BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disea-se.The accuracy of noninvasive biomarkers for detecting hepatic steatosis is still limited.AIM To assess the diagnostic performa...BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disea-se.The accuracy of noninvasive biomarkers for detecting hepatic steatosis is still limited.AIM To assess the diagnostic performance of noninvasive steatosis biomarkers in diag-nosing NAFLD using magnetic resonance imaging proton density fat fraction(MRI-PDFF)as the gold standard.METHODS A total of 131 suspected NAFLD patients(60%male,median age 36 years)under-going MRI-PDFF were consecutively recruited from a tertiary hospital.Steatosis grades determined by MRI-PDFF were classified as none(<5%),mild(5%-11%),moderate(11%-17%),and severe(≥17%).Six steatosis biomarkers were calculated according to clinical parameters and laboratory tests,including fatty liver index,hepatic steatosis index,ZJU index,Framingham steatosis index,triglycerides and glucose index,and visceral adiposity index.The accuracy of these biomarkers in detecting hepatic steatosis was evaluated using the area under the receiver operating characteristic curves(AUCs).The Youden index was used to determine the optimal cut-off for each biomarker.The linear trend analysis of each biomarker across the steatosis grades was conducted by Mantel-Haenszelχ2 test.Spearman's rank correlation assessed the relationship between steatosis biomarkers and MRI-PDFF.RESULTS Steatosis grades based on MRI-PDFF prevalence were:None 27%,mild 40%,moderate 15%and severe 18%.Six steatosis biomarkers showed a linear trend across the steatosis grades and a significant positive correlation with MRI-PDFF.The six steatosis biomarkers demonstrated AUCs near 0.90(range:0.857-0.912,all P<0.001)for diagnosing NAFLD by MRI-PDFF≥5%.The optimal cut-offs showed sensitivity between 84.4%-91.7%and specificity between 71.4%-85.7%.The diagnostic performance of these biomarkers in detecting moderate-to-severe and severe steatosis was relatively weaker.CONCLUSION These noninvasive steatosis biomarkers accurately diagnosed NAFLD and correlated well with MRI-PDFF for detecting NAFLD,but they did not effectively detect moderate or severe steatosis.展开更多
BACKGROUND Iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification sequence(IDEAL-IQ)is based on chemical shift-based water and fat separation technique to get proton d...BACKGROUND Iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification sequence(IDEAL-IQ)is based on chemical shift-based water and fat separation technique to get proton density fat fraction.Multiple studies have shown that using IDEAL-IQ to test the stability and repeatability of liver fat is acceptable and has high accuracy.AIM To explore whether Gadoxetate Disodium(Gd-EOB-DTPA)interferes with the measurement of the hepatic fat content quantified with the IDEAL-IQ and to evaluate the robustness of this technique.METHODS IDEAL-IQ was used to quantify the liver fat content at 3.0T in 65 patients injected with Gd-EOB-DTPA contrast.After injection,IDEAL-IQ was estimated four times,and the fat fraction(FF)and R2* were measured at the following time points:Precontrast,between the portal phase(70 s)and the late phase(180 s),the delayed phase(5 min)and the hepatobiliary phase(20 min).One-way repeated-measures analysis was conducted to evaluate the difference in the FFs between the four time points.Bland-Altman plots were adopted to assess the FF changes before and after injection of the contrast agent.P<0.05 was considered statistically significant.RESULTS The assessment of the FF at the four time points in the liver,spleen and spine showed no significant differences,and the measurements of hepatic FF yielded good consistency between T1 and T2[95%confidence interval:-0.6768%,0.6658%],T1 and T3(-0.3900%,0.3178%),and T1 and T4(-0.3750%,0.2825%).R2* of the liver,spleen and spine increased significantly after injection(P<0.0001).CONCLUSION Using the IDEAL-IQ sequence to measure the FF,we can obtain results that will not be affected by Gd-EOB-DTPA.The high reproducibility of the IDEAL-IQ sequence makes it available in the scanning interval to save time during multiphase examinations.展开更多
