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2. Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease

Author

Younossi, Zobair M, AlQahtani, Saleh A, Alswat, Khalid, Yilmaz, Yusuf, Keklikkiran, Caglayan, Funuyet-Salas, Jesús, Romero-Gómez, Manuel, Fan, Jian-Gao, Zheng, Ming-Hua, El-Kassas, Mohamed, Castera, Laurent, Liu, Chun-Jen, Wong, Vincent Wai-Sun, Zelber-Sagi, Shira, Allen, Alina M, Lam, Brian, Treeprasertsuk, Sombat, Hameed, Saeed, Takahashi, Hirokazu, Kawaguchi, Takumi, Schattenberg, Jörn M, Duseja, Ajay, Newsome, Phil, Francque, Sven, Spearman, C Wendy, Fernández, Marlen I Castellanos, Burra, Patrizia, Roberts, Stuart K, Chan, Wah-Kheong, Arrese, Marco, Silva, Marcelo, Rinella, Mary, Singal, Ashwani K, Gordon, Stuart, Fuchs, Michael, Alkhouri, Naim, Cusi, Kenneth, Loomba, Rohit, Ranagan, Jane, Eskridge, Wayne, Kautz, Achim, Ong, Janus P, Kugelmas, Marcelo, Eguchi, Yuichiro, Diago, Moises, Yu, Ming-Lung, Gerber, Lynn, Fornaresio, Lisa, Nader, Fatema, Henry, Linda, Racila, Andrei, Golabi, Pegah, Stepanova, Maria, Carrieri, Patrizia, Lazarus, Jeffrey V, and Council, the Global NASH

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Liver Disease, Digestive Diseases, Chronic Liver Disease and Cirrhosis, Hepatitis, Health Services, Clinical Research, Prevention, Good Health and Well Being, Global NASH Council, MASH, MASLD, SLD, communication, discrimination, fatty liver, metabolic, patient-reported outcomes, Public Health and Health Services, Gastroenterology & Hepatology, Clinical sciences
Abstract

Background & aimsPatients with fatty liver disease may experience stigma from the disease or comorbidities. In this cross-sectional study, we aimed to understand stigma among patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and healthcare providers.MethodsMembers of the Global NASH Council created two surveys about experiences/attitudes toward NAFLD and related diagnostic terms: a 68-item patient and a 41-item provider survey.ResultsSurveys were completed by 1,976 patients with NAFLD across 23 countries (51% Middle East/North Africa [MENA], 19% Europe, 17% USA, 8% Southeast Asia, 5% South Asia) and 825 healthcare providers (67% gastroenterologists/hepatologists) across 25 countries (39% MENA, 28% Southeast Asia, 22% USA, 6% South Asia, 3% Europe). Of all patients, 48% ever disclosed having NAFLD/NASH to family/friends; the most commonly used term was "fatty liver" (88% at least sometimes); "metabolic disease" or "MAFLD" were rarely used (never by >84%). Regarding various perceptions of diagnostic terms by patients, there were no substantial differences between "NAFLD", "fatty liver disease (FLD)", "NASH", or "MAFLD". The most popular response was being neither comfortable nor uncomfortable with either term (56%-71%), with slightly greater discomfort with "FLD" among the US and South Asian patients (47-52% uncomfortable). Although 26% of patients reported stigma related to overweight/obesity, only 8% reported a history of stigmatization or discrimination due to NAFLD. Among providers, 38% believed that the term "fatty" was stigmatizing, while 34% believed that "nonalcoholic" was stigmatizing, more commonly in MENA (43%); 42% providers (gastroenterologists/hepatologists 45% vs. 37% other specialties, p = 0.03) believed that the name change to metabolic dysfunction-associated steatotic liver disease (or MASLD) might reduce stigma. Regarding the new nomenclature, the percentage of providers reporting "steatotic liver disease" as stigmatizing was low (14%).ConclusionsThe perception of NAFLD stigma varies among patients, providers, geographic locations and sub-specialties.Impact and implicationsOver the past decades, efforts have been made to change the nomenclature of nonalcoholic fatty liver disease (NAFLD) to better align with its underlying pathogenetic pathways and remove any potential stigma associated with the name. Given the paucity of data related to stigma in NAFLD, we undertook this global comprehensive survey to assess stigma in NAFLD among patients and providers from around the world. We found there is a disconnect between physicians and patients related to stigma and related nomenclature. With this knowledge, educational programs can be developed to better target stigma in NAFLD among all stakeholders and to provide a better opportunity for the new nomenclature to address the issues of stigma.

Published
2023

4. THU-453 Stigma in NAFLD and NASH: a global survey of patients and providers

Author

Younossi, Zobair, Yılmaz, Yusuf, Fan, Jian-Gao, Wong, Vincent Wai-Sun, Kassas, Mohamed El, Zelber-Sagi, Shira, Allen, Alina, Rinella, Mary, Singal, Ashwani, Gordon, Stuart C, Fuchs, Michael, Eskridge, Wayne, Alkhouri, Naim, Alswat, Khalid, Takahashi, Hirokazu, Kawaguchi, Takumi, Ranagan, Jane, Zheng, Ming-Hua, Duseja, Ajay Kumar, Burra, Patrizia, Patrizia, Carrieri, Arrese, Marco, Kautz, Achim, Ong, Janus, Castera, Laurent, Francque, Sven, Kugelmas, Marcelo, Eguchi, Yuichiro, Treeprasertsuk, Sombat, Fernández, Marlen Ivon Castellanos, Gomez, Manuel Romero, Newsome, Philip N, Cusi, Kenneth, Loomba, Rohit, Schattenberg, Jörn, Yu, Ming-Lung, Diago, Moises, Gerber, Lynn, Lam, Brian, Fornaresio, Lisa, Nader, Fatema, Henry, Linda, Racila, Andrei, Golabi, Pegah, Stepanova, Maria, Alqahtani, Saleh, and Lazarus, Jeffrey

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Public Health and Health Services, Gastroenterology & Hepatology, Clinical sciences
Published
2023

5. Current therapies and new developments in NASH

Author

Dufour, Jean-François, Anstee, Quentin M, Bugianesi, Elisabetta, Harrison, Stephen, Loomba, Rohit, Paradis, Valerie, Tilg, Herbert, Wong, Vincent Wai-Sun, and Zelber-sagi, Shira

Subjects
Substance Misuse, Liver Disease, Hepatitis, Clinical Research, Chronic Liver Disease and Cirrhosis, Digestive Diseases, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, Clinical Sciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology
Abstract

Non-alcoholic steatohepatitis is becoming the most important aetiology for advanced liver disease. There has been important progress in the field in recent years and the complexity of the pathophysiology of NASH is better understood. Multiple non-invasive circulating and imaging biomarkers have been tested. The importance of lifestyle has been recognised and several drugs are being tested in clinical trials. This review addresses the challenges that healthcare professionals face in the management of NASH patients.

Published
2022

9. The impact of stigma on quality of life and liver disease burden among patients with nonalcoholic fatty liver disease

Author

Younossi, Zobair M., AlQahtani, Saleh A., Funuyet-Salas, Jesús, Romero-Gómez, Manuel, Yilmaz, Yusuf, Keklikkiran, Caglayan, Alswat, Khalid, Yu, Ming-Lung, Liu, Chun-Jen, Fan, Jian-Gao, Zheng, Ming-Hua, Burra, Patrizia, Francque, Sven M., Castera, Laurent, Schattenberg, Jörn M., Newsome, Philip N., Allen, Alina M., El-Kassas, Mohamed, Treeprasertsuk, Sombat, Hameed, Saeed, Wai-Sun Wong, Vincent, Zelber-Sagi, Shira, Takahashi, Hirokazu, Kawaguchi, Takumi, Castellanos Fernández, Marlen I., Duseja, Ajay, Arrese, Marco, Rinella, Mary, Singal, Ashwani K., Gordon, Stuart C., Fuchs, Michael, Eskridge, Wayne, Alkhouri, Naim, Cusi, Kenneth, Loomba, Rohit, Ranagan, Jane, Kautz, Achim, Ong, Janus P., Kugelmas, Marcelo, Eguchi, Yuichiro, Diago, Moises, Gerber, Lynn, Lam, Brian, Fornaresio, Lisa, Nader, Fatema, Spearman, C. Wendy, Roberts, Stuart K., Chan, Wah-Kheong, Silva, Marcelo, Racila, Andrei, Golabi, Pegah, Ananchuensook, Prooksa, Henry, Linda, Stepanova, Maria, Carrieri, Patrizia, and Lazarus, Jeffrey V.

