Jordi Gracia-Sancho, MSc PhD FAASLD’s Post

Patients Of Autoimmune Liver Disease Treated With Immune Suppressants Have Lower Prevalence Of Apical Periodontitis: Study Patients of autoimmune liver disease treated with immune suppressants have a lower prevalence of apical periodontitis suggests a study published in the Journal of US Endodontics. Autoimmune liver diseases (ALDs) are chronic conditions generated by an immune-mediated auto-aggressive inflammatory reaction in genetically susceptible individuals. The purpose of this study was to evaluate the prevalence of apical periodontitis in patients suffering from ALDs, in treatment with the immune-suppressants glucocorticoids, azathioprine, and/or ursodeoxycholic acid. The Autoimmune liver diseases group included 46 patients (11 men and 35 women, average age: 57.9 ± 11.8 years) and 1186 teeth. The control (C) included 50 healthy patients (15 men and 35 women, average age: 58.6 ± 10.4 years) and 1251 teeth), under no medications. Demographic data, and medical, pharmacological, and dental history, were recorded. Dental and radiographic examinations were performed, presence of apical periodontitis, periapical index score, DMFT, quality of restoration, and root canal treatment were evaluated. The influence of the medications assumed by the patients on the prevalence of apical periodontitis was also tested. #Patients #autoimmune #liverdisease #immunesuppressants #lowerprevalence #apicalperiodontitis #study

FIB-4 has become the first step in early MASLD/MASH liver health diagnosis, but is it accurate? “Findings from a recent study suggest clinicians should use caution when interpreting Fibrosis-4 index (FIB-4) scores to risk-stratify patients for metabolic dysfunction-associated steatotic liver disease (MASLD)-related fibrosis.” “”Previous studies have shown FIB-4 to have low accuracy for screening liver fibrosis, especially among obese and diabetic patients,” Mazen Noureddin, MD, MHSc, medical director of the Houston Research Institute and professor of medicine at Houston Methodist Academic Institute, and colleagues wrote. “Thus, there is a concern that classifying patients with FIB-4 can lead to misclassification and missed diagnosis.”” Original paper: https://lnkd.in/gDQwnQJ4 DOI: https://lnkd.in/gBeh7Jjb “Based on these findings, we recommend an exercise of caution when interpreting low-risk FIB-4 results in patients with characteristics that confer a higher likelihood of being misclassified.” American Association for the Study of Liver Diseases (AASLD) EASL | The Home of Hepatology Canadian Association for the Study of the Liver Global NASH Council European Liver Patients' Association - ELPA Barcelona Institute for Global Health (ISGlobal) Naim Alkhouri, MD, FAASLD

🔍 Dive into the latest hepatic health breakthrough! Our recent letter to the editor explores MASLD, a promising diagnostic term for fatty liver patients. Learn how accurate diagnosis can transform treatment outcomes! #LiverHealth #MedicalResearch 💡🔬 Key points: - The letter discusses the proposed diagnostic term MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease), which differs from NAFLD (Non-Alcoholic Fatty Liver Disease). -While the name change from NAFLD to MAFLD (Metabolic Dysfunction-Associated Fatty Liver Disease) has reduced stigma and emphasized the connection with metabolic disorders, the definition of MAFLD is complex and may lead to underdiagnosis and delayed treatment. -MASLD, which simplifies the MAFLD definition, is defined by inclusion rather than exclusion criteria and is diagnosed in patients with hepatic steatosis and metabolic risk factors. -The practicality and effectiveness of MASLD have not been fully tested and validated in real-world settings. -The study involved 9406 patients diagnosed with fatty liver by ultrasound. Most patients (98.2%) were diagnosed with both MAFLD and MASLD, while a small percentage were classified differently due to the lack of specific biomarkers. -MASLD patients were older, predominantly male, and had a higher prevalence of metabolic disorders and elevated liver enzymes compared to non-MASLD patients. -MASLD patients also exhibited significant liver steatosis and fibrosis, highlighting the importance of accurately identifying and treating them to prevent further liver damage and improve outcomes. -In conclusion, the MASLD definition represents an improvement in identifying patients with substantial hepatic fibrosis and steatosis within the fatty liver population, necessitating a name change to reflect the underlying pathophysiology and enhance diagnostic accuracy. Let's redefine to enhance accuracy and reflect pathophysiology! #LiverHealth #Research Learn more! Full (free) article at: https://lnkd.in/gnsjgE-F

Metabolic Syndrome patients who don't fit in with the abdominal adiposity waist circumference criteria but nevertheless still qualify for the MetS criteria overall are TOFI (thin outside fat inside) and many have MASLD/NAFLD. They still amazingly respond well with Therapeutic Carb Restriction (TCR) especially at VLCKD levels. Even those with just MASLD/NAFLD but are not yet MetS 3/5 also get reversed. So IR really is a big factor in MASLD.

