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| 1 | Characteristics and outcomes of acute upper gastrointestinal bleeding after therapeutic endoscopy in the elderly显示文摘AIM: To characterize the effects of age on clinical presentations and endoscopic diagnoses and to determine outcomes after endoscopic therapy among patients aged ≥ 65 years admitted for acute upper gastrointestinal bleeding (UGIB) compared with those aged < 65 years. METHODS: Medical records and an endoscopy data-base of 526 consecutive patients with overt UGIB admitted during 2007-2009 were reviewed. The initial presentations and clinical course within 30 d after endoscopy were obtained. RESULTS: A total of 235 patients aged ≥ 65 years constituted the elderly population (mean age of 74.2 ± 6.7 years, 63% male). Compared to young patients, the elderly patients were more likely to present with melena (53% vs 30%, respectively; P < 0.001), have comorbidities (69% vs 54%, respectively; P < 0.001), and receive antiplatelet agents (39% vs 10%, respectively; P < 0.001). Interestingly, hemodynamic instability was observed less in this group (49% vs 68%, respectively; P < 0.001). Peptic ulcer was the leading cause of UGIB in the elderly patients, followed by varices and gastropathy. The elderly and young patients had a similar clinical course with regard to the utilization of endoscopic therapy, requirement for transfusion, duration of hospital stay, need for surgery [relative risk (RR), 0.31; 95% confidence interval (CI), 0.03-2.75; P = 0.26], rebleeding (RR, 1.44; 95% CI, 0.92-2.25; P = 0.11), and mortality (RR, 1.10; 95% CI, 0.57-2.11; P = 0.77). In Cox's regression analysis, hemodynamic instability at presentation, background of liver cirrhosis or disseminated malignancy, transfusion requirement, and development of rebleeding were significantly associated with 30-d mortality. CONCLUSION: Despite multiple comorbidities and the concomitant use of antiplatelets in the elderly patients, advanced age does not appear to influence adverse outcomes of acute UGIB after therapeutic endoscopy. | Phunchai Charatcharoenwitthaya Nonthalee Pausawasdi Nuttiya Laosanguaneak Jakkrapan Bubthamala Tawesak Tanwandee Somchai Leelakusolvong | 2011 | World Journal of Gastroenterology2011，17，32： | 14 |
| 2 | Fatty Pancreas:Linking Pancreas Pathophysiology to Nonalcoholic Fatty Liver Disease显示文摘Currently,scientific interest has focused on fat accumulation outside of subcutaneous adipose tissue.As various imaging modalities are available to quantify fat accumulation in partic-ular organs,fatty pancreas has become an important area of research over the last decade.The pancreas has an essential role in regulating glucose metabolism and insulin secretion by responding to changes in nutrients under various metabolic circumstances.Mounting evidence has revealed that fatty pancreas is linked to impairedβ-cell function and affects in-sulin secretion with metabolic consequences of impaired glu-cose metabolism,type 2 diabetes,and metabolic syndrome.It has been shown that there is a connection between fatty pancreas and the presence and severity of nonalcoholic fatty liver disease(NAFLD),which has become the predominant cause of chronic liver disease worldwide.Therefore,it is nec-essary to better understand the pathogenic mechanisms of fat accumulation in the pancreas and its relationship with NAFLD.This review summarizes the epidemiology,diagnosis,risk factors,and metabolic consequences of fatty pancreas and discusses its pathophysiology links to NAFLD. | Manus Rugivarodom Tanawat Geeratragool Nonthalee Pausawasdi Phunchai Charatcharoenwitthaya | 2022 | Journal of Clinical and Translational Hepatology2022，10，6： | 3 |
| 3 | Simple Non-Invasive Systems Predict Long-Term Outcomes of Patients With Nonalcoholic Fatty Liver Disease显示文摘 | Paul Angulo Elisabetta Bugianesi Einar S. Bjornsson Phunchai Charatcharoenwitthaya Peter R. Mills Francisco Barrera Svanhildur Haflidadottir Christopher P. Day Jacob George | 2013 | Gastroenterology2013，，： | 2 |
| 4 | Colon Neoplasms Develop Early in the Course of Inflammatory Bowel Disease and Primary Sclerosing Cholangitis显示文摘 | Erin W. Thackeray Phunchai Charatcharoenwitthaya Diaa Elfaki Emmanouil Sinakos Keith D. Lindor | 2011 | Clinical Gastroenterology and Hepatology2011，，1： | 2 |
| 5 | The natural history of nonalcoholic fatty liver disease with advanced fibrosis or cirrhosis: An international collaborative study显示文摘 | Neeraj Bhala Paul Angulo David van der Poorten Eric Lee Jason M. Hui Giorgio Saracco Leon A. Adams Phunchai Charatcharoenwitthaya Joanne H. Topping Elisabetta Bugianesi Christopher P. Day Jacob George | 2011 | Hepatology2011，，4： | 2 |
