 SCIE CAS 2019年第1期37-43,共7页
This study aimed to verify the effects of berberine(BBR)on the fat metabolism proteins involved in the sirtuin 3(SIRT3)/adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)/acetyl-CoA carboxylase(ACC)pat... This study aimed to verify the effects of berberine(BBR)on the fat metabolism proteins involved in the sirtuin 3(SIRT3)/adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)/acetyl-CoA carboxylase(ACC)pathway in the liver tissues of rats with high-fat diet(HFD)-induced non-alcoholic fatty liver disease(NAFLD).Forty-eight rats were randomly divided into the normal control(NC)group,HFD group or BBR group,with 16 rats in each group.After 8 and 16 weeks of treatment,serum and liver samples were collected.Subsequently,body parameters,biochemical parameters and liver pathology were examined.The expression levels of proteins involved in the SIRT3/AMPK/ACC pathway in the liver were detected by Western blotting.After 8 and 16 weeks of a HFD,the successful establishment of rat models with different degrees of NAFLD was confirmed by hematoxylin and eosin(H&E)and Oil Red O staining.NAFLD rat models exhibited obesity and hyperlipidemia,and the protein expression levels of SIRT3,p-AMPK.p-ACC,and CPT-1A in the liver were significantly decreased compared to those in the NC group.The concurrent administration of BBR with the HFD effectively improved serum and liver lipid profiles and ameliorated liver injury.Furthermore,the protein expression levels of SIRT3,p-AMPK,p-ACC,and CPT-1 A in the liver were significantly increased in the BBR group as compared with those in the HFD group.In conclusion,our data suggest that the mechanism by which BBR ameliorates HFD-induced hepatic steatosis may be related to the activation of the SIRT3/AMPK/ACC pathway in the liver. 展开更多
关键词 BERBERINE non-alcoholic FATTY liver disease SIRTUIN 3 LIPID METABOLISM
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Single strain probiotics for dyslipidemia, fatty liver, and obesity: A systematic review and meta-analysis 预览
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作者 Krit Pongpirul Kantima Janchot Yudi Dai 《世界荟萃分析杂志》 2019年第6期323-338,共16页
BACKGROUND A number of non-systematic reviews on the effects or mechanisms of probiotics on improving dyslipidemia, fatty liver, and obesity have been available but inconclusive to determine the independent effects of... BACKGROUND A number of non-systematic reviews on the effects or mechanisms of probiotics on improving dyslipidemia, fatty liver, and obesity have been available but inconclusive to determine the independent effects of probiotics on each of the three conditions. AIM To perform a systematic review and meta-analysis on potential benefits of probiotics among individuals with fatty liver or obesity or hyperlipidemia. METHODS A systematic literature search was performed using PubMed and Embase. Adult participants of any gender without major comorbidities who received probiotics were considered following these criteria:(1) Studies on a single genus of probiotics with or without prebiotics;(2) Studies specifying the probiotic dosage into colony-forming units (CFUs);and (3) Studies on food-based probiotics were excluded. The primary outcome measures for fatty liver, obesity, and dyslipidemia were fibrosis score (kPa), body mass index (BMI;kg/m2), and serum lipid profiles (mg/dL), respectively. The secondary