37 results on '"Bellentani S"'
Search Results
2. Is there an association between commonly employed biomarkers of liver fibrosis and liver stiffness in the general population?
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Foschi F. G., Domenicali M., Giacomoni P., Dall'Aglio A. C., Conti F., Borghi A., Bevilacqua V., Napoli L., Mirici F., Cucchetti A., Ercolani G., Gardini A. C., Bellentani S., Gastaldelli A., Giuffre M., Tiribelli C., Bedogni G., BEDOGNI, GIORGIO, Foschi F.G., Domenicali M., Giacomoni P., Dall'Aglio A.C., Conti F., Borghi A., Bevilacqua V., Napoli L., Mirici F., Cucchetti A., Ercolani G., Gardini A.C., Bellentani S., Gastaldelli A., Giuffre M., Tiribelli C., and Bedogni G.
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Liver Cirrhosis ,Male ,Percentile ,Cross-sectional study ,Epidemiology ,Specialties of internal medicine ,Chronic liver disease ,Gastroenterology ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Medicine ,Metabolic Syndrome ,education.field_of_study ,Elasticity imaging technique ,Alanine Transaminase ,gamma-Glutamyltransferase ,General Medicine ,Middle Aged ,RC581-951 ,030220 oncology & carcinogenesis ,Elasticity Imaging Techniques ,Biomarker (medicine) ,Female ,030211 gastroenterology & hepatology ,Fatty Liver, Alcoholic ,Adult ,medicine.medical_specialty ,Population ,Liver fibrosis ,03 medical and health sciences ,Internal medicine ,BAAT ,Humans ,Clinical significance ,Aspartate Aminotransferases ,Obesity ,education ,Hepatology ,Platelet Count ,business.industry ,Cholesterol, HDL ,Cholesterol, LDL ,Biomarker ,Overweight ,medicine.disease ,business ,Transient elastography ,Biomarkers - Abstract
Introduction and objectives Surrogate biomarkers of liver fibrosis developed in tertiary care are increasingly used in general populations. We evaluated the association between liver stiffness (LS) and five continuous (AST/ALT, APRI, Forns Index, FIB-4, GGT) and two discrete biomarkers (BARD, BAAT) in a general population. Patients and methods 636 (29%) of the 2159 citizens of the Bagnacavallo Study had LS measured by transient elastography. Using linear regression with univariate multiple imputation, we evaluated the association of LS with the above biomarkers in the total sample of 2159 citizens. Results The mean change of LS between the 5th and 95th internal percentile of any continuous biomarker was ≤1 kPa. The mean change of LS between scores 0 and 3 of BARD and scores 0 and ≥3 of BAAT was >1 kPa but of doubtful clinical relevance. Conclusion We found a modest association between LS and seven biomarkers of liver fibrosis in a general population.
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- 2020
3. OC-14Fatty liver Index (FLI) 15 years later: a SANRA (Scale for the quality Assessment of Narrative Review Articles) reappraisal.
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Lonardo, A., primary, Ballestri, S., additional, Bedogni, G., additional, Bellentani, S., additional, and Tiribelli, C., additional
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- 2021
- Full Text
- View/download PDF
4. Could inflammatory indices and metabolic syndrome predict the risk of cancer development? Analysis from the bagnacavallo population study
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Rimini, M., Casadei-Gardini, A., Ravaioli, A., Rovesti, G., Conti, F., Borghi, A., Dall'Aglio, A. C., Bedogni, G., Domenicali, M., Giacomoni, P., Tiribelli, C., Bucchi, L., Falcini, F., Foschi, F. G., Gastaldelli, A., Ercolani, G., Cucchetti, A., Dazzani, F., Bevilacqua, V., Napoli, L., Mirici, F., Bellentani, S., Lanzi, A., Saini, G., Bernardi, M., Andreone, P., and Stefanini, G. F.
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Breast cancer ,Cancer incidence ,Colon cancer ,Inflammatory indices ,Lung cancer ,Metabolic Syndrome ,NLR ,PLR ,SII - Published
- 2020
5. External Validation of Surrogate Indices of Fatty Liver in the General Population: The Bagnacavallo Study
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Foschi, F. G., Conti, F., Domenicali, M., Giacomoni, P., Borghi, A., Bevilacqua, V., Napoli, L., Berardinelli, D., Altini, M., Cucchetti, A., Ercolani, G., Casadei-Gardini, A., Bellentani, S., Gastaldelli, A., Tiribelli, C., Bedogni, G., Andreone, P., Dall'Aglio, A. C., Bernardi, M., Bucchi, L., Dazzani, F., Falcini, F., Lanzi, A., Ravaioli, A., Rimini, M., Rovesti, G., Saini, G., Stefanini, G. F., Foschi, Francesco Giuseppe, Conti, Fabio, Domenicali, Marco, Giacomoni, Pierluigi, Borghi, Alberto, Bevilacqua, Vittoria, Napoli, Lucia, Berardinelli, Dante, Altini, Mattia, Cucchetti, Alessandro, Ercolani, Giorgio, Casadei-Gardini, Andrea, Bellentani, Stefano, Gastaldelli, Amalia, Tiribelli, Claudio, Bedogni, Giorgio, and Group, Bagnacavallo Study
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medicine.medical_specialty ,Validation study ,Calibration (statistics) ,Population ,lcsh:Medicine ,Gastroenterology ,Article ,diagnostic techniques and procedures ,03 medical and health sciences ,0302 clinical medicine ,Fatty liver ,Internal medicine ,Diagnostic techniques and procedures ,medicine ,cross-sectional study ,030212 general & internal medicine ,education ,Cross-sectional study ,fatty liver ,education.field_of_study ,business.industry ,lcsh:R ,fungi ,External validation ,non-alcoholic fatty liver disease ,General Medicine ,medicine.disease ,validation study ,diagnostic techniques and procedure ,030211 gastroenterology & hepatology ,Steatosis ,business ,Non-alcoholic fatty liver disease ,Lipid Accumulation Product - Abstract
We externally validated the fatty liver index (FLI), the lipid accumulation product (LAP), the hepatic steatosis index (HSI), and the Zhejiang University index (ZJU) for the diagnosis of fatty liver (FL) and non-alcoholic fatty liver disease (NAFLD) in the general population. The validation was performed on 2159 citizens of the town of Bagnacavallo (Ravenna, Italy). Calibration was evaluated by calculating the calibration slope and intercept and by inspecting calibration plots, discrimination was evaluated using the c-statistic. The average calibration slope was 1 and the average intercept was 0 for all combinations of outcomes and indices. For the diagnosis of FL, the c-statistic was 0.85 for FLI, 0.83 for ZJU, 0.82 for HSI, and 0.80 for LAP, for the diagnosis of NAFLD, the c-statistic was 0.77 for FLI, 0.76 for ZJU, 0.75 for HSI, and 0.74 for LAP. All indices were strongly correlated with each other. In conclusion, FLI, LAP, HSI, and ZJU perform similarly well to diagnose FL and NAFLD in the Bagnacavallo population, even if FLI has a small advantage as discrimination is concerned.
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- 2021
6. Cow’s Milk Consumption and Health: A Health Professional’s Guide
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Marangoni, F., Pellegrino, L., Verduci, E., Ghiselli, A., Bernabei, Roberto, Calvani, Riccardo, Cetin, I., Giampietro, M., Perticone, F., Piretta, L., Giacco, R., La Vecchia, C., Brandi, M. L., Ballardini, D., Banderali, G., Bellentani, S., Canzone, G., Cricelli, C., Faggiano, P., Ferrara, N., Flachi, E., Gonnelli, S., Macca, C., Magni, P., Marelli, G., Marrocco, W., Miniello, V. L., Origo, C., Pietrantonio, Filomena, Silvestri, P., Stella, R., Strazzullo, P., Troiano, E., Poli, A., Bernabei R. (ORCID:0000-0002-9197-004X), Calvani R. (ORCID:0000-0001-5472-2365), Pietrantonio F., Marangoni, F., Pellegrino, L., Verduci, E., Ghiselli, A., Bernabei, Roberto, Calvani, Riccardo, Cetin, I., Giampietro, M., Perticone, F., Piretta, L., Giacco, R., La Vecchia, C., Brandi, M. L., Ballardini, D., Banderali, G., Bellentani, S., Canzone, G., Cricelli, C., Faggiano, P., Ferrara, N., Flachi, E., Gonnelli, S., Macca, C., Magni, P., Marelli, G., Marrocco, W., Miniello, V. L., Origo, C., Pietrantonio, Filomena, Silvestri, P., Stella, R., Strazzullo, P., Troiano, E., Poli, A., Bernabei R. (ORCID:0000-0002-9197-004X), Calvani R. (ORCID:0000-0001-5472-2365), and Pietrantonio F.
