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| 1 | Pharmacological Therapeutics:Current Trends for Metabolic Dysfunction-associated Fatty Liver Disease(MAFLD)显示文摘Metabolic dysfunction-associated fatty liver disease(MAFLD)is a new term from nonalcoholic fatty liver disease(NAFLD)and is a positive diagnosis based on histopathology,imaging,or blood biomarkers.MAFLD is one of the common causes of liver dysfunction worldwide,likely due to the increase in metabolic syndrome as well as the high burden of disease and its relationship to other extrahepatic conditions.However,effective pharmacological therapeutic agents are still lacking;current management largely focuses on weight reduction and lifestyle modification.The purpose of this review was to summarize the updated evidence of novel therapies targeting different pathogenetic pathways in MAFLD. | Thaninee Prasoppokakorn Panyavee Pitisuttithum Sombat Treeprasertsuk | 2021 | Journal of Clinical and Translational Hepatology2021，9，6： | 3 |
| 2 | Validation of the albumin-bilirubin score for identifying decompensation risk in patients with compensated cirrhosis显示文摘BACKGROUND The albumin-bilirubin(ALBI)score is an index of liver function recently developed to assess prognosis in patients with hepatocellular carcinoma(HCC).It can detect small changes in liver dysfunction and has been successfully applied to the prediction of survival in patients with non-malignant liver diseases of various etiologies.AIM To investigate the ALBI score for identifying decompensation risk at the 3-year follow-up in patients with compensated cirrhosis.METHODS One-hundred and twenty-three patients with compensated cirrhosis without HCC in King Chulalongkorn Memorial Hospital diagnosed by imaging were retrospectively enrolled from January 2016 to December 2020.A total of 113 patients(91.9%)had Child A cirrhosis with a median model for end-stage liver disease(MELD)score of less than 9.Baseline clinical and laboratory variables and decompensation events were collected.The ALBI score was calculated and validated to classify decompensation risk into low-,middle-,and high-risk groups using three ALBI grade ranges(ALBI grade 1:≤-2.60;grade 2:>-2.60 but≤-1.39;grade 3:>-1.39).Decompensation events were defined as ascites development,variceal bleeding,or grade 3 or 4 hepatic encephalopathy.RESULTS Among 123 cirrhotic patients enrolled,13.8%(n=17)developed decompensating events at a median time of 25[95%confidence interval(CI):17-31]mo.Median baseline ALBI score in compensated cirrhosis was significantly lower than that of patients who developed decompensation events[-2.768(-2.956 to-2.453)vs-2.007(-2.533 to-1.537);P=0.01].Analysis of decompensation risk at 3 years showed that ALBI score had a time-dependent area under the curve(tAUC)of 0.86(95%CI:0.78-0.92),which was significantly better than that of ALBI-Fibrosis-4(ALBI-FIB4)score(tAUC=0.77),MELD score(tAUC=0.66),Child-Pugh score(tAUC=0.65),and FIB-4 score(tAUC=0.48)(P<0.05 for all).The 3-year cumulative incidence of decompensation was 3.1%,22.6%,and 50%in the low-,middle-,and high-risk groups,respectively(P<0.001).The odds ratio for decompensation in patients of the high-risk group was 23.33(95%CI:3.88-140.12,P=0.001).CONCLUSION The ALBI score accurately identifies decompensation risk at the 3-year follow-up in patients with compensated cirrhosis.Those cirrhotic patients with a high-risk grade of ALBI score showed a 23 times greater odds of decompensation. | Huttakan Navadurong Kessarin Thanapirom Salisa Wejnaruemarn Thaninee Prasoppokakorn Roongruedee Chaiteerakij Piyawat Komolmit Sombat Treeprasertsuk | 2023 | World Journal of Gastroenterology2023，29，32： | 1 |
| 3 | Total Synthesis of Natural and Unnatural Lamellarins with Saturated and Unsaturated D-Rings显示文摘 | Poonsakdi Ploypradith Thaninee Petchmanee Poolsak Sahakitpichan | | 0，，： | 1 |