outcome measures for fatty liver and obesity were liver enzymes (U/L) and subcutaneous fat area (cm2). RESULTS A total of 13 articles, published between 1997 and 2018, fulfilled the selection criteria. Three probiotics were included, of which Lactobacillus was the most commonly studied (10 studies), followed by Bifidobacterium (two studies) and Pediococcus (one study). Probiotics significantly reduced BMI (P = 0.013), total cholesterol (P = 0.011), and low-density lipoprotein (P = 0.006) while increased high-density lipoprotein (P = 0.028);high heterogeneities were observed. Only Lactobacillus could decrease triglyceride level (P = 0.005) with low heterogeneity. No included studies reported fibrosis score, liver functions, subcutaneous fat outcomes. CONCLUSION Single probiotics, especially Lactobacillus, have a potentially beneficial effect on improving obesity and dyslipidemia. Evidence on the fatty liver is limited. 展开更多
关键词 FATTY LIVER OBESITY Hyperlipidemia DYSLIPIDEMIA PROBIOTICS Non-alcoholic FATTY LIVER disease OVERWEIGHT
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接受抗病毒治疗的慢性乙型肝炎患者非酒精性脂肪性肝病的患病率及其危险因素分析
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作者 高慧 匡哲 +6 位作者 钟春秀 梁携儿 樊蓉 王凯风 林伟寅 侯金林 孙剑 《中华肝脏病杂志》 CAS CSCD 北大核心 2019年第5期347-351,共5页
目的调查正在接受抗病毒治疗的慢性乙型肝炎(CHB)患者非酒精性脂肪性肝病(NAFLD)的患病率并分析其危险因素。方法横断面研究,总共纳入分析3477例正在接受抗病毒治疗的CHB患者。研究调查NAFLD的患病率,然后以CHB患者是否合并NAFLD作为因... 目的调查正在接受抗病毒治疗的慢性乙型肝炎(CHB)患者非酒精性脂肪性肝病(NAFLD)的患病率并分析其危险因素。方法横断面研究,总共纳入分析3477例正在接受抗病毒治疗的CHB患者。研究调查NAFLD的患病率,然后以CHB患者是否合并NAFLD作为因变量,相关影响因素作为自变量,采用逐步回归法筛选和分析危险因素。结果接受抗病毒治疗的CHB患者中,NAFLD的患病率为24.1%。校正年龄和性别后,中心性肥胖[比值比(OR):7.44,95%可信区间(CI):6.06~9.14]、高血压(OR:1.52,95%CI:1.18~1.96)、甘油三酯水平(OR:1.74,95%CI:1.51~2.20)与NAFLD呈正相关,肝硬化(OR:0.42,95%CI:0.34~0.53)与NAFLD呈负相关。抗病毒治疗时间越长,NAFLD患病风险随之增加。结论NAFLD在接受抗病毒治疗的CHB患者中并不少见。接受长期抗病毒治疗的CHB患者应更警惕NAFLD的发生。 展开更多
关键词 脂肪肝 非酒精性 肝炎 乙型 患病率
非酒精性脂肪性肝病患者肠道菌群及生物化学指标相关性分析
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作者 任士萌 梅璐 +3 位作者 黄煌 曹少锋 赵锐豪 郑鹏远 《中华肝脏病杂志》 CAS CSCD 北大核心 2019年第5期369-375,共7页
目的探讨不同类型非酒精性脂肪性肝病(NAFLD)患者肠道菌群结构与生物化学指标改变的相关性,以期为NAFLD临床诊断和防治提供依据。方法随机纳入NAFLD患者(NAFLD组)48例、NAFLD合并2型糖尿病患者(NAFLD合并2型糖尿病组)40例和体检健康者(... 目的探讨不同类型非酒精性脂肪性肝病(NAFLD)患者肠道菌群结构与生物化学指标改变的相关性,以期为NAFLD临床诊断和防治提供依据。方法随机纳入NAFLD患者(NAFLD组)48例、NAFLD合并2型糖尿病患者(NAFLD合并2型糖尿病组)40例和体检健康者(健康组)30例,检测其体质量指数及血清中丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆红素、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、尿酸和空腹血糖,用酶联免疫吸附法检测血清中肿瘤坏死因子-α和空腹胰岛素并计算胰岛素抵抗指数。用16SrDNA高通量测序检测3组对象肠道菌群,最后综合分析各研究因素间的相关性。各组之间的比较采用χ^2检验,符合正态分布且方差齐的多组间比较采用单因素方差分析,进一步两两比较用LSD法,不符合正态分布或方差齐性的多组间比较采用K-W秩和检验。结果NAFLD组体质量指数、天冬氨酸氨基转移酶、甘油三酯、总胆固醇、低密度脂蛋白、尿酸、肿瘤坏死因子-α、空腹胰岛素、胰岛素抵抗指数均高于健康组,高密度脂蛋白低于健康组,差异均有统计学意义(P值均<0.05)。与NAFLD组比较,NAFLD合并2型糖尿病组年龄、空腹血糖和胰岛素抵抗指数升高,体质量指数、天冬氨酸氨基转移酶、总胆固醇和高密度脂蛋白降低,差异均有统计学意义(P值均<0.05)。与健康组比较,NAFLD组厚壁菌门丰度降低(P=0.016),NAFLD合并2型糖尿病组厚壁菌门丰度降低(P<0.001)。NAFLD合并2型糖尿病组拟杆菌门丰度高于健康组,差异有统计学意义(P=0.006)。在"属"水平,NAFLD组Roseburia、Subdoligranulum的丰度降低,且NAFLD合并2型糖尿病组Roseburia明显降低,差异均有统计学意义(P值均<0.05);此外,NAFLD合并2型糖尿病组Faecalibacterium、Blautia、Anaerostipes、Fusicatenibacter丰度均低于健康组,差异均有统计学意义(P值均<0.001)。Fusicatenibacter、Blautia、Anae 展开更多
关键词 脂肪肝 非酒精性 胰岛素抵抗 肠道菌群 炎症反应
Clinical characteristics of non-alcoholic fatty liver disease in Chinese adult hypopituitary patients 预览
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作者 Xian-Xian Yuan Hui-Juan Zhu +7 位作者 Hui Pan Shi Chen Ze-Yu Liu Yue Li Lin-Jie Wang Lin Lu Hong-Bo Yang Feng-Ying Gong 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第14期1741-1752,共12页