Published
2024
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10. American Society for Gastrointestinal Endoscopy–European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity

Author

Jirapinyo, Pichamol, Hadefi, Alia, Thompson, Christopher C., Patai, Árpád V., Pannala, Rahul, Goelder, Stefan K., Kushnir, Vladimir, Barthet, Marc, Apovian, Caroline M., Boskoski, Ivo, Chapman, Christopher G., Davidson, Paul, Donatelli, Gianfranco, Kumbhari, Vivek, Hayee, Bu, Esker, Janelle, Hucl, Tomas, Pryor, Aurora D., Maselli, Roberta, Schulman, Allison R., Pattou, Francois, Zelber-Sagi, Shira, Bain, Paul A., Durieux, Valérie, Triantafyllou, Konstantinos, Thosani, Nirav, Huberty, Vincent, and Sullivan, Shelby

Published
2024
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11. Non-Alcoholic Fatty Liver Disease, Liver Fibrosis, and Regional Amyloid-β and Tau Pathology in Middle-Aged Adults: The Framingham Study.

Author

Weinstein, Galit, ODonnell, Adrienne, Davis-Plourde, Kendra, Zelber-Sagi, Shira, Ghosh, Saptaparni, Decarli, Charles, Thibault, Emma, Sperling, Reisa, Johnson, Keith, Beiser, Alexa, and Seshadri, Sudha

Subjects
Alzheimer’s disease, amyloid-β, liver fibrosis, non-alcoholic fatty liver disease, positron emission tomography, Alzheimer Disease, Amyloid beta-Peptides, Female, Humans, Liver Cirrhosis, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Positron-Emission Tomography, tau Proteins
Abstract

BACKGROUND: Liver steatosis and fibrosis are emerging as risk factors for multiple extrahepatic health conditions; however, their relationship with Alzheimers disease pathology is unclear. OBJECTIVE: To examine whether non-alcoholic fatty liver disease (NAFLD) and FIB-4, a non-invasive index of advanced fibrosis, are associated with brain amyloid-β (Aβ) and tau pathology. METHODS: The study sample included Framingham Study participants from the Offspring and Third generation cohorts who attended exams 9 (2011-2014) and 2 (2008-2011), respectively. Participants underwent 11C-Pittsburgh Compound-B amyloid and 18F-Flortaucipir tau positron emission tomography (PET) imaging and abdomen computed tomography, or had information on all components of the FIB-4 index. Linear regression models were used to assess the relationship of NAFLD and FIB-4 with regional tau and Aβ, adjusting for potential confounders and multiple comparisons. RESULTS: Of the subsample with NAFLD information (N = 169; mean age 52±9 y; 57% males), 57 (34%) had NAFLD. Of the subsample with information on liver fibrosis (N = 177; mean age 50±10 y; 51% males), 34 (19%) had advanced fibrosis (FIB-4 > 1.3). Prevalent NAFLD was not associated with Aβ or tau PET. However, FIB-4 index was significantly associated with increased rhinal tau (β= 1.03±0.33, p = 0.002). Among individuals with prevalent NAFLD, FIB-4 was related to inferior temporal, parahippocampal gyrus, entorhinal and rhinal tau (β= 2.01±0.47, p

Published
2022

12. Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease

Author

Younossi, Zobair M., Alqahtani, Saleh A., Alswat, Khalid, Yilmaz, Yusuf, Keklikkiran, Caglayan, Funuyet-Salas, Jesús, Romero-Gómez, Manuel, Fan, Jian-Gao, Zheng, Ming-Hua, El-Kassas, Mohamed, Castera, Laurent, Liu, Chun-Jen, Wai-Sun Wong, Vincent, Zelber-Sagi, Shira, Allen, Alina M., Lam, Brian, Treeprasertsuk, Sombat, Hameed, Saeed, Takahashi, Hirokazu, Kawaguchi, Takumi, Schattenberg, Jörn M., Duseja, Ajay, Newsome, Phil N., Francque, Sven, Spearman, C. Wendy, Castellanos Fernández, Marlen I., Burra, Patrizia, Roberts, Stuart K., Chan, Wah-Kheong, Arrese, Marco, Silva, Marcelo, Rinella, Mary, Singal, Ashwani K., Gordon, Stuart, Fuchs, Michael, Alkhouri, Naim, Cusi, Kenneth, Loomba, Rohit, Ranagan, Jane, Eskridge, Wayne, Kautz, Achim, Ong, Janus P., Kugelmas, Marcelo, Eguchi, Yuichiro, Diago, Moises, Yu, Ming-Lung, Gerber, Lynn, Fornaresio, Lisa, Nader, Fatema, Henry, Linda, Racila, Andrei, Golabi, Pegah, Stepanova, Maria, Carrieri, Patrizia, and Lazarus, Jeffrey V.

Published
2024
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17. Administrative Coding in Electronic Health Care Record‐Based Research of NAFLD: An Expert Panel Consensus Statement

Author

Hagström, Hannes, Adams, Leon A, Allen, Alina M, Byrne, Christopher D, Chang, Yoosoo, Grønbæk, Henning, Ismail, Mona, Jepsen, Peter, Kanwal, Fasiha, Kramer, Jennifer, Lazarus, Jeffrey V, Long, Michelle T, Loomba, Rohit, Newsome, Philip N, Rowe, Ian A, Ryu, Seungho, Schattenberg, Jörn M, Serper, Marina, Sheron, Nick, Simon, Tracey G, Tapper, Elliot B, Wild, Sarah, Wong, Vincent Wai‐Sun, Yilmaz, Yusuf, Zelber‐Sagi, Shira, and Åberg, Fredrik

Subjects
Patient Safety, Clinical Research, Good Health and Well Being, Biomedical Research, Clinical Coding, Consensus, Electronic Health Records, Humans, Non-alcoholic Fatty Liver Disease, Reference Standards, Medical Biochemistry and Metabolomics, Clinical Sciences, Immunology, Gastroenterology & Hepatology
Abstract

Background and aimsElectronic health record (EHR)-based research allows the capture of large amounts of data, which is necessary in NAFLD, where the risk of clinical liver outcomes is generally low. The lack of consensus on which International Classification of Diseases (ICD) codes should be used as exposures and outcomes limits comparability and generalizability of results across studies. We aimed to establish consensus among a panel of experts on ICD codes that could become the reference standard and provide guidance around common methodological issues.Approach and resultsResearchers with an interest in EHR-based NAFLD research were invited to collectively define which administrative codes are most appropriate for documenting exposures and outcomes. We used a modified Delphi approach to reach consensus on several commonly encountered methodological challenges in the field. After two rounds of revision, a high level of agreement (>67%) was reached on all items considered. Full consensus was achieved on a comprehensive list of administrative codes to be considered for inclusion and exclusion criteria in defining exposures and outcomes in EHR-based NAFLD research. We also provide suggestions on how to approach commonly encountered methodological issues and identify areas for future research.ConclusionsThis expert panel consensus statement can help harmonize and improve generalizability of EHR-based NAFLD research.