Purpose: Bone marrow and muscle adiposity have been considered to correlate with osteoporosis and Sarcopenia. Proton Density Fat Fraction (PDFF) can be measured by Magnetic Resonance Imaging (MRI). The purpose of the ...Purpose: Bone marrow and muscle adiposity have been considered to correlate with osteoporosis and Sarcopenia. Proton Density Fat Fraction (PDFF) can be measured by Magnetic Resonance Imaging (MRI). The purpose of the present study was to measure PDFF in the lumbar spine, paraspinal muscle and subcutaneous fat tissue. Methods: Participants were comprised of 30 patients (18 males, 12 females;age range, 14 - 87 years) who underwent MRI due to low back symptoms. PDFFs for the body of the fourth lumbar vertebra (L4), paraspinal muscle, and subcutaneous fat were measured. Results: PDFFs of the vertebral body and subcutaneous fat were significantly higher than that of paraspinal muscle (p < 0.001). PDFF was significantly higher for subcutaneous fat than for the vertebral body (p < 0.001). Although no significant differences in PDFF of the vertebral body, paraspinal muscle, and subcutaneous fat between females and males, PDFFs of the vertebral body and paraspinal muscle were significantly higher in older subjects (>63 years) than in younger subjects (Conclusions: PDFF of the vertebral body was significantly higher than that of paraspinal muscle. PDFFs of the vertebral body and paraspinal muscle were significantly lower in younger subjects than in older subjects.展开更多
Objective To investigate the effect of adipose stromal vascular fraction cells(SVFs)on the survival rate of fat ransplantation.Methods 0.5mL autologous fat tissue was mixed with: ① DiI-labeled autologous SVFs (Group ...Objective To investigate the effect of adipose stromal vascular fraction cells(SVFs)on the survival rate of fat ransplantation.Methods 0.5mL autologous fat tissue was mixed with: ① DiI-labeled autologous SVFs (Group A);②展开更多
BACKGROUND Efruxifermin(EFX),a fibroblast growth factor 21 analogue,has demonstrated the potential to improve liver fat and markers of liver injury,fibrosis,and key metabolic biomarkers in individuals with metabolic d...BACKGROUND Efruxifermin(EFX),a fibroblast growth factor 21 analogue,has demonstrated the potential to improve liver fat and markers of liver injury,fibrosis,and key metabolic biomarkers in individuals with metabolic dysfunction-associated steatohepatitis(MASH)in phase 2 clinical trials.AIM To summarize the safety and effectiveness of EFX in managing MASH.METHODS Electronic databases and registries were systematically searched from their inception to May 15,2025,for randomized-controlled trials(RCTs)that included EFX in the intervention arm and placebo in the control arm in individuals with MASH.The primary outcome was the safety of EFX,while additional outcomes included its efficacy in altering hepatic and metabolic parameters.Meta-analyses were conducted using the RevMan web computer program with the random-effects model.RESULTS Four phase 2 RCTs(five reports),mostly with low risk of bias,involving 450 subjects,were analyzed.Compared to the placebo,EFX 50 mg was associated with higher risks of treatment-emergent adverse events(TEAEs)[risk ratio(RR)=1.05],TEAEs leading to discontinuation(RR=3.05),nausea(RR=1.78),and diarrhea(RR=1.9).EFX 28 mg increased risks of vomiting(RR=2.17)and frequent bowel movements(RR=8.98).Both doses of EFX were associated with higher risks of drug-related TEAEs(28 mg:RR=1.45;50 mg:RR=1.67)and increased appetite(28 mg:RR=3.16;50 mg:RR=5.66).EFX(28 and 50 mg)and placebo exhibited identical risks for severe TEAEs,serious AEs,abdominal pain,fatigue,headache,injection site erythema,and injection site reactions.EFX(28 and 50 mg)was associated with improvements in hepatic safety outcomes,including liver enzymes and urate levels.EFX outperformed the placebo in both relative and absolute reductions in hepatic fat fraction.Reductions in enhanced liver fibrosis