314 results on '"Bellentani S"'
Search Results
102. Effect of bombesin on plasma trypsin-like immunoreactivity in normal subjects and in patients with and without pancreatic steatorrhea
- Author
-
Severi, C., Bellentani, S., and bruno annibale
103. The risk of non-Hodgkin lymphoma (NHL) inpatients with coeliac disease (CD): Preliminary results of the Italian multicentre case-control study
- Author
-
Catassi, C., Corrao, G., Barbato, M., Renzo, A., antonio carroccio, D'Altilia, MR, Guariso, G., Baldassarre, M., Caramaschi, P., Bertolani, P., Bellentani, S., and Corazza, Gr
104. Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference
- Author
-
Ratziu, V., Bugianesi, E., Ngo, Y., Bellentani, S., Traussnig, S., Day, C., Bedossa, P., Marchesini, G., Poynard, T., Anstee, Q., Charlotte, F., Trauner, M., Romero Gomez, M., Deckmyn, O., Munteanu, M., Oliveira, C., Tiniakos, D., Perazzo, H., and Dufour, Jean-François
- Subjects
610 Medicine & health ,3. Good health - 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.
105. Bombesin, Trypsin, and Chronic Pancreatitis
- Author
-
Severi, C., primary, Annibale, B., additional, Bellentani, S., additional, Corleto, V., additional, and De Magistris, L., additional
- Published
- 1984
- Full Text
- View/download PDF
106. Taurocholate (TC) and sulfobromophtalein (BSP) uptake in isolated hepatocytes: Reciprocal inhibition and role of glutathione (GSH)
- Author
-
Marchegiano, P., primary, Bellentani, S., additional, Tiribelli, C., additional, Armocida, C., additional, Polo, S., additional, and Amarri, S., additional
- Published
- 1989
- Full Text
- View/download PDF
107. Effect of ursodeoxycholic acid treatment on alanine aminotransferase and γ-glutamyltranspeptidase serum levels in patients with hypertransaminasemia
- Author
-
Bellentani, S., primary, Tabarroni, G., additional, Barchi, T., additional, Ferretti, I., additional, Fratti, N., additional, Villa, E., additional, and Manenti, F., additional
- Published
- 1989
- Full Text
- View/download PDF
108. SUSCEPTIBILITY OF CHRONIC SYMPTOMLESS HBsAg CARRIERS TO ETHANOL-INDUCED HEPATIC DAMAGE
- Author
-
Villa, Erica, primary, Barchi, Tiziana, additional, Grisendi, A., additional, Bellentani, S., additional, Rubbiani, Lorenza, additional, Ferretti, Ilva, additional, De Palma, Marisa, additional, and Manenti, Federico, additional
- Published
- 1982
- Full Text
- View/download PDF
109. Taurine increases bile acid pool size and reduces bile saturation index in the hamster
- Author
-
Bellentani, S, primary, Pecorari, M, additional, Cordoma, P, additional, Marchegiano, P, additional, Manenti, F, additional, Bosisio, E, additional, De Fabiani, E, additional, and Galli, G, additional
- Published
- 1987
- Full Text
- View/download PDF
110. Effect of tauroursodeoxycholate feeding, with or without taurine supplementation on hepatic bile acids and cholesterol metabolism in the hamster
- Author
-
Bellentani, S., primary, Bosisio, E., additional, Pecorari, M., additional, De Fabiani, E., additional, Cordoma, P., additional, Crestani, M., additional, and Manenti, F., additional
- Published
- 1987
- Full Text
- View/download PDF
111. Specificity of an Na+ -dependent taurocholate transport site in isolated rat hepatocytes
- Author
-
Hardison, W. G., primary, Bellentani, S., additional, Heasley, V., additional, and Shellhamer, D., additional