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as NAFLD, significantly raises cardiovascular disease (CVD) risk due to shared metabolic disorders like obesity, type 2 diabetes, and hypertension. New research emphasizes the need for early CVD risk assessment using noninvasive tools like transient elastography and the FIB-4 index. Lifestyle changes and pharmacological interventions, such as statins and GLP-1 receptor agonists, can effectively manage MASLD and reduce cardiovascular risk. Future studies aim to uncover new biomarkers and therapeutic targets to further mitigate this risk. “Patients with MASLD have a significantly increased risk of cardiovascular events. Therefore, early assessment of CV risk, noninvasive screening and management of these patients are crucial. Treatment of MASLD focuses on lifestyle.” Original paper: Henry Z., Sechi, L.A., Eliano Pio Navarese, MD, PhD, FESC, FACC. et al. Metabolic dysfunction-associated steatotic liver disease and cardiovascular risk: a comprehensive review. Cardiovasc Diabetol 23, 346 (2024). https://lnkd.in/g_2Dgnu6 American Association for the Study of Liver Diseases (AASLD), EASL | The Home of Hepatology, Canadian Association for the Study of the Liver, Global NASH Council, Global Liver Institute, European Liver Patients' Association - ELPA, LPI LIVER PATIENTS INTERNATIONAL, Aegle Medical. Written in collaboration with CHATGPT4o.

New research led by Stanford University Medical Center reveals important insights about nonalcoholic fatty liver disease (NAFLD) in individuals with a normal body mass index (BMI). The study, published in the Journal of Clinical and Translational Hepatology, shows that "lean NAFLD" patients (BMI <25.0 kg/m^2) have fewer metabolic comorbidities compared to those with higher BMI, but face similar or even greater risks of serious health outcomes. Key findings include: NAFLD Risks Not Limited to Obesity: NAFLD, typically linked with obesity, presents similar risks of advanced liver disease, non-liver cancers, and cardiovascular disease in lean individuals. Metabolic Abnormalities as Key Factors: The development of fatty liver is driven more by metabolic issues like hypertriglyceridemia and insulin resistance, rather than solely by being overweight or obese. Diverse Patient Profiles: The study, covering patients from 1995 to 2021 at Stanford Healthcare, included lean, overweight, and obese individuals with NAFLD. Lean patients were generally older and included more women and Asians, while the obese group had a higher percentage of men and Hispanics. Comparative Health Outcomes: Lean NAFLD patients showed higher instances of NASH, cirrhosis, and non-liver cancer compared to their overweight or obese counterparts. Mortality Rates: Despite similar mortality rates from liver-related causes across all groups, lean NAFLD patients had higher overall and nonliver-related mortality rates. The study concludes that lean NAFLD should be taken seriously in clinical practice, requiring the same level of care and intervention as NAFLD in overweight or obese patients. This highlights a crucial gap in understanding and managing NAFLD in individuals of average weight. [Source: Nguyen VH, Ha A, Rouillard NA, et al. J Clin Transl Hepatol. 2023;11(7):1448-1454]

I have Metabolic Syndrome patients who don't fit in with the abdominal adiposity waist circumference criteria but nevertheless still qualify for the MetS criteria overall and are thus TOFI (thin outside fat inside). They still amazingly respond well with Therapeutic Carb Restriction (TCR) especially at VLCKD levels. Even those with just MASLD/NAFLD but are not yet MetS 3/5 also get reversed. So IR really is a big factor in MASLD. I think it's just a matter of time for these "lean NAFLDs" to develop other manifestations of MetS/IR, much like the current definition of the Metabolically Healthy Obese (MHO) which for most is just transient and later on would eventually become metabolically unhealthy (MUO) based on MetS criteria. 👉https://lnkd.in/dS_jJKQm

I have Metabolic Syndrome patients who don't fit in with the abdominal adiposity waist circumference criteria but nevertheless still qualify for the MetS criteria overall and are thus TOFI (thin outside fat inside). They still amazingly respond well with Therapeutic Carb Restriction (TCR) especially at VLCKD levels. Even those with just MASLD/NAFLD but are not yet MetS 3/5 also get reversed. So IR really is a big factor in MASLD. I think it's just a matter of time for these "lean NAFLDs" to develop other manifestations of MetS/IR, much like the current definition of the Metabolically Healthy Obese (MHO) which for most is just transient and later on would eventually become metabolically unhealthy based on MetS criteria.

Spotlight on MASLD and Cardiovascular Risk Recent research highlights the link between Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as NAFLD, and an increased risk of cardiovascular disease (CVD). With shared risk factors like obesity, type 2 diabetes, and hypertension, it's essential to prioritize early CVD risk assessment using noninvasive tools like #FibroScan and the FIB-4 index. Key Takeaways: - Lifestyle modifications and pharmacological options, including statins and GLP-1 receptor agonists, can effectively manage MASLD and lower cardiovascular risks. - Future studies are set to explore new biomarkers and therapeutic targets to enhance patient outcomes. Let’s drive awareness and promote proactive measures for better health outcomes! #MASLD #CVD #FibroScan #HealthcareInnovation #PatientCare #LiverHealthMatters

“Type 2 diabetes, which can be diagnosed with a simple blood test, exacerbates liver disease through insulin resistance caused by fat deposits, scarring, or cirrhosis in the liver”. This condition often progresses silently, making early detection through simple, singular blood tests like LIVERFASt crucial. LIVERFASt screens for metabolic dysfunction-associated steatotic liver disease (MASLD), a common affliction in those with Type 2 diabetes. From one blood draw, LIVERFASt provides a complete evaluation of the Liver: Stages Fibrosis, Activity (inflammation), and Steatosis. #AASLD #Fibronostics #LIVERFASt #livewell