score,Pro-C3,and liver stiffness were also more robust with EFX.EFX was superior in terms of MASH resolution and improvement in fibrosis stage,MASH resolution and no worsening of the fibrosis stage,and fibrosis regression by≥1 stage and no worsening in steatohepatitis.Furthermore,EFX also improved metabolic parameters,including reductions in HbA1c and insulin resistance,as well as improvements in adiponectin and lipid parameters.CONCLUSION EFX demonstrates promising dual efficacy on liver histology and metabolic markers in MASH.However,gastrointestinal side effects and the need for parenteral administration require caution.Long-term data are still necessary to fully evaluate safety and long-term effectiveness.展开更多
目的:以MRI测定的全肝脏质子密度脂肪分数(PDFF)为标准,探讨MRI可变容积加速肝脏采集(LAVA-Flex)技术和非对称回波最小二乘估算法迭代水脂分离(IDEAL-IQ)技术测定的代谢相关脂肪性肝病(MAFLD)患者的水相、脂相图肝脏脂肪分数(FF)与PDFF...目的:以MRI测定的全肝脏质子密度脂肪分数(PDFF)为标准,探讨MRI可变容积加速肝脏采集(LAVA-Flex)技术和非对称回波最小二乘估算法迭代水脂分离(IDEAL-IQ)技术测定的代谢相关脂肪性肝病(MAFLD)患者的水相、脂相图肝脏脂肪分数(FF)与PDFF的一致性。探讨LAVA-Flex技术行全肝脏脂肪定量快速检测的可行性。方法:收集97例MAFLD患者及23例健康志愿者。在GE 1.5 T MRI扫描仪上行IDEAL-IQ和LAVA-Flex序列扫描,前者得出PDFF、R2*、水相、脂相、同相位、反相位图,后者得出水相、脂相、同相位、反相位图。使用3D Slicer软件对PDFF、水相、脂相图进行全肝勾画,计算全肝各水相、脂相图的脂肪信号分数(FF_(IQ))和(FF_(Flex))。根据PDFF将120例分成4组:正常组23例,PDFF<5%;轻度组15例,5%≤PDFF<10%;中度组48例,10%≤PDFF<25%;重度组34例,PDFF≥25%。使用Pearson相关性分析评估4组FF_(IQ)、FF_(Flex)与PDFF的一致性,并绘制相关性热图及Bland-Altman图。结果:总体FF_(Flex)与PDFF呈极强相关(r=0.959);正常组FF_(IQ)与PDFF呈极强的相关(r=0.991,P<0.01);轻度组FF_(IQ)与PDFF呈较强相关(r=0.848,P<0.01);中度组FF_(IQ)与PDFF呈极强相关(r=0.997,P<0.01),FF_(Flex)与PDFF呈较强相关(r=0.756,P<0.01);重度组FF_(IQ)、FF_(Flex)均与PDFF呈显著相关(r=0.779,0.793;均P<0.01)。Bland-Altman图显示,FF_(Flex)与FF_(IQ)大部分数据点均落在一致性限内,且中心线接近0,两者与PDFF均具有很好的一致性。结论:IDEAL-IQ和LAVA-Flex技术测定的全肝FF与PDFF呈高度一致性,尤其是在中、重度脂肪肝患者中表现更佳,LAVA-Flex技术以其快速成像的优势为临床肝脏脂肪含量的测定提供了重要工具。展开更多
基金Supported by the Leap-forward Development Program for Beijing Biopharmaceutical Industry(G20),No.Z171100001717008the Fundamental Research Funds for the Central Universities and Research projects on biomedical transformation of China-Japan Friendship Hospital,No.PYBZ1815.
文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disea-se.The accuracy of noninvasive biomarkers for detecting hepatic steatosis is still limited.AIM To assess the diagnostic performance of noninvasive steatosis biomarkers in diag-nosing NAFLD using magnetic resonance imaging proton density fat fraction(MRI-PDFF)as the gold standard.METHODS A total of 131 suspected NAFLD patients(60%male,median age 36 years)under-going MRI-PDFF were consecutively recruited from a tertiary hospital.Steatosis grades determined by MRI-PDFF were classified as none(<5%),mild(5%-11%),moderate(11%-17%),and severe(≥17%).Six steatosis biomarkers were calculated according to clinical parameters and laboratory tests,including fatty liver index,hepatic steatosis index,ZJU index,Framingham steatosis index,triglycerides and glucose index,and visceral adiposity index.The accuracy of these biomarkers in detecting hepatic steatosis was evaluated using the area under the receiver operating characteristic curves(AUCs).The Youden index was used to determine the optimal cut-off for each biomarker.The linear trend analysis of each biomarker across the steatosis grades was conducted by Mantel-Haenszelχ2 test.Spearman's rank correlation assessed the relationship between steatosis biomarkers and MRI-PDFF.RESULTS Steatosis grades based on MRI-PDFF prevalence were:None 27%,mild 40%,moderate 15%and severe 18%.Six steatosis biomarkers showed a linear trend across the steatosis grades and a significant positive correlation with MRI-PDFF.The six steatosis biomarkers demonstrated AUCs near 0.90(range:0.857-0.912,all P<0.001)for diagnosing NAFLD by MRI-PDFF≥5%.The optimal cut-offs showed sensitivity between 84.4%-91.7%and specificity between 71.4%-85.7%.The diagnostic performance of these biomarkers in detecting moderate-to-severe and severe steatosis was relatively weaker.CONCLUSION These noninvasive steatosis biomarkers accurately diagnosed NAFLD and correlated well with MRI-PDFF for detecting NAFLD,but they did not effectively detect moderate or severe steatosis.
