2,290 results on '"Chalasani, Naga"'
Search Results
2. Amiodarone and Dronedarone Causes Liver Injury with Distinctly Different Clinical Presentations
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Pop, Alexander, Halegoua-DeMarzio, Dina, Barnhart, Huiman, Kleiner, David, Avigan, Mark, Gu, Jiezhun, Chalasani, Naga, Ahmad, Jawad, Fontana, Robert J., Lee, William, Barritt, A. Sidney, Durazo, Francisco, Hayashi, Paul H., and Navarro, Victor J.
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- 2024
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3. Primary Sclerosing Cholangitis Limited to Intrahepatic Bile Ducts Has Distinctly Better Prognosis
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Are, Vijay S., Gromski, Mark A., Akisik, Fatih, Vilar-Gomez, Eduardo, Lammert, Craig, Ghabril, Marwan, Vuppalanchi, Raj, and Chalasani, Naga
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- 2024
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4. Role of Spleen Stiffness Measurement in the Evaluation of Metabolic Dysfunction-Associated Steatotic Liver Disease
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Williams, Elizabeth E., Mladenovic, Andrea, Ranginani, Dheeksha, Weber, Regina, Samala, Niharika, Gawrieh, Samer, Vilar-Gomez, Eduardo, Chalasani, Naga, and Vuppalanchi, Raj
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- 2024
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5. Abstract 13902: Using a Proteomics-Based Cardiovascular Risk Test to Identify Systemic Changes in a Clinical Trial of Nonalcoholic Fatty Liver Disease
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Sanyal, Arun, Simpson, Missy, Hinterberg, Michael, Hales, Erin, Paterson, Clare, Neuschwander-Tetri, Brent, Diehl, Anna Mae, Dasarathy, Srinivasan, Loomba, Rohit, Chalasani, Naga, Kowdley, Kris, Hameed, Bilal, Kleiner, David, Behling, Cynthia, Tonascia, James, Yates, Katherine, and Williams, Stephen A
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Biomedical and Clinical Sciences ,Clinical Sciences ,Chronic Liver Disease and Cirrhosis ,Clinical Trials and Supportive Activities ,Digestive Diseases ,Cardiovascular ,Clinical Research ,Prevention ,Hepatitis ,Liver Disease ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Oral and gastrointestinal ,Good Health and Well Being ,Cardiorespiratory Medicine and Haematology ,Public Health and Health Services ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences ,Sports science and exercise - Abstract
Background: Nonalcoholic steatohepatitis (NASH) is associated with increased cardiovascular outcomes. Assessment of the impact of NASH therapy on cardiovascular risk is an important element of NASH drug development but is challenging particularly in early phase trials. Aptamer-based proteomic profiles (Somalogic®) in serum have been used to develop and validate a risk score as a surrogate for cardiovascular (CV) risk. Hypothesis: Improvement in NASH histology will result in improved proteomic cardiovascular risk scores. Methods: A post-hoc analysis of proteomic profiles of serum samples, using the Somalogic® platform, from the Pioglitazone vs. Vitamin E vs. Placebo for Treatment of Nonalcoholic Fatty Liver Disease (PIVENS) trial was conducted. PIVENS was a 96-week trial of nondiabetic participants with (NASH). We applied the proteomic CV risk scores to samples from baseline, on therapy and end of treatment visits (n=7) visits and received liver histology results at baseline and 96 weeks on N = 209 (84.6%) study participants. Generalized linear and mixed models were used to assess the association between CV risk score, treatment arm and change in liver biopsy results. Results: Baseline scores were similar across groups (mean 0.19, SD 0.14). There was no association between treatment arms and changes in scores during therapy and end of treatment. However, improvement in histological markers of activity (lobular inflammation and NAFLD activity score) and fibrosis were associated with improved cv risk scores (Figure) (p< 0.05 for all). Conclusions: Improvement in hepatic inflammation, NAFLD activity score and fibrosis were associated with improved proteomic CV risk scores regardless of treatment provided. Additional prospective validation of these findings is warranted. Proteomic profiling can potentially be used to track changes in cardiovascular risk profile changes in response to therapy in the short term NASH treatment trials.
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- 2023
6. Fibrosis Progression Rate in Biopsy-Proven Nonalcoholic Fatty Liver Disease Among People With Diabetes Versus People Without Diabetes: A Multicenter Study
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Huang, Daniel Q, Wilson, Laura A, Behling, Cynthia, Kleiner, David E, Kowdley, Kris V, Dasarathy, Srinivasan, Amangurbanova, Maral, Terrault, Norah A, Diehl, Anna Mae, Chalasani, Naga, Neuschwander-Tetri, Brent A, Sanyal, Arun J, Tonascia, James, Loomba, Rohit, Allende, Daniela, Bellar, Annette, Dasarathy, Jaividhya, Welch, Nicole, Yerrapothu, Rahul, Bashir, Mustafa, Guy, Cynthia, Kopping, Mariko, Piercy, Dawn, Suzuki, Ayako, Tawadrou, Naglaa, Cruz, Mandy, Cummings, Oscar W, Garrison, Lisa, Gawrieh, Samer, Samala, Niharika, Vuppalanchi, Raj, Carpenter, Danielle, Cattoor, Theresa, Freebersyser, Janet, Angkanaworakul, Pannapat, Berihun, Achashman, Buysse, Andrew, Dorrian, Theresa, Gulati, Breanna, Liu, Kevin, Misic, Sandra, Sohal, Adam, Vuong, Joseph, Ajmera, Veeral, Madamba, Egbert, Middleton, Michael S, Richards, Lisa, Singh, Seema, Sirlin, Claude, Gill, Ryan, Hameed, Bilal, Awe, Remilekun, Olvera, Daisy, Terrault, Norah, Yuan, Liyun, Yeh, Matthew, Albhaisi, Somaya, Asgharpour, Amon, Boyett, Sherry, Contos, Melissa J, Luketic, Velimir AC, Schlosser, Jolene, Siddiqui, Mohammad S, Adamo, Peggy, Belt, Patricia, Clark, Jeanne M, DeSanto, Jennifer M, Meinert, Jill, Miriel, Laura, Mitchell, Emily P, Shade, Carrie, Smith, Jacqueline, Smith, Michael, Sternberg, Alice, Van Natta, Mark L, Wagoner, Annette, Woreta, Tinsay, and Yates, Katherine P
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Biomedical and Clinical Sciences ,Clinical Sciences ,Hepatitis ,Liver Disease ,Digestive Diseases ,Chronic Liver Disease and Cirrhosis ,Clinical Research ,Diabetes ,Obesity ,Metabolic and endocrine ,Good Health and Well Being ,Adult ,Humans ,Female ,Male ,Non-alcoholic Fatty Liver Disease ,Diabetes Mellitus ,Type 2 ,Cohort Studies ,Liver Cirrhosis ,Biopsy ,Nonalcoholic Steatohepatitis ,NAFLD ,Cirrhosis ,Type 2 Diabetes Mellitus ,NASH Clinical Research Network ,Neurosciences ,Paediatrics and Reproductive Medicine ,Gastroenterology & Hepatology ,Clinical sciences ,Nutrition and dietetics - Abstract
Background & aimsThere are limited data regarding fibrosis progression in biopsy-proven nonalcoholic fatty liver disease (NAFLD) in people with type 2 diabetes mellitus (T2DM) compared with people without T2DM. We assessed the time to fibrosis progression in people with T2DM compared with people without T2DM in a large, multicenter, study of people with NAFLD who had paired liver biopsies.MethodsThis study included 447 adult participants (64% were female) with NAFLD who had paired liver biopsies more than 1 year apart. Liver histology was systematically assessed by a central pathology committee blinded to clinical data. The primary outcome was the cumulative incidence of a ≥1-stage increase in fibrosis in participants with T2DM compared with participants without T2DM.ResultsThe mean (SD) age and body mass index (calculated as weight in kilograms divided by the square of the height in meters) were 50.9 (11.5) years and 34.7 (6.3), respectively. The median time between biopsies was 3.3 years (interquartile range, 1.8-6.1 years). Participants with T2DM had a significantly higher cumulative incidence of fibrosis progression at 4 years (24% vs 20%), 8 years (60% vs 50%), and 12 years (93% vs 76%) (P = .005). Using a multivariable Cox proportional hazards model adjusted for multiple confounders, T2DM remained an independent predictor of fibrosis progression (adjusted hazard ratio, 1.69; 95% CI, 1.17-2.43; P = .005). The cumulative incidence of fibrosis regression by ≥1 stage was similar in participants with T2DM compared with participants without T2DM (P = .24).ConclusionsIn this large, multicenter cohort study of well-characterized participants with NAFLD and paired liver biopsies, we found that fibrosis progressed faster in participants with T2DM compared with participants without T2DM. These data have important implications for clinical practice and trial design.
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- 2023
7. Effects of Food Insecurity on Hepatic Steatosis and Fibrosis in People With HIV
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Naggie, Susanna, Diehl, Anna Mae, Kopping, Mariko, Mangus, Rebecca, Chalasani, Naga, Cheek, Kaelea, Crandall, Holly, Cummings, Oscar W., Garcia, Nicole, Gawrieh, Samer, Releford, Montreca, Vilar-Gomez, Eduardo, Sulkowski, Mark, Brinkley, Sherilyn, Coleman, Daniel, Gilman, Lee, Mekhael, Sara, Moon, Juhi, Stelmash, Lauren, Williams, Quintara, Woreta, Tinsay, Heath, Sonya L., Goepfert, Paul A., Gray, Meagan, Hogue, Olivia, Lloyd, Audrey, Logan, Heather, Spraggins, Kristen, Tingle, William, Vereen, Latasha, Loomba, Rohit, Ajmera, Veeral, Cachay, Edward, Cervantes, Vanessa, Hernandez, Christie, Madamba, Egbert, Richards, Lisa, Tesfai, Kaleb, Tincopa, Monica, Price, Jennifer, Camberos, Rosaura, Laguardia, Yesenia, Luetkemeyer, Annie, McKinney, Jeffrey, Pearlman, Brittlyn, Stern, Sophie, Lake, Jordan E., Hernandez, Marisel Negret, Somasunderam, Anoma, Sterling, Richard, Devore, Megan, Nixon, Daniel, Kardashian, Ani, Sulkowski, Mark S., Wilson, Laura A., Sterling, Richard K., Heath, Sonya, Chalasani, Naga P., and Price, Jennifer C.
