Publications by authors named "Cheng H Ng"

Background: Major society guidelines recommend transarterial chemoembolization (TACE) as the standard of care for intermediate-stage hepatocellular carcinoma (HCC) patients. However, predicting treatment response remains challenging.

Aims: As artificial intelligence (AI) may predict therapeutic responses, this systematic review aims to assess the performance and effectiveness of radiomics and AI-based models in predicting TACE outcomes in patients with HCC.

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Background: Significant health disparities exist in metabolic dysfunction-associated steatotic liver disease (MASLD), driven by social determinants of health (SDOH). Few studies have explored neighborhood-level SDOH in MASLD.

Methods: This is a retrospective cohort study of patients with MASLD at a multi-state healthcare institution.

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Background & Aims: The epidemiology of adult primary liver cancer continues to evolve, owing to the increasing prevalence of metabolic disease, rising alcohol consumption, advances in vaccination for HBV, and antiviral therapy for HCV. Disparities in care and the burden of liver cancer between populations persist. We assess trends in the burden of liver cancer and contributions by various etiologies across 204 countries and territories from 2010 to 2021.

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Article Synopsis
  • - The study investigates the risk of hepatocellular carcinoma (HCC) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) and a low fibrosis-4 index (FIB-4), which is used to assess liver health.
  • - Out of 613 participants diagnosed with MASLD-related HCC, 13% had a low FIB-4, with 26% among those without cirrhosis, indicating potential missed cases for further evaluation.
  • - The findings suggest that current guidelines may fail to identify over a quarter of MASLD-related HCC patients without cirrhosis who present a low FIB-4, highlighting a need for updated clinical pathways.
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  • Chronic liver disease is a significant risk factor for cholangiocarcinoma (CCA), but its prevalence among CCA patients was previously unclear.
  • A meta-analysis included data from 118,068 CCA patients, finding that about 25% had chronic liver disease and over 10% had cirrhosis.
  • The study revealed a stronger association between chronic liver disease and intrahepatic CCA compared to extrahepatic CCA, except for primary sclerosing cholangitis, which was linked to extrahepatic forms.
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Aims: To compare the efficacy of thyroid hormone receptor beta (THR-β) agonists, fibroblast growth factor 21 (FGF-21) analogues, glucagon-like peptide-1 receptor agonists (GLP-1RAs), GLP-1-based polyagonists, and pan-peroxisome proliferator-activated receptor (Pan-PPAR) agonists in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods: A database search for relevant randomized double-blind controlled trials published until July 11, 2024, was conducted. Primary outcomes were the relative change in hepatic fat fraction (HFF) and liver stiffness assessed non-invasively by magnetic resonance imaging proton density fat fraction and elastography.

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Article Synopsis
  • Metabolic dysfunction-associated steatohepatitis (MASH) is a major cause of liver disease, and changes in liver fat can be monitored using MRI proton-density-fat fraction (PDFF).
  • A systematic review identified 39 clinical trials evaluating various drug treatments for MASH, focusing on their effectiveness in reducing liver fat as measured by MRI-PDFF.
  • The study found aldafermin and pegozafermin to be the most effective therapies for reducing liver fat at 24 weeks, while other options like efinopegdutide and semaglutide also showed promising results for significant fat reduction.
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Background: Although the burden of alcohol-associated hepatocellular carcinoma (HCC) is increasing with rising alcohol consumption, clinical presentation and outcomes of alcohol-associated HCC have not been systematically assessed. We aimed to determine the prevalence, clinical characteristics, surveillance rates, treatment allocation, and outcomes of alcohol-associated HCC.

Methods: Medline and Embase were searched from inception to January 2023.

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Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiometabolic conditions affect populations across economic strata. Nevertheless, there are limited epidemiological studies addressing these diseases in low (LICs) and lower-middle-income countries (lower MICs). Therefore, an analysis of the trend of MASLD and cardiometabolic conditions in these countries is necessary.

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Background: To overcome the limitations of the term "non-alcoholic fatty liver disease" (NAFLD), the term metabolic-associated steatotic liver disease (MASLD) was introduced. While epidemiologic studies have been conducted on MASLD, there is limited evidence on its associated sex and ethnic variations.

Aims: This study assesses the differences across sex and race-ethnicity on the prevalence, associated risk factors and adverse outcomes in individuals with MASLD.

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Article Synopsis
  • - The study analyzed data from the United Network for Organ Sharing between 2000 and 2022 to evaluate how the causes of liver disease impact liver transplantation outcomes for individuals with hepatocellular carcinoma (HCC), focusing on differences between men and women.
  • - Findings revealed that nonalcoholic steatohepatitis (NASH) is the fastest-growing cause of liver disease in women and has surpassed chronic hepatitis C as the leading cause for both genders on transplant waitlists.
  • - Women with HCC experience longer wait times for liver transplants and have lower rates of receiving transplants compared to men, though they tend to have better posttransplant survival rates when suffering from NASH-related HCC.
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  • * Using data from the Global Burden of Disease Study 2019, the study found rising mortality rates from GI cancers related to high body mass index (BMI) in LICs and lower MICs, unlike in wealthier nations where rates have stabilized or decreased.
  • * The findings highlight the growing public health concern of obesity-related GI cancer mortality in LICs and lower MICs, stressing the need for urgent measures to address the obesity epidemic in these regions.
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Aims: The application of indices in the context of metabolic dysfunction-associated steatotic liver disease (MASLD) remains unexplored. We aimed to validate the ability of alanine aminotransferase (ALT), fatty liver index (FLI), and hepatic steatosis index (HSI) to identify MASLD during health checkups.