- Published
- 1984
- Full Text
- View/download PDF
112. Serum PABA test in chronic pancreatitis.
- Author
-
Bellentani, S, primary, Grisendi, A, additional, and Manenti, F, additional
- Published
- 1985
- Full Text
- View/download PDF
113. Mechanisms of liver adaptation to prolonged selective biliary obstruction (SBO) in the rat
- Author
-
Bellentani, S., primary, Hardison, W.G.M., additional, and Manenti, F., additional
- Published
- 1985
- Full Text
- View/download PDF
114. The effect of etofibrate on cholesterol and bile acid metabolism in the hamster
- Author
-
De Fabiani, E., primary, Crestani, M., additional, Malavasi, B., additional, Del Puppo, M., additional, Farina, F., additional, Armocida, C., additional, Bellentani, S., additional, Quack, G., additional, and Bosisio, E., additional
- Published
- 1989
- Full Text
- View/download PDF
115. A simple index of lipid overaccumulation is a good marker of liver steatosis
- Author
-
Bedogni Giorgio, Kahn Henry S, Bellentani Stefano, and Tiribelli Claudio
- Subjects
Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Liver steatosis is often found in association with common cardiometabolic disorders, conditions that may all occur in a shared context of abdominal obesity and dyslipidemia. An algorithm for identifying liver steatosis is the fatty liver index (FLI). The lipid accumulation product (LAP) is an index formulated in a representative sample of the US population to identify cardiometabolic disorders. Because FLI and LAP share two components, namely waist circumference and fasting triglycerides, we evaluated the ability of LAP to identify liver steatosis in the same study population from the Northern Italian town where FLI was initially developed. Methods We studied 588 individuals (59% males) aged 21 to 79 years. Liver steatosis was detected by ultrasonography and coded ordinally as none, intermediate and severe. 44% of the individuals had liver steatosis. Using proportional-odds ordinal logistic regression, we evaluated the ability of log-transformed LAP (lnLAP) to identify liver steatosis. We considered the benefits to our model of including terms for sex, age, suspected liver disease and ethanol intake. We calculated the 3-level probability of liver steatosis according to lnLAP and sex, providing tables and nomograms for risk assessment. Results An ordinal proportional-odds model consisting of lnLAP and sex offered a reasonably accurate identification of liver steatosis. The odds of more severe vs. less severe steatosis increased for increasing values of lnLAP (odds ratio [OR] = 4.28, 95%CI 3.28 to 5.58 for each log-unit increment) and was more likely among males (OR = 1.88, 95%CI 1.31 to 2.69). Conclusion In a study sample of adults from Northern Italy, the simple calculation of LAP was a reasonably accurate approach to recognizing individuals with ultrasonographic liver steatosis. LAP may help primary care physicians to select subjects for liver ultrasonography and intensified lifestyle counseling, and researchers to select patients for epidemiologic studies. A more thorough assessment of LAP's potential for identifying liver steatosis will require its cross-evaluation in external populations.
- Published
- 2010
- Full Text
- View/download PDF
116. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population
- Author
-
Castiglione Anna, Passalacqua Marilena, Masutti Flora, Bellentani Stefano, Miglioli Lucia, Bedogni Giorgio, and Tiribelli Claudio
- Subjects
Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Fatty liver (FL) is the most frequent liver disease in Western countries. We used data from the Dionysos Nutrition & Liver Study to develop a simple algorithm for the prediction of FL in the general population. Methods 216 subjects with and 280 without suspected liver disease were studied. FL was diagnosed by ultrasonography and alcohol intake was assessed using a 7-day diary. Bootstrapped stepwise logistic regression was used to identify potential predictors of FL among 13 variables of interest [gender, age, ethanol intake, alanine transaminase, aspartate transaminase, gamma-glutamyl-transferase (GGT), body mass index (BMI), waist circumference, sum of 4 skinfolds, glucose, insulin, triglycerides, and cholesterol]. Potential predictors were entered into stepwise logistic regression models with the aim of obtaining the most simple and accurate algorithm for the prediction of FL. Results An algorithm based on BMI, waist circumference, triglycerides and GGT had an accuracy of 0.84 (95%CI 0.81–0.87) in detecting FL. We used this algorithm to develop the "fatty liver index" (FLI), which varies between 0 and 100. A FLI < 30 (negative likelihood ratio = 0.2) rules out and a FLI ≥ 60 (positive likelihood ratio = 4.3) rules in fatty liver. Conclusion FLI is simple to obtain and may help physicians select subjects for liver ultrasonography and intensified lifestyle counseling, and researchers to select patients for epidemiologic studies. Validation of FLI in external populations is needed before it can be employed for these purposes.
- Published
- 2006
- Full Text
- View/download PDF
117. Promotional visits by nurses do not increase influenza vaccination among healthcare workers
- Author
-
Bellentani, S
- Published
- 2002
- Full Text
- View/download PDF
118. Ursodiol in the long-term treatment of chronic hepatitis: a double-blind multicenter clinical trial
- Author
-
Bellentani, S., Podda, M., Tiribelli, C., and Callea, F.
- Published
- 1993
- Full Text
- View/download PDF
119. Ex-vivoliver perfusion: a successful technique of liver support
- Author
-
Filipponi, F., Abouna, G.M., Boggi, U., Meacci, L., Burchielli, S., Barbieri, U., Bellentani, S., Fassati, L., Tiribelli, C., and Costa, G.
- Published
- 1998
- Full Text
- View/download PDF
120. A 'systems medicine' approach to the study of non-alcoholic fatty liver disease
- Author
-
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
121. Ex-vivo liver perfusion: a successful technique of liver support
- Author
-
Filipponi, F., Abouna, G.M., Boggi, U., Meacci, L., Burchielli, S., Barbieri, U., Bellentani, S., Fassati, L., Tiribelli, C., and Costa, G.
- Published
- 1998
- Full Text
- View/download PDF
122. AISF position paper on nonalcoholic fatty liver disease (NAFLD): Updates and future directions
- Author
-
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
123. Natural history of nonalcoholic steatohepatitis–associated hepatocellular carcinoma
- Author
-
Stefano Bellentani M.D., Gianluca Svegliati Baroni, Claudio Tiribelli, Fabio Piscaglia, Bellentani S., Baroni G.S., Piscaglia F., and Tiribelli C.