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- 2024
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8. TOP-080 A validated tool consisting of bedside variables predicts high-risk NASH (HRN) in individuals with type 2 diabetes
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Gomez, Eduardo Vilar, Parmar, Deven, Samala, Niharika, Vuppalanchi, Raj, Gawrieh, Samer, Cummings, Oscar, Harrison, Stephen, Loomba, Rohit, and Chalasani, Naga
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Biomedical and Clinical Sciences ,Clinical Sciences ,Public Health and Health Services ,Gastroenterology & Hepatology ,Clinical sciences - Published
- 2023
9. 334 HEPATIC RETICULOENDOTHELIAL SYSTEM CELL IRON DEPOSITION IS INDEPENDENTLY ASSOCIATED WITH ADVANCED FIBROSIS IN NASH: ANALYSIS OF 2833 PATIENTS FROM THE NASH-CRN
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Sohal, Aalam, Wilson, Laura, Loomba, Rohit, Dasarathy, Srinivasan, Sanyal, Arun J, Chalasani, Naga P, Diehl, Anna Mae, and Kowdley, Kris V
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Biomedical and Clinical Sciences ,Clinical Sciences ,Nutrition and Dietetics ,Neurosciences ,Paediatrics and Reproductive Medicine ,Gastroenterology & Hepatology ,Clinical sciences ,Nutrition and dietetics - Published
- 2023
10. Defining the serum proteomic signature of hepatic steatosis, inflammation, ballooning and fibrosis in non-alcoholic fatty liver disease
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Sanyal, Arun J, Williams, Stephen A, Lavine, Joel E, Neuschwander-Tetri, Brent A, Alexander, Leigh, Ostroff, Rachel, Biegel, Hannah, Kowdley, Kris V, Chalasani, Naga, Dasarathy, Srinivasan, Diehl, Anna Mae, Loomba, Rohit, Hameed, Bilal, Behling, Cynthia, Kleiner, David E, Karpen, Saul J, Williams, Jessica, Jia, Yi, Yates, Katherine P, and Tonascia, James
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Biomedical and Clinical Sciences ,Clinical Sciences ,Prevention ,Hepatitis ,Nutrition ,Chronic Liver Disease and Cirrhosis ,Liver Disease ,Digestive Diseases ,Clinical Research ,4.1 Discovery and preclinical testing of markers and technologies ,Detection ,screening and diagnosis ,Good Health and Well Being ,Humans ,Biopsy ,Fibrosis ,Inflammation ,Liver ,Liver Cirrhosis ,Non-alcoholic Fatty Liver Disease ,Pioglitazone ,Proteomics ,Vitamin E ,Nonalcoholic fatty liver disease ,Nonalcoholic steatohepatitis ,NAFLD activity score ,fibrosis stage ,cirrhosis ,stea-tohepatitis ,steatosis ,hepatocellular ballooning ,lobular inflammation ,fibrosis ,proteomics ,aptamers ,steatohepatitis ,Public Health and Health Services ,Gastroenterology & Hepatology ,Clinical sciences - Abstract
Background & aimsDespite recent progress, non-invasive tests for the diagnostic assessment and monitoring of non-alcoholic fatty liver disease (NAFLD) remain an unmet need. Herein, we aimed to identify diagnostic signatures of the key histological features of NAFLD.MethodsUsing modified-aptamer proteomics, we assayed 5,220 proteins in each of 2,852 single serum samples from 636 individuals with histologically confirmed NAFLD. We developed and validated dichotomized protein-phenotype models to identify clinically relevant severities of steatosis (grade 0 vs. 1-3), hepatocellular ballooning (0 vs. 1 or 2), lobular inflammation (0-1 vs. 2-3) and fibrosis (stages 0-1 vs. 2-4).ResultsThe AUCs of the four protein models, based on 37 analytes (18 not previously linked to NAFLD), for the diagnosis of their respective components (at a clinically relevant severity) in training/paired validation sets were: fibrosis (AUC 0.92/0.85); steatosis (AUC 0.95/0.79), inflammation (AUC 0.83/0.72), and ballooning (AUC 0.87/0.83). An additional outcome, at-risk NASH, defined as steatohepatitis with NAFLD activity score ≥4 (with a score of at least 1 for each of its components) and fibrosis stage ≥2, was predicted by multiplying the outputs of each individual component model (AUC 0.93/0.85). We further evaluated their ability to detect change in histology following treatment with placebo, pioglitazone, vitamin E or obeticholic acid. Component model scores significantly improved in the active therapies vs. placebo, and differential effects of vitamin E, pioglitazone, and obeticholic acid were identified.ConclusionsSerum protein scanning identified signatures corresponding to the key components of liver biopsy in NAFLD. The models developed were sufficiently sensitive to characterize the longitudinal change for three different drug interventions. These data support continued validation of these proteomic models to enable a "liquid biopsy"-based assessment of NAFLD.Clinical trial numberNot applicable.Impact and implicationsAn aptamer-based protein scan of serum proteins was performed to identify diagnostic signatures of the key histological features of non-alcoholic fatty liver disease (NAFLD), for which no approved non-invasive diagnostic tools are currently available. We also identified specific protein signatures related to the presence and severity of NAFLD and its histological components that were also sensitive to change over time. These are fundamental initial steps in establishing a serum proteome-based diagnostic signature of NASH and provide the rationale for using these signatures to test treatment response and to identify several novel targets for evaluation in the pathogenesis of NAFLD.
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- 2023
11. Randomized trial of anakinra plus zinc vs. prednisone for severe alcohol-associated hepatitis
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Chalasani, Naga, Patidar, Kavish R., Vuppalanchi, Raj, Samala, Niha, Yoder, Lindsey, Nephew, Lauren, Shah, Vijay H., Simonetto, Douglas A., Kamath, Patrick, Vargas, Hugo E., Yang, Liu, Dasarathy, Srinivasan, Welch, Nicole, Bellar, Annette, Attaway, Amy, Dasarathy, Jaividhya, Growley, Ashley, Streem, David, Nagy, Laura E., Mitchell, Mack C., Herlong, H. Franklin, Kerr, Thomas, Cotter, Thomas, Sanyal, Arun, O'Connor, Sara, Luketic, Velimir, Asgharpour, Amon, Taylor, Stephanie, McClain, Craig J., Vatsalya, Vatsalya, Jophlin, Loretta, Cave, Matt, Jha, Suman Kumar, Marsano, Luis, Barve, Ashutosh, Frimodig, Jane, Bataller, Ramon, Ravi, Samhita, Behari, Jaideep, Shivanekar, Sharvari, Novelli, Paula, Duarte-Rojo, Andres, Jonassaint, Naudia, Szabo, Gyongyi, Curry, Jiang, Zhenghui G., Agarwal, Ushma, Hazel, Mia, Schnabl, Bernd, Gawrieh, Samer, Tu, Wanzhu, Kamath, Patrick S., Chalasani, Naga P., Tang, Qing, Radaeva, Svetlana, Barton, Bruce, and Sanyal, Arun J.
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- 2024
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12. Nutrition assessment and MASH severity in children using the Healthy Eating Index
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Jain, Ajay Kumar, Buchannan, Paula, Yates, Katherine P, Belt, Patricia, Schwimmer, Jeffrey B, Rosenthal, Philip, Murray, Karen F, Molleston, Jean P, Scheimann, Ann, Xanthakos, Stavra A, Behling, Cynthia A, Hertel, Paula, Nilson, Jamie, Neuschwander-Tetri, Brent A, Tonascia, James, Vos, Miriam B, Cavallo, Laurel, Garner, Donna, Hertel, Paula M, Mysore, Krupa R, Ortega, Taira Illescas, Tessier, Mary Elizabeth, Triggs, Nicole, Tsai, Cynthia, Arce-Clachar, Ana Catalina, Bramlage, Kristin, Cecil, Kim, Mouzaki, Marialena, Popelar, Ann, Trout, Andrew, Xanthakos, Stavra, Allende, Daniela, Bellar, Annette, Dasarathy, Jaividhya, Dasarathy, Srinivasan, Welch, Nicole, Yerrapothu, Rahul, Bashir, Mustafa, Diehl, Anna Mae, Guy, Cynthia, Kopping, Mariko, Piercy, Dawn, Suzuki, Ayako, Alazraki, Adina, Garcia, Carmen, Jara-Garra, Jorge, Karpen, Saul, Vos, Miriam, Chalasani, Naga, Cruz, Mandy, Cummings, Oscar W, Garrison, Lisa, Gawrieh, Samer, Adams, Kathryn Harlow, Jarasvaraparn, Chaowapong, Klipsch, Ann, Morlan, Wendy, Ragozzino, Emily, Samala, Niharika, Vuppalanchi, Raj, Angkanaworakul, Pannapat, Berihun, Achashman, Buysse, Andrew, Dorrian, Theresa, Gulati, Breanna, Kowdley, Kris V, Liu, Kevin, Misic, Sandra, Sohal, Adam, Anthony, Angela, Chapin, Catherine, Fishbein, Mark H, Carpenter, Danielle, Cattoor, Theresa, Freebersyser, Janet, Jain, Ajay K, Ajmera, Veeral, Alba, Amy, Behling, Cynthia, Goyal, Nidhi, Keyvan, Leila, Loomba, Rohit, Madamba, Egbert, Middleton, Michael S, Morfin, Rebecca, Newton, Kimberly, Richards, Lisa, Singh, Seema, Sirlin, Claude, Skonieczny, Jaret, Ugalde-Nicalo, Patricia, Wang, Andrew, Awe, Remilekun, Gill, Ryan, Hameed, Bilal, Olvera, Daisy, and Terrault, Norah
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Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Obesity ,Digestive Diseases ,Nutrition ,Prevention ,Clinical Research ,Clinical Trials and Supportive Activities ,Pediatric ,Oral and gastrointestinal ,Metabolic and endocrine ,Good Health and Well Being ,Humans ,Male ,Child ,Female ,Diet ,Healthy ,Nutrition Assessment ,Lipids ,Sugars ,Body Weight ,Nonalcoholic Steatohepatitis Clinical Research Network ,Clinical sciences - Abstract
BackgroundPediatric metabolic-associated fatty liver disease (MAFLD) is a global health problem, with lifestyle modification as its major therapeutic strategy. Rigorous characterization of dietary content on MAFLD in children is lacking. We hypothesized an objectively measured healthier diet would positively modulate MAFLD.MethodsDiet was assessed using the Nutrition Data System for Research in children enrolled from 10 tertiary clinical centers to determine the Healthy Eating Index (HEI, 0-100) and individual food components.ResultsIn all, 119 children were included (13.3 ± 2.7 y), 80 (67%) male, 67 (18%) White, and 90 (76%) Hispanic, with an average body mass index Z-score of 2.2 ± 0.5. Diet was classified as low HEI < 47.94 (n = 39), mid HEI ≥ 47.94 and < 58.89 (n = 41), or high HEI ≥ 58.89 (n=39). Children with high HEI (healthier diet) had lower body weight (p = 0.005) and more favorable lipids. Mean serum triglycerides for low, mid, and high HEI were 163, 148, and 120 mg/dL, respectively; p = 0.04 mid versus high, p = 0.01 low versus high. Mean HDL was 38, 41 and 43 mg/dL; p = 0.02 low vs high. Less severe steatosis was noted with added sugar ≤ 10% of calories (p = 0.03). Higher lobular inflammation is associated with a higher percentage of calories from fat (OR (95% CI) = 0.95 (0.91-1.00), p = 0.04).ConclusionsIn children with MAFLD, high HEI is associated with lower body weight and more favorable lipids, while added sugar and fat intake has individual histologic features. Differential consumption of major dietary components may modify both metabolic risk factors and histologic liver injury, highlighting the importance of objective diet assessments in children with MAFLD.
