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1.
J Clin Med ; 12(17)2023 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-37685725

RESUMEN

Metabolic-dysfunction-associated steatotic liver disease (MASLD) and metabolic syndrome (MetS) are inextricably linked conditions, both of which are experiencing an upward trend in prevalence, thereby exerting a substantial clinical and economic burden. The presence of MetS should prompt the search for metabolic-associated liver disease. Liver fibrosis is the main predictor of liver-related morbidity and mortality. Non-invasive tests (NIT) such as the Fibrosis-4 index (FIB4), aspartate aminotransferase-to-platelet ratio index (APRI), aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), hepatic steatosis index (HIS), transient elastography (TE), and combined scores (AGILE3+, AGILE4) facilitate the detection of liver fibrosis or steatosis. Our study enrolled 217 patients with suspected MASLD, 109 of whom were diagnosed with MetS. We implemented clinical and biological evaluations complemented by transient elastography (TE) to discern the most robust predictors for liver disease manifestation patterns. Patients with MetS had significantly higher values of FIB4, APRI, HSI, liver stiffness, and steatosis parameters measured by TE, as well as AGILE3+ and AGILE4 scores. Machine-learning algorithms enhanced our evaluation. A two-step cluster algorithm yielded three clusters with reliable model quality. Cluster 1 contained patients without significant fibrosis or steatosis, while clusters 2 and 3 showed a higher prevalence of significant liver fibrosis or at least moderate steatosis as measured by TE. A decision tree algorithm identified age, BMI, liver enzyme levels, and metabolic syndrome characteristics as significant factors in predicting cluster membership with an overall accuracy of 89.4%. Combining NITs improves the accuracy of detecting patterns of liver involvement in patients with suspected MASLD.

2.
Hepatogastroenterology ; 58(109): 1296-300, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21937398

RESUMEN

BACKGROUND/AIMS: A geranyl-geranylated protein is synthesized during chronic hepatitis C virus replication; statins can inhibit this synthesis. We aimed at studying the effects of administrating simvastatin to patients who finished the standard antiviral therapy and who did not have hepatic cytolysis. METHODOLOGY: A total of 101 patients were divided into 3 groups. Those without liver cytolysis were divided as follows: In group A1 patients were treated with simvastatin for 3 months and in group A2 the patients were non-treated controls. Those patients with hepatic cytolysis were placed in group B and treated for 3 months with simvastatin. The patients were biologically monitored monthly and the initial viremia was compared with the final one. The results were then statistically analysed. RESULTS: Significant changes of viremia were not observed in the patients from groups A1 and A2. In 24 patients in group B (58.54%) the viremia was significantly reduced (p=0.018), and in 6 patients (39.02%) it increased insignificantly. After 1 and 2 months of treatment, the cholesterolemy and the serum alkaline phosphatase significantly decreased to the patients from group B. CONCLUSIONS: In this study, more than half of the patients chronically infected with the hepatitis C virus, who had hepatic cytolysis and were treated with simvastatin, showed a significant reduction in the level of viremia.


Asunto(s)
Hepatitis C Crónica/tratamiento farmacológico , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Simvastatina/uso terapéutico , Adulto , Alanina Transaminasa/sangre , Aspartato Aminotransferasas/sangre , Femenino , Hepatitis C Crónica/virología , Humanos , Masculino , Persona de Mediana Edad , ARN Viral/análisis
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