- Abstract
The most recent scientific evidence supports the consumption of cow’s milk and dairy products as part of a balanced diet. However, these days, the public and practicing physicans are exposed to a stream of inconsistent (and often misleading) information regarding the relationship between cow’s milk intake and health in the lay press and in the media. The purpose of this article, in this context, is to facilitate doctor–patient communication on this topic, providing physicians with a series of structured answers to frequently asked patient questions. The answers range from milk and milk-derived products’ nutritional function across the life span, to their relationship with diseases such as osteoporosis and cancer, to lactose intolerance and milk allergy, and have been prepared by a panel of experts from the Italian medical and nutritional scientific community. When consumed according to appropriate national guidelines, milk and its derivatives contribute essential micro- and macronutrients to the diet, especially in infancy and childhood where bone mass growth is in a critical phase. Furthermore, preliminary evidence suggests potentially protective effects of milk against overweight, obesity, diabetes, and cardiovascular disease, while no clear data suggest a significant association between milk intake and cancer. Overall, current scientific literature suggests that an appropriate consumption of milk and its derivatives, according to available nutritional guidelines, may be beneficial across all age groups, with the exception of specific medical conditions such as lactose intolerance or milk protein allergy. Key teaching points: Milk and its derivatives contribute essential micro and macronutrients to the diet, when consumed according to appropriate national guidelines, especially in infancy and childhood where bone mass growth is in a critical phase. Preliminary evidence suggests potentially protective effects of milk against overweight, obesity, diabetes and cardio
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- 2019
7. Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference
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Munteanu, M., Tiniakos, D., Anstee, Q., Charlotte, F., Marchesini, G., Bugianesi, E., Trauner, M., Romero Gomez, M., Oliveira, C., Day, C., Dufour, J.‐F., Bellentani, S., Ngo, Y., Traussnig, S., Perazzo, H., Deckmyn, O., Bedossa, P., Ratziu, V., Poynard, T., Ratziu, Vlad, Poynard, Thierry, Castille, Jean‐Marie, Ngo, Yen, Langon, Tania, Day, Chris, Tiniakos, Dina, Lawlor, Debbie, Marchesini, Giulio, Marra, Fabio, Bugianesi, Elisabetta, Bellentani, Stefano, Dufour, Jean‐François, Romero Gomez, Manuel, Sørensen, Thorkild, Tribelli, Claudio, De Minicis, Samuele, Trauner, Michael, Oliveira, Claudia, Bedossa, Pierre, Burt, Alastair D., Gouw, Annette S.H., Lackner, Carolin, Schirmacher, Peter, Terracciano, Luigi, Brain, J., Bury, Yvonne, Cabibi, Daniela, Charlotte, Frederic, David, Ezio, Losi, Luisa, Montani, Matteo, Pareja, Marıa Jesus, Wendum, Dominique, Wrba, Fritz, Ziol, Marianne, Thabut, Dominique, Moussalli, Joseph, Lebray, Pascal, Rudler, Marika, Bismuth, Françoise Imbert, Rosmorduc, Olivier, Calmus, Yvon, Hartemann, Agnes, Jacqueminet, Sophie, Bruckert, Eric, Giral, Philippe, Naveau, Sylvie, Perlemuter, Gabriel, Varsat, Brigitte, Mercadier, Anne, Biopredictive, National and Kapodistrian University of Athens (NKUA), Newcastle University [Newcastle], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO), Università degli studi di Torino (UNITO), Medizinische Universität Wien = Medical University of Vienna, Universidad de Sevilla, University of São Paulo School of Medicine, Universität Bern [Bern], Università degli Studi di Modena e Reggio Emilia (UNIMORE), Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Beaujon, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), National and Kapodistrian University of Athens = University of Athens (NKUA | UoA), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], Università di Bologna [Bologna] (UNIBO), Hôpital Beaujon-Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Munteanu, M., Tiniakos, D., Anstee, Q., Charlotte, F., MARCHESINI REGGIANI, Giulio, Bugianesi, E., Trauner, M., Romero Gomez, M., Oliveira, C., Day, C., Dufour, J. F., Bellentani, S., Ngo, Y., Traussnig, S., Perazzo, H., Deckmyn, O., Bedossa, P., Ratziu, V., Poynard, T., Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Università degli studi di Torino = University of Turin (UNITO), Universidad de Sevilla / University of Sevilla, Universität Bern [Bern] (UNIBE), Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
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Liver Cirrhosis ,Male ,medicine.medical_specialty ,Biopsy ,610 Medicine & health ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Non-alcoholic Fatty Liver Disease ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Prospective Studies ,Stage (cooking) ,Prospective cohort study ,Grading (tumors) ,Inflammation ,Hematologic Tests ,Hepatology ,medicine.diagnostic_test ,business.industry ,FibroTest ,Fatty liver ,Middle Aged ,medicine.disease ,3. Good health ,Non‐invasive Tests of Nafld ,Fatty Liver ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Original Article ,Female ,Steatosis ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
the FLIP Consortium and the FibroFrance Group; International audience; BackgroundBlood tests of liver injury are less well validated in non-alcoholic fatty liver disease (NAFLD) than in patients with chronic viral hepatitis.AimsTo improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading.MethodsWe pre-included new NAFLD patients with biopsy and blood tests from a single-centre cohort (FibroFrance) and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis (SAF) score, which provides a reliable and reproducible diagnosis and grading/staging of the three elementary features of NAFLD (steatosis, inflammatory activity) and fibrosis with reduced interobserver variability. We used nonbinary-ROC (NonBinAUROC) as the main endpoint to prevent spectrum effect and multiple testing.ResultsA total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs (95% CI) of tests were all significant (P < 0.0001): 0.878 (0.864–0.892) for FibroTest and fibrosis stages, 0.846 (0.830–0.862) for ActiTest and activity grades, and 0.822 (0.804–0.840) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 0.820–0.852; P = 0.0001), FIB4 (0.845; 0.829–0.861; P = 0.007) but not significantly different than the NAFLD score (0.866; 0.850–0.882; P = 0.26). FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores (Bonferroni test P < 0.05).ConclusionsIn patients with NAFLD, SteatoTest, ActiTest and FibroTest are non-invasive tests that offer an alternative to biopsy, and they correlate with the simple grading/staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis.
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- 2016
8. AISF position paper on nonalcoholic fatty liver disease (NAFLD): Updates and future directions
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Lonardo, A., Nascimbeni, F., Targher, G., Bernardi, M., Bonino, F., Bugianesi, E., Casini, A., Gastaldelli, A., Marchesini, G., Marra, F., Miele, Luca, Morisco, F., Petta, S., Piscaglia, F., Svegliati-Baroni, G., Valenti, L., Bellentani, S., Miele L. (ORCID:0000-0003-3464-0068), Lonardo, A., Nascimbeni, F., Targher, G., Bernardi, M., Bonino, F., Bugianesi, E., Casini, A., Gastaldelli, A., Marchesini, G., Marra, F., Miele, Luca, Morisco, F., Petta, S., Piscaglia, F., Svegliati-Baroni, G., Valenti, L., Bellentani, S., and Miele L. (ORCID:0000-0003-3464-0068)
- Abstract
This review summarizes our current understanding of nonalcoholic fatty liver disease (NAFLD), a multi-factorial systemic disease resulting from a complex interaction between a specific genetic background and multiple environmental/metabolic “hits”. The role of gut microbiota, lipotoxicity, inflammation and their molecular pathways is reviewed in-depth. We also discuss the epidemiology and natural history of NAFLD by pinpointing the remarkably high prevalence of NAFLD worldwide and its inherent systemic complications: hepatic (steatohepatitis, advanced fibrosis and cirrhosis), cardio-metabolic (cardiovascular disease, cardiomyopathy, arrhythmias and type 2 diabetes) and neoplastic (primary liver cancers and extra-hepatic cancers). Moreover, we critically report on the diagnostic role of non-invasive biomarkers, imaging techniques and liver biopsy, which remains the reference standard for diagnosing the disease, but cannot be proposed to all patients with suspected NAFLD. Finally, the management of NAFLD is also reviewed, by highlighting the lifestyle changes and the pharmacological options, with a focus on the innovative drugs. We conclude that the results of ongoing studies are eagerly expected to lead to introduce into the clinical arena new diagnostic and prognostic biomarkers, prevention and surveillance strategies as well as to new drugs for a tailored approach to the management of NAFLD in the individual patient.