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- 2023
13. All‐cause and liver‐related mortality risk factors in excessive drinkers: Analysis of data from the UK biobank
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Whitfield, John B, Seth, Devanshi, Morgan, Timothy R, Aithal, Guruprasad P, Atkinson, Stephen R, Bataller, Ramon, Botwin, Gregory, Chalasani, Naga P, Cordell, Heather J, Daly, Ann K, Darlay, Rebecca, Day, Christopher P, Eyer, Florian, Foroud, Tatiana, Gleeson, Dermot, Goldman, David, Haber, Paul S, Jacquet, Jean‐Marc, Liang, Tiebing, Liangpunsakul, Suthat, Masson, Steven, Mathurin, Philippe, Moirand, Romain, Moreno, Christophe, Morgan, Marsha Y, Mueller, Sebastian, Müllhaupt, Beat, Nagy, Laura E, Nahon, Pierre, Nalpas, Bertrand, Naveau, Sylvie, Perney, Pascal, Pirmohamed, Munir, Schwantes‐An, Tae‐Hwi, Seitz, Helmut K, Soyka, Michael, Stickel, Felix, Thompson, Andrew, Thursz, Mark R, and Trepo, Eric
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Biomedical and Clinical Sciences ,Clinical Sciences ,Digestive Diseases ,Substance Misuse ,Liver Disease ,Nutrition ,Brain Disorders ,Alcoholism ,Alcohol Use and Health ,Clinical Research ,Cancer ,Oral and gastrointestinal ,Good Health and Well Being ,Humans ,Male ,Female ,Alcoholism ,Alcohol Drinking ,Biological Specimen Banks ,Risk Factors ,Cardiovascular Diseases ,Liver ,United Kingdom ,alcohol ,alcohol dependence ,all-cause mortality ,excessive drinking ,liver disease ,GenomALC Consortium ,Neurosciences ,Psychology ,Substance Abuse ,Clinical sciences ,Biological psychology ,Clinical and health psychology - Abstract
BackgroundHigh alcohol intake is associated with increased mortality. We aimed to identify factors affecting mortality in people drinking extreme amounts of alcohol.MethodsWe obtained information from the UK Biobank on approximately 500,000 participants aged 40-70 years at baseline assessment in 2006-2010. Habitual alcohol intake, lifestyle and physiological data, laboratory test results, and hospital diagnoses and death certificate data (to June 2020) for 5136 men (2.20% of male participants) and 1504 women (0.60%) who reported consuming ≥80 or ≥50 g/day, respectively, were used in survival analysis.ResultsMortality hazard ratios for these excessive drinkers, compared to all other participants, were 2.02 (95% CI 1.89-2.17) for all causes, 1.89 (1.69-2.12) for any cancer, 1.87 (1.61-2.17) for any circulatory disease, and 9.40 (7.00-12.64) for any liver disease. Liver disease diagnosis or abnormal liver function tests predicted not only deaths attributed to liver disease but also those from cancers or circulatory diseases. Mortality among excessive drinkers was also associated with quantitative alcohol intake; diagnosed alcohol dependence, harmful use, or withdrawal syndrome; and current smoking at assessment.ConclusionsPeople with chronic excessive alcohol intake experience decreased average survival, but there is substantial variation in their mortality, with liver abnormality and alcohol dependence or other alcohol use disorders associated with a worse prognosis. Clinically, patients with these risk factors and high alcohol intake should be considered for early or intensive management. Research can usefully focus on the factors predisposing to dependence or liver abnormality.
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- 2022
14. A multiancestry genome-wide association study of unexplained chronic ALT elevation as a proxy for nonalcoholic fatty liver disease with histological and radiological validation
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Vujkovic, Marijana, Ramdas, Shweta, Lorenz, Kim M, Guo, Xiuqing, Darlay, Rebecca, Cordell, Heather J, He, Jing, Gindin, Yevgeniy, Chung, Chuhan, Myers, Robert P, Schneider, Carolin V, Park, Joseph, Lee, Kyung Min, Serper, Marina, Carr, Rotonya M, Kaplan, David E, Haas, Mary E, MacLean, Matthew T, Witschey, Walter R, Zhu, Xiang, Tcheandjieu, Catherine, Kember, Rachel L, Kranzler, Henry R, Verma, Anurag, Giri, Ayush, Klarin, Derek M, Sun, Yan V, Huang, Jie, Huffman, Jennifer E, Creasy, Kate Townsend, Hand, Nicholas J, Liu, Ching-Ti, Long, Michelle T, Yao, Jie, Budoff, Matthew, Tan, Jingyi, Li, Xiaohui, Lin, Henry J, Chen, Yii-Der Ida, Taylor, Kent D, Chang, Ruey-Kang, Krauss, Ronald M, Vilarinho, Silvia, Brancale, Joseph, Nielsen, Jonas B, Locke, Adam E, Jones, Marcus B, Verweij, Niek, Baras, Aris, Reddy, K Rajender, Neuschwander-Tetri, Brent A, Schwimmer, Jeffrey B, Sanyal, Arun J, Chalasani, Naga, Ryan, Kathleen A, Mitchell, Braxton D, Gill, Dipender, Wells, Andrew D, Manduchi, Elisabetta, Saiman, Yedidya, Mahmud, Nadim, Miller, Donald R, Reaven, Peter D, Phillips, Lawrence S, Muralidhar, Sumitra, DuVall, Scott L, Lee, Jennifer S, Assimes, Themistocles L, Pyarajan, Saiju, Cho, Kelly, Edwards, Todd L, Damrauer, Scott M, Wilson, Peter W, Gaziano, J Michael, O’Donnell, Christopher J, Khera, Amit V, Grant, Struan FA, Brown, Christopher D, Tsao, Philip S, Saleheen, Danish, Lotta, Luca A, Bastarache, Lisa, Anstee, Quentin M, Daly, Ann K, Meigs, James B, Rotter, Jerome I, Lynch, Julie A, Rader, Daniel J, Voight, Benjamin F, and Chang, Kyong-Mi
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Genetics ,Liver Disease ,Human Genome ,Digestive Diseases ,Chronic Liver Disease and Cirrhosis ,Aetiology ,2.1 Biological and endogenous factors ,Alanine Transaminase ,Alpha-Ketoglutarate-Dependent Dioxygenase FTO ,Genome-Wide Association Study ,Humans ,Intracellular Signaling Peptides and Proteins ,Lipase ,Membrane Proteins ,Non-alcoholic Fatty Liver Disease ,Polymorphism ,Single Nucleotide ,Protein Serine-Threonine Kinases ,Regeneron Genetics Center ,Geisinger-Regeneron DiscovEHR Collaboration ,EPoS Consortium ,VA Million Veteran Program ,Biological Sciences ,Medical and Health Sciences ,Developmental Biology - Abstract
Nonalcoholic fatty liver disease (NAFLD) is a growing cause of chronic liver disease. Using a proxy NAFLD definition of chronic elevation of alanine aminotransferase (cALT) levels without other liver diseases, we performed a multiancestry genome-wide association study (GWAS) in the Million Veteran Program (MVP) including 90,408 cALT cases and 128,187 controls. Seventy-seven loci exceeded genome-wide significance, including 25 without prior NAFLD or alanine aminotransferase associations, with one additional locus identified in European American-only and two in African American-only analyses (P
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- 2022
15. Comparison of clinical prediction rules for ruling out cirrhosis in nonalcoholic fatty liver disease (NAFLD)
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Brandman, Danielle, Boyle, Marie, McPherson, Stuart, Van Natta, Mark L, Sanyal, Arun J, Kowdley, Kris, Neuschwander‐Tetri, Brent, Chalasani, Naga, Abdelmalek, Manal F, Terrault, Norah A, McCullough, Art, Bettencourt, Ricki, Caussy, Cyrielle, Kleiner, David E, Behling, Cynthia, Tonascia, James, Anstee, Quentin M, Loomba, Rohit, and Network, Members of the Nonalcoholic Steatohepatitis Clinical Research
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Biomedical and Clinical Sciences ,Clinical Sciences ,Digestive Diseases ,Hepatitis ,Liver Disease ,Chronic Liver Disease and Cirrhosis ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Oral and gastrointestinal ,Good Health and Well Being ,Adult ,Biopsy ,Clinical Decision Rules ,Cross-Sectional Studies ,Female ,Fibrosis ,Humans ,Liver ,Liver Cirrhosis ,Non-alcoholic Fatty Liver Disease ,cirrhosis ,nonalcoholic fatty liver disease ,noninvasive assessment ,Members of the Nonalcoholic Steatohepatitis Clinical Research Network ,Pharmacology and Pharmaceutical Sciences ,Gastroenterology & Hepatology ,Clinical sciences ,Pharmacology and pharmaceutical sciences - Abstract
Background and aimsPatients with nonalcoholic fatty liver disease (NAFLD) cirrhosis benefit from referral to subspecialty care. While several clinical prediction rules exist to identify advanced fibrosis, the cutoff for excluding cirrhosis due to NAFLD is unclear. This analysis compared clinical prediction rules for excluding biopsy-proven cirrhosis in NAFLD.MethodsAdult patients were enrolled in the NASH Clinical Research Network (US) and the Newcastle Cohort (UK). Clinical and laboratory data were collected at enrolment, and a liver biopsy was taken within 1 year of enrolment. Optimal cutoffs for each score (eg, FIB-4) to exclude cirrhosis were derived from the US cohort, and sensitivity, specificity, positive predictive value, negative predictive value and AUROC were calculated. The cutoffs were evaluated in the UK cohort.Results147/1483 (10%) patients in the US cohort had cirrhosis. All prediction rules had similarly high NPV (0.95-0.97). FIB-4 and NAFLD fibrosis scores were the most accurate in characterising patients as having cirrhosis (AUROC 0.84-0.86). 59/494 (12%) patients in the UK cohort had cirrhosis. Prediction rules had high NPV (0.92-0.96), and FIB-4 and NAFLD fibrosis score the most accurate in the prediction of cirrhosis in the UK cohort (AUROC 0.87-0.89).ConclusionsThis cross-sectional analysis of large, multicentre international datasets shows that current clinical prediction rules perform well in excluding cirrhosis with appropriately chosen cutoffs. These clinical prediction rules can be used in primary care to identify patients, particularly those who are white, female, and
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- 2022
16. Occult liver disease: A multinational perspective
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Vidal-Cevallos, Paulina, Flores-García, Nayelli, Chávez-Tapia, Norberto C., and Chalasani, Naga P.