- Subjects
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
124. Nutraceutical Approach to Non-Alcoholic Fatty Liver Disease (NAFLD): The Available Clinical Evidence
- Author
-
Arrigo F G Cicero, Stefano Bellentani, Alessandro Colletti, and Cicero AF, Colletti A, Bellentani S
- Subjects
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
125. Incidence and natural course of fatty liver in the general population: The Dionysos study
- Author
-
F. Masutti, Lory Saveria Crocè, Giorgio Bedogni, Claudio Tiribelli, A. Castiglione, Stefano Bellentani, L. Miglioli, Bedogni, G, Miglioli, L, Masutti, F, Castiglione, A, Croce', Saveria, Tiribelli, Claudio, and Bellentani, S.
- Subjects
Adult ,Male ,PREDICTOR ,medicine.medical_specialty ,Cirrhosis ,Adolescent ,Remission, Spontaneous ,Population ,Gastroenterology ,DISEASE ,Liver disease ,Internal medicine ,HISTORY ,REGRESSION ,Humans ,Medicine ,NUTRITION ,PREVALENCE ,HEPATIC STEATOSIS ,METABOLIC SYNDROME ,NONALCOHOLIC STEATOHEPATITIS ,RISK-FACTORS ,Child ,education ,Mean corpuscular volume ,Aged ,education.field_of_study ,Hepatology ,medicine.diagnostic_test ,business.industry ,Incidence ,Incidence (epidemiology) ,Mortality rate ,Fatty liver ,Middle Aged ,medicine.disease ,Surgery ,Fatty Liver ,Italy ,Disease Progression ,Female ,business ,Follow-Up Studies - Abstract
Using the general population of the Dionysos Study, we followed up 144 subjects without fatty liver (FL−) and 336 with fatty liver (FL+) for a median time of 8.5 years. All subjects had suspected liver disease (SLD) defined as altered liver enzymes, high mean corpuscular volume, or low platelet count in the absence of HBV and HCV infection. Ethanol intake was assessed using a food frequency questionnaire, and FL was diagnosed using ultrasonography. The incidence and remission rates of FL were 18.5 and 55.0 per 1,000 person-years. Progression to cirrhosis or HCC was rare in both cohorts (incidence rate: 1.7 versus 1.1 and 0.8 versus 0.4 per 1,000 person-years for FL− versus FL+). Multivariable Poisson regression was performed to identify predictors of FL incidence and remission among sex, age, body mass index, ethanol, and liver enzymes. Every increase of 20 g/day of ethanol intake at baseline was associated with a 17% increase in the rate of incident FL (P = 0.019), a 10% decrease in the rate of remitting FL and SLD (P = 0.043), a 19% decrease in the rate of remitting FL with persistent SLD (P = 0.002), and a 10% increase in mortality rate (P = 0.005) in the FL+ cohort. Conclusion: In the general population of the Dionysos Study, FL regressed in nearly 1 of every 2 cases and had a substantially benign course. Ethanol intake was the most important risk factor for FL remission and incidence and a predictor of mortality in subjects with FL. (HEPATOLOGY 2007.)
- Published
- 2007
126. Moderate alcohol use and health: a consensus document
- Author
-
Simona Costanzo, M. Bucci, Lorenzo Loffredo, Claudio Pelucchi, Francesco Marangoni, Andrea Poli, Giuseppe Marelli, L. Lucchin, Francesco Visioli, Francesco Violi, C. La Vecchia, Alberico L. Catapano, M. Musicco, R. Sterzi, G. de Gaetano, Lucia Fontana, Roberto Vettor, Claudio Cricelli, G. Forlani, Carlo Nozzoli, Francesco Fattirolli, S. Frattini, Salvatore Minisola, Salvatore Novo, Ludovica Perri, Gianvincenzo Barba, Angelo Avogaro, L. Lazzaretto, Filippo Pieralli, A. Di Castelnuovo, Damiano Rizzoni, Rosalba Giacco, Stefano Bellentani, Walter Marrocco, Pompilio Faggiano, R. Cambieri, Poli, A, Marangoni, F, Avogaro, A, Barba, G, Bellentani, S, Bucci, M, Cambieri, R, Catapano, AL, Costanzo, S, Cricelli, C, de Gaetano, G, Di Castelnuovo, A, Faggiano, P, Fattirolli, F, Fontana, L, Forlani, G, Frattini, S, Giacco, R, La Vecchia, C, Lazzaretto, L, Loffredo, L, Lucchin, L, Marelli, G, Marrocco, W, Minisola, S, Musicco, M, Novo, S, Nozzoli, C, Pelucchi, C, Perri, L, Pieralli, F, Rizzoni, D, Sterzi, R, Vettor, R, Violi, F, Visioli, F, A. Poli, F. Marangoni, A. Avogaro, G. Barba, S. Bellentani, M. Bucci, R. Cambieri, A.L. Catapano, S. Costanzo, C. Cricelli, G. de Gaetano, A. Di Castelnuovo, P. Faggiano, F. Fattirolli, L. Fontana, G. Forlani, S. Frattini, R. Giacco, C. La Vecchia, L. Lazzaretto, L. Loffredo, L. Lucchin, G. Marelli, W. Marrocco, S. Minisola, M. Musicco, S. Novo, C. Nozzoli, C. Pelucchi, L. Perri, F. Pieralli, D. Rizzoni, R. Sterzi, R. Vettor, F. Violi, and F. Visioli