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- 2017
9. Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference
- Author
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Munteanu, M. Tiniakos, D. Anstee, Q. Charlotte, F. Marchesini, G. Bugianesi, E. Trauner, M. Romero Gomez, M. Oliveira, C. Day, C. Dufour, J.-F. Bellentani, S. Ngo, Y. Traussnig, S. Perazzo, H. Deckmyn, O. Bedossa, P. Ratziu, V. Poynard, T. Castille, J.-M. Langon, T. Lawlor, D. Marra, F. Sørensen, T. Tribelli, C. De Minicis, S. Burt, A.D. Gouw, A.S.H. Lackner, C. Schirmacher, P. Terracciano, L. Brain, J. Bury, Y. Cabibi, D. David, E. Losi, L. Montani, M. Pareja, M.J. Wendum, D. Wrba, F. Ziol, M. Thabut, D. Moussalli, J. Lebray, P. Rudler, M. Bismuth, F.I. Rosmorduc, O. Calmus, Y. Hartemann, A. Jacqueminet, S. Bruckert, E. Giral, P. Naveau, S. Perlemuter, G. Varsat, B. Mercadier, A. the FLIP Consortium the FibroFrance Group
- Abstract
Background: Blood tests of liver injury are less well validated in non-alcoholic fatty liver disease (NAFLD) than in patients with chronic viral hepatitis. Aims: To improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading. Methods: We pre-included new NAFLD patients with biopsy and blood tests from a single-centre cohort (FibroFrance) and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis (SAF) score, which provides a reliable and reproducible diagnosis and grading/staging of the three elementary features of NAFLD (steatosis, inflammatory activity) and fibrosis with reduced interobserver variability. We used nonbinary-ROC (NonBinAUROC) as the main endpoint to prevent spectrum effect and multiple testing. Results: A total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs (95% CI) of tests were all significant (P < 0.0001): 0.878 (0.864–0.892) for FibroTest and fibrosis stages, 0.846 (0.830–0.862) for ActiTest and activity grades, and 0.822 (0.804–0.840) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 0.820–0.852; P = 0.0001), FIB4 (0.845; 0.829–0.861; P = 0.007) but not significantly different than the NAFLD score (0.866; 0.850–0.882; P = 0.26). FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores (Bonferroni test P < 0.05). Conclusions: In patients with NAFLD, SteatoTest, ActiTest and FibroTest are non-invasive tests that offer an alternative to biopsy, and they correlate with the simple grading/staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis. © 2016 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd
- Published
- 2016
10. Missed treatment in an Italian HBV infected patients cohort: HBV RER
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Cuomo, Gianluca, primary, Borghi, Vanni, additional, Andreone, Pietro, additional, Massari, Marco, additional, Villa, Erica, additional, Pietrangelo, Antonello, additional, Verucchi, Gabriella, additional, Ferrari, Carlo, additional, Ferrari, C., additional, Giuberti, T., additional, Villa, E., additional, Andreone, P., additional, Pietrangelo, A., additional, Abbati, G., additional, Magnani, G., additional, Massari, M., additional, Verucchi, G., additional, Cancellieri, C., additional, Ricca Rosellini, S., additional, Levantesi, F., additional, Mazzella, G., additional, Sacchini, D., additional, Fornaciari, G., additional, Mussini, C., additional, Borghi, V., additional, Foschi, F., additional, Libanore, M., additional, Carradori, S.D., additional, Contini, C., additional, Ballardini, G., additional, Macchia, S., additional, Boccia, S., additional, Vandelli, C., additional, Bassi, P., additional, Zanotti, M., additional, Loria, P., additional, Sbolli, G., additional, Fornari, F., additional, di Maira, P.V., additional, Bellentani, S., additional, Arlotti, M., additional, Grosso, C., additional, Bolondi, G., additional, Pazzi, P., additional, Mazzocchi, A., additional, Govoni, A., additional, Fusaroli, P., additional, Giacomoni, P.L., additional, Lenzi, M., additional, and Pedretti, G., additional
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- 2016
- Full Text
- View/download PDF
11. A 'systems medicine' approach to the study of non-alcoholic fatty liver disease
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Petta, S, Valenti, L, Bugianesi, E, Targher, G, GRIECO, ANTONIO, Bonino, F, Bellentani, S, Special Interest Group on Personalised Hepatology of the Italian Association for the Study of the Liver (AISF), Petta, S, Valenti, L, Bugianesi, E, Targher, G, GRIECO, ANTONIO, Bonino, F, Bellentani, S, and Special Interest Group on Personalised Hepatology of the Italian Association for the Study of the Liver (AISF)
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- 2015
12. Epidemiological modifiers of non-alcoholic fatty liver disease: Focus on high-risk groups
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Lonardo, A., Bellentani, S., Argo, C. K., Ballestri, S., Byrne, C. D., Caldwell, S. H., Cortez-Pinto, H., Grieco, Antonio, Machado, M. V., Miele, Luca, Targher, G., Grieco A. (ORCID:0000-0002-0544-8993), Miele L. (ORCID:0000-0003-3464-0068), Lonardo, A., Bellentani, S., Argo, C. K., Ballestri, S., Byrne, C. D., Caldwell, S. H., Cortez-Pinto, H., Grieco, Antonio, Machado, M. V., Miele, Luca, Targher, G., Grieco A. (ORCID:0000-0002-0544-8993), and Miele L. (ORCID:0000-0003-3464-0068)
- Abstract
An improved understanding of non-alcoholic fatty liver disease epidemiology would lead to identification of individuals at high risk of developing chronic liver disease and extra-hepatic complications, thus contributing to more effective case finding of non-alcoholic fatty liver disease among selected groups.We aimed to illustrate the epidemiology of non-alcoholic fatty liver disease in high-risk groups, which were identified based on existing literature. To this end, PubMed was searched to retrieve original articles published until May 2015 using relevant and pertinent keywords "nonalcoholic fatty liver disease" and "diabetes", "obesity", "hyperlipidaemia", "familial heterozygous hypobetalipoproteinaemia", "hypertension", "metabolic syndrome", "ethnicity", "family history" or "genetic polymorphisms".We found that age, sex and ethnicity are major physiological modifiers of the risk of non-alcoholic fatty liver disease, along with belonging to "non-alcoholic fatty liver disease families" and carrying risk alleles for selected genetic polymorphisms. Metabolic syndrome, diabetes, obesity, mixed hyperlipidaemia and hypocholesterolaemia due to familial hypobetalipoproteinaemia are the major metabolic modifiers of non-alcoholic fatty liver disease risk. Compared with these metabolic conditions, however, arterial hypertension appears to carry a relatively more modest risk of non-alcoholic fatty liver disease.A better understanding of the epidemiology of non-alcoholic fatty liver disease may result in a more liberal policy of case finding among high-risk groups.