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- 2024
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17. Age, BMI, and Type 2 Diabetes Modify the Relationship Between PNPLA3 and Advanced Fibrosis in Children and Adults With NAFLD
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Jarasvaraparn, Chaowapong, Vilar-Gomez, Eduardo, Yates, Katherine P., Wilson, Laura A., Neuschwander-Tetri, Brent, Loomba, Rohit, Cummings, Oscar, Vos, Miriam, Xanthakos, Stavra, Schwimmer, Jeffrey, Molleston, Jean P., Sanyal, Arun, Tonascia, James, and Chalasani, Naga
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- 2024
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18. Clinically important alterations in pharmacogene expression in histologically severe nonalcoholic fatty liver disease
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Powell, Nicholas R., Liang, Tiebing, Ipe, Joseph, Cao, Sha, Skaar, Todd C., Desta, Zeruesenay, Qian, Hui-Rong, Ebert, Philip J., Chen, Yu, Thomas, Melissa K., and Chalasani, Naga
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- 2023
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19. A genetic risk score and diabetes predict development of alcohol-related cirrhosis in drinkers
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Whitfield, John B, Schwantes-An, Tae-Hwi, Darlay, Rebecca, Aithal, Guruprasad P, Atkinson, Stephen R, Bataller, Ramon, Botwin, Greg, Chalasani, Naga P, Cordell, Heather J, Daly, Ann K, Day, Christopher P, Eyer, Florian, Foroud, Tatiana, Gleeson, Dermot, Goldman, David, Haber, Paul S, Jacquet, Jean-Marc, Liang, Tiebing, Liangpunsakul, Suthat, Masson, Steven, Mathurin, Philippe, Moirand, Romain, McQuillin, Andrew, Moreno, Christophe, Morgan, Marsha Y, Mueller, Sebastian, Müllhaupt, Beat, Nagy, Laura E, Nahon, Pierre, Nalpas, Bertrand, Naveau, Sylvie, Perney, Pascal, Pirmohamed, Munir, Seitz, Helmut K, Soyka, Michael, Stickel, Felix, Thompson, Andrew, Thursz, Mark R, Trépo, Eric, Morgan, Timothy R, Seth, Devanshi, and Consortium, GenomALC
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Biomedical and Clinical Sciences ,Clinical Sciences ,Rare Diseases ,Liver Cancer ,Genetics ,Liver Disease ,Clinical Research ,Substance Misuse ,Genetic Testing ,Cancer ,Alcoholism ,Alcohol Use and Health ,Digestive Diseases ,Chronic Liver Disease and Cirrhosis ,Metabolic and endocrine ,Oral and gastrointestinal ,Good Health and Well Being ,Adult ,Alcohol Drinking ,Case-Control Studies ,Cohort Studies ,Diabetes Mellitus ,Female ,Genetic Predisposition to Disease ,Genome-Wide Association Study ,Humans ,Liver Cirrhosis ,Alcoholic ,Male ,Middle Aged ,Polymorphism ,Single Nucleotide ,Risk Assessment ,Hepatocellular carcinoma ,risk stratification ,chronic alcohol use ,genome-wide association ,single nucleotide polymorphism ,coffee ,GenomALC Consortium ,Public Health and Health Services ,Gastroenterology & Hepatology ,Clinical sciences - Abstract
Background & aimsOnly a minority of excess alcohol drinkers develop cirrhosis. We developed and evaluated risk stratification scores to identify those at highest risk.MethodsThree cohorts (GenomALC-1: n = 1,690, GenomALC-2: n = 3,037, UK Biobank: relevant n = 6,898) with a history of heavy alcohol consumption (≥80 g/day (men), ≥50 g/day (women), for ≥10 years) were included. Cases were participants with alcohol-related cirrhosis. Controls had a history of similar alcohol consumption but no evidence of liver disease. Risk scores were computed from up to 8 genetic loci identified previously as associated with alcohol-related cirrhosis and 3 clinical risk factors. Score performance for the stratification of alcohol-related cirrhosis risk was assessed and compared across the alcohol-related liver disease spectrum, including hepatocellular carcinoma (HCC).ResultsA combination of 3 single nucleotide polymorphisms (SNPs) (PNPLA3:rs738409, SUGP1-TM6SF2:rs10401969, HSD17B13:rs6834314) and diabetes status best discriminated cirrhosis risk. The odds ratios (ORs) and (95% CIs) between the lowest (Q1) and highest (Q5) score quintiles of the 3-SNP score, based on independent allelic effect size estimates, were 5.99 (4.18-8.60) (GenomALC-1), 2.81 (2.03-3.89) (GenomALC-2), and 3.10 (2.32-4.14) (UK Biobank). Patients with diabetes and high risk scores had ORs of 14.7 (7.69-28.1) (GenomALC-1) and 17.1 (11.3-25.7) (UK Biobank) compared to those without diabetes and with low risk scores. Patients with cirrhosis and HCC had significantly higher mean risk scores than patients with cirrhosis alone (0.76 ± 0.06 vs. 0.61 ± 0.02, p = 0.007). Score performance was not significantly enhanced by information on additional genetic risk variants, body mass index or coffee consumption.ConclusionsA risk score based on 3 genetic risk variants and diabetes status enables the stratification of heavy drinkers based on their risk of cirrhosis, allowing for the provision of earlier preventative interventions.Lay summaryExcessive chronic drinking leads to cirrhosis in some people, but so far there is no way to identify those at high risk of developing this debilitating disease. We developed a genetic risk score that can identify patients at high risk. The risk of cirrhosis is increased >10-fold with just two risk factors - diabetes and a high genetic risk score. Risk assessment using this test could enable the early and personalised management of this disease in high-risk patients.
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- 2022
20. Validation of the accuracy of the FAST™ score for detecting patients with at-risk nonalcoholic steatohepatitis (NASH) in a North American cohort and comparison to other non-invasive algorithms
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Woreta, Tinsay A, Van Natta, Mark L, Lazo, Mariana, Krishnan, Arunkumar, Neuschwander-Tetri, Brent A, Loomba, Rohit, Diehl, Anna Mae, Abdelmalek, Manal F, Chalasani, Naga, Gawrieh, Samer, Dasarathy, Srinivasan, Vuppalanchi, Raj, Siddiqui, Mohammad S, Kowdley, Kris V, McCullough, Arthur, Terrault, Norah A, Behling, Cynthia, Kleiner, David E, Fishbein, Mark, Hertel, Paula, Wilson, Laura A, Mitchell, Emily P, Miriel, Laura A, Clark, Jeanne M, Tonascia, James, and Sanyal, Arun J
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Biomedical and Clinical Sciences ,Clinical Sciences ,Digestive Diseases ,Liver Disease ,Chronic Liver Disease and Cirrhosis ,Women's Health ,Obesity ,Hepatitis ,Clinical Research ,4.2 Evaluation of markers and technologies ,Oral and gastrointestinal ,Adult ,Algorithms ,Biopsy ,Cohort Studies ,Female ,Fibrosis ,Humans ,Liver ,Liver Cirrhosis ,Male ,Middle Aged ,Non-alcoholic Fatty Liver Disease ,Severity of Illness Index ,NASH Clinical Research Network ,General Science & Technology - Abstract
Background and aimsManagement of patients with NASH who are at elevated risk of progressing to complications of cirrhosis (at-risk NASH) would be enhanced by an accurate, noninvasive diagnostic test. The new FAST™ score, a combination of FibroScan® parameters liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) and aspartate aminotransferase (AST), has shown good diagnostic accuracy for at-risk NASH (area-under-the-Receiver-Operating-Characteristic [AUROC] = 0.80) in European cohorts. We aimed to validate the FAST™ score in a North American cohort and show how its diagnostic accuracy might vary by patient mix. We also compared the diagnostic performance of FAST™ to other non-invasive algorithms for the diagnosis of at-risk NASH.MethodsWe studied adults with biopsy-proven non-alcoholic fatty liver disease (NAFLD) from the multicenter NASH Clinical Research Network (CRN) Adult Database 2 (DB2) cohort study. At-risk-NASH was histologically defined as definite NASH with a NAFLD Activity Score (NAS) ≥ 4 with at least 1 point in each category and a fibrosis stage ≥ 2. We used the Echosens® formula for FAST™ from LSM (kPa), CAP (dB/m), and AST (U/L), and the FAST™-based Rule-Out (FAST™ ≤ 0.35, sensitivity = 90%) and Rule-In (FAST™ ≥ 0.67, specificity = 90%) zones. We determined the following diagnostic performance measures: AUROC, sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV); these were calculated for the total sample and by subgroups of patients and by FibroScan® exam features. We also compared the at-risk NASH diagnostic performance of FAST™ to other non-invasive algorithms: NAFLD fibrosis score (NFS), Fibrosis-4 (FIB-4) index, and AST to platelet ratio index (APRI).ResultsThe NASH CRN population of 585 patients was 62% female, 79% white, 14% Hispanic, and 73% obese; the mean age was 51 years. The mean (SD) AST and ALT were 50 (37) U/L and 66 (45) U/L, respectively. 214 (37%) had at-risk NASH. The AUROC of FAST™ for at-risk NASH in the NASH CRN study population was 0.81 (95% CI: 0.77, 0.84. Using FAST™-based cut-offs, 35% of patients were ruled-out with corresponding NPV = 0.90 and 27% of patients were ruled-in with corresponding PPV = 0.69. The diagnostic accuracy of FAST™ was higher in non-whites vs. whites (AUROC: 0.91 vs 0.78; p = 0.001), and in patients with a normal BMI vs. BMI > 35 kg/m2 (AUROC: 0.94 vs 0.78, p = 0.008). No differences were observed by other patient characteristics or FibroScan® exam features. The FAST™ score had higher diagnostic accuracy than other non-invasive algorithms for the diagnosis of at-risk NASH (AUROC for NFS, FIB-4, and APRI 0.67, 0.73, 0.74, respectively).ConclusionWe validated the FAST™ score for the diagnosis of at-risk NASH in a large, multi-racial population in North America, with a prevalence of at-risk NASH of 37%. Diagnostic performance varies by subgroups of NASH patients defined by race and obesity. FAST™ performed better than other non-invasive algorithms for the diagnosis of at-risk NASH.