Published
2021

18. Measuring NAFLD models of care

Author

Allen, Alina M., Younossi, Zobair M., Tsochatzis, Emmanuel A., Alazawi, William, Zelber-Sagi, Shira, Arab, Juan Pablo, Cusi, Kenneth, and Lazarus, Jeffrey V.

Published
2023
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19. A global research priority agenda to advance public health responses to fatty liver disease

Author

Lazarus, Jeffrey V., Mark, Henry E., Allen, Alina M., Arab, Juan Pablo, Carrieri, Patrizia, Noureddin, Mazen, Alazawi, William, Alkhouri, Naim, Alqahtani, Saleh A., Arrese, Marco, Bataller, Ramon, Berg, Thomas, Brennan, Paul N., Burra, Patrizia, Castro-Narro, Graciela E., Cortez-Pinto, Helena, Cusi, Kenneth, Dedes, Nikos, Duseja, Ajay, Francque, Sven M., Hagström, Hannes, Huang, Terry T-K., Wajcman, Dana Ivancovsky, Kautz, Achim, Kopka, Christopher J., Krag, Aleksander, Miller, Veronica, Newsome, Philip N., Rinella, Mary E., Romero, Diana, Sarin, Shiv Kumar, Silva, Marcelo, Spearman, C. Wendy, Tsochatzis, Emmanuel A., Valenti, Luca, Villota-Rivas, Marcela, Zelber-Sagi, Shira, Schattenberg, Jörn M., Wong, Vincent Wai-Sun, Younossi, Zobair M., Aberg, Fredrik, Adams, Leon, Al-Naamani, Khalid, Albadawy, Reda M., Alexa, Zinaida, Allison, Michael, Alnaser, Faisal A., Alswat, Khalid, Alvares-da-Silva, Mario Reis, Alvaro, Domenico, Alves-Bezerra, Michele, Andrade, Raul J., Anstee, Quentin M., Awuku, Yaw Asante, Baatarkhuu, Oidov, Baffy, Gyorgy, Bakieva, Shokhista, Bansal, Meena B., Barouki, Robert, Batterham, Rachel L., Behling, Cynthia, Belfort-DeAguiar, Renata, Berzigotti, Annalisa, Betel, Michael, Bianco, Cristiana, Bosi, Emanuele, Boursier, Jerome, Brunt, Elizabeth M., Bugianesi, Elisabetta, Byrne, Christopher J., Cabrera Cabrejos, Maria Cecilia, Caldwell, Stephen, Carr, Rotonya, Castellanos Fernández, Marlen Ivón, Castera, Laurent, Castillo-López, Maria Gabriela, Caussy, Cyrielle, Cerda-Reyes, Eira, Ceriello, Antonio, Chan, Wah- Kheong, Chang, Yoosoo, Charatcharoenwitthaya, Phunchai, Chavez-Tapia, Norberto, Chung, Raymond T., Colombo, Massimo, Coppell, Kirsten, Cotrim, Helma P., Craxi, Antonio, Crespo, Javier, Dassanayake, Anuradha, Davidson, Nicholas O., De Knegt, Robert, de Ledinghen, Victor, Demir, Münevver, Desalegn, Hailemichael, Diago, Moises, Dillon, John F., Dimmig, Bruce, Dirac, M. Ashworth, Dirchwolf, Melisa, Dufour, Jean-François, Dvorak, Karel, Ekstedt, Mattias, El-Kassas, Mohamed, Elsanousi, Osama M., Elsharkawy, Ahmed M., Elwakil, Reda, Eskridge, Wayne, Eslam, Mohammed, Esmat, Gamal, Fan, Jian- Gao, Ferraz, Maria Lucia, Flisiak, Robert, Fortin, Davide, Fouad, Yasser, Freidman, Scott L., Fuchs, Michael, Gadano, Adrian, Gastaldelli, Amalia, Geerts, Anja, Geier, Andreas, George, Jacob, Gerber, Lynn H., Ghazinyan, Hasmik, Gheorghe, Liana, Kile, Denise Giangola, Girala, Marcos, Boon Bee, George Goh, Goossens, Nicolas, Graupera, Isabel, Grønbæk, Henning, Hamid, Saeed, Hebditch, Vanessa, Henry, Zachary, Hickman, Ingrid J., Hobbs, L. Ansley, Hocking, Samantha L., Hofmann, Wolf Peter, Idilman, Ramazan, Iruzubieta, Paula, Isaacs, Scott, Isakov, Vasily A., Ismail, Mona H., Jamal, Mohammad H., Jarvis, Helen, Jepsen, Peter, Jornayvaz, François, Sudhamshu, K.C., Kakizaki, Satoru, Karpen, Saul, Kawaguchi, Takumi, Keating, Shelley E., Khader, Yousef, Kim, Seung Up, Kim, Won, Kleiner, David E., Koek, Ger, Joseph Komas, Narcisse Patrice, Kondili, Loreta A., Koot, Bart G., Korenjak, Marko, Kotsiliti, Eleni, Koulla, Yiannoula, Kugelmas, Carina, Kugelmas, Marcelo, Labidi, Asma, Lange, Naomi F., Lavine, Joel E., Lazo, Mariana, Leite, Nathalie, Lin, Han-Chieh, Lkhagvaa, Undram, Long, Michelle T., Lopez-Jaramillo, Patricio, Lozano, Adelina, Macedo, Maria Paula, Malekzadeh, Reza, Marchesini, Giulio, Marciano, Sebastian, Martinez, Kim, Martínez Vázquez, Sophia E., Mateva, Lyudmila, Mato, José M., Nlombi, Charles Mbendi, McCary, Alexis Gorden, McIntyre, Jeff, McKee, Martin, Mendive, Juan M., Mikolasevic, Ivana, Miller, Pamela S., Milovanovic, Tamara, Milton, Terri, Moreno-Alcantar, Rosalba, Morgan, Timothy R., Motala, Ayesha, Muris, Jean, Musso, Carla, Nava-González, Edna J., Negro, Francesco, Nersesov, Alexander V., Neuschwander-Tetri, Brent A., Nikolova, Dafina, Norris, Suzanne, Novak, Katja, Ocama, Ponsiano, Ong, Janus P., Ong-Go, Arlinking, Onyekwere, Charles, Padilla, Martin, Pais, Raluca, Pan, Calvin, Panduro, Arturo, Panigrahi, Manas K., Papatheodoridis, Georgios, Paruk, Imran, Patel, Keyur, Gonçalves, Carlos Penha, Figueroa, Marlene Pérez, Pérez-Escobar, Juanita, Pericàs, Juan M., Perseghin, Gianluca, Pessoa, Mário Guimarães, Petta, Salvatore, Marques Souza de Oliveira, Claudia Pinto, Prabhakaran, Dorairaj, Pyrsopoulous, Nikolaos, Rabiee, Atoosa, Ramji, Alnoor, Ratziu, Vlad, Ravendhran, Natarajan, Ray, Katrina, Roden, Michael, Romeo, Stefano, Romero-Gómez, Manuel, Rotman, Yaron, Rouabhia, Samir, Rowe, Ian A., Sadirova, Shakhlo, Alkhatry, Maryam Salem, Salupere, Riina, Satapathy, Sanjaya K., Schwimmer, Jeffrey B., Sebastiani, Giada, Seim, Lynn, Seki, Yosuke, Serme, Abdel Karim, Shapiro, David, Sharvadze, Lali, Shaw, Jonathan E., Shawa, Isaac Thom, Shenoy, Thrivikrama, Shibolet, Oren, Shimakawa, Yusuke, Shubrook, Jay H., Singh, Shivaram Prasad, Sinkala, Edford, Skladany, Lubomir, Skrypnyk, Igor, Song, Myeong Jun, Sookoian, Silvia, Sridharan, Kannan, Stefan, Norbert, Stine, Jonathan G., Stratakis, Nikolaos, Sheriff, Dhastagir Sultan, Sundaram, Shikha S., Svegliati-Baroni, Gianluca, Swain, Mark G., Tacke, Frank, Taheri, Shahrad, Tan, Soek-Siam, Tapper, Elliot B., Targher, Giovanni, Tcaciuc, Eugen, Thiele, Maja, Tiniakos, Dina, Tolmane, Ieva, Torre, Aldo, Torres, Esther A., Treeprasertsuk, Sombat, Trenell, Michael, Turcan, Svetlana, Turcanu, Adela, Valantinas, Jonas, van Kleef, Laurens A., Velarde Ruiz Velasco, Jose Antonio, Vesterhus, Mette, Vilar-Gomez, Eduardo, Waked, Imam, Wattacheril, Julia, Wedemeyer, Heiner, Wilkins, Fonda, Willemse, José, Wong, Robert J., Yilmaz, Yusuf, Yki-Järvinen, Hannele, Yu, Ming-Lung, Yumuk, Volkan, Zeybel, Müjdat, Zheng, Kenneth I., Zheng, Ming-Hua, and Huang, Terry T.-K.