- Published
- 2015
13. P0340 : Clinical patterns of hepatocellular carcinoma (HCC) in non alcoholic fatty liver disease (NAFLD): A multicenter case-control study
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Piscaglia, F., primary, Svegliati Baroni, G., additional, Barchetti, A., additional, Pecorelli, A., additional, Marinelli, S., additional, Tiribelli, C., additional, Bellentani, S., additional, Bolondi, L., additional, Zoli, M., additional, Trevisani, F., additional, Malagotti, D., additional, Bugianesi, E., additional, Vanni, E., additional, Mezzabotta, L., additional, Cabibbo, G., additional, Petta, S., additional, Fracanzani, A., additional, Fargion, S., additional, Marra, F., additional, Fani, B., additional, Sacco, R., additional, Morisco, F., additional, Caporaso, F., additional, and Guarino, M., additional
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- 2015
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- View/download PDF
14. Clinical patterns of hepatocellular carcinoma (HCC) in non alcoholic fatty liver disease (NAFLD): a multicenter case-control study
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Piscaglia, F., primary, Baroni, G. Svegliati, additional, Barchetti, A., additional, Pecorelli, A., additional, Marinelli, S., additional, Tiribelli, C., additional, Bellentani, S., additional, Bolondi, L., additional, Zoli, M., additional, Malagotti, D., additional, Brandi, G., additional, Bugianesi, E., additional, Vanni, E., additional, Mezzabotta, L., additional, Cabibbo, G., additional, Petta, S., additional, Fracanzani, A., additional, Fargion, S., additional, Marra, F., additional, Fani, B., additional, Sacco, R., additional, Morisco, F., additional, Caporaso, N., additional, Guarino, M., additional, Colombo, M., additional, D’Ambrosio, R., additional, Crocè, L.S., additional, Patti, R., additional, Giannini, E., additional, Lonardo, A., additional, Baldelli, E., additional, Miele, L., additional, Grieco, A., additional, Farinati, F., additional, Pozzan, C., additional, Borzio, M., additional, Dionigi, E., additional, Soardo, G., additional, Roselli, P., additional, Ciccarese, F., additional, Virdone, F., additional, Affronti, A., additional, Foschi, F.G., additional, Borzio, F., additional, and Trevisani, F., additional
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- 2015
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15. A 'systems medicine' approach to the study of non-alcoholic fatty liver disease
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Giovanni Targher, Maurizia Rossana Brunetto, Gianluca Svegliati Baroni, Fabio Nascimbeni, Anna Prinster, Luca Valenti, Ele Ferrannini, Stefano Taddei, Elisabetta Bugianesi, Fabio Marra, Silvia Fargion, Carmela Loguercio, Stefano Ballestri, Loreta A. Kondili, Stefano Vella, Salvatore Petta, Luca Miele, Antonio Grieco, Ester Vanni, Dante Romagnoli, Valerio Nobili, Federico Alessandro, Ferruccio Bonino, Marcello Mancini, Stefano Bellentani, Barbara Coco, Amedeo Lonardo, Petta, S, Valenti, L, Bugianesi, E, Targher, G, Bellentani, S, Bonino, F, Ferrannini, E, Loguercio, Carmelina, Lonardo, A, Marra, F, Mancini, M, Miele, L, Nobili, V, Baroni, G, Federico, Alessandro, Ballestri, S, Rossana Brunetto, M, Coco, B, Grieco, A, Fargion, S, Kondili, L, Nascimbeni, F, Prinster, A, Romagnoli, D, Taddei, S, Vanni, E, Vella, S., Petta, S., Valenti, L., Bugianesi, E., Targher, G., Bellentani, S., and Bonino, F.
- Subjects
0301 basic medicine ,Pathology ,medicine.medical_specialty ,Fatty liver ,Medicine ,NAFLD ,NASH ,Personalized ,Systems medicine ,Gastroenterology ,Hepatology ,Systems Analysis ,Systems biology ,Population ,Disease ,Bioinformatics ,03 medical and health sciences ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Risk Factors ,Internal medicine ,medicine ,Humans ,education ,Disease Progression ,Phenotype ,Systems Biology ,Medicine (all) ,education.field_of_study ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,medicine.disease ,Clinical trial ,030104 developmental biology ,030211 gastroenterology & hepatology ,Steatosis ,business - Abstract
a b s t r a c t The prevalence of fatty liver (steatosis) in the general population is rapidly increasing worldwide. The progress of knowledge in the physiopathology of fatty liver is based on the systems biology approach to studying the complex interactions among different physiological systems. Similarly, translational and clinical research should address the complex interplay between these systems impacting on fatty liver. The clinical needs drive the applications of systems medicine to re-define clinical phenotypes, assessing the multiple nature of disease susceptibility and progression (e.g. the definition of risk, prognosis, diag- nosis criteria, and new endpoints of clinical trials). Based on this premise and in light of recent findings, the complex mechanisms involved in the pathology of fatty liver and their impact on the short- and long- term clinical outcomes of cardiovascular, metabolic liver diseases associated with steatosis are presented in this review using a new "systems medicine" approach. A new data set is proposed for studying the impairments of different physiological systems that have an impact on fatty liver in different subsets of subjects and patients.
- Published
- 2015
16. AISF position paper on nonalcoholic fatty liver disease (NAFLD): Updates and future directions
- Author
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Giovanni Targher, Salvatore Petta, Ferruccio Bonino, Luca Valenti, Filomena Morisco, Luca Miele, Fabio Piscaglia, Amalia Gastaldelli, Amedeo Lonardo, Stefano Bellentani, Giulio Marchesini, Alessandro Casini, Elisabetta Bugianesi, Fabio Marra, Fabio Nascimbeni, Mauro Bernardi, Gianluca Svegliati-Baroni, Lonardo, Amedeo, Nascimbeni, Fabio, Targher, Giovanni, Bernardi, Mauro, Bonino, Ferruccio, Bugianesi, Elisabetta, Casini, Alessandro, Gastaldelli, Amalia, Marchesini, Giulio, Marra, Fabio, Miele, Luca, Morisco, Filomena, Petta, Salvatore, Piscaglia, Fabio, Svegliati Baroni, Gianluca, Valenti, Luca, Bellentani, Stefano, Lonardo, A, Nascimbeni, F, Targher, G, Bernardi, M, Bonino, F, Bugianesi, E, Casini, A, Gastaldelli, A, Marchesini, G, Marra, F, Miele, L, Morisco, F, Petta, S, Piscaglia, F, Svegliati-Baroni, G, Valenti, L, Bellentani, S., Lonardo, A., Nascimbeni, F., Targher, G., Bernardi, M., Bonino, F., Bugianesi, E., Casini, A., Gastaldelli, A., Marchesini, G., Marra, F., Miele, L., Morisco, F., Petta, S., Piscaglia, F., Svegliati-Baroni, G., and Valenti, L.
- Subjects
0301 basic medicine ,Diagnostic Imaging ,Liver Cirrhosis ,medicine.medical_specialty ,Cirrhosis ,Epidemiology ,Settore MED/12 - GASTROENTEROLOGIA ,Physiopathology ,Natural history ,Type 2 diabetes ,Disease ,Diagnosis ,Genetics ,Management ,Bioinformatics ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Genetic ,Non-alcoholic Fatty Liver Disease ,Internal medicine ,Nonalcoholic fatty liver disease ,medicine ,Humans ,medicine.diagnostic_test ,Hepatology ,business.industry ,Liver Neoplasms ,medicine.disease ,030104 developmental biology ,Lipotoxicity ,Diabetes Mellitus, Type 2 ,Liver ,Cardiovascular Diseases ,Liver biopsy ,030211 gastroenterology & hepatology ,Steatohepatitis ,business ,Biomarkers ,Diagnosi - Abstract
This review summarizes our current understanding of nonalcoholic fatty liver disease (NAFLD), a multi-factorial systemic disease resulting from a complex interaction between a specific genetic background and multiple environmental/metabolic “hits”. The role of gut microbiota, lipotoxicity, inflammation and their molecular pathways is reviewed in-depth. We also discuss the epidemiology and natural history of NAFLD by pinpointing the remarkably high prevalence of NAFLD worldwide and its inherent systemic complications: hepatic (steatohepatitis, advanced fibrosis and cirrhosis), cardio-metabolic (cardiovascular disease, cardiomyopathy, arrhythmias and type 2 diabetes) and neoplastic (primary liver cancers and extra-hepatic cancers). Moreover, we critically report on the diagnostic role of non-invasive biomarkers, imaging techniques and liver biopsy, which remains the reference standard for diagnosing the disease, but cannot be proposed to all patients with suspected NAFLD. Finally, the management of NAFLD is also reviewed, by highlighting the lifestyle changes and the pharmacological options, with a focus on the innovative drugs. We conclude that the results of ongoing studies are eagerly expected to lead to introduce into the clinical arena new diagnostic and prognostic biomarkers, prevention and surveillance strategies as well as to new drugs for a tailored approach to the management of NAFLD in the individual patient.
- Published
- 2017
17. Natural history of nonalcoholic steatohepatitis–associated hepatocellular carcinoma
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Stefano Bellentani M.D., Gianluca Svegliati Baroni, Claudio Tiribelli, Fabio Piscaglia, Bellentani S., Baroni G.S., Piscaglia F., and Tiribelli C.