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- 2022
21. Confusion assessment method accurately screens for hepatic encephalopathy and predicts short-term mortality in hospitalized patients with cirrhosis
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Desai, Archita P., Gandhi, Devika, Xu, Chenjia, Ghabril, Marwan, Nephew, Lauren, Patidar, Kavish R., Campbell, Noll L., Chalasani, Naga, Boustani, Malaz, and Orman, Eric S.
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- 2023
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22. The Safe Use of Analgesics in Patients with Cirrhosis: A Narrative Review
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Ma, Jiayi, Björnsson, Einar Stefán, and Chalasani, Naga
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- 2024
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23. Increases and decreases in liver stiffness measurement are independently associated with the risk of liver-related events in NAFLD
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Gawrieh, Samer, Vilar-Gomez, Eduardo, Wilson, Laura A., Pike, Francis, Kleiner, David E., Neuschwander-Tetri, Brent A., Diehl, Anna Mae, Dasarathy, Srinivasan, Kowdley, Kris V., Hameed, Bilal, Tonascia, James, Loomba, Rohit, Sanyal, Arun J., and Chalasani, Naga
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- 2024
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24. Hospital frailty risk score is superior to legacy comorbidity indices for risk adjustment of in-hospital cirrhosis cases
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Desai, Archita P., Parvataneni, Swetha, Knapp, Shannon M., Nephew, Lauren D., Chalasani, Naga, Ghabril, Marwan S., and Orman, Eric S.
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- 2024
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25. Vancomycin-Induced Liver Injury, DRESS, and HLA-A∗32:01
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Asif, Bilal A., Koh, Christopher, Phillips, Elizabeth J., Gu, Jiezhun, Li, Yi-Ju, Barnhart, Huiman, Chalasani, Naga, Fontana, Robert J., Hayashi, Paul H., Navarro, Victor J., and Hoofnagle, Jay H.
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- 2024
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26. Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease
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Sanyal, Arun J, Van Natta, Mark L, Clark, Jeanne, Neuschwander-Tetri, Brent A, Diehl, AnnaMae, Dasarathy, Srinivasan, Loomba, Rohit, Chalasani, Naga, Kowdley, Kris, Hameed, Bilal, Wilson, Laura A, Yates, Katherine P, Belt, Patricia, Lazo, Mariana, Kleiner, David E, Behling, Cynthia, and Tonascia, James
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Chronic Liver Disease and Cirrhosis ,Clinical Research ,Liver Disease ,Digestive Diseases ,Good Health and Well Being ,Adult ,Biopsy ,Carcinoma ,Hepatocellular ,Female ,Gastrointestinal Hemorrhage ,Humans ,Incidence ,Liver ,Liver Cirrhosis ,Liver Neoplasms ,Male ,Middle Aged ,Non-alcoholic Fatty Liver Disease ,Prognosis ,Prospective Studies ,Severity of Illness Index ,NASH Clinical Research Network ,Medical and Health Sciences ,General & Internal Medicine - Abstract
BackgroundThe prognoses with respect to mortality and hepatic and nonhepatic outcomes across the histologic spectrum of nonalcoholic fatty liver disease (NAFLD) are not well defined.MethodsWe prospectively followed a multicenter patient population that included the full histologic spectrum of NAFLD. The incidences of death and other outcomes were compared across baseline histologic characteristics.ResultsA total of 1773 adults with NAFLD were followed for a median of 4 years. All-cause mortality increased with increasing fibrosis stages (0.32 deaths per 100 person-years for stage F0 to F2 [no, mild, or moderate fibrosis], 0.89 deaths per 100 persons-years for stage F3 [bridging fibrosis], and 1.76 deaths per 100 person-years for stage F4 [cirrhosis]). The incidence of liver-related complications per 100 person-years increased with fibrosis stage (F0 to F2 vs. F3 vs. F4) as follows: variceal hemorrhage (0.00 vs. 0.06 vs. 0.70), ascites (0.04 vs. 0.52 vs. 1.20), encephalopathy (0.02 vs. 0.75 vs. 2.39), and hepatocellular cancer (0.04 vs. 0.34 vs. 0.14). As compared with patients with stage F0 to F2 fibrosis, patients with stage F4 fibrosis also had a higher incidence of type 2 diabetes (7.53 vs. 4.45 events per 100 person-years) and a decrease of more than 40% in the estimated glomerular filtration rate (2.98 vs. 0.97 events per 100 person-years). The incidence of cardiac events and nonhepatic cancers were similar across fibrosis stages. After adjustment for age, sex, race, diabetes status, and baseline histologic severity, the incidence of any hepatic decompensation event (variceal hemorrhage, ascites, or encephalopathy) was associated with increased all-cause mortality (adjusted hazard ratio, 6.8; 95% confidence interval, 2.2 to 21.3).ConclusionsIn this prospective study involving patients with NAFLD, fibrosis stages F3 and F4 were associated with increased risks of liver-related complications and death. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; NAFLD DB2 ClinicalTrials.gov number, NCT01030484.).
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- 2021
27. Relationship of ELF and PIIINP With Liver Histology and Response to Vitamin E or Pioglitazone in the PIVENS Trial
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Gawrieh, Samer, Wilson, Laura A, Yates, Katherine P, Cummings, Oscar W, Vilar‐Gomez, Eduardo, Ajmera, Veeral, Kowdley, Kris V, Rosenberg, William M, Tonascia, James, and Chalasani, Naga
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Trials and Supportive Activities ,Liver Disease ,Hepatitis ,Clinical Research ,Digestive Diseases ,Chronic Liver Disease and Cirrhosis ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Clinical sciences - Abstract
Enhanced liver fibrosis score (ELF) and one of its components, amino-terminal propeptide of type III procollagen (PIIINP) are promising noninvasive biomarkers of liver histology in patients with nonalcoholic steatohepatitis (NASH). We evaluated the association of ELF and PIIINP with fibrosis stages at baseline and end of treatment (EOT) with vitamin E or pioglitazone in the PIVENS trial (Pioglitazone vs. Vitamin E vs. Placebo for the Treatment of Nondiabetic Patients With NASH) and characterized ELF and PIIINP changes and their associations with changes in the histological endpoints. ELF and PIIINP were measured at baseline and weeks 16, 48, and 96 on sera from 243 PIVENS participants. Baseline and EOT ELF were significantly associated with fibrosis stage (P
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- 2021
28. A composite score using quantitative magnetic resonance cholangiopancreatography predicts clinical outcomes in primary sclerosing cholangitis
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Vuppalanchi, Raj, Are, Vijay, Telford, Alison, Young, Liam, Mouchti, Sofia, Ferreira, Carlos, Kettler, Carla, Gromski, Mark, Akisik, Fatih, and Chalasani, Naga
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- 2023
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29. The Protection Conferred by HSD17B13 rs72613567 on Hepatic Fibrosis Is Likely Mediated by Lowering Ballooning and Portal Inflammation
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Vilar-Gomez, Eduardo, Liang, Tiebing, Yates, Katherine, Wilson, Laura, Loomba, Rohit, and Chalasani, Naga
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- 2023
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30. Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report
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Andrade, Raúl J., Aithal, Guruprasad P., de Boer, Ynto S., Liberal, Rodrigo, Gerbes, Alexander, Regev, Arie, Terziroli Beretta-Piccoli, Benedetta, Schramm, Christoph, Kleiner, David E., De Martin, Eleonora, Kullak-Ublick, Gerd A., Stirnimann, Guido, Devarbhavi, Harshad, Vierling, John M., Manns, Michael P., Sebode, Marcial, Londoño, Maria Carlota, Avigan, Mark, Robles-Diaz, Mercedes, García-Cortes, Miren, Atallah, Edmond, Heneghan, Michael, Chalasani, Naga, Trivedi, Palak J., Hayashi, Paul H., Taubert, Richard, Fontana, Robert J., Weber, Sabine, Oo, Ye Htun, Zen, Yoh, Licata, Anna, Lucena, M Isabel, Mieli-Vergani, Giorgina, Vergani, Diego, and Björnsson, Einar S.
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- 2023
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31. Drug-Induced Acute-on-Chronic Liver Failure: Challenges and Future Directions
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Ma, Jiayi, Ghabril, Marwan, and Chalasani, Naga
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- 2023
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32. Fibrosis Progression Rate in Biopsy-Proven Nonalcoholic Fatty Liver Disease Among People With Diabetes Versus People Without Diabetes: A Multicenter Study
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Allende, Daniela, Bellar, Annette, Dasarathy, Jaividhya, Dasarathy, Srinivasan, Welch, Nicole, Yerrapothu, Rahul, Bashir, Mustafa, Diehl, Anna Mae, Guy, Cynthia, Kopping, Mariko, Piercy, Dawn, Suzuki, Ayako, Tawadrou, Naglaa, Chalasani, Naga, Cruz, Mandy, Cummings, Oscar W., Garrison, Lisa, Gawrieh, Samer, Samala, Niharika, Vuppalanchi, Raj, Carpenter, Danielle, Cattoor, Theresa, Freebersyser, Janet, Neuschwander-Tetri, Brent A., Angkanaworakul, Pannapat, Berihun, Achashman, Buysse, Andrew, Dorrian, Theresa, Gulati, Breanna, Kowdley, Kris V., Liu, Kevin, Misic, Sandra, Sohal, Adam, Vuong, Joseph, Ajmera, Veeral, Behling, Cynthia, Loomba, Rohit, Madamba, Egbert, Middleton, Michael S., Richards, Lisa, Singh, Seema, Sirlin, Claude, Gill, Ryan, Hameed, Bilal, Awe, Remilekun, Olvera, Daisy, Terrault, Norah, Yuan, Liyun, Yeh, Matthew, Albhaisi, Somaya, Asgharpour, Amon, Boyett, Sherry, Contos, Melissa J., Luketic, Velimir A.C., Sanyal, Arun J., Schlosser, Jolene, Siddiqui, Mohammad S., Kleiner, David E., Adamo, Peggy, Belt, Patricia, Clark, Jeanne M., DeSanto, Jennifer M., Meinert, Jill, Miriel, Laura, Mitchell, Emily P., Shade, Carrie, Smith, Jacqueline, Smith, Michael, Sternberg, Alice, Tonascia, James, Van Natta, Mark L., Wagoner, Annette, Wilson, Laura A., Woreta, Tinsay, Yates, Katherine P., Huang, Daniel Q., Amangurbanova, Maral, and Terrault, Norah A.