BACKGROUND Patients with hypothalamic-pituitary disease have the feature of central obesity, insulin resistance, and dyslipidemia, and there is increased prevalence of liver dysfunction consistent with non-alcoholic f... BACKGROUND Patients with hypothalamic-pituitary disease have the feature of central obesity, insulin resistance, and dyslipidemia, and there is increased prevalence of liver dysfunction consistent with non-alcoholic fatty liver disease (NAFLD) in this population. The causes of hypopituitarism in the reported studies varied and combined pituitary hormone deficiency including central diabetes insipidus is much common in this population. This retrospective cross-sectional study was performed to analyze the clinical characteristics and related factors with NAFLD and cirrhosis in Chinese adult hypopituitary/panhypopituitary patients. AIM To analyze the clinical characteristics of and related risk factors for NAFLD in Chinese adult hypopituitary patients. METHODS Adult Chinese patients with hypopituitarism and/or panhypopituitarism were enrolled at the Pituitary Center of Peking Union Medical College Hospital between August 2012 and April 2018. According to abdominal ultrasonography, these patients were divided into an NAFLD (-) group and an NAFLD (+) group, and the latter was further divided into an NAFLD group and a cirrhotic group. The data, such as patient characteristics, diagnosis, and treatment, were extracted from medical records, and statistical analysis was performed. RESULTS A total of 36 male and 14 female adult Chinese patients with hypopituitarism were included in this retrospective study;43 (87.0%) of these patients exhibited growth hormone (GH) deficiency, and 39 (78.3%) had diabetes insipidus. A total of 27 (54.0%) patients were diagnosed with NAFLD, while seven patients were cirrhotic. No significant differences were noted in serum GH or insulin-like growth factor 1 among patients with cirrhosis, subjects with NAFLD, and those without NAFLD. However, plasma osmolality and serum sodium concentration of the cirrhotic patients were 314.9 mOsm/kgH2O and 151.0 mmol/L, respectively, which were significantly higher than those of the NAFLD patients (P = 0.036 and 0.042, respectively). Overweight/obesity and i 展开更多
关键词 HYPOPITUITARISM Non-alcoholic FATTY liver disease CIRRHOSIS Diabetes insipidus Plasma OSMOLALITY
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Comprehensive lifestyle intervention vs soy protein-based meal regimen in non-alcoholic steatohepatitis 预览
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作者 Peter Deibert Adhara Lazaro +7 位作者 Denise Schaffner Aloys Berg Daniel Koenig Wolfgang Kreisel Manfred W Baumstark Daniel Steinmann Martin Buechert Thomas Lange 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第9期1116-1131,共16页
BACKGROUND Non-alcoholic steatohepatitis(NASH)has become one of the leading causes of liver disease in the western world.In obese patients weight reduction is recommended.Up to now there are no specific guidelines for... BACKGROUND Non-alcoholic steatohepatitis(NASH)has become one of the leading causes of liver disease in the western world.In obese patients weight reduction is recommended.Up to now there are no specific guidelines for weight loss in order to reduce hepatic fat content.AIM To investigate the