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Nonalcoholic steatohepatitis ,medicine.medical_specialty ,Hepatology ,business.industry ,MEDLINE ,Reviews ,medicine.disease ,Gastroenterology ,Natural history ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,business ,hepatocellular carcinoma, nonalcoholic steatohepatitis - Abstract
No abstract available
- Published
- 2016
18. Nutraceutical Approach to Non-Alcoholic Fatty Liver Disease (NAFLD): The Available Clinical Evidence
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Arrigo F G Cicero, Stefano Bellentani, Alessandro Colletti, and Cicero AF, Colletti A, Bellentani S
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Cirrhosis ,Berberine ,Ubiquinone ,medicine.medical_treatment ,Salvia miltiorrhiza ,Review ,Xanthophylls ,Gastroenterology ,Antioxidants ,chemistry.chemical_compound ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Vitamin E ,Vitamin D ,Randomized Controlled Trials as Topic ,nutraceuticals ,chemistry.chemical_classification ,education.field_of_study ,Nutrition and Dietetics ,Fatty liver ,Observational Studies as Topic ,030220 oncology & carcinogenesis ,Fatty Acids, Unsaturated ,030211 gastroenterology & hepatology ,nutraceutical ,lcsh:Nutrition. Foods and food supply ,Silymarin ,Polyunsaturated fatty acid ,medicine.medical_specialty ,Curcumin ,Population ,lcsh:TX341-641 ,digestive system ,dietary supplements ,03 medical and health sciences ,Meta-Analysis as Topic ,NAFLD ,Internal medicine ,Fatty Acids, Omega-3 ,medicine ,Vitamin D and neurology ,Humans ,Obesity ,education ,Coenzyme Q10 ,clinical trials ,Plant Extracts ,business.industry ,Probiotics ,nutritional and metabolic diseases ,medicine.disease ,digestive system diseases ,chemistry ,Resveratrol ,dietary supplement ,Steatohepatitis ,business ,Food Science - Abstract
Non-alcoholic fatty liver disease (NAFLD) is a clinical condition characterized by lipid infiltration of the liver, highly prevalent in the general population affecting 25% of adults, with a doubled prevalence in diabetic and obese patients. Almost 1/3 of NAFLD evolves in Non-Alcoholic SteatoHepatitis (NASH), and this can lead to fibrosis and cirrhosis of the liver. However, the main causes of mortality of patients with NAFLD are cardiovascular diseases. At present, there are no specific drugs approved on the market for the treatment of NAFLD, and the treatment is essentially based on optimization of lifestyle. However, some nutraceuticals could contribute to the improvement of lipid infiltration of the liver and of the related anthropometric, haemodynamic, and/or biochemical parameters. The aim of this paper is to review the available clinical data on the effect of nutraceuticals on NAFLD and NAFLD-related parameters. Relatively few nutraceutical molecules have been adequately studied for their effects on NAFLD. Among these, we have analysed in detail the effects of silymarin, vitamin E, vitamin D, polyunsaturated fatty acids of the omega-3 series, astaxanthin, coenzyme Q10, berberine, curcumin, resveratrol, extracts of Salvia milthiorriza, and probiotics. In conclusion, Silymarin, vitamin E and vitamin D, polyunsaturated fatty acids of the omega-3 series, coenzyme Q10, berberine and curcumin, if well dosed and administered for medium–long periods, and associated to lifestyle changes, could exert positive effects on NAFLD and NAFLD-related parameters.
- Published
- 2018
19. Nonalcoholic fatty liver disease burden - Switzerland 2018-2030.
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Goossens N, Bellentani S, Cerny A, Dufour JF, Jornayvaz FR, Mertens J, Moriggia A, Muellhaupt B, Negro F, Razavi H, Semela D, and Estes C
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Female, Humans, Male, Markov Chains, Middle Aged, Obesity enzymology, Switzerland epidemiology, Young Adult, Non-alcoholic Fatty Liver Disease complications, Non-alcoholic Fatty Liver Disease epidemiology, Obesity complications
- Abstract
As a result of epidemic levels of obesity and diabetes mellitus, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) will contribute to increases in the liver-related disease burden in Switzerland. A Markov model was built to quantify fibrosis progression among the NAFLD and NASH populations, and predict disease burden up to 2030. Long-term trending of NAFLD prevalence was based on changes in the prevalence of adult obesity. Published estimates and surveillance data were applied to build and validate the model projections. The prevalence of NAFLD increased up to 2030 in tandem with projected increases in adult obesity. By 2030, there were an estimated 2,234,000 (1,918,000–2,553,000) NAFLD cases, or 24.3% (20.9–27.8%) of the total Swiss population (all ages). Increases in NASH cases were relatively greater than NAFLD cases. Incident cases of advanced liver disease are projected to increase by approximately 40% by 2030, and incident NAFLD liver deaths to increase from 580 deaths in 2018 to 820 deaths in 2030. Continued growth in obesity, in combination with an aging population, will result in increasing number of cases of advanced liver disease and mortality related to NAFLD and NASH. Slowing the growth in obesity and metabolic syndrome, along with future potential therapies, are required to reduce liver disease burden.  .
- Published
- 2019
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20. Cow's Milk Consumption and Health: A Health Professional's Guide.
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Marangoni F, Pellegrino L, Verduci E, Ghiselli A, Bernabei R, Calvani R, Cetin I, Giampietro M, Perticone F, Piretta L, Giacco R, La Vecchia C, Brandi ML, Ballardini D, Banderali G, Bellentani S, Canzone G, Cricelli C, Faggiano P, Ferrara N, Flachi E, Gonnelli S, Macca C, Magni P, Marelli G, Marrocco W, Miniello VL, Origo C, Pietrantonio F, Silvestri P, Stella R, Strazzullo P, Troiano E, and Poli A
- Subjects
- Animals, Cattle, Food Hypersensitivity, Humans, Diet, Milk, Nutritive Value
- Abstract
The most recent scientific evidence supports the consumption of cow's milk and dairy products as part of a balanced diet. However, these days, the public and practicing physicans are exposed to a stream of inconsistent (and often misleading) information regarding the relationship between cow's milk intake and health in the lay press and in the media. The purpose of this article, in this context, is to facilitate doctor-patient communication on this topic, providing physicians with a series of structured answers to frequently asked patient questions. The answers range from milk and milk-derived products' nutritional function across the life span, to their relationship with diseases such as osteoporosis and cancer, to lactose intolerance and milk allergy, and have been prepared by a panel of experts from the Italian medical and nutritional scientific community. When consumed according to appropriate national guidelines, milk and its derivatives contribute essential micro- and macronutrients to the diet, especially in infancy and childhood where bone mass growth is in a critical phase. Furthermore, preliminary evidence suggests potentially protective effects of milk against overweight, obesity, diabetes, and cardiovascular disease, while no clear data suggest a significant association between milk intake and cancer. Overall, current scientific literature suggests that an appropriate consumption of milk and its derivatives, according to available nutritional guidelines, may be beneficial across all age groups, with the exception of specific medical conditions such as lactose intolerance or milk protein allergy. Key teaching points: Milk and its derivatives contribute essential micro and macronutrients to the diet, when consumed according to appropriate national guidelines, especially in infancy and childhood where bone mass growth is in a critical phase. Preliminary evidence suggests potentially protective effects of milk against overweight, obesity, diabetes and cardiovascular disease No clear data are available about the association between milk intake and cancer. Current scientific literature suggests that an appropriate consumption of milk and its derivatives may be beneficial at all ages, with the exception of specific medical conditions such as lactose intolerance or milk protein allergy.
- Published
- 2019
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21. Prevalence of and risk factors for fatty liver in the general population of Northern Italy: the Bagnacavallo Study.
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Foschi FG, Bedogni G, Domenicali M, Giacomoni P, Dall'Aglio AC, Dazzani F, Lanzi A, Conti F, Savini S, Saini G, Bernardi M, Andreone P, Gastaldelli A, Casadei Gardini A, Tiribelli C, Bellentani S, and Stefanini GF
- Subjects
- Adult, Alanine Transaminase blood, Anthropometry, Aspartate Aminotransferases blood, Cross-Sectional Studies, Fatty Liver diagnostic imaging, Fatty Liver enzymology, Fatty Liver, Alcoholic epidemiology, Female, Humans, Italy epidemiology, Liver diagnostic imaging, Liver enzymology, Male, Middle Aged, Non-alcoholic Fatty Liver Disease epidemiology, Prevalence, Risk Factors, Ultrasonography, Fatty Liver epidemiology
- Abstract
Background: The estimation of the burden of disease attributable to fatty liver requires studies performed in the general population., Methods: The Bagnacavallo Study was performed between October 2005 and March 2009. All the citizens of Bagnacavallo (Ravenna, Italy) aged 30 to 60 years as of January 2005 were eligible. Altered liver enzymes were defined as alanine transaminase > 40 U/l and/or aspartate transaminase > 37 U/l., Results: Four thousand and thirty-three (58%) out of 6920 eligible citizens agreed to participate and 3933 (98%) had complete data. 393 (10%) of the latter had altered liver enzymes and 3540 had not. After exclusion of subjects with HBV or HCV infection, liver ultrasonography was available for 93% of subjects with altered liber enzymes and 52% of those with normal liver enzymes. The prevalence of fatty liver, non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD) was 0.74 (95%CI 0.70 to 0.79) vs. 0.35 (0.33 to 0.37), 0.46 (0.41 to 0.51) vs. 0.22 (0.21 to 0.24) and 0.28 (0.24 to 0.33) vs. 0.13 (0.11 to 0.14) in citizens with than in those without altered liver enzymes. Ethanol intake was not associated and all the components of the metabolic syndrome (MS) were associated with fatty liver. All potential risk factors were associated with a lower odds of normal liver vs. NAFLD while they were unable to discriminate AFLD from NAFLD., Conclusions: Fatty liver as a whole was highly prevalent in Bagnacavallo in 2005/9 and was more common among citizens with altered liver enzymes.