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- 2023
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33. Artificial Intelligence Applications in Hepatology
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Schattenberg, Jörn M., Chalasani, Naga, and Alkhouri, Naim
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- 2023
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34. Measuring Medication Use, Obstacles, and Knowledge in Individuals With Cirrhosis
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Desai, Archita P., Duzdar, Shahd, Stump, Timothy, Orman, Eric S., Nephew, Lauren, Patidar, Kavish R., Ghabril, Marwan S., Block, Geoffrey, Fallon, Michael, Chalasani, Naga, and Monahan, Patrick O.
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- 2023
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35. Multicenter Validation of Association Between Decline in MRI‐PDFF and Histologic Response in NASH
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Loomba, Rohit, Neuschwander‐Tetri, Brent A, Sanyal, Arun, Chalasani, Naga, Diehl, Anna Mae, Terrault, Norah, Kowdley, Kris, Dasarathy, Srinivasan, Kleiner, David, Behling, Cynthia, Lavine, Joel, Van Natta, Mark, Middleton, Michael, Tonascia, James, Sirlin, Claude, and Network, for the NASH Clinical Research
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Biomedical and Clinical Sciences ,Clinical Sciences ,Digestive Diseases ,Clinical Research ,Clinical Trials and Supportive Activities ,Liver Disease ,Hepatitis ,Chronic Liver Disease and Cirrhosis ,Biomedical Imaging ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Oral and gastrointestinal ,Adipose Tissue ,Adult ,Aged ,Chenodeoxycholic Acid ,Double-Blind Method ,Female ,Humans ,Liver ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Non-alcoholic Fatty Liver Disease ,Protons ,Weight Loss ,NASH Clinical Research Network ,Medical Biochemistry and Metabolomics ,Immunology ,Gastroenterology & Hepatology ,Clinical sciences - Abstract
Background and aimsEmerging data from a single-center study suggests that a 30% relative reduction in liver fat content as assessed by magnetic resonance imaging-proton density fat fraction (MRI-PDFF) from baseline may be associated with histologic improvement in nonalcoholic steatohepatitis (NASH). There are limited multicenter data comparing an active drug versus placebo on the association between the quantity of liver fat reduction assessed by MRI-PDFF and histologic response in NASH. This study aims to examine the association between 30% relative reduction in MRI-PDFF and histologic response in obeticholic acid (OCA) versus placebo-treated patients in the FLINT (farnesoid X receptor ligand obeticholic acid in NASH trial).Approach and resultsThis is a secondary analysis of the FLINT trial including 78 patients with MRI-PDFF measured before and after treatment along with paired liver histology assessment. Histologic response was defined as a 2-point improvement in nonalcoholic fatty liver disease activity score without worsening of fibrosis. OCA (25 mg orally once daily) was better than placebo in improving MRI-PDFF by an absolute difference of -3.4% (95% confidence interval [CI], -6.5 to -0.2%, P value = 0.04) and relative difference of -17% (95% CI, -34 to 0%, P value = 0.05). The optimal cutoff point for relative decline in MRI-PDFF for histologic response was 30% (using Youden's index). The rate of histologic response in those who achieved less than 30% decline in MRI-PDFF versus those who achieved a 30% or greater decline in MRI-PDFF (MRI-PDFF responders) relative to baseline was 19% versus 50%, respectively. Compared with MRI-PDFF nonresponders, MRI-PDFF responders demonstrated both a statistically and clinically significant higher odds 4.86 (95% CI, 1.4-12.8, P value
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- 2020
36. Impact of obeticholic acid on the lipoprotein profile in patients with non-alcoholic steatohepatitis
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Siddiqui, Mohammad Shadab, Van Natta, Mark L, Connelly, Margery A, Vuppalanchi, Raj, Neuschwander-Tetri, Brent A, Tonascia, James, Guy, Cynthia, Loomba, Rohit, Dasarathy, Srinivasan, Wattacheril, Julia, Chalasani, Naga, Sanyal, Arun J, and CRN, for the NASH
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Biomedical and Clinical Sciences ,Clinical Sciences ,Atherosclerosis ,Hepatitis ,Clinical Trials and Supportive Activities ,Cardiovascular ,Chronic Liver Disease and Cirrhosis ,Liver Disease ,Clinical Research ,Digestive Diseases ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Good Health and Well Being ,Adult ,Biopsy ,Chenodeoxycholic Acid ,Drug Therapy ,Combination ,Female ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Lipoproteins ,HDL ,Lipoproteins ,LDL ,Lipoproteins ,VLDL ,Liver ,Male ,Middle Aged ,Non-alcoholic Fatty Liver Disease ,Receptors ,Cytoplasmic and Nuclear ,Treatment Outcome ,Nonalcoholic steatohepatitis ,NASH ,Very low-density lipoprotein ,Low-density lipoprotein ,High-density lipoprotein ,Lipoproteins ,Cholesterol ,OCA ,NASH CRN ,Public Health and Health Services ,Gastroenterology & Hepatology ,Clinical sciences - Abstract
Background & aimsObeticholic acid (OCA), a farnesoid X receptor agonist, increases total and low-density lipoprotein cholesterol (LDL-C) in patients with non-alcoholic steatohepatitis. In the present study, we aimed to evaluate the impact of OCA therapy on lipoprotein sub-particles.MethodThis study included 196 patients (99 OCA group and 97 placebo group) who were enrolled in the FLINT trial and had samples available for lipid analysis and liver biopsies at enrollment and end-of-treatment (EOT) at 72 weeks. Very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) particles were evaluated at baseline, 12 and 72 weeks after randomization, and 24 weeks following EOT.ResultsBaseline lipoprotein profiles were similar among OCA and placebo groups. OCA did not affect total VLDL particle concentrations, but OCA vs. placebo treatment was associated with decreased large VLDL particle concentration at 12 weeks (baseline-adjusted mean: 6.8 vs. 8.9 nmol/L; p = 0.002), mirrored by an increase in less atherogenic, small VLDL particle concentration (33.9 vs. 28.0 nmol/L; p = 0.02). After 12 weeks, total LDL particle concentration was higher in the OCA group than the placebo group (1,667 vs. 1,329 nmol/L; p
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- 2020
37. A Pilot Genome-Wide Analysis Study Identifies Loci Associated With Response to Obeticholic Acid in Patients With NASH.
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Gawrieh, Samer, Guo, Xiuqing, Tan, Jingyi, Lauzon, Marie, Taylor, Kent D, Loomba, Rohit, Cummings, Oscar W, Pillai, Sreekumar, Bhatnagar, Pallav, Kowdley, Kris V, Yates, Katherine, Wilson, Laura A, Chen, Yii-Der Ida, Rotter, Jerome I, Chalasani, Naga, and NASH Clinical Research Network
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NASH Clinical Research Network - Abstract
A significantly higher proportion of patients with nonalcoholic steatohepatitis (NASH) who received obeticholic acid (OCA) had histological improvement relative to placebo in the FLINT (farnesoid X nuclear receptor ligand obeticholic acid for noncirrhotic, NASH treatment) trial. However, genetic predictors of response to OCA are unknown. We conducted a genome-wide association study (GWAS) in FLINT participants to identify variants associated with NASH resolution and fibrosis improvement. Genotyping was performed using the Omni2.5 content GWAS chip. To avoid false positives introduced by population stratification, we focused our GWAS on white participants. Six regions on chromosomes 1, 4, 6, 7, 15, and 17 had multiple single nucleotide polymorphisms (SNPs) with suggestive association (P
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- 2019
38. Haptoglobin 2 Allele is Associated With Histologic Response to Vitamin E in Subjects With Nonalcoholic Steatohepatitis
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Banini, Bubu A, Cazanave, Sophie C, Yates, Katherine P, Asgharpour, Amon, Vincent, Robert, Mirshahi, Faridoddin, Le, Peter, Contos, Melissa J, Tonascia, James, Chalasani, Naga P, Kowdley, Kris V, McCullough, Arthur J, Behling, Cynthia A, Schwimmer, Jeffrey B, Lavine, Joel E, and Sanyal, Arun J
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Hepatitis ,Clinical Trials and Supportive Activities ,Chronic Liver Disease and Cirrhosis ,Digestive Diseases ,Clinical Research ,Complementary and Integrative Health ,Liver Disease ,Oral and gastrointestinal ,Adult ,Alleles ,Female ,Genotype ,Haptoglobins ,Humans ,Male ,Non-alcoholic Fatty Liver Disease ,Randomized Controlled Trials as Topic ,Treatment Outcome ,Vitamin E ,nonalcoholic steatohepatitis ,nonalcoholic fatty liver disease ,vitamin E ,haptoglobin genotype ,oxidative stress ,Nonalcoholic Steatohepatitis Clinical Research Network ,Clinical Sciences ,Gastroenterology & Hepatology - Abstract
BackgroundHaptoglobin (Hp) genotype has been linked to oxidative stress and cardiovascular outcomes in response to vitamin E (VitE) among patients with diabetes mellitus. Its effect on histologic response to VitE in nonalcoholic steatohepatitis (NASH) is unknown.GoalsOur objective was to determine if Hp genotype associates with response to VitE in patients with NASH.StudyA post hoc analysis of 228 patients receiving VitE or placebo in 2 clinical trials was performed. Regression analysis was used to assess the effect of VitE versus placebo, by Hp genotype (1-1, 2-1, or 2-2), on histologic features and laboratory markers of nonalcoholic fatty liver disease, comparing baseline to end of treatment values. An interaction term was included in the regression models to assess differential treatment effect across Hp genotype.ResultsHp 2-2 patients treated with VitE versus placebo showed significant histologic improvement (51% vs. 20%; OR=4.2; P=0.006), resolution of steatohepatitis (44% vs. 12%; OR=6.2; P=0.009), decrease in nonalcoholic fatty liver disease Activity Score (NAS) (-2.2 vs. -0.6; P=0.001), and decrease in liver enzymes alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and γ-glutamyl transpeptidase. Hp 2-1 patients on VitE versus placebo showed improved resolution of steatohepatitis, NAS and liver enzymes. Hp 1-1 patients showed no significant improvement in histology or liver enzymes. VitE had no effect on fibrosis stage in any group. Regression analysis showed incremental benefit of having Hp 2-2 or 2-1 versus 1-1 for all liver enzyme.ConclusionsHp 2 allele is associated with greater histologic and biological improvement in NASH with VitE treatment compared with the Hp 1 allele.
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- 2019
39. Histologic Findings of Advanced Fibrosis and Cirrhosis in Patients With Nonalcoholic Fatty Liver Disease Who Have Normal Aminotransferase Levels.
