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  1. Article ; Online: The Efficacy of Dietary Interventions in Patients with Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis of Intervention Studies.

    Lakananurak, Narisorn / Pitisuttithum, Panyavee / Susantitaphong, Paweena / Patcharatrakul, Tanisa / Gonlachanvit, Sutep

    Nutrients

    2024  Volume 16, Issue 3

    Abstract: Background: International guidelines recommend dietary interventions as one of the most important treatments for patients with gastroesophageal reflux disease (GERD). Evidence to confirm the efficacy of these treatment modalities is lacking. The present ...

    Abstract Background: International guidelines recommend dietary interventions as one of the most important treatments for patients with gastroesophageal reflux disease (GERD). Evidence to confirm the efficacy of these treatment modalities is lacking. The present study aims to evaluate the efficacy of dietary interventions on GERD-related outcomes evaluated in intervention studies on GERD patients.
    Methods: A systematic review and meta-analysis was performed according to PRISMA. The PubMed/MEDLINE, Web of Sciences, and Scopus databases were utilized for the literature search. Two independent researchers searched for relevant publications published up until June 2023. Intervention studies evaluating the efficacy of dietary interventions in patients with GERD were included.
    Results: A total of 577 articles were identified during the initial literature search. After reviewing, 21 studies with 16 different types of dietary interventions were included in the analysis. The interventions were divided into low-carbohydrate diets (3 studies), high-fat diets (2 studies), speed of eating studies (3 studies), low-FODMAP diets (2 studies), and other interventions (12 studies). A meta-analysis could be performed for low-carbohydrate diets and speed of eating interventions. Low-carbohydrate diets resulted in a significant reduction in esophageal acid exposure time (mean difference = -2.834%, 95% confidence interval (CI): -4.554 to -1.114), while a slow speed of eating did not lead to a lower percentage of reflux events compared to fast eating (risk ratio = 1.044, 95% CI: 0.543-2.004). Most other interventions showed positive effects in only a single study.
    Conclusion: Low-carbohydrate diets showed a significant improvement in GERD-related outcomes, while a slow eating speed did not result in a reduction in reflux events. The overall evidence regarding dietary interventions in GERD remains scarce. High-quality, long-term RCTs are still required to confirm the effects of dietary interventions in GERD patients.
    MeSH term(s) Humans ; Gastroesophageal Reflux ; Diet, Carbohydrate-Restricted
    Language English
    Publishing date 2024-02-05
    Publishing country Switzerland
    Document type Meta-Analysis ; Systematic Review ; Journal Article ; Review
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu16030464
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  2. Article: Pharmacological Therapeutics: Current Trends for Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD).

    Prasoppokakorn, Thaninee / Pitisuttithum, Panyavee / Treeprasertsuk, Sombat

    Journal of clinical and translational hepatology

    2021  Volume 9, Issue 6, Page(s) 939–946

    Abstract: 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 ... ...

    Abstract 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.
    Language English
    Publishing date 2021-07-28
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 3019822-7
    ISSN 2310-8819 ; 2225-0719
    ISSN (online) 2310-8819
    ISSN 2225-0719
    DOI 10.14218/JCTH.2021.00189
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  3. Article: Spot Hydrogen Breath Test for Predicting Response to Low Fermentable Oligo-, Di-, Mono-saccharides, and Polyols Dietary Advice in Patients With Bloating.

    Somvanapanich, Pochara / Pitisuttithum, Panyavee / Sirimongkolkasem, Jarongkorn / Rattanachaisit, Pakkapon / Jangsirikul, Sureeporn / Patcharatrakul, Tanisa / Gonlachanvit, Sutep

    Journal of neurogastroenterology and motility

    2023  Volume 29, Issue 4, Page(s) 513–519

    Abstract: Background/aims: An increase in postprandial intestinal gas plays a role in bloating symptoms. We aim to study the utility of spot breath hydrogen (H: Methods: Patients with functional gastrointestinal disorders diagnosed by Rome IV criteria with ... ...