Published
2023
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20. Research Priorities for Precision Medicine in NAFLD

Author

Iruzubieta, Paula, Bataller, Ramon, Arias-Loste, María Teresa, Arrese, Marco, Calleja, José Luis, Castro-Narro, Graciela, Cusi, Kenneth, Dillon, John F., Martínez-Chantar, María Luz, Mateo, Miguel, Pérez, Antonio, Rinella, Mary E., Romero-Gómez, Manuel, Schattenberg, Jörn M., Zelber-Sagi, Shira, Crespo, Javier, and Lazarus, Jeffrey V.

Published
2023
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23. EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD): Executive Summary.

Author

Tacke, Frank, Horn, Paul, Wong, Vincent Wai-Sun, Ratziu, Vlad, Bugianesi, Elisabetta, Francque, Sven, Zelber-Sagi, Shira, Valenti, Luca, Roden, Michael, Schick, Fritz, Yki-Järvinen, Hannele, Gastaldelli, Amalia, Vettor, Roberto, Frühbeck, Gema, and Dicker, Dror

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease (NAFLD), is defined as steatotic liver disease (SLD) in the presence of one or more cardiometabolic risk factor(s) and the absence of harmful alcohol intake. The spectrum of MASLD includes steatosis, metabolic dysfunction-associated steatohepatitis (MASH, previously NASH), fibrosis, cirrhosis and MASH-related hepatocellular carcinoma (HCC). This joint EASL–EASD–EASO guideline provides an update on definitions, prevention, screening, diagnosis and treatment for MASLD. Case-finding strategies for MASLD with liver fibrosis, using non-invasive tests, should be applied in individuals with cardiometabolic risk factors, abnormal liver enzymes and/or radiological signs of hepatic steatosis, particularly in the presence of type 2 diabetes or obesity with additional metabolic risk factor(s). A stepwise approach using blood-based scores (such as the fibrosis-4 index [FIB-4]) and, sequentially, imaging techniques (such as transient elastography) is suitable to rule-out/in advanced fibrosis, which is predictive of liver-related outcomes. In adults with MASLD, lifestyle modification—including weight loss, dietary changes, physical exercise and discouraging alcohol consumption—as well as optimal management of comorbidities—including use of incretin-based therapies (e.g. semaglutide, tirzepatide) for type 2 diabetes or obesity, if indicated—is advised. Bariatric surgery is also an option in individuals with MASLD and obesity. If locally approved and dependent on the label, adults with non-cirrhotic MASH and significant liver fibrosis (stage ≥2) should be considered for a MASH-targeted treatment with resmetirom, which demonstrated histological effectiveness on steatohepatitis and fibrosis with an acceptable safety and tolerability profile. No MASH-targeted pharmacotherapy can currently be recommended for the cirrhotic stage. Management of MASH-related cirrhosis includes adaptations of metabolic drugs, nutritional counselling, surveillance for portal hypertension and HCC, as well as liver transplantation in decompensated cirrhosis. [ABSTRACT FROM AUTHOR]

Published
2024
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25. The EASL–Lancet Liver Commission: protecting the next generation of Europeans against liver disease complications and premature mortality

Author

Karlsen, Tom H, Sheron, Nick, Zelber-Sagi, Shira, Carrieri, Patrizia, Dusheiko, Geoffrey, Bugianesi, Elisabetta, Pryke, Rachel, Hutchinson, Sharon J, Sangro, Bruno, Martin, Natasha K, Cecchini, Michele, Dirac, Mae Ashworth, Belloni, Annalisa, Serra-Burriel, Miquel, Ponsioen, Cyriel Y, Sheena, Brittney, Lerouge, Alienor, Devaux, Marion, Scott, Nick, Hellard, Margaret, Verkade, Henkjan J, Sturm, Ekkehard, Marchesini, Giulio, Yki-Järvinen, Hannele, Byrne, Chris D, Targher, Giovanni, Tur-Sinai, Aviad, Barrett, Damon, Ninburg, Michael, Reic, Tatjana, Taylor, Alison, Rhodes, Tim, Treloar, Carla, Petersen, Claus, Schramm, Christoph, Flisiak, Robert, Simonova, Marieta Y, Pares, Albert, Johnson, Philip, Cucchetti, Alessandro, Graupera, Isabel, Lionis, Christos, Pose, Elisa, Fabrellas, Núria, Ma, Ann T, Mendive, Juan M, Mazzaferro, Vincenzo, Rutter, Harry, Cortez-Pinto, Helena, Kelly, Deirdre, Burton, Robyn, Lazarus, Jeffrey V, Ginès, Pere, Buti, Maria, Newsome, Philip N, Burra, Patrizia, and Manns, Michael P

Published
2022
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26. Advancing the global public health agenda for NAFLD: a consensus statement

Author

Lazarus, Jeffrey V., Mark, Henry E., Anstee, Quentin M., Arab, Juan Pablo, Batterham, Rachel L., Castera, Laurent, Cortez-Pinto, Helena, Crespo, Javier, Cusi, Kenneth, Dirac, M. Ashworth, Francque, Sven, George, Jacob, Hagström, Hannes, Huang, Terry T.-K., Ismail, Mona H., Kautz, Achim, Sarin, Shiv Kumar, Loomba, Rohit, Miller, Veronica, Newsome, Philip N., Ninburg, Michael, Ocama, Ponsiano, Ratziu, Vlad, Rinella, Mary, Romero, Diana, Romero-Gómez, Manuel, Schattenberg, Jörn M., Tsochatzis, Emmanuel A., Valenti, Luca, Wong, Vincent Wai-Sun, Yilmaz, Yusuf, Younossi, Zobair M., and Zelber-Sagi, Shira

Published
2022
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28. TOP-445 Associations of food insecurity and healthcare access with the prevalence and mortality of metabolic dysfunction-associated steatotic liver disease (MASLD): a global study of the United Nation and the global burden of disease data

Author

Younossi, Zobair, primary, Zelber-Sagi, Shira, additional, Kugelmas, Carina, additional, Lazarus, Jeffrey V., additional, Paik, Annette, additional, Deavila, Leyla, additional, Gerber, Lynn, additional, and Paik, James M., additional

Published
2024
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31. Non-alcoholic fatty liver disease: A patient guideline

Author

Francque, Sven M., Marchesini, Giulio, Kautz, Achim, Walmsley, Martine, Dorner, Rebecca, Lazarus, Jeffrey V., Zelber-Sagi, Shira, Hallsworth, Kate, Busetto, Luca, Frühbeck, Gema, Dicker, Dror, Woodward, Euan, Korenjak, Marko, Willemse, José, Koek, Gerardus H., Vinker, Shlomo, Ungan, Mehmet, Mendive, Juan M., and Lionis, Christos

Published
2021
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32. Defining comprehensive models of care for NAFLD

Author

Lazarus, Jeffrey V., Anstee, Quentin M., Hagström, Hannes, Cusi, Kenneth, Cortez-Pinto, Helena, Mark, Henry E., Roden, Michael, Tsochatzis, Emmanuel A., Wong, Vincent Wai-Sun, Younossi, Zobair M., Zelber-Sagi, Shira, Romero-Gómez, Manuel, and Schattenberg, Jörn M.