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Gawrieh, Samer, Wilson, Laura A, Cummings, Oscar W, Clark, Jeanne M, Loomba, Rohit, Hameed, Bilal, Abdelmalek, Manal F, Dasarathy, Srinivasan, Neuschwander-Tetri, Brent A, Kowdley, Kris, Kleiner, David, Doo, Edward, Tonascia, James, Sanyal, Arun, and Chalasani, Naga
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Biomedical and Clinical Sciences ,Clinical Sciences ,Liver Disease ,Chronic Liver Disease and Cirrhosis ,Clinical Research ,Digestive Diseases ,Hepatitis ,Oral and gastrointestinal ,Aged ,Alanine Transaminase ,Aspartate Aminotransferases ,Biopsy ,Disease Progression ,Female ,Humans ,Liver ,Liver Cirrhosis ,Liver Function Tests ,Logistic Models ,Male ,Middle Aged ,Models ,Biological ,Non-alcoholic Fatty Liver Disease ,Predictive Value of Tests ,Prevalence ,Prospective Studies ,Risk Assessment ,Risk Factors ,NASH Clinical Research Network ,Gastroenterology & Hepatology ,Clinical sciences - Abstract
ObjectivesPatients with nonalcoholic fatty liver disease (NAFLD) and normal aminotransferase levels may have advanced liver histology. We conducted a study to characterize the prevalence of and factors associated with advanced liver histology in patients with histologically characterized NAFLD and normal aminotransferase levels.MethodsWe evaluated 534 adults with biopsy-proven NAFLD and alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
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- 2019
40. Identification of Reduced ERAP2 Expression and a Novel HLA Allele as Components of a Risk Score for Susceptibility to Liver Injury Due to Amoxicillin-Clavulanate
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Nicoletti, Paola, Dellinger, Andrew, Li, Yi Ju, Barnhart, Huiman X., Chalasani, Naga, Fontana, Robert J., Odin, Joseph A., Serrano, Jose, Stolz, Andrew, Etheridge, Amy S., Innocenti, Federico, Govaere, Olivier, Grove, Jane I., Stephens, Camilla, Aithal, Guruprasad P., Andrade, Raul J., Bjornsson, Einar S., Daly, Ann K., Lucena, M. Isabel, and Watkins, Paul B.
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- 2023
- Full Text
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41. Clinical features, outcomes, and HLA risk factors associated with nitrofurantoin-induced liver injury
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Chalasani, Naga, Li, Yi-Ju, Dellinger, Andrew, Navarro, Victor, Bonkovsky, Herbert, Fontana, Robert J., Gu, Jiezhun, Barnhart, Huiman, Phillips, Elizabeth, Lammert, Craig, Schwantes-An, Tae-Hwi, Nicoletti, Paola, Kleiner, David E., and Hoofnagle, Jay H.
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- 2023
- Full Text
- View/download PDF
42. Prevalence of High-risk Nonalcoholic Steatohepatitis (NASH) in the United States: Results From NHANES 2017–2018
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Vilar-Gomez, Eduardo, Vuppalanchi, Raj, Mladenovic, Andrea, Samala, Niharika, Gawrieh, Samer, Newsome, Phil N., and Chalasani, Naga
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- 2023
- Full Text
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43. Low MBOAT7 expression, a genetic risk for MASH, promotes a pro-fibrotic pathway involving hepatocyte TAZ upregulation
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Moore, Mary P., primary, Wang, Xiaobo, additional, Kennelly, John Paul, additional, Shi, Hongxue, additional, Ishino, Yuki, additional, Kano, Kuniyuki, additional, Aoki, Junken, additional, Cherubini, Alessandro, additional, Ronzoni, Luisa, additional, Guo, Xiuqing, additional, Chalasani, Naga P., additional, Khalid, Shareef, additional, Saleheen, Danish, additional, Mitsche, Mathew A., additional, Rotter, Jerome I., additional, Yates, Katherine P., additional, Valenti, Luca, additional, Kono, Nozomu, additional, Tontonoz, Peter, additional, and Tabas, Ira, additional
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- 2024
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- View/download PDF
44. PNPLA3 rs738409, age, diabetes, sex, and advanced fibrosis jointly contribute to the risk of major adverse liver outcomes in metabolic-associated steatotic liver disease
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Chalasani, Naga, primary, Vilar-Gomez, Eduardo, additional, Loomba, Rohit, additional, Yates, Katherine P, additional, Diehl, Anna Mae, additional, Neuschwander-Tetri, Brent A., additional, Dasarathy, Srinivasan, additional, Kowdley, Kris V., additional, Terrault, Norah, additional, Wilson, Laura A., additional, Tonascia, James, additional, and Sanyal, Arun, additional
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- 2024
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45. Attitudes of Chinese Patients with Non-alcoholic Fatty Liver Disease Toward Participation in Clinical Trials from a National Multicenter Survey
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Huang, Rui, Rao, Huiying, Lv, Fangfang, Nan, Yuemin, Ren, Wanhua, Huang, Yan, Li, Jun, Tang, Hong, Huang, Yuan, Chalasani, Naga, and Wei, Lai
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- 2022
- Full Text
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46. Diagnostic Accuracy of Noninvasive Fibrosis Models to Detect Change in Fibrosis Stage
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Siddiqui, Mohammad Shadab, Yamada, Goro, Vuppalanchi, Raj, Van Natta, Mark, Loomba, Rohit, Guy, Cynthia, Brandman, Danielle, Tonascia, James, Chalasani, Naga, Neuschwander-Tetri, Brent, Sanyal, Arun J, Allende, Daniela, Dasarathy, Srinivasan, McCullough, Arthur J, Penumatsa, Revathi, Dasarathy, Jaividhya, Lavine, Joel E, Abdelmalek, Manal F, Bashir, Mustafa, Buie, Stephanie, Diehl, Anna Mae, Kigongo, Christopher, Kopping, Mariko, Malik, David, Piercy, Dawn, Cummings, Oscar W, Gawrieh, Samer, Ragozzino, Linda, Sandrasegaran, Kumar, Brunt, Elizabeth M, Cattoor, Theresa, Carpenter, Danielle, Freebersyser, Janet, King, Debra, Lai, Jinping, Neuschwander-Tetri, Brent A, Siegner, Joan, Stewart, Susan, Torretta, Susan, Wriston, Kristina, Gonzalez, Maria Cardona, Davila, Jodie, Jhaveri, Manan, Kowdley, Kris V, Mukhtar, Nizar, Ness, Erik, Poitevin, Michelle, Quist, Brook, Soo, Sherilynn, Ang, Brandon, Behling, Cynthia, Bhatt, Archana, Middleton, Michael S, Sirlin, Claude, Akhter, Maheen F, Bass, Nathan M, Gill, Ryan, Hameed, Bilal, Maher, Jacqueline, Terrault, Norah, Ungermann, Ashley, Yeh, Matthew, Boyett, Sherry, Contos, Melissa J, Kirwin, Sherri, Luketic, Velimir AC, Puri, Puneet, Schlosser, Jolene, Siddiqui, Mohammad S, Yost-Schomer, Leslie, Fowler, Kathryn, Kleiner, David E, Doo, Edward C, Hall, Sherry, Hoofnagle, Jay H, Lee, Jessica J, Robuck, Patricia R, Sherker, Averell H, Torrance, Rebecca, Belt, Patricia, Clark, Jeanne M, Dodge, John, Donithan, Michele, Hallinan, Erin, Isaacson, Milana, Lazo, Mariana, Meinert, Jill, Miriel, Laura, Smith, Jacqueline, Smith, Michael, Sternberg, Alice, and Van Natta, Mark L
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Clinical Research ,Chronic Liver Disease and Cirrhosis ,Liver Disease ,Digestive Diseases ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Adult ,Alanine Transaminase ,Aspartate Aminotransferases ,Biopsy ,Disease Progression ,Female ,Humans ,Liver ,Liver Cirrhosis ,Male ,Middle Aged ,Non-alcoholic Fatty Liver Disease ,Platelet Count ,Predictive Value of Tests ,Retrospective Studies ,Sensitivity and Specificity ,Severity of Illness Index ,Nonalcoholic Steatohepatitis ,Diagnostic ,Prognostic ,Scoring System Comparison ,NASH Clinical Research Network ,Clinical Sciences ,Gastroenterology & Hepatology - Abstract
Background & aimsNoninvasive methods are needed to determine disease stage in patients with nonalcoholic fatty liver disease (NAFLD). We evaluated the diagnostic performance of several widely available fibrosis models for the assessment of hepatic fibrosis in patients with NAFLD.MethodsWe performed a retrospective analysis of data from individuals enrolled in the NIDDK NASH Clinical Research Network, from 2004 through 2018. Using biopsy as the reference standard, we determined the diagnostic performance of the aspartate aminotransferase (AST):platelet ratio (APRI), FIB-4, ratio of AST:alanine aminotransferase (ALT) and the NAFLD fibrosis score (NFS) in a cross-sectional study of 1904 subjects. The ability of these models to detect changes in fibrosis stage was assessed in a longitudinal data set of 292 subjects with 2 biopsies and accompanying laboratory data. Outcomes were detection of fibrosis of any stage (stages 0-4), detection of moderate fibrosis (stages 0-1 vs 2-4), and detection of advanced fibrosis (stages 0-2 vs 3-4). Diagnostic performance was evaluated using the C-statistic, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) analyses.ResultsIn the cross-sectional study, FIB-4 and NFS outperformed other non-invasive models for detecting advanced fibrosis; the C-statistics were 0.80 for FIB-4 and 0.78 for NFS. In the longitudinal study, 216 patients had non-advanced fibrosis at baseline and 35 patients progressed to advanced fibrosis after median follow up of 2.6 years. After we adjusted for fibrosis stage and model score at initial biopsy, change in APRI, FIB-4, and NFS were significantly associated with change in fibrosis. A unit change in APRI, FIB-4, or NFS was associated with changes in fibrosis stage of 0.33 (95% CI, 0.20-0.45; P < .001), 0.26 (95% CI, 0.15-0.37; P < .001), and 0.19 (95% CI, 0.07-0.31; P = .002), respectively. The cross-validated C-statistic for detecting progression to advanced fibrosis for APRI was 0.82 (95% CI, 0.74-0.89), for FIB-4 was 0.81 (95% CI, 0.73-0.81), and for NFS was 0.80 (95% CI, 0.71-0.88).ConclusionsIn a combined analysis of data from 2 large studies, we found that FIB-4, APRI, and NFS can detect advanced fibrosis and fibrosis progression in patients with NAFLD.