- Subjects
Polyphenol ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,MEDLINE ,Medicine (miscellaneous) ,Cognitive decline ,Disease ,Diabete ,alcohol ,cancer ,cardiovascular disease ,cognitive decline ,diabetes ,metabolic syndrome ,overall mortality ,polyphenols ,prevention ,ALCOHOLIC LIVER DISEASE ,Breast cancer ,Diabetes mellitus ,Intervention (counseling) ,medicine ,Overall mortality ,Psychiatry ,Cancer ,Nutrition and Dietetics ,business.industry ,Prevention ,Primary care physician ,medicine.disease ,Moderation ,Cardiovascular disease ,Metabolic syndrome ,Settore MED/11 - Malattie Dell'Apparato Cardiovascolare ,HEALTH ,Cardiology and Cardiovascular Medicine ,business ,Alcohol ,Polyphenols ,Diabetes - Abstract
Aims The aim of this consensus paper is to review the available evidence on the association between moderate alcohol use, health and disease and to provide a working document to the scientific and health professional communities. Data synthesis In healthy adults and in the elderly, spontaneous consumption of alcoholic beverages within 30 g ethanol/d for men and 15 g/d for women is to be considered acceptable and do not deserve intervention by the primary care physician or the health professional in charge. Patients with increased risk for specific diseases, for example, women with familiar history of breast cancer, or subjects with familiar history of early cardiovascular disease, or cardiovascular patients should discuss with their physician their drinking habits. No abstainer should be advised to drink for health reasons. Alcohol use must be discouraged in specific physiological or personal situations or in selected age classes (children and adolescents, pregnant and lactating women and recovering alcoholics). Moreover, the possible interactions between alcohol and acute or chronic drug use must be discussed with the primary care physician. Conclusions The choice to consume alcohol should be based on individual considerations, taking into account the influence on health and diet, the risk of alcoholism and abuse, the effect on behaviour and other factors that may vary with age and lifestyle. Moderation in drinking and development of an associated lifestyle culture should be fostered.
- Published
- 2013
127. Stage of change and motivation to healthier lifestyle in non-alcoholic fatty liver disease
- Author
-
Anna Ludovica Fracanzani, Stefano Bellentani, Salvatore Petta, Giulio Marchesini, Elisabetta Bugianesi, Elena Centis, Simona Moscatiello, Simona Calugi, Riccardo Dalle Grave, Centis, E, Moscatiello, S, Bugianesi, E, Bellentani, S, Fracanzani, A, Calugi, S, Petta, S, Dalle Grave, R, Marchesini, G, E. Centi, S. Moscatiello, E. Bugianesi, S. Bellentani, A.L. Fracanzani, S. Calugi, S. Petta, R. Dalle Grave, and G. Marchesini Reggiani
- Subjects
Adult ,Male ,medicine.medical_specialty ,Health Behavior ,Disease ,Motor Activity ,Logistic regression ,Psychological factors ,DIET ,NAFLD. LIFESTYLE ,Young Adult ,03 medical and health sciences ,WEIGHT LOSS ,0302 clinical medicine ,Humans ,NON-ALCOHOLIC FATTY LIVER DISEASE ,Medicine ,030212 general & internal medicine ,Young adult ,Life Style ,Aged ,Hepatology ,business.industry ,Physical activity ,Behavior change ,Fatty liver ,Transtheoretical model ,LIFESTYLE DETERMINANTS ,MOTIVATION ,Odds ratio ,Middle Aged ,medicine.disease ,Lifestyle ,3. Good health ,Fatty Liver ,Healthy diet ,Physical therapy ,Female ,030211 gastroenterology & hepatology ,sense organs ,Steatohepatitis ,business ,Demography - Abstract
Backgrounds & Aims: Healthy diet and physical activity are the treatment cornerstones of non-alcoholic fatty liver disease (NAFLD); their effectiveness is however limited by difficulties in implementing lifestyle changes. We aimed at determining the stage of change and associated psychological factors as a prerequisite to refine strategies to implement behavior changes. Methods: We studied 138 consecutive NAFLD patients (73% male, age 19-73 years). The diagnosis was confirmed by liver biopsy in 64 cases (steatohepatitis, 47%). All cases completed the validated EMME-3 questionnaire, consisting of two parallel sets of instruments (for diet and physical activity, respectively) and providing