    Abstract Background/aims: An increase in postprandial intestinal gas plays a role in bloating symptoms. We aim to study the utility of spot breath hydrogen (H
    Methods: Patients with functional gastrointestinal disorders diagnosed by Rome IV criteria with bothersome bloating for > 6 months were prospectively enrolled. Patients completed 7-day food diaries and collected a breath sample 2 hours after their usual lunch at baseline and 4 weeks after low FODMAPs dietary advice by a dietitian. The responder was defined as an improvement of ≥ 30% bloating scores in the fourth week.
    Results: Thirty-eight patients (32 female, 52.6 ± 13.8 years; 22 irritable bowel syndrome) completed the study. Twenty-one patients (55%) were classified as responders. Baseline global gastrointestinal symptoms, bloating, abdominal pain scores, and numbers of high FODMAPs items were similar between responders and non-responders. Both groups significantly decreased high FODMAPs items intake with similar numbers at the follow-up. The area under the curve for predicting low FODMAPs responsiveness using baseline H
    Conclusions: A higher baseline breath hydrogen level was associated with bloating improvement after low FODMAPs dietary advice. A spot breath test after lunch, a simple point-of-care test, is possibly helpful in managing patients with bloating.
    Language English
    Publishing date 2023-10-09
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2573719-3
    ISSN 2093-0887 ; 2093-0879
    ISSN (online) 2093-0887
    ISSN 2093-0879
    DOI 10.5056/jnm22214
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  4. Article ; Online: Four-dimensional impedance manometry volume metrics for predicting abnormal bolus retention.

    Pitisuttithum, Panyavee / Goudie, Eric / Araujo, Isis K / Halder, Sourav / Carlson, Dustin A / Pandolfino, John E / Kou, Wenjun

    Neurogastroenterology and motility

    2024  , Page(s) e14803

    Abstract: Background: The objective measurement for esophageal bolus volume and bolus clearance could classify abnormal high-resolution manometry (HRM) beyond the current Chicago classification. We aimed to compare the novel four-dimensional impedance manometry ( ... ...

    Abstract Background: The objective measurement for esophageal bolus volume and bolus clearance could classify abnormal high-resolution manometry (HRM) beyond the current Chicago classification. We aimed to compare the novel four-dimensional impedance manometry (4D HRM) volume metrics with timed barium esophagram (TBE).
    Methods: Adults with esophageal symptoms undergoing HRM and TBE were included. A custom-built program for 4D HRM analysis measured esophageal luminal cross-sectional area (CSA) from impedance and subsequently derived esophageal bolus volume and clearance. 4D HRM volume metrics included pre-swallow residual volume, maximal volume, retention volume, and clearance ratio defined as 1.0-retention volume divided by the maximal volume. An abnormal TBE was defined as a column height >5 cm at 1 min or 5 min.
    Key results: A total of 95 patients (normal motility: 33%; ineffective esophageal motility: 12%; absent contractility: 10%; esophagogastric junction outflow obstruction: 30%; type I achalasia: 5%; type II achalasia: 12%) were categorized into normal TBE (58%), abnormal TBE at 1 min (17%), and abnormal TBE at 5 min (25%). The AUROC demonstrated that, among all 4D HRM volume metrics, the clearance ratio had the best performance in predicting abnormal TBE at 5 min (AUROC, 95% confidence interval: 0.89, 0.82-0.96), and exhibited a strong negative correlation with TBE at 5 min (r = -0.65; p < 0.001).
    Conclusions & inferences: Novel 4D HRM volume metrics provide objective measurement of esophageal bolus volume and bolus clearance. The clearance ratio has a strong correlation with TBE and could potentially serve as a substitute for TBE to measure esophageal retention.
    Language English
    Publishing date 2024-04-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 1186328-6
    ISSN 1365-2982 ; 1350-1925
    ISSN (online) 1365-2982
    ISSN 1350-1925
    DOI 10.1111/nmo.14803
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  5. Article ; Online: COVID-19 vaccine acceptance, hesitancy, and determinants among physicians in a university-based teaching hospital in Thailand.