- Published
- 2018
- Full Text
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22. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030.
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Estes C, Anstee QM, Arias-Loste MT, Bantel H, Bellentani S, Caballeria J, Colombo M, Craxi A, Crespo J, Day CP, Eguchi Y, Geier A, Kondili LA, Kroy DC, Lazarus JV, Loomba R, Manns MP, Marchesini G, Nakajima A, Negro F, Petta S, Ratziu V, Romero-Gomez M, Sanyal A, Schattenberg JM, Tacke F, Tanaka J, Trautwein C, Wei L, Zeuzem S, and Razavi H
- Subjects
- China epidemiology, Cost of Illness, Diabetes Mellitus, Type 2 epidemiology, Humans, Liver Diseases etiology, Markov Chains, Models, Theoretical, Non-alcoholic Fatty Liver Disease complications, Non-alcoholic Fatty Liver Disease economics, Obesity epidemiology, Prevalence, Time Factors, Non-alcoholic Fatty Liver Disease epidemiology
- Abstract
Background & Aims: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are increasingly a cause of cirrhosis and hepatocellular carcinoma globally. This burden is expected to increase as epidemics of obesity, diabetes and metabolic syndrome continue to grow. The goal of this analysis was to use a Markov model to forecast NAFLD disease burden using currently available data., Methods: A model was used to estimate NAFLD and NASH disease progression in eight countries based on data for adult prevalence of obesity and type 2 diabetes mellitus (DM). Published estimates and expert consensus were used to build and validate the model projections., Results: If obesity and DM level off in the future, we project a modest growth in total NAFLD cases (0-30%), between 2016-2030, with the highest growth in China as a result of urbanization and the lowest growth in Japan as a result of a shrinking population. However, at the same time, NASH prevalence will increase 15-56%, while liver mortality and advanced liver disease will more than double as a result of an aging/increasing population., Conclusions: NAFLD and NASH represent a large and growing public health problem and efforts to understand this epidemic and to mitigate the disease burden are needed. If obesity and DM continue to increase at current and historical rates, both NAFLD and NASH prevalence are expected to increase. Since both are reversible, public health campaigns to increase awareness and diagnosis, and to promote diet and exercise can help manage the growth in future disease burden., Lay Summary: Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis can lead to advanced liver disease. Both conditions are becoming increasingly prevalent as the epidemics of obesity and diabetes continue to increase. A mathematical model was built to understand how the disease burden associated with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis will change over time. Results suggest increasing cases of advanced liver disease and liver-related mortality in the coming years., (Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
23. Nutraceutical Approach to Non-Alcoholic Fatty Liver Disease (NAFLD): The Available Clinical Evidence.
- Author
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Cicero AFG, Colletti A, and Bellentani S
- Subjects
- Antioxidants pharmacology, Berberine pharmacology, Curcumin pharmacology, Fatty Acids, Omega-3 pharmacology, Fatty Acids, Unsaturated pharmacology, Humans, Meta-Analysis as Topic, Obesity therapy, Observational Studies as Topic, Plant Extracts pharmacology, Probiotics administration & dosage, Randomized Controlled Trials as Topic, Resveratrol pharmacology, Salvia miltiorrhiza chemistry, Silymarin pharmacology, Ubiquinone analogs & derivatives, Ubiquinone pharmacology, Vitamin D pharmacology, Vitamin E pharmacology, Xanthophylls pharmacology, Dietary Supplements, Non-alcoholic Fatty Liver Disease therapy
- Abstract
Non-alcoholic fatty liver disease (NAFLD) is a clinical condition characterized by lipid infiltration of the liver, highly prevalent in the general population affecting 25% of adults, with a doubled prevalence in diabetic and obese patients. Almost 1/3 of NAFLD evolves in Non-Alcoholic SteatoHepatitis (NASH), and this can lead to fibrosis and cirrhosis of the liver. However, the main causes of mortality of patients with NAFLD are cardiovascular diseases. At present, there are no specific drugs approved on the market for the treatment of NAFLD, and the treatment is essentially based on optimization of lifestyle. However, some nutraceuticals could contribute to the improvement of lipid infiltration of the liver and of the related anthropometric, haemodynamic, and/or biochemical parameters. The aim of this paper is to review the available clinical data on the effect of nutraceuticals on NAFLD and NAFLD-related parameters. Relatively few nutraceutical molecules have been adequately studied for their effects on NAFLD. Among these, we have analysed in detail the effects of silymarin, vitamin E, vitamin D, polyunsaturated fatty acids of the omega-3 series, astaxanthin, coenzyme Q10, berberine, curcumin, resveratrol, extracts of Salvia milthiorriza , and probiotics. In conclusion, Silymarin, vitamin E and vitamin D, polyunsaturated fatty acids of the omega-3 series, coenzyme Q10, berberine and curcumin, if well dosed and administered for medium⁻long periods, and associated to lifestyle changes, could exert positive effects on NAFLD and NAFLD-related parameters.
- Published
- 2018
- Full Text
- View/download PDF
24. Two drinks per day does not take your fatty liver away.
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Bellentani S, Bedogni G, and Tiribelli C
- Subjects
- Food, Humans, Carbonated Beverages, Fatty Liver
- Published
- 2018
- Full Text
- View/download PDF
25. Viewpoint: "Alcohol Consumption in Late Adolescence is Associated with an Increased Risk of Severe Liver Disease Later in Life".
- Author
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Tamburello A, Marando M, and Bellentani S
- Subjects
- Adolescent, Adult, Humans, Male, Prospective Studies, Alcohol Drinking, Liver Diseases
- Abstract
Drinking alcohol during adolescence predispose to severe liver disease in the adult phase. This is the main message of this prospective study. Each daily gram of alcohol men consumed in their youth was linked with a two percent increase in the risk of severe liver disease. No threshold level emerged for liver damage and this is a warning for all the sociologists and politics. New legiferation and educational campaigns addressed to young people, with particular attention to the access to alcohol, prices and advertising are necessary.
- Published
- 2018
- Full Text
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26. Global epidemiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: What we need in the future.
- Author
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Araújo AR, Rosso N, Bedogni G, Tiribelli C, and Bellentani S
- Subjects
- Biomarkers, Biopsy, Needle, Disease Progression, Global Health, Humans, Prevalence, Risk Factors, Ultrasonography, Cost of Illness, Non-alcoholic Fatty Liver Disease diagnostic imaging, Non-alcoholic Fatty Liver Disease epidemiology
- Abstract
The estimated prevalence of non-alcoholic fatty liver disease (NAFLD) worldwide is approximately 25%. However, the real prevalence of NAFLD and the associated disorders is unknown mainly because reliable and applicable diagnostic tests are lacking. This is further complicated by the lack of consensus on the terminology of different entities such as NAFLD or nonalcoholic steatohepatitis (NASH). Although assessing fatty infiltration in the liver is simple by ultrasound, the gold standard for the assessment of fibrosis, the only marker of progression towards more severe liver disease is still liver biopsy. Although other non-invasive tests have been proposed, they must still be validated in large series. Because NAFL/NAFLD/NASH and related metabolic diseases represent an economic burden, finding an inexpensive method to diagnose and stage fatty liver is a priority. A translational approach with the use of cell and/or animal models could help to reach this goal., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2018
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27. Is it time to change NAFLD and NASH nomenclature?