stages of change according to transtheoretical model. Logistic regression analysis was used to identify factors associated with stages making behavioral changes more demanding. Results: The individual profiles were variable; for diet, no cases had precontemplation as prevalent stage of change (highest score in individual profiles); 36% had contemplation. For physical activity, 50% were classified in either precontemplation or contemplation. Minor differences were recorded in relation to associated metabolic complications or steatohepatitis. Logistic regression identified male sex (odds ratio, 4.51; 95% confidence interval, 1.69-12.08) and age (1.70; 1.20-2.43 per decade) as the independent parameters predicting precontemplation or contemplation for diet. No predictors were identified for physical activity. Conclusions: NAFLD cases have scarce readiness to lifestyle changes, particularly with regard to physical activity. Defining stages of change and motivation offers the opportunity to improve clinical care of NAFLD people through individual programs exploiting the powerful potential of behavioral counseling, an issue to be tested in longitudinal studies. © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
- Published
- 2012
128. Natural Course of Chronic HCV and HBV Infection and Role of Alcohol in the General Population: The Dionysos Study
- Author
-
Claudio Tiribelli, L. Miglioli, Alessandro Granito, Lory Saveria Crocè, Stefano Bellentani, Giorgio Bedogni, S. Ferri, Flora Masutti, A. Castiglione, Marco Lenzi, Bedogni G, Miglioli L, Masutti F, Ferri S, Castiglione A, Lenzi M, Crocè LS, Granito A, Tiribelli C, Bellentani S., Giorgio, Bedogni, Lucia, Miglioli, Flora, Masutti, Silvia, Ferri, Anna, Castiglione, Marco, Lenzi, Croce', Saveria, Alessandro, Granito, Tiribelli, Claudio, and AND STEFANO, Bellentani
- Subjects
Adult ,Male ,Adolescent ,Alcohol Drinking ,Population ,Statistics, Nonparametric ,Cause of Death ,Surveys and Questionnaires ,Prevalence ,medicine ,HBV ,Humans ,Poisson Distribution ,Child ,education ,Aged ,Cause of death ,education.field_of_study ,Natural course ,Hepatology ,business.industry ,alcohol ,Incidence ,Incidence (epidemiology) ,Gastroenterology ,virus diseases ,Viral hepatitis b ,natural history ,HCV ,Hepatitis C, Chronic ,Middle Aged ,Hepatitis B ,medicine.disease ,Virology ,digestive system diseases ,Natural history ,Italy ,RNA, Viral ,Female ,Viral disease ,business - Abstract
BACKGROUND: Population-based studies of the natural course of chronic viral liver disease that consider comorbidity factors are lacking. Using data from the Dionysos Study, we quantified the burden of chronic viral liver disease and the role of alcohol intake to morbidity and mortality in a representative sample of subjects from the general population of two communities of Northern Italy. METHODS AND FINDINGS: We followed up 139 subjects with chronic hepatitis C virus (HCV) infection and 61 with chronic hepatitis B virus (HBV) infection for a median (IQR) time of 8.4 (1.0) and 8.3 (0.9) yr, respectively. Ethanol intake was evaluated using a food-frequency questionnaire, fatty liver (FL) was diagnosed by ultrasonography, and liver cirrhosis (LC) and hepatocarcinoma (HCC) were diagnosed by liver biopsy. Exact multivariable Poisson regression was performed to identify predictors of death. The incidence and remission rates of FL were 9.0 and 29.7 in the HCV cohort and 4.0 and 30.4 per 1,000 person-years (PY) in the HBV cohort. Progression to LC and HCC was more common in the HCV than in the HBV cohort (4.5 vs 2.0 and 2.7 vs 2.0 per 1,000 PY, respectively). Ethanol intake was an independent predictor of LC in the HCV cohort [rate ratio (RR) = 4.15 (95% CI 1.02-41.2) for every increase of 30 g/day of ethanol intake at baseline] and of death rate in both cohorts [RR = 8.53 (95% CI 1.40-24.61) and 3.56 (1.34 to 26.50) for every increase of 30 g/day of ethanol intake at baseline]. CONCLUSIONS: The morbidity and mortality rate of HBV and HCV infection in the general population is lower than that reported in secondary-care populations, blood donors, or clinical series. Ethanol intake is an independent predictor of LC in subjects with chronic HCV infection and an independent predictor of death in subjects with either HCV or HBV infection.