effects of a 24-wk guided lifestyle intervention program compared to a meal replacement regimen based on soy protein.METHODS Twenty-six subjects with NASH participated in a randomized single-center study.They were randomly assigned to either meal replacement group(MR-G)with soy-yogurt-honey preparation or to guided lifestyle change group(LC-G)with endurance activity and nutrition counselling.Serum alanine transaminase(ALT),aspartate transaminase(AST),lipid parameters,and adipokines were measured.Liver fat content and lipid composition were determined by magnetic resonance imaging and magnetic resonance spectroscopy.Body fat mass and lean body mass were assessed using Bod Pod?device.Pre-and post-intervention monitoring of parameters was performed.Statistical analyses were conducted with SPSS software,results were expressed as median(interquartile range).RESULTS Twenty-two subjects(MR-G,n=11 and LC-G,n=11)completed the study(9 women,13 men;age 52.1(15.0)years,body mass index(BMI)32.3(3.3)kg/m2).In both groups a significant weight loss was achieved(MR-G:-6.4(3.6)kg,P<0.01;LC-G:-9.1(10.4)kg,P<0.01).BMI dropped in both groups(MR-G:-2.3(1.5)kg/m2,P=0.003;LC-G:-3.0(3.4)kg/m2,P=0.006).Internal fat and hepatic lipid content were markedly reduced in both groups in comparable amount.There was a strong correlation between reduction in liver fat and decrease in ALT.Likewise,both groups showed an improvement in glycemic control and lipid profile.Changes in adipokines,particularly in adiponectin and leptin were closely related to intrahepatic lipid changes.CONCLUSION Comprehensive lifestyle intervention and meal replacement regimen have comparable effects on body and liver fat,as well as decrease in markers of hepatic inflammation among NASH 展开更多
关键词 Non-alcoholic STEATOHEPATITIS MEAL replacement therapy SOY protein LIFESTYLE change Weight reduction Obesity
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Procyanidin B2 protects against diet-induced obesity and nonalcoholic fatty liver disease via the modulation of the gut microbiota in rabbits 预览
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作者 Ya-Wei Xing Guang-Tao Lei +2 位作者 Qing-Hua Wu Yu Jiang Man-Xiang Huang 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第8期955-966,共12页
BACKGROUND Procyanidins have beneficial effects on metabolic syndrome and antimicrobial activity,but the mechanisms underlying these effects are unclear.AIM To investigate the effects of procyanidin B2(PB2)on non-alco... BACKGROUND Procyanidins have beneficial effects on metabolic syndrome and antimicrobial activity,but the mechanisms underlying these effects are unclear.AIM To investigate the effects of procyanidin B2(PB2)on non-alcoholic fatty liver disease and to explore the possible mechanism.METHODS Thirty male New Zealand white rabbits were randomized into three groups.All of them were fed either a high-fat-cholesterol diet(HCD)or chow diet.HCD-fed rabbits were treated with vehicle or PB2 daily for 12 wk.Body weight and food intake were evaluated once a week.Serum biomarkers,such as total cholesterols,triglycerides,and aspartate transaminase,were detected.All rabbits were sacrificed and histological parameters of liver were assessed by hematoxylin and eosin-stained sections.Moreover,several lipogenic genes and gut microbiota(by 16S rRNA sequencing)were investigated to explore the possible mechanism.RESULTS The HCD group had