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- 2019
47. Relationship between resolution of non‐alcoholic steatohepatitis and changes in lipoprotein sub‐fractions: a post‐hoc analysis of the PIVENS trial
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Corey, Kathleen E, Wilson, Laura A, Altinbas, Akif, Yates, Katherine P, Kleiner, David E, Chung, Raymond T, Krauss, Ronald M, Chalasani, Naga, and Network, the NASH Clinical Research
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Digestive Diseases ,Clinical Trials and Supportive Activities ,Hepatitis ,Cardiovascular ,Clinical Research ,Nutrition ,Liver Disease ,Chronic Liver Disease and Cirrhosis ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Adult ,Biomarkers ,Biopsy ,Dyslipidemias ,E-Selectin ,Female ,Humans ,Intercellular Adhesion Molecule-1 ,Lipoproteins ,Macrophage Activation ,Male ,Middle Aged ,Non-alcoholic Fatty Liver Disease ,Particle Size ,Pioglitazone ,Remission Induction ,Retrospective Studies ,Treatment Outcome ,Vascular Cell Adhesion Molecule-1 ,Vitamin E ,NASH Clinical Research Network ,Clinical Sciences ,Pharmacology and Pharmaceutical Sciences ,Gastroenterology & Hepatology - Abstract
BackgroundDyslipidaemia is frequent in non-alcoholic steatohepatitis (NASH); however, it is unclear if improvement in liver histology is associated with favourable changes in cardiovascular disease (CVD) risk.AimsTo evaluate the relationship of NASH resolution and lipoprotein subfraction levels, markers of endothelial dysfunction, and macrophage activation.MethodsOne hundred and seventeen individuals with NASH who participated in the Pioglitazone vs Vitamin E vs Placebo for the Treatment of Nondiabetic Patients with NASH (PIVENS) trial with paired liver biopsies and serum samples available at baseline and after 96 weeks of treatment were included. Participants in the PIVENS trials received vitamin E, pioglitazone, or placebo for 96 weeks. Lipoprotein subfraction levels, intracellular adhesion molecule 1 (ICAM-1), vascular cellular adhesion molecule 1 (VCAM-1), E-selectin, and sCD163 levels were assessed at baseline and week 96 and their relationship with NASH resolution was examined.ResultsFifty-seven individuals had NASH resolution and 60 individuals did not have resolution of NASH. NASH resolution was associated with favourable changes in lipoprotein subfraction levels compared to those without NASH resolution. Individuals with resolution of NASH had a significantly increased mean peak LDL diameter (ratio of geometric means [96 weeks vs baseline] 1.007 vs 0.996, P = 0.004), and higher frequency of LDL phenotype A (58% vs 33%, P = 0.003) at week 96, after adjustment for relevant co-variates including treatment group. No differences in VCAM, ICAM, E-selectin, or sCD163 levels by NASH resolution were found.ConclusionsNASH resolution is associated with favourable changes in a subset of serum lipoprotein levels. More studies are warranted to understand if these favourable changes are associated with decreased risk of CVD.
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- 2019
48. Relationship between three commonly used non‐invasive fibrosis biomarkers and improvement in fibrosis stage in patients with non‐alcoholic steatohepatitis
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Chalasani, Naga, Abdelmalek, Manal F, Loomba, Rohit, Kowdley, Kris V, McCullough, Arthur J, Dasarathy, Srinivasan, Neuschwander‐Tetri, Brent A, Terrault, Norah, Ferguson, Beatrice, Shringarpure, Reshma, Shapiro, David, and Sanyal, Arun J
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Biomedical and Clinical Sciences ,Clinical Sciences ,Digestive Diseases ,Hepatitis ,Clinical Trials and Supportive Activities ,Chronic Liver Disease and Cirrhosis ,Clinical Research ,Liver Disease ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Oral and gastrointestinal ,Good Health and Well Being ,Adult ,Biomarkers ,Biopsy ,Chenodeoxycholic Acid ,Female ,Humans ,Liver ,Liver Cirrhosis ,Logistic Models ,Male ,Middle Aged ,Non-alcoholic Fatty Liver Disease ,United States ,biomarkers ,fibrosis ,non-alcoholic steatohepatitis ,non-invasive ,Gastroenterology & Hepatology ,Clinical sciences - Abstract
Background & aimsNon-invasive biomarkers are needed for monitoring changes in liver histology in patients with non-alcoholic steatohepatitis (NASH). Obeticholic acid (OCA) was shown to improve fibrosis in patients with NASH in the FLINT trial; a post hoc analysis of these data was performed to determine the relationship between 3 non-invasive fibrosis markers and liver fibrosis improvement.MethodsIn the Phase 2b FLINT trial, patients were randomised (1:1) to receive 25 mg OCA or placebo once daily for 72 weeks. Aspartate aminotransferase:platelet ratio index (APRI), fibrosis-4 (FIB-4) index and non-alcoholic fatty liver disease fibrosis score (NFS) were evaluated in serum at baseline and weeks 24, 48, 72 and 96. Liver biopsies were obtained at baseline and 72 weeks.ResultsIn patients with fibrosis improvement at week 24, scores were reduced by a median of 34% for APRI, 10% for FIB-4 and 4% for NFS. Reductions in APRI (P = 0.015) and FIB-4 (P = 0.036), but not NFS (P = 0.201) at week 24, significantly correlated with ≥1-stage improvement in histologic fibrosis at week 72. Reductions in APRI at week 72 were significantly correlated with fibrosis improvement at week 72 (P = 0.012). Patients receiving OCA had significant reductions in all markers compared with patients receiving placebo at week 72 [APRI and FIB-4 (P
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- 2019
49. Oxidized Derivatives of Linoleic Acid in Pediatric Metabolic Syndrome: Is Their Pathogenic Role Modulated by the Genetic Background and the Gut Microbiota?
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Tricò, Domenico, Di Sessa, Anna, Caprio, Sonia, Chalasani, Naga, Liu, Wanqing, Liang, Tiebing, Graf, Joerg, Herzog, Raimund I, Johnson, Casey D, Umano, Giuseppina Rosaria, Feldstein, Ariel E, and Santoro, Nicola
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Obesity ,Genetics ,Nutrition ,Prevention ,Pediatric ,Adolescent ,Age Factors ,Biomarkers ,Child ,Delta-5 Fatty Acid Desaturase ,Disease Susceptibility ,Fatty Acid Desaturases ,Female ,Gastrointestinal Microbiome ,Genetic Background ,Genetic Predisposition to Disease ,Haplotypes ,Humans ,Linoleic Acid ,Lipid Metabolism ,Lipoproteins ,Male ,Metabolic Syndrome ,Metabolome ,Oxidation-Reduction ,genetic predisposition ,gut microbiota ,linoleic acid ,metabolic syndrome ,oxidized low-density lipoproteins ,oxidized metabolites of linoleic acid ,pediatric obesity ,Biochemistry and Cell Biology ,Medical Biochemistry and Metabolomics ,Pharmacology and Pharmaceutical Sciences ,Biochemistry & Molecular Biology - Abstract
We tested whether oxidized linoleic acid metabolites (OXLAM) are associated with pediatric metabolic syndrome (MetS) and a proatherogenic lipoprotein profile in 122 obese adolescents. Furthermore, we examined whether genetic and metagenomic factors can modulate plasma OXLAM concentrations by genotyping the fatty acid desaturase 1/2 (FADS) gene and by characterizing the gut microbiota. Subjects with MetS (n = 50) showed higher concentrations of 9- and 13-oxo-octadecadienoic acid (9- and 13-oxo-ODE) than subjects without MetS (n = 72). Both metabolites were associated with an adverse lipoprotein profile that was characterized by elevated very small-dense low-density lipoprotein (p
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- 2019
50. Factors Associated With Histologic Response in Adult Patients With Nonalcoholic Steatohepatitis
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Loomba, Rohit, Sanyal, Arun J, Kowdley, Kris V, Terrault, Norah, Chalasani, Naga P, Abdelmalek, Manal F, McCullough, Arthur J, Shringarpure, Reshma, Ferguson, Beatrice, Lee, Lois, Chen, Jianfen, Liberman, Alexander, Shapiro, David, and Neuschwander-Tetri, Brent A
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Liver Disease ,Clinical Trials and Supportive Activities ,Chronic Liver Disease and Cirrhosis ,Hepatitis ,Digestive Diseases ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Oral and gastrointestinal ,Adult ,Biomarkers ,Biopsy ,Chenodeoxycholic Acid ,Clinical Enzyme Tests ,Decision Support Techniques ,Female ,Gastrointestinal Agents ,Humans ,Ligands ,Liver ,Liver Cirrhosis ,Male ,Middle Aged ,Non-alcoholic Fatty Liver Disease ,Predictive Value of Tests ,Receptors ,Cytoplasmic and Nuclear ,Time Factors ,Treatment Outcome ,United States ,FLINT Trial ,OCA ,FXR Agonist ,NAFLD ,Neurosciences ,Paediatrics and Reproductive Medicine ,Gastroenterology & Hepatology ,Clinical sciences ,Nutrition and dietetics - Abstract
Background & aimsNonalcoholic steatohepatitis (NASH) is a leading cause of liver transplantation, and many trials are underway to evaluate potential therapies. The farnesoid X receptor ligand obeticholic acid in the NASH treatment trial evaluated the effects of obeticholic acid vs placebo on histologic response (defined as decrease in nonalcoholic fatty liver disease activity score [NAS] by ≥2, with no worsening of fibrosis); 45% of patients had a histologic response to obeticholic acid (25 mg), and 21% had a response to placebo (P < .01). We performed a secondary analysis of data from this trial to identify clinical parameters associated with a histologic response.MethodsWe used a logistic regression model with a stepwise selection procedure to identify baseline and early on-treatment factors associated with a histologic response at 72 weeks. Baseline demographics, liver histology, medical history, concomitant medications, cardiometabolic parameters, and serum biochemistry, as well as the changes over the course of the trial (at weeks 12 and 24), were evaluated as potential predictors of a histologic response. The model was cross-validated by a jackknife method, and performance was evaluated with the area under the receiver operating characteristic curve.ResultsThe logistic regression model found that obeticholic acid treatment, baseline NAS > 5, baseline triglyceride level ≤ 154 mg/dL, baseline international normalized ratio ≤ 1, baseline aspartate aminotransferase level ≤ 49 U/L, and a decrease in alanine aminotransferase level at week 24 by 17 U/L or more, to be significantly associated with histologic response (area under the receiver operating characteristic curve, 0.83; 95% confidence interval, 0.77-0.89; P < .0001).ConclusionsIn a secondary analysis of data from a clinical trial of obeticholic acid in patients with NASH, we identified routine clinical and laboratory parameters during the first 24 weeks of treatment (such as baseline NAS, triglyceride levels, and a decrease in alanine aminotransferase level) to significantly associate with histologic markers of response.
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- 2019
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