Published
2021
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35. Comparison of the Simplified sWHI and the Standard CHS Frailty Phenotypes for Prediction of Mortality, Incident Falls, and Hip Fractures in Older Women.

Author

Zaslavsky, Oleg, Zelber-Sagi, Shira, LaCroix, Andrea Z, Brunner, Robert L, Wallace, Robert B, Cochrane, Barbara B, and Woods, Nancy F

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Clinical Sciences, Prevention, Physical Injury - Accidents and Adverse Effects, Genetics, Cardiovascular, Aging, Good Health and Well Being, Accidental Falls, Activities of Daily Living, Aged, Aged, 80 and over, Cause of Death, Disability Evaluation, Female, Frail Elderly, Geriatric Assessment, Hip Fractures, Humans, Middle Aged, Phenotype, Randomized Controlled Trials as Topic, Falls, Frailty, Function, Hip fracture, Mortality, Predictive ability, SF-36, Gerontology, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundWe compared the simplified Women's Health Initiative (sWHI) and the standard Cardiovascular Health Study (CHS) frailty phenotypes in predicting falls, hip fracture, and death in older women.MethodsParticipants are from the WHI Clinical Trial. CHS frailty criteria included weight loss, exhaustion, weakness, slowness, and low physical activity. The sWHI frailty score used two items from the RAND-36 physical function and vitality subscales, one item from the WHI physical activity scale plus the CHS weight loss criteria. Specifically, level of physical function was the capacity to walk one block and scored as severe (2-points), moderate (1-point), or no limitation (0). Vitality was based on feeling tired most or all of the time (1-point) versus less often (0). Low physical activity was walking outside less than twice a week (1-point) versus more often (0). A total score of 3 resulted in a frailty classification, a score of 1 or 2 defined pre-frailty, and 0 indicated nonfrailty. Outcomes were modeled using Cox regression and Harrell C-statistics were used for comparisons.ResultsApproximately 5% of the participants were frail based on the CHS or sWHI phenotype. The sWHI frailty phenotype was associated with higher rates of mortality (hazard ratio [HR] = 2.36, p ≤ .001) and falls (HR = 1.45, p = .005). Comparable HRs in CHS-phenotype were 1.97 (p < .001) and 1.36 (p = .03), respectively. Neither phenotype predicted hip fracture. Harrell C-statistics revealed nonsignificant differences in HRs between the CHS and sWHI frailty phenotypes.ConclusionThe sWHI phenotype, which is self-reported and brief, might be practical in settings with limited resources.

Published
2017

37. A global action agenda for turning the tide on fatty liver disease

Author

Lazarus, Jeffrey V., Mark, Henry E., Allen, Alina M., Arab, Juan Pablo, Carrieri, Patrizia, Noureddin, Mazen, Alazawi, William, Alkhouri, Naim, Alqahtani, Saleh A., Anstee, Quentin M., Arrese, Marco, Bataller, Ramon, Berg, Thomas, Brennan, Paul N., Burra, Patrizia, Castro-Narro, Graciela E., Cortez-Pinto, Helena, Cusi, Kenneth, Dedes, Nikos, Duseja, Ajay, Francque, Sven M., Gastaldelli, Amalia, Hagström, Hannes, Huang, Terry T.K., Wajcman, Dana Ivancovsky, Kautz, Achim, Kopka, Christopher J., Krag, Aleksander, Newsome, Philip N., Rinella, Mary E., Romero, Diana, Sarin, Shiv Kumar, Silva, Marcelo, Spearman, C. Wendy, Terrault, Norah A., Tsochatzis, Emmanuel A., Valenti, Luca, Villota-Rivas, Marcela, Zelber-Sagi, Shira, Schattenberg, Jörn M., Wong, Vincent Wai Sun, Younossi, Zobair M., Lazarus, Jeffrey V., Mark, Henry E., Allen, Alina M., Arab, Juan Pablo, Carrieri, Patrizia, Noureddin, Mazen, Alazawi, William, Alkhouri, Naim, Alqahtani, Saleh A., Anstee, Quentin M., Arrese, Marco, Bataller, Ramon, Berg, Thomas, Brennan, Paul N., Burra, Patrizia, Castro-Narro, Graciela E., Cortez-Pinto, Helena, Cusi, Kenneth, Dedes, Nikos, Duseja, Ajay, Francque, Sven M., Gastaldelli, Amalia, Hagström, Hannes, Huang, Terry T.K., Wajcman, Dana Ivancovsky, Kautz, Achim, Kopka, Christopher J., Krag, Aleksander, Newsome, Philip N., Rinella, Mary E., Romero, Diana, Sarin, Shiv Kumar, Silva, Marcelo, Spearman, C. Wendy, Terrault, Norah A., Tsochatzis, Emmanuel A., Valenti, Luca, Villota-Rivas, Marcela, Zelber-Sagi, Shira, Schattenberg, Jörn M., Wong, Vincent Wai Sun, and Younossi, Zobair M.

Abstract

Background and Aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care. Approach and Results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of "agree"responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% "agree"). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance. Conclusions: This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce the prevalence of fatty liver disease and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.

Published
2024

38. A global action agenda for turning the tide on fatty liver disease

Author

Lazarus, J, Mark, H, Allen, A, Arab, J, Carrieri, P, Noureddin, M, Alazawi, W, Alkhouri, N, Alqahtani, S, Anstee, Q, Arrese, M, Bataller, R, Berg, T, Brennan, P, Burra, P, Castro-Narro, G, Cortez-Pinto, H, Cusi, K, Dedes, N, Duseja, A, Francque, S, Gastaldelli, A, Hagström, H, Huang, T, Ivancovsky Wajcman, D, Kautz, A, Kopka, C, Krag, A, Newsome, P, Rinella, M, Romero, D, Sarin, S, Silva, M, Spearman, C, Terrault, N, Tsochatzis, E, Valenti, L, Villota-Rivas, M, Zelber-Sagi, S, Schattenberg, J, Wong, V, Younossi, Z, Perseghin, G, Lazarus, Jeffrey V, Mark, Henry E, Allen, Alina M, Arab, Juan Pablo, Carrieri, Patrizia, Noureddin, Mazen, Alazawi, William, Alkhouri, Naim, Alqahtani, Saleh A, Anstee, Quentin M, Arrese, Marco, Bataller, Ramon, Berg, Thomas, Brennan, Paul N, Burra, Patrizia, Castro-Narro, Graciela E, Cortez-Pinto, Helena, Cusi, Kenneth, Dedes, Nikos, Duseja, Ajay, Francque, Sven M, Gastaldelli, Amalia, Hagström, Hannes, Huang, Terry T K, Ivancovsky Wajcman, Dana, Kautz, Achim, Kopka, Christopher J, Krag, Aleksander, Newsome, Philip N, Rinella, Mary E, Romero, Diana, Sarin, Shiv Kumar, Silva, Marcelo, Spearman, C Wendy, Terrault, Norah A, Tsochatzis, Emmanuel A, Valenti, Luca, Villota-Rivas, Marcela, Zelber-Sagi, Shira, Schattenberg, Jörn M, Wong, Vincent Wai-Sun, Younossi, Zobair M, Perseghin, Gianluca, Lazarus, J, Mark, H, Allen, A, Arab, J, Carrieri, P, Noureddin, M, Alazawi, W, Alkhouri, N, Alqahtani, S, Anstee, Q, Arrese, M, Bataller, R, Berg, T, Brennan, P, Burra, P, Castro-Narro, G, Cortez-Pinto, H, Cusi, K, Dedes, N, Duseja, A, Francque, S, Gastaldelli, A, Hagström, H, Huang, T, Ivancovsky Wajcman, D, Kautz, A, Kopka, C, Krag, A, Newsome, P, Rinella, M, Romero, D, Sarin, S, Silva, M, Spearman, C, Terrault, N, Tsochatzis, E, Valenti, L, Villota-Rivas, M, Zelber-Sagi, S, Schattenberg, J, Wong, V, Younossi, Z, Perseghin, G, Lazarus, Jeffrey V, Mark, Henry E, Allen, Alina M, Arab, Juan Pablo, Carrieri, Patrizia, Noureddin, Mazen, Alazawi, William, Alkhouri, Naim, Alqahtani, Saleh A, Anstee, Quentin M, Arrese, Marco, Bataller, Ramon, Berg, Thomas, Brennan, Paul N, Burra, Patrizia, Castro-Narro, Graciela E, Cortez-Pinto, Helena, Cusi, Kenneth, Dedes, Nikos, Duseja, Ajay, Francque, Sven M, Gastaldelli, Amalia, Hagström, Hannes, Huang, Terry T K, Ivancovsky Wajcman, Dana, Kautz, Achim, Kopka, Christopher J, Krag, Aleksander, Newsome, Philip N, Rinella, Mary E, Romero, Diana, Sarin, Shiv Kumar, Silva, Marcelo, Spearman, C Wendy, Terrault, Norah A, Tsochatzis, Emmanuel A, Valenti, Luca, Villota-Rivas, Marcela, Zelber-Sagi, Shira, Schattenberg, Jörn M, Wong, Vincent Wai-Sun, Younossi, Zobair M, and Perseghin, Gianluca