higher body weight,liver index,serum lipid profile,insulin resistance,serum glucose,and hepatic steatosis compared to the CHOW group.PB2 treatment prevented HCD-induced increases in body weight and hypertriglyceridemia in association with triglyceride accumulation in the liver.PB2 also ameliorated low-grade inflammation,which was reflected by serum lipopolysaccharides and improved insulin resistance.In rabbit liver,PB2 prevented the upregulation of steroid response element binding protein 1c and fatty acid synthase and the downregulation of carnitine palmitoyltransferase,compared to the HCD group.Moreover,HCD led to a decrease of Bacteroidetes in gut microbiota.PB2 significantly improved the proportions of Bacteroidetes at the phylum level and Akkermansia at the genus level.CONCLUSION Our results indicate the possible mechanism of PB2 to improve HCD-induced features of metabolic syndrome and provide a new dietary supplement. 展开更多
关键词 PROCYANIDIN Rabbit Non-alcoholic FATTY liver disease GUT MICROBIOTA 16S rRNA
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三维斑点追踪技术评价2型糖尿病合并非酒精性脂肪性肝病患者左心室功能 预览
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作者 董彧 王颖 +2 位作者 常文星 李影 礼广森 《中国医学影像技术》 CSCD 北大核心 2019年第6期837-842,共6页
目的探讨三维斑点追踪(3D-STE)技术评估2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者左心室功能的可行性。方法对30例T2DM不合并NAFLD(A组)、32例T2DM合并轻度NAFLD(B组)及35例T2DM合并中重度NAFLD患者(C组)行3D-STE检查,检测常... 目的探讨三维斑点追踪(3D-STE)技术评估2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者左心室功能的可行性。方法对30例T2DM不合并NAFLD(A组)、32例T2DM合并轻度NAFLD(B组)及35例T2DM合并中重度NAFLD患者(C组)行3D-STE检查,检测常规参数,包括二尖瓣口舒张早期与晚期峰值血流速度比值(E/A)、舒张末期室间隔厚度(IVSTd)、左心室下侧壁厚度(PWTd)及舒张末期左心室内径(LVDd)、收缩末期左心室内径(LVDs),左心室功能参数包括收缩末期左心房容积(LAV)、左心室质量(LVM)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室质量指数(LVMI)、左心室射血分数(LVEF),以及3D-STE应变参数左心室整体纵向应变(GLS)、整体面积应变(GAS)、整体径向应变(GRS)和整体圆周应变(GCS)。以Pearson线性相关分析3D-STE参数与糖化血红蛋白(HbA1c)、体质量指数(BMI)的相关性。结果3组E/A、IVSTd、PWTd、LVDd、LVDs、LVMI、LVEF、LVEDV及LVESV差异均无统计学意义(P均>0.05),A、B组GRS、GCS、GLS、GAS均较C组增加(P均<0.05)。GLS、GRS、GCS、GAS与HbA1c均呈负相关(r=-0.540、-0.476、-0.489、-0.623,P=0.040、0.032、0.037、0.020),与BMI均无相关性(P均>0.05)。结论3D-STE可用于评价T2DM合并NAFLD患者左心室功能。 展开更多
关键词 脂肪肝 非酒精性 糖尿病 2型 超声心动描记术 三维 心室功能
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Effect of Soothing Gan(Liver) and Invigorating Pi(Spleen) Recipes on TLR4-p38 MAPK Pathway in Kupffer Cells of Non-alcoholic Steatohepatitis Rats
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作者 GONG Xiang-wen XU Yong-jian +4 位作者 YANG Qin-he LIANG Yin-ji ZHANG Yu-pei WANG Guan-long LI Yuan-yuan 《中国结合医学杂志:英文版》 SCIE CAS CSCD 2019年第3期216-224,共9页
Objective: To investigate the mechanism of inflammatory-mediated toll-like receptor 4(TLR4)-p38 mitogen-activated protein kinase(p38 MAPK) pathway in Kupffer cells(KCs) of non-alcoholic steatohepatitis(NASH) rats and ... Objective: To investigate the mechanism of inflammatory-mediated toll-like receptor 4(TLR4)-p38 mitogen-activated protein kinase(p38 MAPK) pathway in Kupffer cells(KCs) of non-alcoholic steatohepatitis(NASH) rats and the intervention effect of soothing Gan(Liver) and invigorating Pi(Spleen) recipes on this pathway. Methods: After 1 week of acclimatization, 120 Sprague-Dawley male rats were randomly divided into 8 groups using a random number table(n=15 per group): normal group, model group, low-dose Chaihu Shugan Powder(柴胡疏肝散, CHSG) group(3.2 g/kg), high-dose CHSG group(9.6 g/kg), low-dose Shenling Baizhu