Publications by authors named "Grazia Pennisi"

Purpose: To assess the performance and the reproducibility of ultrasound-guided attenuation parameter (UGAP) and two-dimensional shear wave elastography (2D-SWE) in patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods: This study included consecutive adult patients with MASLD who underwent ultrasound with UGAP, 2D-SWE and percutaneous liver biopsy. The median values of 12 consecutive UGAP measurements were acquired by two independent radiologists (R1 and R2).

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Article Synopsis
  • Scientists studied a health problem called MASH, which affects people's livers, and worked on two tests to help doctors tell if someone has it.
  • They looked at data from over 3,000 people to make sure their first test, called acMASH, worked well, and then created a new test called acFibroMASH to find more severe cases.
  • The new acFibroMASH test was better at predicting who might have future liver problems compared to another test, showing it's a useful tool for doctors to keep patients healthy.
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Importance: The recent change in terminology from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) highlights the link between hepatic steatosis and metabolic dysfunction, taking out the stigmata of alcohol.

Objective: We compared the effects of NAFLD and MAFLD definitions on the risk of overall and cardiovascular (CV) mortality, liver-related events (LRE), nonfatal CV events (CVE), chronic kidney disease (CKD), and extra-hepatic cancers (EHC).

Data Sources And Study Selection: We systematically searched four large electronic databases for cohort studies (published through August 2023) that simultaneously used NAFLD and MAFLD definitions for examining the risk of mortality and adverse CV, renal, or oncological outcomes associated with both definitions.

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Background: Statins have multiple benefits in patients with metabolic-associated steatotic liver disease (MASLD).

Aim: To explore the effects of statins on the long-term risk of all-cause mortality, liver-related clinical events (LREs) and liver stiffness progression in patients with MASLD.

Methods: This cohort study collected data on patients with MASLD undergoing at least two vibration-controlled transient elastography examinations at 16 tertiary referral centres.

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Background: Artificial intelligence (AI)-based chatbots have shown promise in providing counseling to patients with metabolic dysfunction-associated steatotic liver disease (MASLD). While ChatGPT3.5 has demonstrated the ability to comprehensively answer MASLD-related questions in English, its accuracy remains suboptimal.

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Metabolic dysfunction-associated steatotic liver disease (MASLD), with its steadily increasing prevalence, represents now a major problem in public health. A proper referral could benefit from tools allowing more precise risk stratification. To this end, in recent decades, several genetic variants that may help predict and refine the risk of development and progression of MASLD have been investigated.

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Metabolic Dysfunction-Associated Steatotic Liver (MASL), previously named nonalcoholic fatty liver (NAFL), is a multifactorial disease in which metabolic, genetic, and environmental risk factors play a predominant role. Obesity and type 2 diabetes act as triggers of the inflammatory response, which contributes to the progression of MASL to Metabolic Dysfunction-Associated Steatohepatitis and the development of hepatocellular carcinoma. In the liver, several parenchymal, nonparenchymal, and immune cells maintain immunological homeostasis, and different regulatory pathways balance the activation of the innate and adaptative immune system.

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Importance: Metabolic dysfunction-associated steatotic liver disease (MASLD) is currently the most common chronic liver disease worldwide. It is important to develop noninvasive tests to assess the disease severity and prognosis.

Objective: To study the prognostic implications of baseline levels and dynamic changes of the vibration-controlled transient elastography (VCTE)-based scores developed for the diagnosis of advanced fibrosis (Agile 3+) and cirrhosis (Agile 4) in patients with MASLD.

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Background: ANGPTL3 (angiopoietin-like protein 3) is a circulating protein with a key role in maintaining lipoprotein homeostasis. A monoclonal antibody against ANGPTL3 is an approved and well-tolerated treatment to reduce lipoproteins in familial hypercholesterolemia homozygotes. However, the reduction of hepatic ANGPTL3 synthesis using an antisense oligonucleotide unexpectedly resulted in a dose-dependent increase in liver lipid content and circulating transaminases, resulting in the termination of the clinical trial.

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Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a global health concern with no effective and specific drug treatment available. The rs2642438 minor allele in mitochondrial amidoxime-reducing component 1 (MARC1) results in an aminoacidic substitution (p.Ala165Thr) and associates with protection against MASLD.

