- Nutritional issues in patients with obesity and cirrhosis. [Review]
- WJWorld J Gastroenterol 2018 Aug 14; 24(30):3330-3346
- Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation...
Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress to cirrhosis. Patients with obesity also have an increased risk of primary liver malignancies and increased body mass index is a predictor of decompensation of liver cirrhosis. Sarcopenic obesity confers a risk of physical impairment and disability that is significantly higher than the risk induced by each of the two conditions alone as it has been shown to be an independent risk factor for chronic liver disease in patients with obesity and a prognostic negative marker for the evolution of liver cirrhosis and the results of liver transplantation. Cirrhotic patients with obesity are at high risk for depletion of various fat-soluble, water-soluble vitamins and trace elements and should be supplemented appropriately. Diet, physical activity and protein intake should be carefully monitored in these fragile patients according to recent recommendations. Bariatric surgery is sporadically used in patients with morbid obesity and cirrhosis also in the setting of liver transplantation. The risk of sarcopenia, micronutrient status, and the recommended supplementation in patients with obesity and cirrhosis are discussed in this review. Furthermore, the indications and contraindications of bariatric surgery-induced weight loss in the cirrhotic patient with obesity are discussed.
- Chronic oral rapamycin decreases adiposity, hepatic triglycerides, and insulin resistance in male mice fed a diet high in sucrose and saturated fat. [Journal Article]
- EPExp Physiol 2018 Aug 16
- CONCLUSIONS: A moderately low dose of rapamycin decreased adiposity and improved the metabolic profile in a model of diet-induced obesity. These data suggest that low-grade chronic mTORC1 inhibition may be a potential strategy for anti-obesity therapies. This article is protected by copyright. All rights reserved.
- A Rare Case of Multiple Anomalies of the Coronary Arteries. [Journal Article]
- CCureus 2018 Jun 13; 10(6):e2796
- Coronary artery anomalies represent a rare phenomenon, which is observed in approximately 1% of the population. Although not a frequent anomaly, they may lead to complications during various procedur...
Coronary artery anomalies represent a rare phenomenon, which is observed in approximately 1% of the population. Although not a frequent anomaly, they may lead to complications during various procedures and can sometimes present with angina pectoris or myocardial infarction. Herein, we present a rare case of a patient with origin of the left main coronary artery from the right sinus of Valsalva combined with a superdominant right coronary artery due to a hypoplastic left circumflex artery. A 67-year-old male patient presented with symptoms of chest pain on exertion, which lasted for approximately 10 minutes and resolved after rest. Physical examination, auscultation, electrocardiogram, and transthoracic echocardiography revealed normal findings. Cardiac enzymes were within the reference ranges, while the levels of triglycerides and low density lipoprotein (LDL)-cholesterol were elevated. The patient was further evaluated through coronary angiography. It revealed the origin of the left coronary artery from the right sinus of Valsalva, with a markedly hypoplastic left circumflex artery and the presence of a 'superdominant' right coronary artery. Atherosclerotic lesions were not observed, and the symptoms were discussed to have been caused by the anomalous pattern of the coronary arteries and the hypoplastic left circumflex artery in particular. The most common symptom of a hypoplastic or absent left circumflex artery is chest pain on exertion which is explained by the 'steal' phenomenon - due to increased demand in the area normally supplied by the left circumflex artery, a transitory ischemia occurs in the basins supplied by the left anterior descending artery and the right coronary artery. These findings were similar to our case. Such variations, although mostly asymptomatic, can sometimes lead to serious cardiovascular conditions and should be considered by clinicians during the assessment of cardiac symptoms.
- C-type natriuretic peptide (CNP) in endothelial cells attenuates hepatic fibrosis and inflammation in non-alcoholic steatohepatitis. [Journal Article]
- LSLife Sci 2018 Aug 13
- CONCLUSIONS: The overexpression of CNP in endothelial cells has anti-fibrotic and anti-inflammatory effects in liver during HFD-induced NASH in mice.