Powder(参苓白术散, SLBZ) group(10 g/kg), high-dose SLBZ(30 g/kg) group, and low-and highdose integrated recipe(L-IR, H-IR) groups. All rats in the model and treatment groups were fed with a high-fat diet(HFD). The treatments were administrated by gastrogavage once daily and lasted for 26 weeks. The liver tissues were detected with hematoxylin-eosin(HE) and oil red O staining. Levels of liver lipids, serum lipids and transaminases were measured. KCs were isolated from the livers of rats to evaluate the mRNA expressions of TLR4 and p38 MAPK by real-time fluorescence quantitative polymerase chain reaction, and proteins expressions of TLR4, p-p38 MAPK and p38 MAPK by Western blot. Levels of inflammatory cytokines including tumor necrosis factor α(TNF-α), interleukin(IL)-1 and IL-6 in KCs were measured by enzyme-linked immunosorbent assay. Results: After 26 weeks of HFD feeding, HE and oil red O staining showed that the NASH model rats successfully reproduced typical pathogenesis and histopathological features. Compared with the normal group, the model group exhibited significant increases in body weight, liver weight, liver index, serum levels of total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol, and aspartate aminotransferase as well as TC and TG levels in liver tissues, and significant decrease in serum level of high-density lipoprotein cholesterol(P<0.05 or P<0.01), whi 展开更多
关键词 non-alcoholic steatohepatitis soothing GAN (Liver)and invigorating PI (Spleen)recipes Kupffer cel toll-like receptor 4-p38 MITOGEN-ACTIVATED protein kinase signaling pathway inflammation Chinese medicine
Microbial metabolites in non-alcoholic fatty liver disease 预览
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作者 Da Zhou Jian-Gao Fan 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第17期2019-2028,共10页
The prevalence of non-alcoholic fatty liver disease (NAFLD) is rising exponentially worldwide. The spectrum of NAFLD includes non-alcoholic fatty liver, non-alcoholic steatohepatitis, liver cirrhosis, and even hepatoc... The prevalence of non-alcoholic fatty liver disease (NAFLD) is rising exponentially worldwide. The spectrum of NAFLD includes non-alcoholic fatty liver, non-alcoholic steatohepatitis, liver cirrhosis, and even hepatocellular carcinoma. Evidence shows that microbial metabolites play pivotal roles in the onset and progression of NAFLD. In this review, we discuss how microbederived metabolites, such as short-chain fatty acids, endogenous ethanol, bile acids and so forth, contribute to the pathogenesis of NAFLD. 展开更多
关键词 MICROBIAL METABOLITES Non-alcoholic STEATOHEPATITIS Short-chain FATTY ACIDS
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Chronic hepatitis B and metabolic risk factors:A call for rigorous longitudinal studies 预览
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作者 Wai-Kay Seto 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第3期282-286,共5页