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Bellentani S and Tiribelli C
- Subjects
- Humans, Non-alcoholic Fatty Liver Disease classification, Terminology as Topic
- Published
- 2017
- Full Text
- View/download PDF
28. Microbiota, NASH, HCC and the potential role of probiotics.
- Author
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Brandi G, De Lorenzo S, Candela M, Pantaleo MA, Bellentani S, Tovoli F, Saccoccio G, and Biasco G
- Subjects
- Carcinoma, Hepatocellular pathology, Humans, Liver Neoplasms pathology, Non-alcoholic Fatty Liver Disease microbiology, Risk Factors, Carcinoma, Hepatocellular microbiology, Gastrointestinal Microbiome, Liver Neoplasms microbiology, Probiotics
- Abstract
Hepatocellular carcinoma (HCC) accounts for the majority of primary liver cancers. Clearly identifiable risk factors are lacking in up to 30% of HCC patients and most of these cases are attributed to non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Beyond the known risk factors for NAFLD, the intestinal microbiota, in particular dysbiosis (defined as any change in the composition of the microbiota commonly found in healthy conditions) is emerging as a new factor promoting the development of chronic liver diseases and HCC. Intestinal microbes produce a large array of bioactive molecules from mainly dietary compounds, establishing an intense microbiota-host transgenomic metabolism with a major impact on physiological and pathological conditions. A better knowledge of these 'new' pathways could help unravel the pathogenesis of HCC in NAFLD to devise new prevention strategies. Currently unsettled issues include the relative role of a 'negative microbiota' (in addition to the other known risk factors for NASH) and the putative prevention of NAFLD through modulation of the gut microbiota., (© The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2017
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29. The epidemiology of non-alcoholic fatty liver disease.
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Bellentani S
- Subjects
- Carcinoma, Hepatocellular epidemiology, Disease Progression, Humans, Liver pathology, Liver Neoplasms epidemiology, Liver Transplantation, Mass Screening, Metabolic Syndrome epidemiology, Recurrence, Risk Factors, Liver Cirrhosis epidemiology, Non-alcoholic Fatty Liver Disease epidemiology
- Abstract
The increase in Non-alcoholic Fatty Liver Disease (NAFLD) and the imminent disappearance of chronic viral hepatitis thanks to new and effective therapies is motivating hepatologists to change their clinical approach to chronic liver disease. NAFLD-cirrhosis or NAFLD-Hepatocellular Carcinoma (HCC) are now the second cause of liver transplantation in the USA. This short-review is focused to the epidemiology of NAFLD/Non-alchoholic Steatohepatitis (NASH), including the definition of this disease which should be revised as well discussing the prevalence, risk factors for progression, natural history and mortality. NAFLD is considered to be the hepatic manifestation of the metabolic syndrome (MS). It affects 25-30% of the general population and the risk factors are almost identical to those of MS. The natural history involves either the development of cardiovascular diseases or cirrhosis and HCC. HCC can also develop in NASH in the absence of cirrhosis (45% of cases). We conclude that an international consensus conference on the definition, natural history, policies of surveillance and new pharmacological treatments of NAFLD and NASH is urgently needed., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2017
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30. Natural history of nonalcoholic steatohepatitis-associated hepatocellular carcinoma.
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Bellentani S, Baroni GS, Piscaglia F, and Tiribelli C
- Published
- 2016
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31. Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference.
- Author
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Munteanu M, Tiniakos D, Anstee Q, Charlotte F, Marchesini G, Bugianesi E, Trauner M, Romero Gomez M, Oliveira C, Day C, Dufour JF, Bellentani S, Ngo Y, Traussnig S, Perazzo H, Deckmyn O, Bedossa P, Ratziu V, and Poynard T
- Subjects
- Biopsy, Female, Hematologic Tests methods, Humans, Inflammation diagnosis, Male, Middle Aged, Prospective Studies, Fatty Liver diagnosis, Liver Cirrhosis diagnosis, Non-alcoholic Fatty Liver Disease diagnosis
- Abstract
Background: Blood tests of liver injury are less well validated in non-alcoholic fatty liver disease (NAFLD) than in patients with chronic viral hepatitis., Aims: To improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading., Methods: We pre-included new NAFLD patients with biopsy and blood tests from a single-centre cohort (FibroFrance) and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis (SAF) score, which provides a reliable and reproducible diagnosis and grading/staging of the three elementary features of NAFLD (steatosis, inflammatory activity) and fibrosis with reduced interobserver variability. We used nonbinary-ROC (NonBinAUROC) as the main endpoint to prevent spectrum effect and multiple testing., Results: A total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs (95% CI) of tests were all significant (P < 0.0001): 0.878 (0.864-0.892) for FibroTest and fibrosis stages, 0.846 (0.830-0.862) for ActiTest and activity grades, and 0.822 (0.804-0.840) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 0.820-0.852; P = 0.0001), FIB4 (0.845; 0.829-0.861; P = 0.007) but not significantly different than the NAFLD score (0.866; 0.850-0.882; P = 0.26). FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores (Bonferroni test P < 0.05)., Conclusions: In patients with NAFLD, SteatoTest, ActiTest and FibroTest are non-invasive tests that offer an alternative to biopsy, and they correlate with the simple grading/staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis., (© 2016 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.)
- Published
- 2016
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32. Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study.
- Author
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Piscaglia F, Svegliati-Baroni G, Barchetti A, Pecorelli A, Marinelli S, Tiribelli C, and Bellentani S
- Subjects
- Aged, Aged, 80 and over, Carcinoma, Hepatocellular mortality, Female, Humans, Liver Neoplasms mortality, Male, Middle Aged, Prospective Studies, Carcinoma, Hepatocellular virology, Hepatitis C, Chronic complications, Liver Neoplasms virology, Non-alcoholic Fatty Liver Disease complications
- Abstract
Unlabelled: Nonalcoholic fatty liver disease (NAFLD) represents the hepatic manifestation of metabolic syndrome and may evolve into hepatocellular carcinoma (HCC). Only scanty clinical information is available on HCC in NAFLD. The aim of this multicenter observational prospective study was to assess the clinical features of patients with NAFLD-related HCC (NAFLD-HCC) and to compare them to those of hepatitis C virus (HCV)-related HCC. A total of 756 patients with either NAFLD (145) or HCV-related chronic liver disease (611) were enrolled in secondary care Italian centers. Survival was modeled according to clinical parameters, lead-time bias, and propensity analysis. Compared to HCV, HCC in NAFLD patients had a larger volume, showed more often an infiltrative pattern, and was detected outside specific surveillance. Cirrhosis was present in only about 50% of NAFLD-HCC patients, in contrast to the near totality of HCV-HCC. Regardless of tumor stage, survival was significantly shorter (P = 0.017) in patients with NAFLD-HCC, 25.5 months (95% confidence interval 21.9-29.1), than in those with HCV-HCC, 33.7 months (95% confidence interval 31.9-35.4). To eliminate possible confounders, a propensity score analysis was performed, which showed no more significant difference between the two groups. Additionally, analysis of patients within Milan criteria submitted to curative treatments did not show any difference in survival between NAFLD-HCC and HCV-HCC (respectively, 38.6 versus 41.0 months, P = nonsignificant), Conclusions: NAFLD-HCC is more often detected at a later tumor stage and could arise also in the absence of cirrhosis, but after patient matching, it has a similar survival rate compared to HCV infection; a future challenge will be to identify patients with NAFLD who require more stringent surveillance in order to offer the most timely and effective treatment., (© 2015 by the American Association for the Study of Liver Diseases.)
- Published
- 2016
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33. A "systems medicine" approach to the study of non-alcoholic fatty liver disease.