- Nonalcoholic Fatty Liver Disease Is Associated with Increased Atrial Fibrillation Risk in an Elderly Chinese Population: A Cross-Sectional Study. [Journal Article]
- BRBiomed Res Int 2018; 2018:5628749
- CONCLUSIONS: Our results show that nonalcoholic fatty liver disease is associated with an increased risk of atrial fibrillation in an elderly Chinese population.
- Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study. [Journal Article]
- IJInt J Obes (Lond) 2018 Aug 14
- CONCLUSIONS: Worse baseline risk factors may explain any difference in mortality risk between obese and non-obese groups both labelled as healthy, further challenging the concept of MHO.
- Active cushing syndrome patients have increased ectopic fat deposition and bone marrow fat content compared to cured patients and healthy subjects: a pilot 1H-MRS study. [Journal Article]
- EJEur J Endocrinol 2018 Aug 14
- CONCLUSIONS: Accumulation of BMF is induced by hypercortisolism. In remission patients BMF reached values of controls. Further studies are needed to determine whether this increase in marrow adiposity in CS is associated with bone loss.
- StemBell therapy stabilizes atherosclerotic plaques after myocardial infarction. [Journal Article]
- CCytotherapy 2018 Aug 11
- CONCLUSIONS: StemBell therapy increased cap thickness and decreased intra-plaque inflammation after MI, indicative of stabilized atherosclerotic plaque. It also induced a shift of circulating monocytes and intra-plaque and intra-cardiac macrophages towards anti-inflammatory phenotypes. Hence, StemBell therapy may be a therapeutic option to prevent atherosclerosis acceleration after MI.
- PGC-1α in hepatic UPR during high-fat high-fructose diet and exercise training in mice. [Journal Article]
- PRPhysiol Rep 2018; 6(15):e13819
- Diet-induced obesity is associated with hepatic steatosis, which has been linked with activation of the unfolded protein response (UPR). PGC-1α is a transcriptional coactivator involved in exercise t...
Diet-induced obesity is associated with hepatic steatosis, which has been linked with activation of the unfolded protein response (UPR). PGC-1α is a transcriptional coactivator involved in exercise training-induced adaptations in muscle and liver. Therefore, the aim of this study was to test the hypothesis that PGC-1α is required for exercise training-mediated prevention of diet-induced steatosis and UPR activation in liver. Male liver-specific PGC-1α knockout (LKO) and littermate floxed (lox/lox) mice were divided into two groups receiving either control diet (CON) or high-fat high-fructose diet (HFF). After 9 weeks, half of the HFF mice were treadmill exercise trained for 4 weeks (HFF+ExT), while the rest were kept sedentary. HFF resulted in increased body and liver weight, adiposity, hepatic steatosis and whole body glucose intolerance as well as decreased hepatic IRE1α phosphorylation. Exercise training prevented the HFF-induced weight gain and partially prevented increased liver weight, adiposity and glucose intolerance, but with no effect on liver triglycerides. In addition, BiP protein and CHOP mRNA content increased with exercise training compared with CON and HFF, respectively. Lack of PGC-1α in the liver only resulted in minor changes in the PERK pathway. In conclusion, this study provides evidence for dissociation between diet-induced hepatic triglyceride accumulation and hepatic UPR activation. In addition, PGC-1α was not required for maintenance of basal UPR in the liver and due to only minor exercise training effects on UPR further studies are needed to conclude on the potential role of PGC-1α in exercise training-induced adaptations in hepatic UPR.
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- Metabolic effects of initiating lopinavir/ritonavir-based regimens among young children: 7-year follow-up of the IMPAACT P1060 trial. [Journal Article]
- AIDSAIDS 2018 Aug 09
- CONCLUSIONS: Given the virologic superiority of LPV/r-based regimens in young children and open questions regarding the roll-out of dolutegravir in resource-limited settings, children are currently being maintained on LPV/r-based regimens. Our results suggest continual assessment of total cholesterol among young children initiating a LPV/r-based regimen to monitor cardiometabolic health.