- Published
- 2008
129. The fatty liver index: a simple and accurate predictor of hepatic steatosis in the general population
- Author
-
Claudio Tiribelli, Giorgio Bedogni, Flora Masutti, Marilena Passalacqua, A. Castiglione, Stefano Bellentani, L. Miglioli, Bedogni, G, Bellentani, S, Miglioli, L, Masutti, F, Passalacqua, M, and Tiribelli, Claudio
- Subjects
Adult ,Male ,DIONYSOS ,medicine.medical_specialty ,Waist ,Population ,Aspartate transaminase ,Intra-Abdominal Fat ,Gastroenterology ,Body Mass Index ,Liver disease ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,lcsh:RC799-869 ,ARTICLE ,education ,METABOLIC ,Triglycerides ,Aged ,Ultrasonography ,education.field_of_study ,Likelihood Functions ,biology ,business.industry ,Fatty liver ,RISK-FACTORS ,BODY-MASS INDEX ,General Medicine ,gamma-Glutamyltransferase ,Stepwise regression ,Middle Aged ,medicine.disease ,Fatty Liver ,Endocrinology ,Logistic Models ,Alanine transaminase ,biology.protein ,Female ,lcsh:Diseases of the digestive system. Gastroenterology ,business ,Body mass index ,Algorithms ,Research Article - Abstract
Background Fatty liver (FL) is the most frequent liver disease in Western countries. We used data from the Dionysos Nutrition & Liver Study to develop a simple algorithm for the prediction of FL in the general population. Methods 216 subjects with and 280 without suspected liver disease were studied. FL was diagnosed by ultrasonography and alcohol intake was assessed using a 7-day diary. Bootstrapped stepwise logistic regression was used to identify potential predictors of FL among 13 variables of interest [gender, age, ethanol intake, alanine transaminase, aspartate transaminase, gamma-glutamyl-transferase (GGT), body mass index (BMI), waist circumference, sum of 4 skinfolds, glucose, insulin, triglycerides, and cholesterol]. Potential predictors were entered into stepwise logistic regression models with the aim of obtaining the most simple and accurate algorithm for the prediction of FL. Results An algorithm based on BMI, waist circumference, triglycerides and GGT had an accuracy of 0.84 (95%CI 0.81–0.87) in detecting FL. We used this algorithm to develop the "fatty liver index" (FLI), which varies between 0 and 100. A FLI < 30 (negative likelihood ratio = 0.2) rules out and a FLI ≥ 60 (positive likelihood ratio = 4.3) rules in fatty liver. Conclusion FLI is simple to obtain and may help physicians select subjects for liver ultrasonography and intensified lifestyle counseling, and researchers to select patients for epidemiologic studies. Validation of FLI in external populations is needed before it can be employed for these purposes.
- Published
- 2006
130. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study
- Author
-
Claudio Tiribelli, Giulio Marchesini, Stefano Bellentani, L. Miglioli, Giorgio Bedogni, Flora Masutti, Bedogni, G, Miglioli, L, Masutti, F, Tiribelli, Claudio, Marchesini, G, and Bellentani, S.
- Subjects
Adult ,Male ,medicine.medical_specialty ,NASH ,SENSITIVITY ,ASSOCIATION ,STEATOHEPATITIS ,NATURAL-HISTORY ,ALANINE AMINOTRANSFERASE ,GENERAL-POPULATION ,METABOLIC SYNDROME ,INSULIN-RESISTANCE ,HOMEOSTASIS MODEL ASSESSMENT ,Population ,Comorbidity ,Gastroenterology ,Liver disease ,Risk Factors ,Internal medicine ,Nonalcoholic fatty liver disease ,Prevalence ,medicine ,Humans ,education ,education.field_of_study ,Hepatology ,business.industry ,Incidence ,Liver Diseases ,Hypertriglyceridemia ,Fatty liver ,nutritional and metabolic diseases ,Middle Aged ,medicine.disease ,digestive system diseases ,Fatty Liver ,Cross-Sectional Studies ,Endocrinology ,Italy ,Chronic Disease ,Female ,Alcoholic fatty liver ,Steatohepatitis ,Metabolic syndrome ,business - Abstract
The prevalence of and the risk factors for fatty liver have not undergone a formal evaluation in a representative sample of the general population. We therefore performed a cross-sectional study in the town of Campogalliano (Modena, Italy), within the context of the Dionysos Project. Of 5,780 eligible persons aged 18 to 75 years, 3,345 (58%) agreed to participate in the study. Subjects with suspected liver disease (SLD), defined on the basis of elevated serum alanine aminotransferase (ALT) and gamma-glutamyl-transferase (GGT) activity, hepatitis B surface antigen (HBsAg), or hepatitis C virus (HCV)-RNA positivity, were matched with randomly selected subjects of the same age and sex without SLD. A total of 311 subjects with and 287 without SLD underwent a detailed clinical, laboratory, and anthropometrical evaluation. Fatty liver was diagnosed by ultrasonography, and alcohol intake was assessed by using a 7-day diary. Multinomial logistic regression was used to detect risk factors for normal liver versus nonalcoholic fatty liver disease (NAFLD) and for alcoholic fatty liver (AFLD) versus NAFLD. The prevalence of NAFLD was similar in subjects with and without SLD (25 vs. 20%, P = .203). At multivariable analysis, normal liver was more likely than NAFLD in older subjects and less likely in the presence of obesity, hyperglycemia, hyperinsulinemia, hypertriglyceridemia, and systolic hypertension; AFLD was more likely than NAFLD in older subjects, males, and in the presence of elevated GGT and hypertriglyceridemia, and less likely in the presence of obesity and hyperglycemia. In conclusion, NAFLD is highly prevalent in the general population, is not associated with SLD, but is associated with many features of the metabolic syndrome.