Abstract

Background and Aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care. Approach and Results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of “agree” responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% “agree”). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance. Conclusions: This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce fatty liver disease prevalence and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.

Published
2024

39. Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease

Author

Center for Outcomes Research in Liver Diseases (US), Younossi, Zobair M., Alqahtani, Saleh A., Alswat, Khalid, Yilmaz, Yusuf, Keklikkiran, Caglayan, Funuyet-Salas, Jesús, Romero-Gómez, Manuel, Fan, Jian-Gao, Zheng, Ming-Hua, El-Kassas, Mohamed, Castera, Laurent, Liu, Chun-Jen, Wai-Sun Wong, Vincent, Zelber-Sagi, Shira, Allen, Alina M., Lam, Brian, Treeprasertsuk, Sombat, Hameed, Saeed, Takahashi, Hirokazu, Kawaguchi, Takumi, Schattenberg, Jörn M., Duseja, Ajay, Newsome, Phil N., Francque, Sven, Spearman, C. Wendy, Castellanos Fernandez, Marlen Ivon, Burra, Patrizia, Roberts, Stuart K., Chan, Wah-Kheong, Arrese, Marco, Silva, Marcelo, Rinella, Mary, Singal, Ashwani K., Gordon, Stuart, Fuchs, Michael, Alkhouri, Naim, Cusi, Kenneth, Loomba, Rohit, Ranagan, Jane, Eskridge, Wayne, Kautz, Achim, Ong, Janus P., Kugelmas, Marcelo, Eguchi, Yuichiro, Diago, Moises, Yu, Ming-Lung, Gerber, Lynn, Fornaresio, Lisa, Nader, Fatema, Henry, Linda, Racila, Andrei, Golabi, Pegah, Stepanova, Maria, Carrieri, Patrizia, Lazarus, Jeffrey V., Center for Outcomes Research in Liver Diseases (US), Younossi, Zobair M., Alqahtani, Saleh A., Alswat, Khalid, Yilmaz, Yusuf, Keklikkiran, Caglayan, Funuyet-Salas, Jesús, Romero-Gómez, Manuel, Fan, Jian-Gao, Zheng, Ming-Hua, El-Kassas, Mohamed, Castera, Laurent, Liu, Chun-Jen, Wai-Sun Wong, Vincent, Zelber-Sagi, Shira, Allen, Alina M., Lam, Brian, Treeprasertsuk, Sombat, Hameed, Saeed, Takahashi, Hirokazu, Kawaguchi, Takumi, Schattenberg, Jörn M., Duseja, Ajay, Newsome, Phil N., Francque, Sven, Spearman, C. Wendy, Castellanos Fernandez, Marlen Ivon, Burra, Patrizia, Roberts, Stuart K., Chan, Wah-Kheong, Arrese, Marco, Silva, Marcelo, Rinella, Mary, Singal, Ashwani K., Gordon, Stuart, Fuchs, Michael, Alkhouri, Naim, Cusi, Kenneth, Loomba, Rohit, Ranagan, Jane, Eskridge, Wayne, Kautz, Achim, Ong, Janus P., Kugelmas, Marcelo, Eguchi, Yuichiro, Diago, Moises, Yu, Ming-Lung, Gerber, Lynn, Fornaresio, Lisa, Nader, Fatema, Henry, Linda, Racila, Andrei, Golabi, Pegah, Stepanova, Maria, Carrieri, Patrizia, and Lazarus, Jeffrey V.

Abstract

[Background & Aims] Patients with fatty liver disease may experience stigma from the disease or comorbidities. In this cross-sectional study, we aimed to understand stigma among patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and healthcare providers., [Methods] Members of the Global NASH Council created two surveys about experiences/attitudes toward NAFLD and related diagnostic terms: a 68-item patient and a 41-item provider survey., [Results] Surveys were completed by 1,976 patients with NAFLD across 23 countries (51% Middle East/North Africa [MENA], 19% Europe, 17% USA, 8% Southeast Asia, 5% South Asia) and 825 healthcare providers (67% gastroenterologists/hepatologists) across 25 countries (39% MENA, 28% Southeast Asia, 22% USA, 6% South Asia, 3% Europe). Of all patients, 48% ever disclosed having NAFLD/NASH to family/friends; the most commonly used term was “fatty liver” (88% at least sometimes); “metabolic disease” or “MAFLD” were rarely used (never by >84%). Regarding various perceptions of diagnostic terms by patients, there were no substantial differences between “NAFLD”, “fatty liver disease (FLD)”, “NASH”, or “MAFLD”. The most popular response was being neither comfortable nor uncomfortable with either term (56%-71%), with slightly greater discomfort with “FLD” among the US and South Asian patients (47-52% uncomfortable). Although 26% of patients reported stigma related to overweight/obesity, only 8% reported a history of stigmatization or discrimination due to NAFLD. Among providers, 38% believed that the term “fatty” was stigmatizing, while 34% believed that “nonalcoholic” was stigmatizing, more commonly in MENA (43%); 42% providers (gastroenterologists/hepatologists 45% vs. 37% other specialties, p = 0.03) believed that the name change to metabolic dysfunction-associated steatotic liver disease (or MASLD) might reduce stigma. Regarding the new nomenclature, the percentage of providers reporting “steatotic liver disease” as stigmatizing was low (14%)., [Conclusions] The perception of NAFLD stigma varies among patients, providers, geographic locations and sub-specialties.