    Sirikalyanpaiboon, May / Ousirimaneechai, Krittin / Phannajit, Jeerath / Pitisuttithum, Panyavee / Jantarabenjakul, Watsamon / Chaiteerakij, Roongruedee / Paitoonpong, Leilani

    BMC infectious diseases

    2021  Volume 21, Issue 1, Page(s) 1174

    Abstract: Background: The COVID-19 vaccines provide renewed hope in the fight against the recent pandemic. To ensure widespread vaccination, it is crucial to analyze vaccine willingness and its determinants among physicians, key health care influencers. This ... ...

    Abstract Background: The COVID-19 vaccines provide renewed hope in the fight against the recent pandemic. To ensure widespread vaccination, it is crucial to analyze vaccine willingness and its determinants among physicians, key health care influencers. This study aimed to assess acceptance rate and identify factors associated with vaccine hesitancy among Thai physicians.
    Methods: A cross-sectional online-based questionnaire was distributed to all physicians at King Chulalongkorn Memorial Hospital during March 31, 2021 to April 30, 2021 in order to assess their attitudes toward receiving the COVID-19 vaccine. Reasons for vaccine acceptance and refusal as well as predictors of vaccine hesitancy were analyzed by bivariate and multivariable analysis.
    Results: A total of 705 complete responses were received with 95.6% (n = 675) of physicians expressing willingness to receive a COVID-19 vaccine. Only one of the 31 physicians (4.4%) who expressed a hesitancy or unwillingness to be vaccinated was a faculty member; the others were physicians-in-training. Approximately one-fifths of physicians surveyed were also not willing to recommend the vaccine to their family members (21.4%, n = 151) or patients (18.7%, n = 132). Using multivariable logistic regression, vaccine hesitancy was independently associated with preference for particular vaccines over the government allocated option, especially for mRNA vaccine (aOR 8.86; 95% CI 1.1-71.54; p = 0.041). Vaccine literacy showed an inverse relationship (aOR 0.34; 95% CI 0.13-0.9; p = 0.029) with vaccine hesitancy. Uncertainty of the vaccine efficacy (83.9%) and fear of adverse events (48.4%) were major concerns contributing to vaccine hesitancy.
    Conclusion: This study revealed a high rate of physician willingness to take the COVID-19 vaccine especially among staffs; however, a significant proportion would not currently suggest vaccination to their families or patients. Restrictions on vaccine choice and vaccine illiteracy, together with concerns over adverse effects and uncertainty of efficacy, were associated with negative attitudes toward vaccination. To raise acceptance of the vaccination program, efforts should be made to balance individual preference for vaccine type in addition to increasing the availability of accurate data on safety and efficacy for each vaccine.
    MeSH term(s) COVID-19 ; COVID-19 Vaccines ; Cross-Sectional Studies ; Hospitals, Teaching ; Hospitals, University ; Humans ; Physicians ; SARS-CoV-2 ; Thailand ; Universities ; Vaccination ; Vaccines
    Chemical Substances COVID-19 Vaccines ; Vaccines
    Language English
    Publishing date 2021-11-22
    Publishing country England
    Document type Journal Article
    ISSN 1471-2334
    ISSN (online) 1471-2334
    DOI 10.1186/s12879-021-06863-5
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  6. Article ; Online: Validation model of fibrosis-8 index score to predict significant fibrosis among patients with nonalcoholic fatty liver disease.

    Prasoppokakorn, Thaninee / Chan, Wah-Kheong / Wong, Vincent Wai-Sun / Pitisuttithum, Panyavee / Mahadeva, Sanjiv / Nik Mustapha, Nik Raihan / Wong, Grace Lai-Hung / Leung, Howard Ho-Wai / Sripongpun, Pimsiri / Treeprasertsuk, Sombat

    World journal of gastroenterology

    2022  Volume 28, Issue 15, Page(s) 1563–1573

    Abstract: 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 ... ...

    Abstract 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/m
    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
    MeSH term(s) Aspartate Aminotransferases ; Biopsy ; Diabetes Mellitus/diagnosis ; Female ; Fibrosis ; Humans ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/epidemiology ; Male ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology ; Severity of Illness Index
    Chemical Substances Aspartate Aminotransferases (EC 2.6.1.1)
    Language English
    Publishing date 2022-05-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v28.i15.1563
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  7. Article ; Online: How to approach esophagogastric junction outflow obstruction?