Methods: We recruited 627 participants and utilized their health checkup data and ultrasound to assess the potential of using ALT, FLI, and HSI as indices for MASLD; this was indicated by the area under the curve (AUC) and restricted cubic spline (RCS) model.

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Food-derived extracellular vesicles (FEVs) are nanoscale membrane vesicles obtained from dietary materials such as breast milk, plants and probiotics. Distinct from other EVs, FEVs can survive the harsh degrading conditions in the gastrointestinal tract and reach the intestines. This unique feature allows FEVs to be promising prebiotics in health and oral nanomedicine for gut disorders, such as inflammatory bowel disease.

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  • Alcohol consumption is linked to significant health issues worldwide, including alcohol use disorder (AUD), liver disease, and heart disease, contributing to increased disability and mortality rates, especially among lower socio-economic groups.
  • In 2019, AUD had the highest rate of disability-adjusted life years, with liver disease and alcohol-induced heart problems also notable, although some rates showed slight declines.
  • The burden of alcohol-related health complications is rising particularly in low and low-middle income countries, highlighting an urgent need for effective public health strategies to tackle these challenges.
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Background And Aims: The worldwide burden of cancer is increasing in younger populations. However, the epidemiology of primary liver cancer remains understudied in young adults compared to other cancer forms.

Approach And Results: This study analyzed data from the Global Burden of Disease study between 2010 and 2019 to assess the age-standardized incidence, mortality, and disability-adjusted life years associated with primary liver cancer in the young (15-49 y), stratified by region, nation, sociodemographic index, and sex.

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Background: Chronic infection with hepatitis C virus (HCV) has a long-term impact on hepatic consequences. A comprehensive evaluation of the global burden of HCV-related health outcomes can help to develop a global HCV prevention and treatment program.

Methods: We used the 2019 Global Burden of Disease (GBD) Study to comprehensively investigate burden and temporal trends in incidence, mortality and disability-adjusted life-years (DALYs) of HCV-related diseases, including liver cancer and cirrhosis and other liver diseases across 264 countries and territories from 2010 to 2019.

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Objective: To quantify the burden of metabolic dysfunction-associated steatotic liver disease (MASLD) and related metabolic disorders in premenopausal women.

Patients And Methods: Between 2010 and 2019, global evaluations of prevalence, mortality, disability-adjusted life years (DALYs), and their age-standardized rate (ASR) were conducted for metabolic conditions such as MASLD, type 2 diabetes mellitus, dyslipidemia, hypertension (HTN), obesity, and polycystic ovarian syndrome. Subgroup assessments were conducted according to geographical regions and the sociodemographic index.

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Background & Aims: Alcohol-associated liver diseases (ALDs) and alcohol use disorder (AUD) pose a global health risk. AUD is underrecognized in the elderly, and the burden of AUD complications, including ALD, may increase with aging populations and rising alcohol intake. However, there is a lack of epidemiological evidence on AUD and ALD in the elderly.

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Alcohol is a substance that impacts premature mortality and morbidity. The liver is invariably subjected to the impact of alcohol, which can result in cirrhosis and cancer. Alcohol also has detrimental effects that extend beyond the liver.

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Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease and 10%-20% occurs in lean individuals. There is little data in the literature regarding outcomes in an ethnically-diverse patient populations with MASLD. Thus, we aim to investigate the natural history and ethnic disparities of MASLD patients in a diverse population, and stratified by body mass index categories.

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Introduction: Given the global rise in obesity-related metabolic diseases, the upper limit of normal (ULN) alanine aminotransferase (ALT) in individuals with and without metabolic diseases may have changed. We performed a meta-analysis combined with bootstrap modelling to estimate the ALT ULN levels for individuals with and without metabolic diseases.

Methods And Results: Two separate searches of the PubMed, Embase and Cochrane databases were performed, one to identify healthy individuals which yielded 12 articles (349,367 individuals); another to include those with potential metabolic diseases but without known liver disease which yielded 35 articles (232,388 individuals).

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Article Synopsis
  • * Out of 19 studies with nearly 19,000 participants, it was found that 53.8% of individuals practiced alcohol abstinence, which significantly improved their overall survival compared to those who continued drinking.
  • * The research concludes that while abstinence is linked to better health outcomes, only about half of those with this condition manage to stay abstinent.
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Backgrounds/objectives: The escalating incidence of early-onset gastrointestinal cancers is becoming a primary global health concern. Biliary tract cancer (BTC) has been relatively understudied in this regard. We conducted an epidemiological study regarding the burden of this condition.

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Article Synopsis
  • The study investigates the significant burden of alcohol-related issues like liver disease and alcohol use disorder (AUD) among young women, a demographic identified as particularly vulnerable compared to men.
  • Utilizing data from the Global Burden of Disease Study 2019, researchers analyzed prevalence, mortality, and disability-adjusted life years of alcohol-associated cirrhosis, liver cancer from alcohol, and AUD in young women, with findings organized by region and sociodemographic factors.
  • Results show that AUD has the highest prevalence rates, followed by alcohol-associated cirrhosis and liver cancer; Central Europe shows the highest burdens, indicating an urgent need for targeted public health strategies to address these issues in young women.
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