Nonalcoholic fatty liver disease(NAFLD)is a multisystemic clinical condition that presents with a wide spectrum of extrahepatic manifestations,such as obesity,type 2 diabetes mellitus,metabolic syndrome,cardiovascular...Nonalcoholic fatty liver disease(NAFLD)is a multisystemic clinical condition that presents with a wide spectrum of extrahepatic manifestations,such as obesity,type 2 diabetes mellitus,metabolic syndrome,cardiovascular diseases,chronic kidney disease,extrahepatic malignancies,cogni-tive disorders,and polycystic ovarian syndrome.Among NAFLD patients,the most common mortality etiology is cardiovascular disorders,followed by extrahepatic malignancies,diabetes mellitus,and liver-related complications.Furthermore,the severity of extrahepatic diseases is parallel to the severity of NAFLD.In clinical practice,awareness of the associations of concomitant diseases is of major importance for initiating prompt and timely screening and multidisciplinary management of the disease spectrum.In 2020,a consensus from 22 countries redefined the disease as metabolic(dysfunction)-associated fatty liver disease(MAFLD),which resulted in the redefinition of the corre-sponding population.Although the patients diagnosed with MAFLD and NAFLD mostly overlap,the MAFLD and NAFLD populations are not identical.In this review,we compared the associations of key extrahepatic diseases between NAFLD and MAFLD.展开更多
Atrial fibrillation(AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression(from paroxysmal to persistent and permanent types) have been repo...Atrial fibrillation(AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression(from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and heart failure and the congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category scores as well as biomarkers related to inflammation may also add important information on this topic. There is now increasing evidence that even in patients with so-called lone or idiopathic AF, the arrhythmia is the manifestation of a structural atrial disease which has recently been defined and described as fibrotic atrial cardiomyopathy. Fibrosis results from a broad range of factors related to AF inducing pathologies such as cell stretch, neurohumoral activation, and oxidative stress. The extent of fibrosis as detected either by late gadolinium enhancement-magnetic resonance imaging or electroanatomic voltage mapping may guide the therapeutic approach based on the arrhythmia substrate. The knowledge of these risk factors may not only delay arrhythmia progression, but also reduce the arrhythmia burden in patients with first detected AF. The present review highlights on the conventional and novel risk factors of development and progression of AF.展开更多
Evidence has accumulated to suggest an important role of ethanol and/or its metabolites in the pathogenesis of alcohol-related liver disease. In this review, the fibrogenic effects of ethanol and its metabolites on he...Evidence has accumulated to suggest an important role of ethanol and/or its metabolites in the pathogenesis of alcohol-related liver disease. In this review, the fibrogenic effects of ethanol and its metabolites on hepatic stellate cells (HSCs) are discussed. In brief, ethanol interferes with retinoid metabolism and its signaling, induces the release of fibrogenic cytokines such as transforming growth factor β-1 (TGFβ-1) from HSCs, up-regulates the gene expression of collagen I and enhances type I collagen protein production by HSCs. Ethanol further perpetuates an activated HSC phenotype through extracellular matrix remodeling. The underlying pathophysiologic mechanisms by which ethanol exerts these pro-fibrogenic effects on HSCs are reviewed.展开更多
文摘Nonalcoholic fatty liver disease(NAFLD)is a multisystemic clinical condition that presents with a wide spectrum of extrahepatic manifestations,such as obesity,type 2 diabetes mellitus,metabolic syndrome,cardiovascular diseases,chronic kidney disease,extrahepatic malignancies,cogni-tive disorders,and polycystic ovarian syndrome.Among NAFLD patients,the most common mortality etiology is cardiovascular disorders,followed by extrahepatic malignancies,diabetes mellitus,and liver-related complications.Furthermore,the severity of extrahepatic diseases is parallel to the severity of NAFLD.In clinical practice,awareness of the associations of concomitant diseases is of major importance for initiating prompt and timely screening and multidisciplinary management of the disease spectrum.In 2020,a consensus from 22 countries redefined the disease as metabolic(dysfunction)-associated fatty liver disease(MAFLD),which resulted in the redefinition of the corre-sponding population.Although the patients diagnosed with MAFLD and NAFLD mostly overlap,the MAFLD and NAFLD populations are not identical.In this review,we compared the associations of key extrahepatic diseases between NAFLD and MAFLD.
文摘Atrial fibrillation(AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression(from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and heart failure and the congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category scores as well as biomarkers related to inflammation may also add important information on this topic. There is now increasing evidence that even in patients with so-called lone or idiopathic AF, the arrhythmia is the manifestation of a structural atrial disease which has recently been defined and described as fibrotic atrial cardiomyopathy. Fibrosis results from a broad range of factors related to AF inducing pathologies such as cell stretch, neurohumoral activation, and oxidative stress. The extent of fibrosis as detected either by late gadolinium enhancement-magnetic resonance imaging or electroanatomic voltage mapping may guide the therapeutic approach based on the arrhythmia substrate. The knowledge of these risk factors may not only delay arrhythmia progression, but also reduce the arrhythmia burden in patients with first detected AF. The present review highlights on the conventional and novel risk factors of development and progression of AF.
文摘Evidence has accumulated to suggest an important role of ethanol and/or its metabolites in the pathogenesis of alcohol-related liver disease. In this review, the fibrogenic effects of ethanol and its metabolites on hepatic stellate cells (HSCs) are discussed. In brief, ethanol interferes with retinoid metabolism and its signaling, induces the release of fibrogenic cytokines such as transforming growth factor β-1 (TGFβ-1) from HSCs, up-regulates the gene expression of collagen I and enhances type I collagen protein production by HSCs. Ethanol further perpetuates an activated HSC phenotype through extracellular matrix remodeling. The underlying pathophysiologic mechanisms by which ethanol exerts these pro-fibrogenic effects on HSCs are reviewed.