    Patcharatrakul, Tanisa / Alkaddour, Ahmad / Pitisuttithum, Panyavee / Jangsirikul, Sureeporn / Vega, Kenneth J / Clarke, John O / Gonlachanvit, Sutep

    Annals of the New York Academy of Sciences

    2020  Volume 1481, Issue 1, Page(s) 210–223

    Abstract: The diagnosis of esophagogastric junction outflow obstruction (EGJOO) is currently based on high-resolution esophageal manometry and is characterized by impaired EGJ relaxation with preserved esophageal peristalsis. This condition has been defined by the ...

    Abstract The diagnosis of esophagogastric junction outflow obstruction (EGJOO) is currently based on high-resolution esophageal manometry and is characterized by impaired EGJ relaxation with preserved esophageal peristalsis. This condition has been defined by the Chicago Classification as a major esophageal motility disorder, although its clinical significance is controversial since heterogeneous and irrelevant presentations have been reported. EGJOO commonly has a benign clinical course, with spontaneous resolution, but it can also be associated with opioid usage, early achalasia, and mechanical obstruction. A careful medical, surgical, and medication history coupled with a careful manometry interpretation focused on the factors that might affect the integrated relaxation pressure are the keys for an accurate diagnosis. The advance of esophageal physiological tests can evaluate the clearance of the esophageal contents across the EGJ. The manometry technique, including testing in an upright position and provocative tests, can also complement those tests and demonstrate the evidence of EGJ obstruction. After making a diagnosis, endoscopy should be an initial step to exclude anatomical causes if it has not yet been done. Imaging studies can identify infiltrative lesions, but the reported diagnostic yield is relatively low. Management of EGJOO depends on the underlying etiology. Functional EGJOO patients with persistent dysphagia associated with the presence of outflow obstruction may require EGJ disruption therapy.
    MeSH term(s) Deglutition Disorders/diagnosis ; Deglutition Disorders/physiopathology ; Deglutition Disorders/therapy ; Esophageal Achalasia/diagnosis ; Esophageal Achalasia/physiopathology ; Esophageal Achalasia/therapy ; Esophagogastric Junction/physiopathology ; Esophagoscopy ; Humans ; Manometry
    Language English
    Publishing date 2020-06-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 211003-9
    ISSN 1749-6632 ; 0077-8923
    ISSN (online) 1749-6632
    ISSN 0077-8923
    DOI 10.1111/nyas.14412
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  8. Article ; Online: Thailand guideline 2020 for medical management of gastroesophageal reflux disease.

    Maneerattanaporn, Monthira / Pittayanon, Rapat / Patcharatrakul, Tanisa / Bunchorntavakul, Chalermrat / Sirinthornpanya, Siam / Pitisuttithum, Panyavee / Sudcharoen, Asawin / Kaosombatwattana, Uayporn / Tangvoraphongchai, Kawin / Chaikomin, Reawika / Harinwan, Kamin / Techathuvanan, Karjpong / Jandee, Sawangpong / Kijdamrongthum, Phuripong / Tangaroonsanti, Anupong / Rattanakovit, Kulthep / Chirapongsathorn, Sakkarin / Gonlachanvit, Sutep / Surangsrirat, Surapol /
    Werawatganon, Duangporn / Chunlertrith, Kitti / Mahachai, Varocha / Leelakusolvong, Somchai / Piyanirun, Wanich

    Journal of gastroenterology and hepatology

    2022  Volume 37, Issue 4, Page(s) 632–643

    Abstract: Gastroesophageal reflux disease (GERD) is one of the most prevalent and bothersome functional gastrointestinal disorders worldwide, including in Thailand. After a decade of the first Thailand GERD guideline, physician and gastroenterologist encountered ... ...