- Published
- 2005
131. The epidemiology of fatty liver
- Author
-
Claudio Tiribelli, L. Miglioli, Stefano Bellentani, Giorgio Bedogni, Bellentani, S, Bedogni, G, Migliolil, and Tiribelli, Claudio
- Subjects
Hepatitis ,medicine.medical_specialty ,Hepatology ,business.industry ,Incidence ,Incidence (epidemiology) ,Fatty liver ,Gastroenterology ,medicine.disease ,Bioinformatics ,Fatty Liver ,Natural history ,Alcoholism ,Fat accumulation ,Risk Factors ,Internal medicine ,Epidemiology ,Prevalence ,medicine ,Humans ,business - Abstract
There are insufficient data available on the epidemiology of fatty liver to design a complete and correct view of the prevalence, incidence and natural history of this disorder. This article, mainly based on the revision of recently published papers in this field, attempts to give an overview of the current findings on the epidemiology of fatty liver worldwide. The possible factors involved in the development of fat accumulation in the liver, and their potential role in the progression of the disorder will be also addressed.
- Published
- 2004
132. DNA OXIDATIVE DAMAGE IN LEUKOCYTES CORRELATES WITH THE SEVERITY OF HCV-RELATED LIVER DISEASE: VALIDATION IN AN OPEN POPULATION STUDY
- Author
-
Claudio Tiribelli, Stefano Bellentani, Flora Masutti, Romilda Cardin, Gioconda Saccoccio, Fabio Farinati, Cardin, R, Saccoccio, G, Masutti, F, Bellentani, S, Farinati, F, and Tiribelli, Claudio
- Subjects
Adult ,Male ,Cirrhosis ,Adolescent ,Genotype ,Hepatitis C virus ,Population ,Hepacivirus ,Biology ,medicine.disease_cause ,Severity of Illness Index ,Liver disease ,Reference Values ,medicine ,Leukocytes ,Humans ,8-hydroxydeoxyguanosine ,hepatitis C virus-related liver disease ,education ,Child ,Hepatitis ,education.field_of_study ,population study ,Hepatology ,Deoxyguanosine ,Hepatitis C ,DNA ,Middle Aged ,medicine.disease ,DNA oxidative damage ,Oxidative Stress ,Liver ,8-Hydroxy-2'-Deoxyguanosine ,Immunology ,Female ,DNA oxidative damage, 8-hydroxydeoxyguanosine, leukocytes, hepatitis C virus-related liver disease, population study ,Oxidative stress - Abstract
Oxidative DNA damage, identifiable in the formation of 8-hydroxydeoxyguanosine (8-OHdG), is relevant in the mutagenesis/carcinogenesis process. The aim of this study was to assess 8-OHdG levels in patients with hepatitis C virus (HCV) infection in relation to extent of liver damage and HCV genotype.8-OHdG levels were measured in DNA from circulating leukocytes of 110 anti-HCV positive subjects belonging to the population of the Dionysos study, subgrouped in: 50 anti-HCV+ with persistently normal ALT, 48 with chronic hepatitis and 12 with cirrhosis. Twenty normal subjects served as Controls. 8-OHdG levels were assayed by HPLC/electrochemical detector.8-OHdG levels rose (P0.00001) from Controls to HCV+; chronic hepatitis and cirrhosis were associated with a further increase (P0.02 versus HCV+). Genotype 1 was associated with higher levels of 8-OHdG (P0.04). Multiple logistic regression analysis showed that, after correction for potential confoundings, 8-OHdG levels correlated (P0.02) with presence and extent of liver damage.An accumulation of 8-OHdG in circulating leukocytes is a reliable marker of the extent of liver damage in HCV+ patients and is present in particular in genotype 1 infection. This genomic damage may contribute to liver carcinogenesis by causing persistent DNA changes.
- Published
- 2001
133. High prevalence of celiac disease in Italian general population
- Author
-
U, Volta, S, Bellentani, F B, Bianchi, G, Brandi, L, De Franceschi, L, Miglioli, A, Granito, F, Balli, C, Tiribelli, Volta U., Bellentani S., Bianchi F.B., Brandi G., De Franceschi L., Miglioli L., Granito A., Balli F., and Tiribelli C.