| 4 | Validation model of fibrosis-8 index score to predict significant fibrosis among patients with nonalcoholic fatty liver disease显示文摘BACKGROUND Identifying hepatic fibrosis is crucial for nonalcoholic fatty liver disease(NAFLD)management.The fibrosis-8(FIB-8)score,recently developed by incorporating four additional variables into the fibrosis-4(FIB-4)score,showed better performance in predicting significant fibrosis in NAFLD.AIM To validate the FIB-8 score in a biopsy-proven NAFLD cohort and compare the diagnostic performance of the FIB-8 and FIB-4 scores and NAFLD fibrosis score(NFS)for predicting significant fibrosis.METHODS We collected the data of biopsy-proven NAFLD patients from three Asian centers in three countries.All the patients with available variables for the FIB-4 score(age,platelet count,and aspartate and alanine aminotransferase levels)and FIB-8 score(the FIB-4 variables plus 4 additional parameters:The body mass index(BMI),albumin to globulin ratio,gamma-glutamyl transferase level,and presence of diabetes mellitus)were included.The fibrosis stage was scored using nonalcoholic steatohepatitis CRN criteria,and significant fibrosis was defined as at least fibrosis stage 2.RESULTS A total of 511 patients with biopsy-proven NAFLD and complete data were included for validation.Of these 511 patients,271(53.0%)were female,with a median age of 51(interquartile range:41,58)years.The median BMI was 29(26.3,32.6)kg/m2,and 268(52.4%)had diabetes.Among the 511 NAFLD patients,157(30.7%)had significant fibrosis(≥F2).The areas under the receiver operating characteristic curves of the FIB-8 and FIB-4 scores and NFS for predicting significant fibrosis were 0.774,0.743,and 0.680,respectively.The FIB-8 score demonstrated significantly better performance for predicting significant fibrosis than the NFS(P=0.001)and was also clinically superior to FIB-4,although statistical significance was not reached(P=0.073).The low cutoff point of the FIB-8 score for predicting significant fibrosis of 0.88 showed 92.36%sensitivity,and the high cutoff point of the FIB-8 score for predicting significant fibrosis of 1.77 showed 67.51%specificity.CONCLUSION We demonstrated that the FIB-8 score had significantly better performance for predicting significant fibrosis in NAFLD patients than the NFS,as well as clinically superior performance vs the FIB-4 score in an Asian population.A novel simple fibrosis score comprising commonly accessible basic laboratories may be beneficial to use for an initial assessment in primary care units,excluding patients with significant liver fibrosis and aiding in patient selection for further hepatologist referral. | Thaninee Prasoppokakorn Wah-Kheong Chan Vincent Wai-Sun Wong Panyavee Pitisuttithum Sanjiv Mahadeva Nik Raihan Nik Mustapha Grace Lai-Hung Wong Howard Ho-Wai Leung Pimsiri Sripongpun Sombat Treeprasertsuk | 2022 | World Journal of Gastroenterology2022，28，15： | 0 |
| 5 | Urinary neutrophil gelatinase‐associated lipocalin:A novel biomarker for predicting chronic kidney disease in patients with nonalcoholic fatty liver disease显示文摘Aims:Nonalcoholic fatty liver disease(NAFLD)and chronic kidney disease(CKD)are common diseases worldwide.Reports of a high prevalence of CKD in NAFLD patients have been documented.Urinary neutrophil gelatinaseassociated lipocalin(NGAL)is a reliable biomarker for renal dysfunction,and it is recommended for early detection of acute kidney injury(AKI)in cirrhotic patients.Currently,there is no evidence for using urine NGAL to predict CKD in NAFLD patients.We aim to determine the proportion of CKD and identify the predictive value of NGAL and other factors associated with CKD in these patients.Methods:A single‐center,cross‐sectional study was conducted between July 2018 and December 2019 in consecutive NAFLD patients diagnosed by transient elastography(TE)or liver biopsy at a tertiary care university hospital in Bangkok,Thailand.Advanced liver fibrosis is defined as fibrosis stages 3–4.The definition of CKD is estimated glomerular filtration rate(eGFR)<60 ml⋅min−1⋅1.73m−2 based on the Kidney Disease Improving Global Outcomes(KDIGO)guideline 2012.Urine NGAL level was measured by enzyme linked immunosorbent assay technique.Results:A total of 101 NAFLD patients were included with a mean age of 54±16 years.Among these