    Abstract Gastroesophageal reflux disease (GERD) is one of the most prevalent and bothersome functional gastrointestinal disorders worldwide, including in Thailand. After a decade of the first Thailand GERD guideline, physician and gastroenterologist encountered substantially increase of patients with GERD. Many of them are complicated case and refractory to standard treatment. Concurrently, the evolution of clinical characteristics as well as the progression of investigations and treatment have developed and changed tremendously. As a member of Association of Southeast Asian Nations, which are developing countries, we considered that the counterbalance between advancement and sufficient economy is essential in taking care of patients with GERD. We gather physicians from university hospitals, as well as internist and general practitioners who served in rural area, to make a consensus in this updated version of GERD guideline focusing in medical management of GERD. This clinical practice guideline was constructed adhering with standard procedure. We categorized the guideline in to four parts including definition, investigation, treatment, and long-term follow up. We anticipate that this guideline would improve physicians' proficiency and help direct readers to choose investigations and treatments in patients with GERD wisely. Moreover, we wish that this guideline would be applicable in countries with limited resources as well.
    MeSH term(s) Consensus ; Gastroesophageal Reflux/complications ; Gastroesophageal Reflux/diagnosis ; Gastroesophageal Reflux/therapy ; Humans ; Proton Pump Inhibitors/therapeutic use ; Thailand
    Chemical Substances Proton Pump Inhibitors
    Language English
    Publishing date 2022-01-25
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 632882-9
    ISSN 1440-1746 ; 0815-9319
    ISSN (online) 1440-1746
    ISSN 0815-9319
    DOI 10.1111/jgh.15758
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  9. Article ; Online: Predictors of advanced fibrosis in elderly patients with biopsy-confirmed nonalcoholic fatty liver disease: the GOASIA study.

    Pitisuttithum, Panyavee / Chan, Wah Kheong / Piyachaturawat, Panida / Imajo, Kento / Nakajima, Atsushi / Seki, Yosuke / Kasama, Kazunori / Kakizaki, Satoru / Fan, Jian Gao / Song, Myeong Jun / Yoon, Seung Kew / Dan, Yock Young / Lesmana, Laurentius / Ho, Khek Yu / Goh, Khean Lee / Wong, Vincent Wai Sun / Treeprasertsuk, Sombat

    BMC gastroenterology

    2020  Volume 20, Issue 1, Page(s) 88

    Abstract: Background: The Gut and Obesity in Asia (GOASIA) Workgroup was formed to study obesity and gastrointestinal diseases in the Asia Pacific region. We aimed to 1) compare the characteristics of elderly (i.e. age ≥ 60) vs. non-elderly patients with biopsy- ... ...

    Abstract Background: The Gut and Obesity in Asia (GOASIA) Workgroup was formed to study obesity and gastrointestinal diseases in the Asia Pacific region. We aimed to 1) compare the characteristics of elderly (i.e. age ≥ 60) vs. non-elderly patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD); 2) identify predictors of advanced fibrosis in elderly patients with NAFLD; and 3) assess the performance of non-invasive fibrosis scores in the prediction of advance fibrosis in the elderly population.
    Methods: We abstracted the data of 1008 patients with NAFLD from nine centers across eight countries. Characteristics of elderly and non-elderly patients with NAFLD were compared using 1:3 sex-matched analysis.
    Results: Of the 1008 patients, 175 were elderly [age 64 (62-67) years], who were matched with 525 non-elderly patients [46 (36-54) years]. Elderly patients were more likely to have advanced fibrosis (35.4% vs. 13.3%; p < 0.001). By multivariable analysis, factors associated with advanced fibrosis in elderly patients included female sex [odds ratio (OR) 3.21; 95% confidence interval (CI) 1.37-7.54] and hypertension (OR 3.68; 95%CI 1.11-12.23). The area under receiver-operating characteristics curve (95% CI) of aspartate aminotransferase-to-platelet ratio index, NAFLD fibrosis score and Fibrosis-4 index for predicting advanced fibrosis in elderly patients were 0.62 (0.52-0.72), 0.65 (0.55-0.75) and 0.64 (0.54-0.74) respectively.
    Conclusions: Elderly patients with NAFLD had a higher prevalence of advanced fibrosis than non-elderly patients. Female and hypertension were predicting factors for advanced fibrosis in the elderly. Non-invasive fibrosis scores had a lower specificity in elderly.
    MeSH term(s) Adult ; Age Factors ; Aged ; Asia/epidemiology ; Aspartate Aminotransferases/blood ; Biopsy ; Comorbidity ; Cross-Sectional Studies ; Diabetes Mellitus/epidemiology ; Dyslipidemias/epidemiology ; Female ; Humans ; Hypertension/epidemiology ; Liver Cirrhosis/blood ; Liver Cirrhosis/epidemiology ; Liver Cirrhosis/pathology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/blood ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/pathology ; Obesity/epidemiology ; Platelet Count ; Severity of Illness Index ; Sex Factors
    Chemical Substances Aspartate Aminotransferases (EC 2.6.1.1)
    Language English
    Publishing date 2020-04-06
    Publishing country England
    Document type Journal Article
    ISSN 1471-230X
    ISSN (online) 1471-230X
    DOI 10.1186/s12876-020-01240-z
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  10. Article ; Online: Gamma-glutamyl transferase and cardiovascular risk in nonalcoholic fatty liver disease: The Gut and Obesity Asia initiative.

