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Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the population distribution of non-alcoholic fatty liver disease before and after renaming and the association between the types of metabolic risk factors (MRF) for metabolic dysfunction-associated steatotic liver disease (MASLD) and advanced liver fibrosis. Methods This study was conducted among 515 patients who were admitted to The Affiliated Hospital of Xuzhou Medical University and Wuxi Fifth People’s Hospital from January 2019 to January 2022 and had hepatocyte steatosis ≥5% by liver biopsy. Among these patients, 2 patients did not meet the diagnostic criteria for nonalcoholic fatty liver disease (NAFLD) and metabolic associated fatty liver disease (MAFLD), respectively, and were classified as steatotic liver disease (SLD) with other specific causes, and the other 513 patients were divided into MASLD group with 275 patients, comorbid group with 216 patients (MASLD comorbid with other liver diseases), and cryptogenic SLD group with 22 patients. The above groups were compared in terms of clinical features, laboratory markers, and advanced liver fibrosis. The MASLD patients with different types of MRF were compared in terms of clinical features, laboratory markers, and advanced liver fibrosis, and the risk factors for advanced liver fibrosis in patients with MASLD were analyzed. The Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups and further comparison between two groups； the chi-square test was used for comparison of categorical data between multiple groups, and Bonferroni correction was used for further comparison between two groups. The logistic regression analysis was used to identify the risk factors for liver fibrosis. Results Among the 515 patients with SLD, 297 patients (57.7%) met the diagnostic criteria for NAFLD, among whom 22 were classified as cryptogenic SLD and 275 met the diagnostic criteria for MASLD, and 467 (90.7%) were diagnosed with MAFLD. There were significant differences between the three groups in sex, body mass index (BMI), gamma-glutamyl transpeptidase, triglyceride, cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting plasma glucose, NAFLD fibrosis score (NFS), fibrosis-4 (FIB-4), and F3-4 (all P<0.05). Compared with the MASLD group and the cryptogenic SLD group, the comorbid group had the highest proportion of patients with advanced liver fibrosis (P<0.001) . With the increase in the type of MRF, the patients tended to have an older age, a significantly higher proportion of female patients, a higher possibility of hypertension and diabetes, and higher levels of metabolic parameters including BMI, blood lipids, and blood glucose (all P<0.05) . With the increase in the types of MRF in MASLD patients, they tended to have significantly higher noninvasive fibrosis scores (NFS and FIB-4) and a significantly higher proportion of patients with advanced liver fibrosis (P<0.05). The multivariate logistic regression analysis showed that age ≥50 years (odds ratio [OR] =2.622, 95% confidence interval [CI] : 1.091—6.300, P=0.031) and the increase in the type of MRF (OR=1.876, 95%CI: 1.194—2.947, P=0.006) were independent risk factors for MASLD with severe liver fibrosis. Conclusion The new definition of MASLD is based on the positive identification of MRF, and the reclassified population of MASLD is smaller than that of MAFLD, with little difference from that of NAFLD. In addition, age ≥50 years and the increase in the type of MRF are independent risk factors for MASLD with advanced liver fibrosis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Hepatology / Linchuang Gandanbing Zazhi is the property of Journal of Clinical Hepatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To analyze the relationship between liver fibrosis and renal injury in patients with chronic hepatitis B ( CHB) . Methods We retrospectively analyzed the renal function of798 CHB patients who were enrolled from May 2010 to October 2019. According to the quartile of fibrosis - 4 ( FIB - 4) index, the population was divided into four groups: group Q 1 ( FIB - 4 ≤ 0. 74), group Q2 ( 0. 74 FIB - 4 < 1. 13 ), Q3 group ( 1. 13,≤ FlB - 4 < 2. 0), and Q4 group ( FIB - 4≥ 2. 0) . The Mann - Whitney U test was used for comparison of non - normally distributed continuous data between multiple groups. The chi - square test was used for comparison of categorical data between groups. Spearman partial correlation analysis was used to determine the relationship between FIB - 4 and estimated glomerular filtration rate ( eGFR) . Multivariate Logistic regression model was used to assess the risk factors of renal injury using odds ratio ( OR ) and 95% confidence intervals ( CI) . Multiple Logistic regression was used to analyze the relationship between FIB -4 and renal injury in different groups. Results Because FIB -4 was correlated with age ( r = 0. 