| 6 | Prognostic Relevance of Metabolic Dysfunction-associated Steatohepatitis for Patients with Chronic Hepatitis B显示文摘Background and Aims:Metabolic dysfunction-associated fatty liver disease(MAFLD)is prevalent in patients with chronic hepatitis B(CHB).The effect of the histologic MAFLD phenotype on long-term CHB outcomes is unknown.We performed a longitudinal study to determine the prognostic relevance of biopsy-proven hepatic steatosis and steatohepatitis for CHB patients.Methods:Clinical and laboratory data were obtained from CHB patients who underwent liver biopsy during 2002–2008 and were treated with antiviral drugs.A hepatopathologist reviewed the biopsy specimens.Cox proportional hazards regression was used to estimate the adjusted hazard ratio(aHR)of outcomes,including all-cause mortality,liver transplantation,and liver-related events.Results:In accordance with Brunt’s classification,408 patients had steatohepatitis(n=34),“steatosis but not steatohepatitis”(n=118),or“non-steatosis”(n=256).All steatohepatitis patients had features of metabolic dysfunction.Over a mean follow-up of 13.8±3.1 years,18 patients died or underwent liver transplantation.In multivariate-adjusted analysis,steatohepatitis(aHR,6.37;95%confidence interval[CI]:1.59–25.5)compared with non-steatosis and advanced fibrosis(aHR,11.3;95%CI:1.32–96.3)compared with no fibrosis were associated with overall mortality/liver transplantation.Thirty-five patients developed 43 liver-related events,among which 32 were hepatocellular carcinoma.These events were associated with steatohepatitis(aHR,5.55;95%CI:2.01–15.3)compared with non-steatosis and advanced fibrosis(aHR,6.23;95%CI:1.75–22.2)compared with no fibrosis.The steatosis but not steatohepatitis group had a nonsignificantly higher risk of overall mortality and liver-related events.Conclusions:Metabolic dysfunction-associated steatohepatitis increased the risk of long-term mortality/transplantation and liver-related events in CHB patients. | Manus Rugivarodom Ananya Pongpaibul Siwaporn Chainuvati Supot Nimanong Watcharasak Chotiyaputta Tawesak Tanwandee Phunchai Charatcharoenwitthaya | 2023 | Journal of Clinical and Translational Hepatology2023，11，1： | 2 |
| 7 | Gamma-glutamyl transferase and cardiovascular risk in nonalcoholic fatty liver disease:The Gut and Obesity Asia initiative显示文摘BACKGROUND Gamma-glutamyl transferase(GGT)is associated with the risk of cardiovascular disease(CVD)in the general population.AIM To identify the association of baseline GGT level and QRISK2 score among patients with biopsy-proven nonalcoholic fatty liver disease(NAFLD).METHODS This was a retrospective study involving 1535 biopsy-proven NAFLD patients from 10 Asian centers in 8 countries using data collected by the Gut and Obesity in Asia(referred to as“GO ASIA”)workgroup.All patients with available baseline GGT levels and all 16 variables for the QRISK2 calculation(QRISK2-2017;developed by researchers at the United Kingdom National Health Service;https://qrisk.org/2017/;10-year cardiovascular risk estimation)were included and compared to healthy controls with the same age,sex,and ethnicity.Relative risk was reported.QRISK2 score>10%was defined as the high-CVD-risk group.Fibrosis stages 3 and 4(F3 and F4)were considered advanced fibrosis.RESULTS A total of 1122 patients(73%)had complete data and were included in the final analysis;314(28%)had advanced fibrosis.The median age(interquartile range[IQR])of the study population was 53(44-60)years,532(47.4%)were females,and 492(43.9%)were of Chinese ethnicity.The median 10-year CVD risk(IQR)was 5.9%(2.6-10.9),and the median relative risk of CVD over 10 years(IQR)was 1.65(1.13-2.2)compared to healthy individuals with the same age,sex,and ethnicity.The high-CVD-risk group was significantly older than the low-risk group(median[IQR]:63[59-67]vs 49[41-55]years;P<0.001).Higher fibrosis stages in biopsy-proven NAFLD patients brought a significantly higher CVD risk(P<0.001).Median GGT level was not different between the two groups(GGT[U/L]:Median[IQR],high risk 60[37-113]vs low risk 66[38-103],P=0.56).There was no correlation between baseline GGT level and 10-year CVD risk based on the QRISK2 score(r=0.02).CONCLUSION The CVD risk of NAFLD patients is higher than that of healthy individuals.Baseline GGT level cannot predict CVD risk in NAFLD patients.However,advanced fibrosis is a predictor of a high CVD risk. | Panyavee Pitisuttithum Wah-Kheong Chan George Boon-Bee Goh Jian-Gao Fan Myeong Jun Song Phunchai Charatcharoenwitthaya Ajay Duseja Yock-Young Dan Kento Imajo Atsushi Nakajima Khek-Yu Ho Khean-Lee Goh Vincent Wai-Sun Wong Sombat Treeprasertsuk | 2020 | World Journal of Gastroenterology2020，26，19： | 1 |
| 8 | Colon Neoplasms Develop Early in the Course of Inflammatory Bowel Disease and Primary Sclerosing Cholangitis显示文摘 | Erin W. Thackeray Phunchai Charatcharoenwitthaya Diaa Elfaki Emmanouil Sinakos Keith D. Lindor | 2011 | Clinical Gastroenterology and Hepatology2011，，1： | 1 |
| 9 | Metabolic Phenotypes:Drivers of Health Outcomes in Fatty Liver Diseases显示文摘Dear Editor,Nonalcoholic fatty liver disease(NAFLD)and alcoholic fatty liver disease(AFLD)are the leading causes of chronic liver disease worldwide,representing major contributing factors of cirrhosis and hepatocellular carcinoma(HCC)and highlighting the major public health importance of these conditions. | Phunchai Charatcharoenwitthaya | 2023 | Journal of Clinical and Translational Hepatology2023，11，4： | 0 |
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