Published
2024

41. The association between liver fibrosis score and incident dementia: A nationwide retrospective cohort study.

Author

Weinstein, Galit, Schonmann, Yochai, Yeshua, Hanny, and Zelber‐Sagi, Shira

Abstract

BACKGROUND: We assessed the relationship of liver fibrosis score with incident dementia in a large, national sample. METHODS: For this retrospective cohort study, data of dementia‐free individuals aged 40‐69 years were derived from electronic records of the largest healthcare provider in Israel. The association between liver fibrosis score (FIB‐4), assessed from routine laboratory measurements, and incident dementia was explored through multivariate cox regression models. RESULTS: Of the total sample (N = 826,578, mean age 55 ± 8 years at baseline), 636,967 (77%) had no fibrosis, 180,114 (21.8%) had inconclusive fibrosis status and 9497 (1.2%) had high risk for advanced fibrosis. Over a median follow‐up of 17 years, 41,089 dementia cases were recorded. Inconclusive liver fibrosis and advanced fibrosis were associated with increased dementia risk (HR = 1.09, 95%CI: 1.07–1.11 and HR = 1.18, 95%CI: 1.10–1.27, respectively). This association remained robust through seven sensitivity analyses. CONCLUSIONS: Liver fibrosis assessed through a serum‐based algorithm may serve as a risk factor for dementia in the general population. Highlights: Liver fibrosis may predict dementia diagnosis in the general population.Inconclusive liver fibrosis was associated with 9% increased dementia risk.Advanced liver fibrosis was associated with 18% increased dementia risk.Findings remained robust in sensitivity analyses and after adjustments. [ABSTRACT FROM AUTHOR]

Published
2024
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42. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement

Author

Eslam, Mohammed, Newsome, Philip N., Sarin, Shiv K., Anstee, Quentin M., Targher, Giovanni, Romero-Gomez, Manuel, Zelber-Sagi, Shira, Wai-Sun Wong, Vincent, Dufour, Jean-François, Schattenberg, Jörn M., Kawaguchi, Takumi, Arrese, Marco, Valenti, Luca, Shiha, Gamal, Tiribelli, Claudio, Yki-Järvinen, Hannele, Fan, Jian-Gao, Grønbæk, Henning, Yilmaz, Yusuf, Cortez-Pinto, Helena, Oliveira, Claudia P., Bedossa, Pierre, Adams, Leon A., Zheng, Ming-Hua, Fouad, Yasser, Chan, Wah-Kheong, Mendez-Sanchez, Nahum, Ahn, Sang Hoon, Castera, Laurent, Bugianesi, Elisabetta, Ratziu, Vlad, and George, Jacob

Published
2020
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45. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Sepanlou, Sadaf G, Safiri, Saeid, Bisignano, Catherine, Ikuta, Kevin S, Merat, Shahin, Saberifiroozi, Mehdi, Poustchi, Hossein, Tsoi, Derrick, Colombara, Danny V, Abdoli, Amir, Adedoyin, Rufus Adesoji, Afarideh, Mohsen, Agrawal, Sutapa, Ahmad, Sohail, Ahmadian, Elham, Ahmadpour, Ehsan, Akinyemiju, Tomi, Akunna, Chisom Joyqueenet, Alipour, Vahid, Almasi-Hashiani, Amir, Almulhim, Abdulaziz M, Al-Raddadi, Rajaa M, Alvis-Guzman, Nelson, Anber, Nahla Hamed, Angus, Colin, Anoushiravani, Amir, Arabloo, Jalal, Araya, Ephrem Mebrahtu, Asmelash, Daniel, Ataeinia, Bahar, Ataro, Zerihun, Atout, Maha Moh'd Wahbi, Ausloos, Floriane, Awasthi, Ashish, Badawi, Alaa, Banach, Maciej, Bejarano Ramirez, Diana Fernanda, Bhagavathula, Akshaya Srikanth, Bhala, Neeraj, Bhattacharyya, Krittika, Biondi, Antonio, Bolla, Srinivasa Rao, Boloor, Archith, Borzì, Antonio M, Butt, Zahid A, Cámera, Luis LA Alberto, Campos-Nonato, Ismael R, Carvalho, Félix, Chu, Dinh-Toi, Chung, Sheng-Chia, Cortesi, Paolo Angelo, Costa, Vera M, Cowie, Benjamin C, Daryani, Ahmad, de Courten, Barbora, Demoz, Gebre Teklemariam, Desai, Rupak, Dharmaratne, Samath Dhamminda, Djalalinia, Shirin, Do, Hoa Thi, Dorostkar, Fariba, Drake, Thomas M, Dubey, Manisha, Duncan, Bruce B, Effiong, Andem, Eftekhari, Aziz, Elsharkawy, Aisha, Etemadi, Arash, Farahmand, Mohammad, Farzadfar, Farshad, Fernandes, Eduarda, Filip, Irina, Fischer, Florian, Gebremedhin, Ketema Bizuwork Bizuwork, Geta, Birhanu, Gilani, Syed Amir, Gill, Paramjit Singh, Gutirrez, Reyna Alma, Haile, Michael Tamene, Haj-Mirzaian, Arvin, Hamid, Saeed S, Hasankhani, Milad, Hasanzadeh, Amir, Hashemian, Maryam, Hassen, Hamid Yimam, Hay, Simon I, Hayat, Khezar, Heidari, Behnam, Henok, Andualem, Hoang, Chi Linh, Hostiuc, Mihaela, Hostiuc, Sorin, Hsieh, Vivian Chia-rong, Igumbor, Ehimario U, Ilesanmi, Olayinka Stephen, Irvani, Seyed Sina Naghibi, Jafari Balalami, Nader, James, Spencer L, Jeemon, Panniyammakal, Jha, Ravi Prakash, Jonas, Jost B, Jozwiak, Jacek Jerzy, Kabir, Ali, Kasaeian, Amir, Kassaye, Hagazi Gebremedhin, Kefale, Adane Teshome, Khalilov, Rovshan, Khan, Muhammad Ali, Khan, Ejaz Ahmad, Khater, Amir, Kim, Yun Jin, Koyanagi, Ai, La Vecchia, Carlo, Lim, Lee-Ling, Lopez, Alan D, Lorkowski, Stefan, Lotufo, Paulo A., Lozano, Rafael, Magdy Abd El Razek, Muhammed, Mai, Hue Thi, Manafi, Navid, Manafi, Amir, Mansournia, Mohammad Ali, Mantovani, Lorenzo Giovanni, Mazzaglia, Giampiero, Mehta, Dhruv, Mendoza, Walter, Menezes, Ritesh G, Mengesha, Melkamu Merid, Meretoja, Tuomo J, Mestrovic, Tomislav, Miazgowski, Bartosz, Miller, Ted R, Mirrakhimov, Erkin M, Mithra, Prasanna, Moazen, Babak, Moghadaszadeh, Masoud, Mohammadian-Hafshejani, Abdollah, Mohammed, Shafiu, Mokdad, Ali H, Montero-Zamora, Pablo A, Moradi, Ghobad, Naimzada, Mukhammad David, Nayak, Vinod, Negoi, Ionut, Nguyen, Trang Huyen, Ofori-Asenso, Richard, Oh, In-Hwan, Olagunju, Tinuke O, Padubidri, Jagadish Rao, Pakshir, Keyvan, Pana, Adrian, Pathak, Mona, Pourshams, Akram, Rabiee, Navid, Radfar, Amir, Rafiei, Alireza, Ramezanzadeh, Kiana, Rana, Saleem Muhammad M, Rawaf, Salman, Rawaf, David Laith, Reiner, Robert C, Jr., Roever, Leonardo, Room, Robin, Roshandel, Gholamreza, Safari, Saeed, Samy, Abdallah M, Sanabria, Juan, Sartorius, Benn, Schmidt, Maria Inês, Senthilkumaran, Subramanian, Shaikh, Masood Ali, Sharif, Mehdi, Sharifi, Amrollah, Shigematsu, Mika, Singh, Jasvinder A., Soheili, Amin, Suleria, Hafiz Ansar Rasul, Teklehaimanot, Berhane Fseha, Tesfay, Berhe Etsay, Vacante, Marco, Vahedian-Azimi, Amir, Valdez, Pascual R, Vasankari, Tommi Juhani, Vu, Giang Thu, Waheed, Yasir, Weldegwergs, Kidu Gidey, Werdecker, Andrea, Westerman, Ronny, Wondafrash, Dawit Zewdu, Wondmieneh, Adam Belay, Yeshitila, Yordanos Gizachew, Yonemoto, Naohiro, Yu, Chuanhua, Zaidi, Zoubida, Zarghi, Afshin, Zelber-Sagi, Shira, Zewdie, Kaleab Alemayehu, Zhang, Zhi-Jiang, Zhao, Xiu-Ju, Naghavi, Mohsen, and Malekzadeh, Reza