基金Supported by National Natural Science Foundation of China,No.82272053.
文摘BACKGROUND Iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification sequence(IDEAL-IQ)is based on chemical shift-based water and fat separation technique to get proton density fat fraction.Multiple studies have shown that using IDEAL-IQ to test the stability and repeatability of liver fat is acceptable and has high accuracy.AIM To explore whether Gadoxetate Disodium(Gd-EOB-DTPA)interferes with the measurement of the hepatic fat content quantified with the IDEAL-IQ and to evaluate the robustness of this technique.METHODS IDEAL-IQ was used to quantify the liver fat content at 3.0T in 65 patients injected with Gd-EOB-DTPA contrast.After injection,IDEAL-IQ was estimated four times,and the fat fraction(FF)and R2* were measured at the following time points:Precontrast,between the portal phase(70 s)and the late phase(180 s),the delayed phase(5 min)and the hepatobiliary phase(20 min).One-way repeated-measures analysis was conducted to evaluate the difference in the FFs between the four time points.Bland-Altman plots were adopted to assess the FF changes before and after injection of the contrast agent.P<0.05 was considered statistically significant.RESULTS The assessment of the FF at the four time points in the liver,spleen and spine showed no significant differences,and the measurements of hepatic FF yielded good consistency between T1 and T2[95%confidence interval:-0.6768%,0.6658%],T1 and T3(-0.3900%,0.3178%),and T1 and T4(-0.3750%,0.2825%).R2* of the liver,spleen and spine increased significantly after injection(P<0.0001).CONCLUSION Using the IDEAL-IQ sequence to measure the FF,we can obtain results that will not be affected by Gd-EOB-DTPA.The high reproducibility of the IDEAL-IQ sequence makes it available in the scanning interval to save time during multiphase examinations.
文摘Purpose: Bone marrow and muscle adiposity have been considered to correlate with osteoporosis and Sarcopenia. Proton Density Fat Fraction (PDFF) can be measured by Magnetic Resonance Imaging (MRI). The purpose of the present study was to measure PDFF in the lumbar spine, paraspinal muscle and subcutaneous fat tissue. Methods: Participants were comprised of 30 patients (18 males, 12 females;age range, 14 - 87 years) who underwent MRI due to low back symptoms. PDFFs for the body of the fourth lumbar vertebra (L4), paraspinal muscle, and subcutaneous fat were measured. Results: PDFFs of the vertebral body and subcutaneous fat were significantly higher than that of paraspinal muscle (p < 0.001). PDFF was significantly higher for subcutaneous fat than for the vertebral body (p < 0.001). Although no significant differences in PDFF of the vertebral body, paraspinal muscle, and subcutaneous fat between females and males, PDFFs of the vertebral body and paraspinal muscle were significantly higher in older subjects (>63 years) than in younger subjects (Conclusions: PDFF of the vertebral body was significantly higher than that of paraspinal muscle. PDFFs of the vertebral body and paraspinal muscle were significantly lower in younger subjects than in older subjects.
