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Metabolic Effects of Exercise on Childhood Obesity
Published in Peter M. Tiidus, Rebecca E. K. MacPherson, Paul J. LeBlanc, Andrea R. Josse, The Routledge Handbook on Biochemistry of Exercise, 2020
Kristi B. Adamo, Taniya S. Nagpal, Danilo F. DaSilva
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children with obesity and is estimated to be present in one out of five Canadian children with overweight or obesity (48). The accumulation of fat in the liver can lead to increased inflammation and a more severe liver disease called non-alcoholic steatohepatitis (NASH). The development of NAFLD starts with excessive accumulation of triglycerides in the liver, followed by hepatic oxidative stress (i.e., high levels of reactive oxygen species [ROS]), lipid peroxidation, and finally hepatocyte damage (96). Although a liver biopsy is the gold standard for diagnosis and grading of NAFLD, biopsies are not routinely performed in children. Less invasive assessments, including blood tests for liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST], and gamma-glutamyl transferase [GGT]), and abdominal ultrasonography to measure intrahepatic fat, are more common. More costly examinations using proton magnetic resonance or magnetic resonance imaging can also be used.
The liver, gallbladder and pancreas
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Dina G. Tiniakos, Alastair D. Burt
A condition that is histologically similar to alcohol-related steatosis and steatohepatitis is increasingly encountered in obese patients; in such patient populations, there is a high incidence of type 2 diabetes mellitus and other features of the metabolic syndrome, a constellation of disorders related to adverse cardiovascular outcomes. Patients are usually discovered to have abnormal liver function tests, after blood testing for complaints of liver tenderness or tiredness without markers of other liver disease (viral, autoimmune, or drug induced). On imaging, they have evidence of fatty liver (‘bright liver’ on ultrasound). The underlying pathogenesis is thought to be related to an insulin-resistant state with oversupply of fatty acids, coupled with altered fatty acid metabolism. The accumulation of triglycerides in the fat droplets, leading to steatosis, is now considered an adaptive protective response, whereas lipotoxic metabolites of hepatocellular free fatty acids are considered major players in inducing steatohepatitis, the progressive form of non-alcoholic fatty liver disease that may lead to cirrhosis (Figure 11.11). Steatosis usually has a benign course but there are now well-documented instances of slow progression to cirrhosis. The importance of the condition is its increasing prevalence related to the obesity ‘epidemic’, its relationship to treatable or preventable conditions such as diabetes and obesity, and the necessity to ensure that patients are not falsely accused of secret excessive alcohol consumption and the attendant stigma associated with it.
Magnetic Resonance Imaging and CT Scanning in Colorectal Cancer
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Anuradha Chandramohan, Gina Brown
Complications and toxicities associated with the treatment of mCRC can be assessed using imaging. 5-Flurouracil based treatment is known to cause fatty liver, which appears as diffuse or patchy low attenuation of liver parenchyma on the CT scan. Liver metastases may be easily missed on CT scan in a background of fatty liver. The degree of fat deposition can be estimated using CT scan and chemical shift MRI. This information is important whilst planning major hepatic resection in order to ensure an adequate functional future liver remnant. Oxaliplatin induced sinusoidal liver injury presents with changes of portal hypertension and fibrosis. Both CT and MRI are useful in identifying such changes. Diagnosis of steatohepatitis is more challenging on CT and MRI and may appear as abnormal heterogeneous liver enhancement and diffusion restriction. Anti-VEGF agents like bevacizumab are associated with bowel and vascular complications. Bowel perforation is seen in 2% of patients being treated with bevacizumab, especially when there is residual tumour or peritoneal metastases and after recent colonoscopy or surgery. Similarly, pneumotosis intestinalis is a class specific toxicity seen in patients treated with anti-VEGF agents. Other complications seen in patients treated with bevacizumab include increased risk of thromboembolic complications, posterior reversible encephalopathy sysndrome (PRES) and acute acalculous cholecystitis. These can be diagnosed with CT and MRI.
