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Nonalcoholic Fatty Liver Disease (NAFLD)
Published in Charles Theisler, Adjuvant Medical Care, 2023
NAFLD is one of the most common liver diseases globally. Generally, fatty liver disease means there is extra fat in the liver, even in people who drink little or no alcohol. If more than 5%-10% of the liver's weight is fat, it is called a fatty liver. Even though there is extra fat, there is not necessarily any inflammation in the liver or damage to the cells. However, nonalcoholic fatty liver disease (NAFLD) can consist of a spectrum of conditions ranging from a simple fatty infiltration to steatohepatitis, fibrosis, and cirrhosis. NAFLD is histologically similar to alcoholic liver disease.1 Conditions such as alcohol abuse, type 2 diabetes, hypertension, high triglycerides, low HDL levels, and obesity are often associated with fatty liver disease. NAFLD is estimated to progress to a more severe condition called nonalcoholic steatohepatitis (NASH) in about one-third of NAFLD patients. It also increases the risk of cirrhosis and liver cancer.2
Liver, Biliary Tract and Pancreatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
The prognosis of simple fatty liver is good; there is an increased mortality but this is associated primarily with cardio- and cerebrovascular disease. However, where there is evidence of a superimposed hepatitis (as in NASH), there is a higher probability of progression to fibrosis, cirrhosis and cancer.
Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Gastrointestinal complications of diabetes are often caused by abnormal GI motility, a result of diabetic autonomic neuropathy of the GI tract. Factors that contribute to diabetes-related reflux include hyperglycemia, obesity, and decrease bicarbonate secretion from the parotid glands. Gastroparesis is idiopathic in more than 50% of all cases, but autonomic neuropathy remains a significant cause of the condition in people with type 1 or type 2 diabetes. Between 30% and 50% of affected patients have had diabetes for years. The vagus nerve becomes damaged by years of high blood glucose, or insufficient transport of glucose into the cells. Constipation, as part of intestinal enteropathy, is caused by neuronal dysfunction in the large intestine as well as impairment of the gastrocolic reflex. If an individual has elevated hepatic transaminase levels, it is important to assess other possible causes of liver disease, which include hepatitis and hemochromatosis. The cause of nonalcoholic fatty liver disease is unknown but is often related to obesity and type 2 diabetes. All severely obese patients with diabetes have some amount of steatosis, and about 50% have steatohepatitis.
Microanatomy of the metabolic associated fatty liver disease (MAFLD) by single-cell transcriptomics
Published in Journal of Drug Targeting, 2023
Lijun Wang, Kebing Zhou, Qing Wu, Lingping Zhu, Yang Hu, Xuefeng Yang, Duo Li
Metabolic-associated fatty liver disease remains a prominent risk factor for many chronic diseases, including obesity, diabetes, cardiovascular disease, and cancer [16]. Moreover, MAFLD can progress to steatohepatitis or cirrhosis. However, there is no definite target and therapeutic mechanism for MAFLD. Single-cell sequencing has guiding significance for screening potential therapeutic targets and molecular mechanisms of MAFLD. In the present study, we conducted transcriptome profiling of 30,038 single cells, including hepatocytes and non-hepatocytes, from normal and steatosis adult mouse livers. Comparative analysis of hepatocytes and non-hepatocytes revealed significant heterogeneity, and non-hepatocytes acted as major cell communication hubs. Systematic analysis of cellular compositions and cell-cell interaction networks showed that hepatocyte metabolism was significantly correlated with changes in liver function. We also uncovered the active involvement of non-hepatocyte cells in regulating the behaviour of hepatocytes, exemplified by Kupffer cells, which could preserve liver function after steatosis.
Increased Risk of Hypertension in Alcohol Use Disorder of alcohol-related Liver disease-A Hospital Based Case Control Study
Published in Alcoholism Treatment Quarterly, 2023
Prabhudas Nelaturi, Sangeetha P Kademani, Vithiavathi Siva Subramanian, Sambandam Ravikumar
Non-alcohol-related fatty liver disease is a common cause of liver disease and is positively correlated with MetS (increased BMI, diabetes, etc.). Mortality in NAFLD is mainly related to cardiovascular complications. Patients with liver diseases (steatohepatitis and fibrosis) such as NAFLD reported an increased risk of developing CVD as an independent risk factor(Fracanzani et al., 2016; Sung, Ryan, & Wilson, 2009; Targher, Day, & Bonora, 2010). NAFLD has been characterized by abnormal liver adipose tissue deposition in the liver without hepatic fat accumulation. The disease ranges from simple steatosis to non-alcohol-related steatohepatitis and cirrhosis. A study reported that ectopic fat accumulation due to increased triglycerides and low-density lipoprotein cholesterol (LDL-C) leads to cardiovascular risk(Fotbolcu & Zorlu, 2016; Gaziano, Hennekens, O’Donnell, Breslow, & Buring, 1997).
Successful secukinumab treatment in focal segmental glomerulosclerosis associated with plaque psoriasis
Published in Renal Failure, 2022
Zhiqiang Cao, Zhaoyang Liu, Xia Zhu, Qinbo Yang, Qingqing Xu, Chunhong Zhang
The laboratory examinations were performed. 24-hour(h) urine protein quantification, 0.891 g/d [normal, 0–0.150]; uric acid, 491.0 μmo/L [normal, 142.8–339.2]. Except for urine protein 3+, erythrocyte, leukocyte, cast and crystal on urine analysis were normal. Renal function was normal, with creatinine at 50 μmoI/L [normal, 41–73], urea at 4.20 mmol/L [normal, 2.60–7.50], and albuminemia at 50.4 g/L [normal, 40.0–55.0]. The blood and stool routine, the aldosterone/renin concentration ratio, and glycosylated hemoglobin were all normal. Abdomen CT scan revealed fatty liver. Immunoglobulin (Ig) A level was mildly elevated at 4.39 g/L [normal, 0.7–4.0] and ANA was 1:100 positive. The GBM-IgG, anti-PLA2R, ANCA, anti-dsDNA, the serum complement, and the IgG, IgM values were within normal limits. Viral serologies for HIV, hepatitis B and C were negative. The kidney biopsy was performed on 19 December 2019. On light microscopy, it showed partial glomerular ischemia shrinkage, adhesion balloon in the affected segment, and interstitial inflammatory infiltration, glomerular podocyte swelling, mesangial matrix slightly expanded (Figure 2). The tubules showed a few erythrocyte and protein casts. Immunofluorescence was negative for IgG, IgA, C3 and C1q, only positive for IgM. Combining the medical history and pathology, the diagnosis of FSGS was considered first.