650, P <0. 001), Spearman partial correlation analysis was used to adjust for age and gender. We found FIB - 4 index was significantly associated with ALT, AST, ALP, GGT, LDH, TBil, DBil, TP, Alb, Glo, TBA, LAP, PLT, HBV DNA, AFP and eGFR (r values were 0. 202, 0. 354, 0. 292, 0. 287, 0. 222, 0. 377, 0. 361, -0. 085, -0.412, 0. 168, 0. 422, 0. 427, 0. 247, - 0. 421, 0. 172, 0. 318, - 0. 359, respectively, all P < 0. 001 ) . eGFR was negatively correlated with FIB - 4 ( R² = 0. 192 9). Multivariate logistic regression analysis found that HBV DNA (OR = 1. 227, 95% CI: L 038 - L 452, P = 0. 017 ), FIB - 4 ( OR = 1. 581, 95 % CI: L 359 - 1. 839, P < 0. 001) were independent risk factors for renal injury. The AUG value of FIB - 4 in predicting renal injury was 0 . 74 ( 95% CI: 0. 67 - 0. 82, P < 0. 001 ), with a sensitivity of 0. 47, a specificity of O. 93, and an optimal cutoff value of 3. 48. Conclusions The degree of liver fibrosis in CHB patients is associated with the risk of renal injury. [ABSTRACT FROM AUTHOR]

Nonalcoholic steatohepatitis (NASH) can cause end - stage liver diseases such as liver cirrhosis and liver cancer, and therefore, it is urgent to treat NASH, reverse hepatic steatosis, and delay the onset of end - stage liver diseases. NASH has a complex pathogenesis and there are currently no effective drugs for treatment. At present, new drugs still have huge market potential and are the research hotspots of various pharmaceutical companies in China and globally. This article mainly reviews and summarizes the clinical research status, drug types, mechanism of action, and future market prospects of the new drugs for NASH in existing phase III studies. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Hepatology / Linchuang Gandanbing Zazhi is the property of Journal of Clinical Hepatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Hepatology / Linchuang Gandanbing Zazhi is the property of Journal of Clinical Hepatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the clinical effect and safety of pegylated interferon-α-2a (PEG-IFN-α-2a) versus pegylated interferon-α-2b (PEG-IFN-α-2b) in the treatment of chronic hepatitis B (CHB). Methods The CHB patients who were treated with PEG-IFN-α-2a (180 μg/week) or PEG-IFN-α-2b (180 μg/week) in Department of Infectious Diseases in our hospital from January 2017 to June 2018 were enrolled. The two groups were compared in terms of the levels of HBsAg, HBV DNA, HBeAg, and alanine aminotransferase (ALT) at 4, 12, 24, and 48 weeks of treatment, and the indices for antiviral effect at 48 weeks were used as main outcome measures. The above indices were compared between response group and non-response group. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. Results There were no significant differences between the PEG-IFN-α-2a group and the PEG-IFN-α-2b group in serum HBV DNA clearance rate (67.6% vs 59.4%, P＞0.05) and HBeAg seroconversion rate (27.2% vs 34.6%, P＞0.05). In the PEG-IFN-α-2a group, the HBV DNA response group had a significantly lower baseline ALT level than the HBV DNA non-response group (Z=2.390, P=0.016); the HBeAg response group had a significantly lower baseline HBeAg level than the HBeAg non-response group (Z=2.286, P=0.021). In the PEG-IFN-α-2b group, the HBV DNA response group had significantly lower baseline HBV DNA level and baseline HBeAg level than the HBV DNA non-response group (Z=2.154 and 2.057, P=0.030 and 0.041); the HBeAg response group had a significantly lower baseline HBV DNA level than the HBeAg non-response group (Z=2.052, P=0.042). There were no significant differences in the incidence rates of adverse reactions between the two groups (P＞0.05); in the PEG-IFN-α-2b group, one patient experienced Purtscher’s retinopathy and one experienced thrombocytopenia, while no similar adverse reactions were observed in the PEG-IFN-α-2a group. Conclusion Both PEG-IFN-α-2a and PEG-IFN-α-2b have strong antiviral and immunomodulatory effects in the treatment of CHB, with similar clinical effect and safety. [ABSTRACT FROM AUTHOR]