Long-term nucleos(t)ide analogue therapy in chronic hepatitis B virus(HBV)infection is effective in suppressing viral replication and reducing liver-related complications.However,HBV-related liver events can still occ... Long-term nucleos(t)ide analogue therapy in chronic hepatitis B virus(HBV)infection is effective in suppressing viral replication and reducing liver-related complications.However,HBV-related liver events can still occur in different patient sub-groups.There is emerging evidence that,similar to chronic hepatitis C virus infection,metabolic risk factors may play a role in the disease process of chronic HBV.While the mechanistic nature of metabolic-HBV interactions remains uncertain,studies in different HBV-infected populations have demonstrated that hepatic steatosis,increased body-mass index,diabetes,or a combination of different metabolic risk factors are associated with an increased risk of hepatocellular carcinoma and cirrhosis.The impact of metabolic risk factors is especially prominent in patients with quiescent virological activity,including on-treatment patients with effective viral suppression.As the proportion of on-treatment chronic HBV patients increases worldwide,longitudinal studies determining the relative risks of different metabolic parameters with respect to clinical outcomes are needed.Future studies should also determine if metabolic-directed interventions can improve disease outcomes in chronic HBV. 展开更多
关键词 HEPATITIS B virus DIABETES OBESITY STEATOSIS Non-alcoholic FATTY liver disease Body-mass index
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Current status,problems,and perspectives of non-alcoholic fatty liver disease research 预览
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作者 Naoki Tanaka Takefumi Kimura +3 位作者 Naoyuki Fujimori Tadanobu Nagaya Michiharu Komatsu Eiji Tanaka 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第2期163-177,共15页
Non-alcoholic fatty liver disease(NAFLD)is a major chronic liver disease that can lead to liver cirrhosis,liver cancer,and ultimately death.NAFLD is pathologically classified as non-alcoholic fatty liver(NAFL)or non-a... Non-alcoholic fatty liver disease(NAFLD)is a major chronic liver disease that can lead to liver cirrhosis,liver cancer,and ultimately death.NAFLD is pathologically classified as non-alcoholic fatty liver(NAFL)or non-alcoholic steatohepatitis(NASH)based on the existence of ballooned hepatocytes,although the states have been known to transform into each other.Moreover,since the detection of ballooned hepatocytes may be difficult with limited biopsied specimens,its clinical significance needs reconsideration.Repeated liver biopsy to assess histological NAFLD activity for therapeutic response is also impractical,creating the need for body fluid biomarkers and less invasive imaging modalities.Recent longitudinal observational studies have emphasized the importance of advanced fibrosis as a determinant of NAFLD outcome.Thus,identifying predictors of fibrosis progression and developing better screening methods will enable clinicians to isolate high-risk NAFLD patients requiring early intensive intervention.Despite the considerable heterogeneity of NAFLD with regard to underlying disease,patient age,and fibrosis stage,several clinical trials are underway to develop a first-in-class drug.In this review,we summarize the present status and future direction of NAFLD/NASH research towards solving unmet medical needs. 展开更多
关键词 Non-alcoholic STEATOHEPATITIS FIBROSIS STEATOSIS BALLOONING BIOMARKER Outcome Treatment
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SGLT-2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus:A systematic review 预览
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作者 Henith Raj Harsh Durgia +4 位作者 Rajan Palui Sadishkumar Kamalanathan Sandhiya Selvarajan Sitanshu Sekhar Kar Jayaprakash Sahoo 《世界糖尿病杂志:英文版(电子版)》 2019年第2期114-132,共19页