patients,14(13.9%),13(12.9%),and 32(31.7%)had fibrosis stages 2,3,and 4,respectively.Nine percent(9 of 101)of patients with NAFLD with a mean eGFR of 42.66±17.42 ml⋅min−1⋅1.73m−2.The statistically significant factors associated with CKD were a higher level of urine NGAL(55.1[25.15–150.60]vs.15.1[9.67–25.15]ng/ml;p=0.006),a higher level of TE(17.3[6.85–46.20]vs.7.7[5.6–11.7]kPa;p=0.038),and a presence of advanced fibrosis(77.8%vs.40.7%;p=0.041),compared to those without CKD.Urine NGAL was the only significant factor associated with CKD in NAFLD patients.The cutoff level of urine NGAL at 36.75 ng/ml showed odds ratio of 21.27(95%CI:3.97–113.82;p<0.001)and 1.02(95%CI:1.00–1.04;p=0.024)by univariate and multivariate analyses,respectively.The selected urine NGAL cutoff demonstrated a sensitivity and specificity of 77.8%and 85.9%for predicting CKD,respectively.Conclusions:The proportion of CKD in NAFLD patients was 9%and the presence of advanced fibrosis was a significant risk factor associated with CKD.Additionally,urine NGAL was significantly associated with CKD in NAFLD patients using a cutoff level of 36.75 ng/ml for predicting CKD with acceptable sensitivity and specificity.A larger prospective cohort study is needed to validate our findings. | Huttakan Navadurong Thaninee Prasoppokakorn Nattachai Srisawat Roongruedee Chaiteerakij Piyawat Komolmit Pisit Tangkijvanich Sombat Treeprasertsuk | 2022 | Portal Hypertension & Cirrhosis2022，1，3： | 0 |
| 6 | Modified albumin-bilirubin predicted survival of unresectable hepatocellular carcinoma patients treated with immunotherapy显示文摘BACKGROUND Modified albumin-bilirubin(mALBI)grade has been established as a survival determinant in hepatocellular carcinoma(HCC)patients who receive locoregional and targeted therapies.AIM To investigate whether mALBI could predict survival in unresectable HCC(uHCC)patients who were treated with atezolizumab plus bevacizumab(AB).METHODS A single-center,retrospective cohort study enrolled uHCC patients who received AB treatment between September 2020 and April 2023 and were followed up until June 2023.An association between mALBI and patient survival was determined using Cox proportional hazards analysis.RESULTS Of the 83 patients,67 patients(80.7%)were male with the mean age of 60.6 years.Among them,22 patients(26.5%)were classified as Barcelona Clinic Liver Cancer B,and 61 patients(73.5%)were classified as Barcelona Clinic Liver Cancer C.Cirrhosis was present in 76 patients(91.6%),with 58 patients classified as Child-Turcotte-Pugh(CTP)A and 18 as CTP B.The median overall survival(OS)and progression-free survival were 13.0 mo[95%confidence interval(CI):5.2-20.8]and 9.0 mo(95%CI:5.0-13.0),respectively.The patients were divided into two groups based on mALBI grades:42 patients(50.6%)in the mALBI 1+2a group;and 41 patients(49.4%)in the mALBI 2b+3 group.During the median follow-up period of 7.0 mo,the mALBI 1+2a group exhibited significantly better survival compared to the mALBI 2b+3 group,with a median OS that was not reached vs 3.0 mo(95%CI:0.1-6.0,P<0.001).In a subgroup of patients with CTP A,the mALBI 1+2a group also showed significantly longer survival compared to the mALBI 2b+3 group,with a median OS that was not reached vs 6.0 mo(95%CI:3.4-8.6,P<0.001).In the multivariate analysis,both CTP class and mALBI grade were independently associated with survival,with adjusted hazard ratios(95%CI)of 2.63(1.19-5.78,P=0.020)and 3.90(1.71-8.90,P=0.001),respectively.CONCLUSION mALBI grades can determine survival of uHCC patients receiving AB treatment,particularly those who have mildly impaired liver function.This highlights the importance of assessing mALBI before initiating AB treatment to optimize therapeutic efficacy in clinical practice. | Huttakan Navadurong Thaninee Prasoppokakorn Nanicha Siriwong Chonlada Phathong Nattaya Teeyapun Suebpong Tanasanvimon Kessarin Thanapirom Piyawat Komolmit Pisit Tangkijvanich Sombat Treeprasertsuk Roongruedee Chaiteerakij | 2023 | World Journal of Gastrointestinal Oncology2023，15，10： | 0 |
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