文摘Objective To investigate the effect of adipose stromal vascular fraction cells(SVFs)on the survival rate of fat ransplantation.Methods 0.5mL autologous fat tissue was mixed with: ① DiI-labeled autologous SVFs (Group A);②
文摘BACKGROUND Efruxifermin(EFX),a fibroblast growth factor 21 analogue,has demonstrated the potential to improve liver fat and markers of liver injury,fibrosis,and key metabolic biomarkers in individuals with metabolic dysfunction-associated steatohepatitis(MASH)in phase 2 clinical trials.AIM To summarize the safety and effectiveness of EFX in managing MASH.METHODS Electronic databases and registries were systematically searched from their inception to May 15,2025,for randomized-controlled trials(RCTs)that included EFX in the intervention arm and placebo in the control arm in individuals with MASH.The primary outcome was the safety of EFX,while additional outcomes included its efficacy in altering hepatic and metabolic parameters.Meta-analyses were conducted using the RevMan web computer program with the random-effects model.RESULTS Four phase 2 RCTs(five reports),mostly with low risk of bias,involving 450 subjects,were analyzed.Compared to the placebo,EFX 50 mg was associated with higher risks of treatment-emergent adverse events(TEAEs)[risk ratio(RR)=1.05],TEAEs leading to discontinuation(RR=3.05),nausea(RR=1.78),and diarrhea(RR=1.9).EFX 28 mg increased risks of vomiting(RR=2.17)and frequent bowel movements(RR=8.98).Both doses of EFX were associated with higher risks of drug-related TEAEs(28 mg:RR=1.45;50 mg:RR=1.67)and increased appetite(28 mg:RR=3.16;50 mg:RR=5.66).EFX(28 and 50 mg)and placebo exhibited identical risks for severe TEAEs,serious AEs,abdominal pain,fatigue,headache,injection site erythema,and injection site reactions.EFX(28 and 50 mg)was associated with improvements in hepatic safety outcomes,including liver enzymes and urate levels.EFX outperformed the placebo in both relative and absolute reductions in hepatic fat fraction.Reductions in enhanced liver fibrosis score,Pro-C3,and liver stiffness were also more robust with EFX.EFX was superior in terms of MASH resolution and improvement in fibrosis stage,MASH resolution and no worsening of the fibrosis stage,and fibrosis regression by≥1 stage and no worsening in steatohepatitis.Furthermore,EFX also improved metabolic parameters,including reductions in HbA1c and insulin resistance,as well as improvements in adiponectin and lipid parameters.CONCLUSION EFX demonstrates promising dual efficacy on liver histology and metabolic markers in MASH.However,gastrointestinal side effects and the need for parenteral administration require caution.Long-term data are still necessary to fully evaluate safety and long-term effectiveness.
文摘目的:以MRI测定的全肝脏质子密度脂肪分数(PDFF)为标准,探讨MRI可变容积加速肝脏采集(LAVA-Flex)技术和非对称回波最小二乘估算法迭代水脂分离(IDEAL-IQ)技术测定的代谢相关脂肪性肝病(MAFLD)患者的水相、脂相图肝脏脂肪分数(FF)与PDFF的一致性。探讨LAVA-Flex技术行全肝脏脂肪定量快速检测的可行性。方法:收集97例MAFLD患者及23例健康志愿者。在GE 1.5 T MRI扫描仪上行IDEAL-IQ和LAVA-Flex序列扫描,前者得出PDFF、R2*、水相、脂相、同相位、反相位图,后者得出水相、脂相、同相位、反相位图。使用3D Slicer软件对PDFF、水相、脂相图进行全肝勾画,计算全肝各水相、脂相图的脂肪信号分数(FF_(IQ))和(FF_(Flex))。根据PDFF将120例分成4组:正常组23例,PDFF<5%;轻度组15例,5%≤PDFF<10%;中度组48例,10%≤PDFF<25%;重度组34例,PDFF≥25%。使用Pearson相关性分析评估4组FF_(IQ)、FF_(Flex)与PDFF的一致性,并绘制相关性热图及Bland-Altman图。结果:总体FF_(Flex)与PDFF呈极强相关(r=0.959);正常组FF_(IQ)与PDFF呈极强的相关(r=0.991,P<0.01);轻度组FF_(IQ)与PDFF呈较强相关(r=0.848,P<0.01);中度组FF_(IQ)与PDFF呈极强相关(r=0.997,P<0.01),FF_(Flex)与PDFF呈较强相关(r=0.756,P<0.01);重度组FF_(IQ)、FF_(Flex)均与PDFF呈显著相关(r=0.779,0.793;均P<0.01)。Bland-Altman图显示,FF_(Flex)与FF_(IQ)大部分数据点均落在一致性限内,且中心线接近0,两者与PDFF均具有很好的一致性。结论:IDEAL-IQ和LAVA-Flex技术测定的全肝FF与PDFF呈高度一致性,尤其是在中、重度脂肪肝患者中表现更佳,LAVA-Flex技术以其快速成像的优势为临床肝脏脂肪含量的测定提供了重要工具。