    Pitisuttithum, Panyavee / Chan, Wah-Kheong / Goh, George Boon-Bee / Fan, Jian-Gao / Song, Myeong Jun / Charatcharoenwitthaya, Phunchai / Duseja, Ajay / Dan, Yock-Young / Imajo, Kento / Nakajima, Atsushi / Ho, Khek-Yu / Goh, Khean-Lee / Wong, Vincent Wai-Sun / Treeprasertsuk, Sombat

    World journal of gastroenterology

    2020  Volume 26, Issue 19, Page(s) 2416–2426

    Abstract: Background: Gamma-glutamyl transferase (GGT) is associated with the risk of cardiovascular disease (CVD) in the general population.: Aim: To identify the association of baseline GGT level and QRISK2 score among patients with biopsy-proven ... ...

    Abstract Background: Gamma-glutamyl transferase (GGT) is associated with the risk of cardiovascular disease (CVD) in the general population.
    Aim: To identify the association of baseline GGT level and QRISK2 score among patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD).
    Methods: This was a retrospective study involving 1535 biopsy-proven NAFLD patients from 10 Asian centers in 8 countries using data collected by the Gut and Obesity in Asia (referred to as "GO ASIA") workgroup. All patients with available baseline GGT levels and all 16 variables for the QRISK2 calculation (QRISK2-2017; developed by researchers at the United Kingdom National Health Service; https://qrisk.org/2017/; 10-year cardiovascular risk estimation) were included and compared to healthy controls with the same age, sex, and ethnicity. Relative risk was reported. QRISK2 score > 10% was defined as the high-CVD-risk group. Fibrosis stages 3 and 4 (F3 and F4) were considered advanced fibrosis.
    Results: A total of 1122 patients (73%) had complete data and were included in the final analysis; 314 (28%) had advanced fibrosis. The median age (interquartile range [IQR]) of the study population was 53 (44-60) years, 532 (47.4%) were females, and 492 (43.9%) were of Chinese ethnicity. The median 10-year CVD risk (IQR) was 5.9% (2.6-10.9), and the median relative risk of CVD over 10 years (IQR) was 1.65 (1.13-2.2) compared to healthy individuals with the same age, sex, and ethnicity. The high-CVD-risk group was significantly older than the low-risk group (median [IQR]: 63 [59-67]
    Conclusion: The CVD risk of NAFLD patients is higher than that of healthy individuals. Baseline GGT level cannot predict CVD risk in NAFLD patients. However, advanced fibrosis is a predictor of a high CVD risk.
    MeSH term(s) Adult ; Age Factors ; Aged ; Aged, 80 and over ; Asia/epidemiology ; Biomarkers/blood ; Biopsy ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Cross-Sectional Studies ; Female ; Heart Disease Risk Factors ; Humans ; Liver/pathology ; Liver Cirrhosis/blood ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/pathology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/blood ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/pathology ; Observational Studies as Topic ; Retrospective Studies ; Risk Assessment/methods ; Severity of Illness Index ; gamma-Glutamyltransferase/blood
    Chemical Substances Biomarkers ; gamma-Glutamyltransferase (EC 2.3.2.2) ; gamma-glutamyltransferase, human (EC 2.3.2.2)
    Language English
    Publishing date 2020-06-01
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v26.i19.2416
    Database MEDical Literature Analysis and Retrieval System OnLINE

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