- Author
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Petta S, Valenti L, Bugianesi E, Targher G, Bellentani S, and Bonino F
- Subjects
- Disease Progression, Humans, Non-alcoholic Fatty Liver Disease diagnosis, Non-alcoholic Fatty Liver Disease therapy, Phenotype, Risk Factors, Systems Biology, Non-alcoholic Fatty Liver Disease metabolism, Systems Analysis
- Abstract
The prevalence of fatty liver (steatosis) in the general population is rapidly increasing worldwide. The progress of knowledge in the physiopathology of fatty liver is based on the systems biology approach to studying the complex interactions among different physiological systems. Similarly, translational and clinical research should address the complex interplay between these systems impacting on fatty liver. The clinical needs drive the applications of systems medicine to re-define clinical phenotypes, assessing the multiple nature of disease susceptibility and progression (e.g. the definition of risk, prognosis, diagnosis criteria, and new endpoints of clinical trials). Based on this premise and in light of recent findings, the complex mechanisms involved in the pathology of fatty liver and their impact on the short- and long-term clinical outcomes of cardiovascular, metabolic liver diseases associated with steatosis are presented in this review using a new "systems medicine" approach. A new data set is proposed for studying the impairments of different physiological systems that have an impact on fatty liver in different subsets of subjects and patients., (Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
34. Epidemiological modifiers of non-alcoholic fatty liver disease: Focus on high-risk groups.
- Author
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Lonardo A, Bellentani S, Argo CK, Ballestri S, Byrne CD, Caldwell SH, Cortez-Pinto H, Grieco A, Machado MV, Miele L, and Targher G
- Subjects
- Age Factors, Ethnicity, Humans, Hypertension complications, Non-alcoholic Fatty Liver Disease genetics, Risk Factors, Sex Factors, Diabetes Mellitus, Type 2 complications, Hyperlipidemias complications, Metabolic Syndrome complications, Non-alcoholic Fatty Liver Disease epidemiology, Obesity complications
- Abstract
An improved understanding of non-alcoholic fatty liver disease epidemiology would lead to identification of individuals at high risk of developing chronic liver disease and extra-hepatic complications, thus contributing to more effective case finding of non-alcoholic fatty liver disease among selected groups. We aimed to illustrate the epidemiology of non-alcoholic fatty liver disease in high-risk groups, which were identified based on existing literature. To this end, PubMed was searched to retrieve original articles published until May 2015 using relevant and pertinent keywords "nonalcoholic fatty liver disease" and "diabetes", "obesity", "hyperlipidaemia", "familial heterozygous hypobetalipoproteinaemia", "hypertension", "metabolic syndrome", "ethnicity", "family history" or "genetic polymorphisms". We found that age, sex and ethnicity are major physiological modifiers of the risk of non-alcoholic fatty liver disease, along with belonging to "non-alcoholic fatty liver disease families" and carrying risk alleles for selected genetic polymorphisms. Metabolic syndrome, diabetes, obesity, mixed hyperlipidaemia and hypocholesterolaemia due to familial hypobetalipoproteinaemia are the major metabolic modifiers of non-alcoholic fatty liver disease risk. Compared with these metabolic conditions, however, arterial hypertension appears to carry a relatively more modest risk of non-alcoholic fatty liver disease. A better understanding of the epidemiology of non-alcoholic fatty liver disease may result in a more liberal policy of case finding among high-risk groups., (Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
35. Fulminant hepatitis in a patient with hepatocellular carcinoma related to nonalcoholic steatohepatitis treated with sorafenib.
- Author
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Brandi G, De Lorenzo S, Di Girolamo S, Bellentani S, Saccoccio G, and Biasco G
- Subjects
- Aged, Antineoplastic Agents administration & dosage, Carcinoma, Hepatocellular complications, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular etiology, Fatal Outcome, Humans, Jaundice etiology, Liver Failure, Acute chemically induced, Liver Failure, Acute complications, Liver Failure, Acute physiopathology, Liver Neoplasms complications, Liver Neoplasms diagnostic imaging, Liver Neoplasms etiology, Male, Muscle Weakness etiology, Niacinamide administration & dosage, Niacinamide adverse effects, Phenylurea Compounds administration & dosage, Protein Kinase Inhibitors administration & dosage, Sorafenib, Tomography, X-Ray Computed, Tremor etiology, Antineoplastic Agents adverse effects, Carcinoma, Hepatocellular drug therapy, Liver Failure, Acute etiology, Liver Neoplasms drug therapy, Niacinamide analogs & derivatives, Non-alcoholic Fatty Liver Disease complications, Phenylurea Compounds adverse effects, Protein Kinase Inhibitors adverse effects
- Abstract
We describe a case of acute liver failure in a patient with advanced hepatocellular carcinoma related to nonalcoholic steatohepatitis during sorafenib treatment. A 74-year-old man with diabetes mellitus and hypertension was diagnosed with hepatocellular carcinoma associated with fatty liver. Three weeks after sorafenib therapy, at Eastern Cooperative Oncology Group performance status 3, he developed jaundice, general weakness, flapping tremor, nausea, and anorexia. Sorafenib was stopped: laboratory tests showed a relevant elevation of transaminases suggesting diagnosis of acute hepatitis. During hospital admission, the patient died of liver failure. Sorafenib is the first successful target therapy effective for advanced hepatocellular carcinoma. The most common adverse events are fatigue, hand-foot skin reaction, skin rash/desquamation, diarrhea, and hypertension, whereas liver dysfunction is uncommon. To our knowledge, this is the first patient reported in the literature with hepatocellular carcinoma related to nonalcoholic steatohepatitis who died of rapid worsening of liver function during sorafenib treatment.
- Published
- 2015
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36. PDX-1 mRNA expression in endoscopic ultrasound-guided fine needle cytoaspirate: perspectives in the diagnosis of pancreatic cancer.
- Author
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Marzioni M, Germani U, Agostinelli L, Bedogni G, Saccomanno S, Marini F, Bellentani S, Barbera C, De Minicis S, Rychlicki C, Santinelli A, Ferretti M, Di Maira PV, Baroni GS, Benedetti A, Caletti G, Lorenzini I, and Fusaroli P
- Subjects
- Aged, Carcinoma, Pancreatic Ductal diagnosis, Case-Control Studies, Cystadenocarcinoma, Mucinous diagnosis, Cystadenocarcinoma, Serous diagnosis, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Female, Humans, Male, Middle Aged, Pancreatic Neoplasms diagnosis, Pancreatic Pseudocyst diagnosis, Pancreatitis, Chronic diagnosis, Reverse Transcriptase Polymerase Chain Reaction, Carcinoma, Pancreatic Ductal genetics, Cystadenocarcinoma, Mucinous genetics, Cystadenocarcinoma, Serous genetics, Homeodomain Proteins genetics, Pancreatic Neoplasms genetics, RNA, Messenger metabolism, Trans-Activators genetics
- Abstract
Background and Aims: Endoscopic ultrasound-guided fine needle aspiration is routinely used in the diagnostic work up of pancreatic cancer but has a low sensitivity. Studies showed that Pancreatic Duodenal Homeobox-1 (PDX-1) is expressed in pancreatic cancer, which is associated with a worse prognosis. We aimed to verify whether the assessment of PDX-1 in endoscopic ultrasound-guided fine needle aspiration samples may be helpful for the diagnosis of pancreatic cancer., Methods: mRNA of 54 pancreatic cancer and 25 cystic lesions was extracted. PDX-1 expression was assessed by Real-Time PCR., Results: In all but two patients with pancreatic cancer, PDX-1 was expressed and was found positive in 7 patients with pancreatic cancer in which cytology was negative. The positivity was associated with a probability of 0.98 (95% CI 0.90-1.00) of having cancer and the negativity with one of 0.08 (95% CI 0.01-0.27). The probability of cancer rose to 1.00 (95% CI 0.97-1.00) for patients positive to both PDX-1 and cytology and fell to 0.0 (95% CI 0.00-0.15) in patients negative for both., Conclusions: PDX-1mRNA is detectable in samples of pancreatic cancer. Its quantification may be helpful to improve the diagnosis of pancreatic cancer., (Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
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37. Alimentary regimen in non-alcoholic fatty liver disease: Mediterranean diet.
- Author
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Abenavoli L, Milic N, Peta V, Alfieri F, De Lorenzo A, and Bellentani S
- Subjects
- Humans, Non-alcoholic Fatty Liver Disease blood, Non-alcoholic Fatty Liver Disease diagnosis, Non-alcoholic Fatty Liver Disease epidemiology, Non-alcoholic Fatty Liver Disease physiopathology, Nutritional Status, Risk Assessment, Risk Factors, Treatment Outcome, Weight Loss, Diet, Mediterranean, Non-alcoholic Fatty Liver Disease diet therapy, Non-alcoholic Fatty Liver Disease prevention & control, Risk Reduction Behavior
- Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. The mechanisms of the underlying disease development and progression are awaiting clarification. Insulin resistance and obesity-related inflammation status, among other possible genetic, dietary, and lifestyle factors, are thought to play the key role. There is no consensus concerning the pharmacological treatment. However, the dietary nutritional management to achieve weight loss is an essential component of any treatment strategy. On the basis of its components, the literature reports on the effectiveness of the Mediterranean diet in reducing cardiovascular risk and in preventing major chronic diseases, including obesity and diabetes. New evidence supports the idea that the Mediterranean diet, associated with physical activity and cognitive behaviour therapy, may have an important role in the prevention and the treatment of NAFLD.
- Published
- 2014
- Full Text
- View/download PDF
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