Role of silymarin as antioxidant in clinical management of chronic liver diseases: a narrative review
Published in Annals of Medicine, 2022
Alessio Aghemo, Olga P. Alekseeva, Francesco Angelico, Igor G. Bakulin, Natalia V. Bakulina, Dmitry Bordin, Alexey O. Bueverov, Oxana M. Drapkina, Anton Gillessen, Elvira M. Kagarmanova, Natalia V. Korochanskaya, U. A. Kucheryavii, Leonid B. Lazebnik, Maria A. Livzan, Igor V. Maev, Anatolii I. Martynov, Marina F. Osipenko, Evgenii I. Sas, Antonina Starodubova, Yurii P. Uspensky, Elena V. Vinnitskaya, Emilia P. Yakovenko, Alexey A. Yakovlev
Chronic liver diseases (CLDs) are a major cause of global morbidity and mortality, including in the Russian Federation (RF) [1–4]. Several pathophysiological conditions, such as viral infections, alcoholism, genetic inheritance, metabolic abnormalities, autoimmune responses, biliary and vascular conditions, drugs, toxins, environmental pollutants, or even cryptogenic reasons, can lead to hepatic injury. If the injury persists for more than 6 months, it can be classified as CLD, which may eventually progress to cirrhosis or hepatocellular carcinoma (HCC). Progressive steatosis/steatohepatitis ultimately leads to fibrosis/cirrhosis, which can be caused by exogenous and endogenous factors, such as alcohol, which causes alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD) if alcohol was not involved. Steatosis/steatohepatitis can also be due to metabolic dysfunction or medication-induced, which are identified as metabolic-associated fatty liver disease (MAFLD) and drug-induced liver injury (DILI), respectively. In 90% of patients with NAFLD, at least one component of metabolic syndrome is evident, whereas up to 30% of patients with NAFLD show all the components of metabolic syndrome causing MAFLD [5–7].
Longitudinal evolution of catheter-related bloodstream infections, kidney function and liver status in a nationwide adult intestinal failure cohort
Published in Scandinavian Journal of Gastroenterology, 2022
Anne K. Pohju, Antti I. Hakkarainen, Mikko P. Pakarinen, Taina M. Sipponen
A subgroup of patients (n = 12) monitored in the gastroenterology clinic of Helsinki University Hospital had undergone more detailed imaging tests of the liver. Abdominal ultrasound revealed liver steatosis in eight patients, and gallstones in one patient. Transient elastography (TE; Fibroscan®; Echosens, Paris, France) suggested advanced fibrosis or cirrhosis (F3–F4) in five patients. Liver fat content (LFC) according to magnetic resonance spectroscopy (MRS) was increased (≥5.56%) in three patients. Liver biopsy was clinically indicated in three patients. Advanced fibrosis (Metavir classification F3 or F4) was present in two patients, and of these two, one had also moderate steatohepatitis. The third patient was diagnosed with mild steatohepatitis. Both patients with histologically confirmed advanced fibrosis had a TE result exceeding 10.3 kPa, suggestive of cirrhosis. The patient with moderate steatohepatitis had, according to MRS, an abnormal LFC, while LFC was normal in the patient with mild steatohepatitis.
Combined Amelioration of Prebiotic Resveratrol and Probiotic Bifidobacteria on Obesity and Nonalcoholic Fatty Liver Disease
Published in Nutrition and Cancer, 2021
Danhong Hu, Wenjuan Yang, Peijiang Mao, Minyu Cheng
In the last two decades, nonalcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver disease globally [1]. It was estimated in 2018 that about 25% of the world population has NAFLD. NAFLD is strongly associated with overweight or obesity. A recent analysis of studies involving more than 8.5 million person from 22 countries showed that more than 80% patients with NAFLD are overweight or obese. The WHO Global Health Observatory data in 2014 indicates that obesity occurs in 15% of women and 11% of men aged 18 and over globally [2]. However, there is no approved drug regimen to treat nonalcoholic steatohepatitis (NASH) until now. As a consequence of the lack of treatment and the growing global epidemic of obesity, the prevalence of NAFLD is likely to increase in the next few years. Thus, it is urgent to propose effective regimen to alleviated NAFLD and obesity.