- Subjects
Adult ,Male ,Adolescent ,Antibodie ,Antibodies ,Gliadin ,Seroepidemiologic Studies ,Prevalence ,Humans ,Dionysos study ,Child ,Aged ,Cross-Sectional Studie ,nutritional and metabolic diseases ,Middle Aged ,Immunoglobulin A ,Celiac Disease ,Cross-Sectional Studies ,Antibody screening ,Italy ,Anti-gliadin antibodie ,Immunoglobulin G ,Female ,Anti-endomysial antibodie ,Villous atrophy ,Human - Abstract
The worldwide increase of celiac disease prompted us to assess its prevalence in the Italian general population. The 3483 inhabitants of Campogalliano were tested for immunoglobulin A anti-endomysial antibodies. Twenty subjects showed antibody positivity and duodenal biopsy detected typical mucosal lesions of celiac disease in 17 of them; the remaining three cases had a normal villous architecture, but the finding of increased gamma/delta intraepithelial lymphocytes in all and the heterodimer DQA1*0501, DQB1*0201 in two of them was consistent with potential celiac disease. Only one patient had an overt malabsorption syndrome, characterized by diarrhea, weight loss, and severe weakness. In eight subjects atypical symptoms of celiac disease, such as dyspepsia and depression, were present, whereas the remaining subjects were silent. Celiac disease was more frequent in younger age groups. Our cross-sectional design study demonstrates that celiac disease prevalence in the Italian general population is 4.9 per 1000 (95% CI 2.8-7.8), increasing up to 5.7 per 1000 (95% CI 3.5-8.8) with the inclusion of potential cases.
- Published
- 2001
134. Bombesin, trypsin and chronic pancreatitis
- Author
-
Carola Severi, V.D. Corleto, Bruno Annibale, L. De Magistris, Stefano Bellentani, Severi, C, Annibale, B, Bellentani, S, Corleto, V, and DE MAGISTRIS, Laura
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Bombesin ,medicine.disease ,Trypsin ,chemistry.chemical_compound ,Endocrinology ,Pancreatitis ,chemistry ,Internal medicine ,Chronic Disease ,medicine ,Humans ,Peptides ,business ,medicine.drug - Published
- 1984
135. Fulminant hepatitis in a patient with hepatocellular carcinoma related to nonalcoholic steatohepatitis treated with sorafenib
- Author
-
Giovanni Brandi, Stefania De Lorenzo, Stefania Di Girolamo, Stefano Bellentani, Gioconda Saccoccio, Guido Biasco, Brandi, G, De Lorenzo, S, Di Girolamo, S, Bellentani, S, Saccoccio, G, and Biasco G
- Subjects
Male ,Niacinamide ,Cancer Research ,Carcinoma, Hepatocellular ,Jaundice ,Antineoplastic Agents ,03 medical and health sciences ,Fatal Outcome ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Tremor ,Humans ,Protein Kinase Inhibitors ,Aged ,Muscle Weakness ,Phenylurea Compounds ,Liver Neoplasms ,steatohepatiti ,hepatocellular carcinoma ,General Medicine ,Liver Failure, Acute ,digestive system diseases ,Oncology ,030220 oncology & carcinogenesis ,sorafenib ,030211 gastroenterology & hepatology ,Tomography, X-Ray Computed - 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.
136. Nonalcoholic fatty liver disease burden - Switzerland 2018-2030.
- Author
-
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
- Full Text
- View/download PDF
137. Cow's Milk Consumption and Health: A Health Professional's Guide.
- Author
-
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
- Full Text
- View/download PDF
138. Prevalence of and risk factors for fatty liver in the general population of Northern Italy: the Bagnacavallo Study.
- Author
-
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
- View/download PDF
139. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030.
- Author
-
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
140. Nutraceutical Approach to Non-Alcoholic Fatty Liver Disease (NAFLD): The Available Clinical Evidence.
- Author
-
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
141. Two drinks per day does not take your fatty liver away.
- Author
-
Bellentani S, Bedogni G, and Tiribelli C
- Subjects
- Food, Humans, Carbonated Beverages, Fatty Liver
- Published
- 2018
- Full Text
- View/download PDF
142. Viewpoint: "Alcohol Consumption in Late Adolescence is Associated with an Increased Risk of Severe Liver Disease Later in Life".
- Author
-
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
- View/download PDF
143. Global epidemiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: What we need in the future.
- Author
-
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
- Full Text
- View/download PDF
144. Is it time to change NAFLD and NASH nomenclature?
- Author
-
Bellentani S and Tiribelli C
- Subjects
- Humans, Non-alcoholic Fatty Liver Disease classification, Terminology as Topic
- Published
- 2017
- Full Text
- View/download PDF
145. Microbiota, NASH, HCC and the potential role of probiotics.
- Author
-
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
- Full Text
- View/download PDF
146. The epidemiology of non-alcoholic fatty liver disease.
- Author
-
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
- Full Text
- View/download PDF
147. Natural history of nonalcoholic steatohepatitis-associated hepatocellular carcinoma.
- Author
-
Bellentani S, Baroni GS, Piscaglia F, and Tiribelli C
- Published
- 2016
- Full Text
- View/download PDF
148. Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference.
- Author
-
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
- Full Text
- View/download PDF
149. Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study.
- Author
-
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
- Full Text
- View/download PDF
150. A "systems medicine" approach to the study of non-alcoholic fatty liver disease.
- Author
-
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
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.