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a common comorbidity with type 2 diabetes.The existing therapeutic options for NAFLD are not adequate.Hypocaloric diet and exercise is the cornerstone of therapy i... BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a common comorbidity with type 2 diabetes.The existing therapeutic options for NAFLD are not adequate.Hypocaloric diet and exercise is the cornerstone of therapy in NAFLD.Pioglitazone is the only drug recommended in diabetes patients with biopsy proven non-alcoholic steatohepatitis.The frequent coexistence of NAFLD and type 2 diabetes with their combined adverse health consequences and inadequate therapeutic options makes it necessary to search for newer alternatives.AIM To assess the effect of sodium glucose cotransporter-2(SGLT-2)inhibitors on liver enzymes in type 2 diabetes patients with NAFLD.METHODS We searched PubMed/MEDLINE,Cochrane library,Google scholar,and Clinicaltrials.gov for the relevant articles to be included in this systematic review.Human studies done in type 2 diabetes patients with NAFLD treated with SGLT-2 inhibitors for at least 12 wk were included.Data from eight studies(four randomised controlled trials and four observational studies)were extracted and a narrative synthesis was done.A total of 214 patients were treated with SGLT-2 inhibitors in these studies(94 in randomised controlled trials and 120 in observational studies).RESULTS The primary outcome measure was change in serum alanine aminotransferase level.Out of eight studies,seven studies showed a significant decrease in serum alanine aminotransferase level.Most of the studies revealed reduction in serum level of other liver enzymes like aspartate aminotransferase and gamma glutamyl transferase.Five studies that reported a change in hepatic fat exhibited a significant reduction in hepatic fat content in those treated with SGLT-2 inhibitors.Likewise,among the three studies that evaluated a change in indices of hepatic fibrosis,two studies revealed a significant improvement in liver fibrosis.Moreover,there was an improvement in obesity,insulin resistance,glycaemia,and lipid parameters in those subjects taking SGLT-2 inhibitors.The studies disclosed that about 17%(30/176)of the sub 展开更多
关键词 Alanine AMINOTRANSFERASE HEPATIC fat HEPATIC fibrosis Non-alcoholic fatty liver disease Sodium-glucose cotransporter-2 inhibitor Type 2 diabetes MELLITUS
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非酒精性脂肪性肝炎斑马鱼模型的建立
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作者 芈肖肖 严健 +1 位作者 曾小丹 施军平 《中华肝脏病杂志》 CSCD 北大核心 2018年第7期519-523,共5页
目的通过给予过量饮食的方法建立斑马鱼非酒精性脂肪性肝炎模型。方法采用每日给予3倍于正常饮食的方式喂养野生型斑马鱼,20d后检测其体长、体质量、体内甘油三酯等指标。用定量PCR检测与胆固醇代谢、脂质代谢、内质网应激及炎症等相... 目的通过给予过量饮食的方法建立斑马鱼非酒精性脂肪性肝炎模型。方法采用每日给予3倍于正常饮食的方式喂养野生型斑马鱼,20d后检测其体长、体质量、体内甘油三酯等指标。用定量PCR检测与胆固醇代谢、脂质代谢、内质网应激及炎症等相关基因的表达变化。用肝脏组织切片HE染色评价病理学变化。组间比较采用t检验进行统计学分析。结果模型组斑马鱼体长(0.71±0.01)cm和体质量(44.83±1.83)mg高于对照组的体长(0.50±0.01)cm和体质量(19.33±2.75)mg(t体长=12.36,t体质量=7.71,P〈0.01),模型组体内三酰甘油的含量为(59.15±0.56)μmol/L,高于对照组的(16.71±0.36)μmol/L(t=63.84,P〈0.01)。定量PCR结果显示模型组与胆固醇合成相关基因表达高于对照组(P〈0.01)、模型组与脂质生成和脂质氧化相关因子表达量较对照组升高,两组比较,差异有统计学意义(P〈0.05)、模型组与炎症相关的因子表达量也高于对照组(P〈0.01)、模型组与内质网应激相关基因表达高于对照组(P〈0.01)。肝脏HE染色结果显示模型组相较于对照组出现脂肪大泡和小泡等病理学改变。结论连续给予3倍于正常量的饮食20d,可在斑马鱼体内模拟人类非酒精性脂肪性肝炎的疾病特征。 展开更多
关键词 脂肪肝 非酒精胜 食品 配方 斑马鱼 非酒精性脂肪幽干炎
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