ObjectiveTo investigate the efficiency of FibroTouch noninvasive liver stiffness measurement (LSM) in evaluating liver fibrosis degree in nonalcoholic fatty liver disease (NAFLD) patients with different levels of body mass index (BMI). MethodsA total of 238 NAFLD patients who were admitted to The Affiliated Hospital of Xuzhou Medical University from June 2015 to January 2018 and underwent liver biopsy were enrolled in this study, and according to BMI, they were divided into group A (BMI ＜24), group B (24≤BMI＜28), and group C (BMI≥28). FibroTouch was performed within one week after liver biopsy, and fasting blood samples were collected on the same day. The fibrosis indices were calculated. The efficiency of LSM in evaluating fibrosis degree was analyzed in all groups, and the correlation of LSM with related serological fibrosis indices was analyzed. The receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was used to evaluate the diagnostic value of LSM and serum markers. A one-way analysis of variance and the SNK-q test were used to investigate the differences in related indices between NAFLD patients with varying fibrosis degrees, and the Kruskal-Wallis H test was used for comparison of non-normally distributed data. The Spearman′s rank correlation analysis was used to investigate the correlation between LSM and other indices. ResultsIn group A, B, or C, there was a significant difference in LSM between the NAFLD patients with different fibrosis degrees (F=18.543, 22.985, and 5.904, P＜0.001, P＜0.001, and P=0.004). In the NAFLD patients with progressive liver fibrosis, there was a significant difference in LSM between the patients with different levels of BMI (F=3.899, P=0.026). LSM was correlated with Hui score, Forns index, fibrosis-4, and NAFLD fibrosis score (r=0.459, 0.388, 0427, and 0.422, all P＜0.001). LSM had the highest efficiency in the diagnosis of progressive liver fibrosis in NAFLD patients, with an AUC of 0.870, a specificity of 86%, and a sensitivity of 70%. ConclusionFibroTouch has good value in evaluating the liver fibrosis degree of NAFLD patients, and BMI may affect the result of LSM. LSM is well correlated with other diagnostic indices for liver fibrosis and holds promise for clinical application. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinical value of serum protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ) and alpha-fetoprotein (AFP), alone or in combination, in the diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Methods A total of 450 patients with HBV infection, who underwent serological tests in the Department of Infectious Diseases, The Affiliated Hospital of Xuzhou Medical University, from February 2016 to June 2017, were enrolled in our hospital, including 200 patients with HBV-related HCC (80 surgically treated cases), 143 patients with hepatitis B cirrhosis, 65 patients with severe chronic hepatitis B (CHB), and 42 CHB patients with liver failure. The serum levels of PIVKA-Ⅱ and AFP were compared between the four groups. An analysis of variance was used to compare normally distributed continuous data between multiple groups; the Kruskal-Wallis H test was used to compare non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between groups. A binary stepwise logistic regression was used to obtain a new variable as a combination of PIVKA-Ⅱ and AFP. The receiver operating characteristic (ROC) curve was used to calculate the area under the ROC curve (AUC) of AFP and PIVKA-Ⅱ, alone or in combination, in the diagnosis of HBV-related HCC, and the DeLong test was used for comparison of AUC between these variables. Results The HBV-related HCC patients had significantly higher PIVKA-Ⅱ and AFP levels than other groups (Z=-9.432, -6.369, -2.158, -13.202, -9.609, and -7.584, all P＜0.05). The PIVKA-Ⅱ levels of the patients with severe CHB and CHB patients with liver failure were significantly higher than that of the patients with hepatitis B cirrhosis (Z=-2.977 and -2.308, both P＜0.05). The HBV-related HCC patients showed significant reductions in AFP and PIVKA-Ⅱ levels within 5-7 days after surgical treatment (Z=-96.892 and -76.997, both P＜0.05). In the diagnosis of HBV-related HCC, PIVKA-Ⅱ had 84.0% sensitivity and 86.4% specificity, and AFP had 81.5% sensitivity and 50.4% specificity. The AUCs of AFP, PIVKA-Ⅱ, and a combination of AFP and PIVKA-Ⅱ in the diagnosis of HBV-related HCC were 0.757, 0.905, and 0.912, respectively; there were significant differences in AUC between PIVKA-Ⅱ and AFP (Z=6.048, P＜0.001) and between AFP and a combination of AFP and PIVKA-Ⅱ (Z=7.814, P＜0.001). A combination of AFP and PIVKA-Ⅱ had the highest diagnostic efficiency for HBV-related HCC. Conclusion Serum PIVKA-II has a better diagnostic value for HBV-related HCC than AFP, and a combination of the two can increase the detection rate of HCC and reduce the rate of misdiagnosis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Hepatology / Linchuang Gandanbing Zazhi is the property of Journal of Clinical Hepatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)