Published
2020
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46. The future of International Classification of Diseases coding in steatotic liver disease: An expert panel Delphi consensus statement

Author

Hagström, Hannes, primary, Adams, Leon A., additional, Allen, Alina M., additional, Byrne, Christopher D., additional, Chang, Yoosoo, additional, Duseja, Ajay, additional, Grønbæk, Henning, additional, Ismail, Mona H., additional, Jepsen, Peter, additional, Kanwal, Fasiha, additional, Kramer, Jennifer, additional, Loomba, Rohit, additional, Mark, Henry E., additional, Newsome, Philip N., additional, Rinella, Mary E., additional, Rowe, Ian A., additional, Ryu, Seungho, additional, Sanyal, Arun, additional, Schattenberg, Jörn M., additional, Serper, Marina, additional, Sheron, Nick, additional, Simon, Tracey G., additional, Spearman, C. Wendy, additional, Tapper, Elliot B., additional, Villota-Rivas, Marcela, additional, Wild, Sarah H., additional, Wong, Vincent Wai-Sun, additional, Yilmaz, Yusuf, additional, Zelber-Sagi, Shira, additional, Åberg, Fredrik, additional, and Lazarus, Jeffrey V., additional

Published
2024
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48. Functional bowel disorders among bariatric surgery candidates before and after surgery: A prospective cohort study

Author

Yassin, Sharif, primary, Sori, Noa, additional, Gilad, Ophir, additional, Shnell, Mati, additional, Richer, Relly, additional, Bar, Nir, additional, Ron, Yishai, additional, Cohen, Nathaniel Aviv, additional, Abu-Abeid, Subhi, additional, Dayan, Danit, additional, Eldar, Shai Meron, additional, Zelber-Sagi, Shira, additional, and Fishman, Sigal, additional

Published
2024
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49. Comparison of Frailty Phenotypes for Prediction of Mortality, Incident Falls, and Hip Fracture in Older Women

Author

Zaslavsky, Oleg, Zelber‐Sagi, Shira, Gray, Shelly L, LaCroix, Andrea Z, Brunner, Robert L, Wallace, Robert B, O'Sullivan, Mary J, Cochrane, Barbara, and Woods, Nancy F

Subjects
Public Health, Health Sciences, Aging, Genetics, Prevention, Patient Safety, Accidental Falls, Activities of Daily Living, Aged, Aged, 80 and over, Cause of Death, Cohort Studies, Disability Evaluation, Fatigue, Female, Frail Elderly, Gait, Hip Fractures, Humans, Longitudinal Studies, Middle Aged, Phenotype, Risk Assessment, Sedentary Behavior, Weight Loss, SF-36, falls, frailty, function, hip fracture, mortality, predictive ability, Medical and Health Sciences, Geriatrics, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

ObjectivesTo compare the ability of the commonly used Women's Health Initiative (WHI) and Cardiovascular Health Study (CHS) frailty phenotypes to predict falls, hip fracture, and death in WHI Clinical Trial participants aged 65 and older.DesignLongitudinal cohort study.SettingWHI Clinical Trial.ParticipantsParticipants with data for WHI and CHS frailty phenotypes (N = 3,558).MeasurementsFrailty was operationally defined in the CHS as the presence of three or more of weight loss, poor energy, weakness, slowness, and low physical activity. WHI operationalized frailty similarly but with the RAND-36 physical function scale substituted for slowness and weakness (RAND-36 physical function scale score 78 = 0 points). Frailty was defined as a summary score of 3 or greater, prefrailty as a score of 2 or 1, and nonfrailty as a score of 0. Outcomes were modeled using Cox regression. Harrell C-statistics were compared for models containing alternative instruments.ResultsApproximately 5% of participants were frail based on the CHS or WHI phenotype. The WHI frailty phenotype was associated with higher rates of falls (hazard ratio (HR) = 1.48, P = .003), hip fracture (HR = 1.87, P = .04), and death (HR = 2.32, P < .001). Comparable HRs in CHS-phenotype frail women were 1.32 (P = .04), 1.08 (P = .83), and 1.91 (P < .001), respectively. Harrell C-statistics revealed marked but insignificant differences in predicting abilities between CHS and WHI phenotype models (P > .50 for all).ConclusionThe WHI phenotype, which does not require direct measurements of physical performance, might offer a practical advantage for epidemiological and clinical needs.

Published
2016

50. Association Between Anthropometric Measures and Long‐Term Survival in Frail Older Women: Observations from the Women's Health Initiative Study

Author

Zaslavsky, Oleg, Rillamas-Sun, Eileen, LaCroix, Andrea Z, Woods, Nancy F, Tinker, Lesley F, Zisberg, Anna, Shadmi, Efrat, Cochrane, Barbara, Edward, Beatrice J, Kritchevsky, Stephen, Stefanick, Marcia L, Vitolins, Mara Z, Wactawski-Wende, Jean, and Zelber-Sagi, Shira

Subjects
Biomedical and Clinical Sciences, Epidemiology, Public Health, Health Sciences, Nutrition and Dietetics, Aging, Prevention, Aetiology, 2.4 Surveillance and distribution, Good Health and Well Being, Aged, Aged, 80 and over, Anthropometry, Body Mass Index, Cause of Death, Female, Frail Elderly, Humans, Longitudinal Studies, Mortality, Phenotype, Prospective Studies, Risk Factors, Survival Analysis, Waist Circumference, Waist-Hip Ratio, body mass index, frailty, mortality, obesity, women's health, Medical and Health Sciences, Geriatrics, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

ObjectivesTo evaluate the association between currently recommended guidelines and commonly used clinical criteria for body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) and all-cause mortality in frail older women.DesignLongitudinal prospective cohort study.SettingWomen's Health Initiative (WHI)-Observational Study.ParticipantsA sample of women aged 65-84 with complete data to characterize frailty in the third year of WHI follow-up (N = 11,070).MeasurementsFrailty phenotype was determined using the modified Fried criteria. Information on anthropometric measures (BMI, WC, WHR) was collected in clinical examinations. Cox proportional hazards models were used to estimate the effect of BMI, WC, and WHR on mortality adjusted for demographic characteristics and health behaviors.ResultsOver a mean follow-up of 11.5 years, there were 2,911 (26%) deaths in the sample. Women with a BMI from 25.0 to 29.9 kg/m(2) (hazard rate ratio (HR) = 0.80, 95% confidence interval (CI) = 0.73-0.88) and those with a BMI from 30.0 to 34.9 kg/m(2) (HR = 0.79, 95% CI = 0.71-0.88) had lower mortality than those with a BMI from 18.5 to 24.9 kg/m(2) . Women with a WHR greater than 0.8 had higher mortality (HR = 1.16, 95% CI = 1.07-1.26) than those with a WHR of 0.8 or less. No difference in mortality was observed according to WC. Stratifying according to chronic morbidity or smoking status or excluding women with early death and unintentional weight loss did not substantially change these findings.ConclusionIn frail, older women, having a BMI between 25.0 and 34.9 kg/m(2) or a WHR of 0.8 or less was associated with lower mortality. Currently recommended healthy BMI guidelines should be reevaluated for frail older women.

Published
2016

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