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Article Synopsis
  • This study investigates the prevalence of metabolic dysfunction associated steatotic liver disease (MASLD) and advanced fibrosis among relatives of patients with advanced MASLD, highlighting the condition's genetic aspects.
  • Results showed that 56.8% of relatives had MASLD, with 14.4% presenting advanced fibrosis, indicating a significant risk, especially linked to factors like body mass index and diabetes.
  • Despite some genetic risk variants being more common among affected individuals, they did not effectively enhance the screening process for advanced fibrosis in relatives, underscoring the need for family screening based on clinical guidelines.
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Objective: Hyperferritinaemia is associated with liver fibrosis severity in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), but the longitudinal implications have not been thoroughly investigated. We assessed the role of serum ferritin in predicting long-term outcomes or death.

Design: We evaluated the relationship between baseline serum ferritin and longitudinal events in a multicentre cohort of 1342 patients.

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Background And Aims: A simple noninvasive score, the Agile 3+ score, combining liver stiffness measurement, aspartate aminotransferase/alanine aminotransferase ratio, platelet count, diabetes status, sex, and age, has been proposed for the identification of advanced fibrosis in patients with suspected NAFLD. We performed a systematic review and meta-analysis of observational studies to evaluate the diagnostic accuracy of the Agile 3+ score in identifying patients with NAFLD and advanced fibrosis. Recently, an International consensus changed the nomenclature of NAFLD into metabolic-associated steatotic liver disease, so currently, the two terms are interchangeable.

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Background & Aims: Sirtuin 5, encoded by the SIRT5 gene, is a NAD-dependent deacylase that modulates mitochondrial metabolic processes through post-translational modifications. In this study, we aimed to examine the impact of the SIRT5 rs12216101 T>G non-coding single nucleotide polymorphism on disease severity in patients with non-alcoholic fatty liver disease (NAFLD).

Methods: The rs12216101 variant was genotyped in 2,606 consecutive European patients with biopsy-proven NAFLD.

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Background And Aims: International regulatory agencies recommend testing drug therapy for patients with noncirrhotic high-risk metabolic dysfunction-associated steatohepatitis (MASH) because they are at risk of liver-related events (LRE). We aimed to compare the risk of LRE in patients with MASLD stratified for F2-F4 fibrosis and MASH.

Approach And Results: Overall, 1938 consecutive patients with biopsy-proven MASLD were enrolled.

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Background & Aims: Individual risk prediction of liver-related events (LRE) is needed for clinical assessment of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) patients. We aimed to provide point-of-care validated liver stiffness measurement (LSM)-based risk prediction models for the development of LRE in patients with NAFLD, focusing on selecting patients for clinical trials at risk of clinical events.

Methods: Two large multicenter cohorts were evaluated, 2638 NAFLD patients covering all LSM values as the derivation cohort and 679 more advanced patients as the validation cohort.

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Background & Aims: We aimed to evaluate the impact of oesophageal varices (OV) and their evolution on the risk of complications of compensated advanced chronic liver disease (cACLD) caused by non-alcoholic fatty liver disease (NAFLD). We also assessed the accuracy of non-invasive scores for predicting the development of complications and for identifying patients at low risk of high-risk OV.

Methods: We performed a retrospective assessment of 629 patients with NAFLD-related cACLD who had baseline and follow-up oesophagogastroduodenoscopy and clinical follow-up to record decompensation, portal vein thrombosis (PVT), and hepatocellular carcinoma.

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Article Synopsis
  • - The study aimed to compare the effectiveness of non-invasive tests for assessing liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) against the traditional method of histological evaluation. - Researchers conducted a meta-analysis involving 2518 patients with biopsy-confirmed NAFLD, looking into various prognostic tests including liver stiffness measurement and scoring systems, while tracking patient outcomes over a minimum of 12 months. - The findings highlighted the prognostic value of these non-invasive tests in predicting serious health outcomes like liver complications, cancer, or death, potentially offering alternative methods for monitoring NAFLD progression.
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Background And Aims: Nonalcoholic fatty liver disease (NAFLD) is a complex disease, resulting from the interplay between environmental determinants and genetic variations. Single nucleotide polymorphism rs738409 C>G in the PNPLA3 gene is associated with hepatic fibrosis and with higher risk of developing hepatocellular carcinoma. Here, we analyzed a longitudinal cohort of biopsy-proven NAFLD subjects with the aim to identify individuals in whom genetics may have a stronger impact on disease progression.

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Background And Aims: Programmed cell death 1/programmed cell death-ligand 1 (PD-1/PDL-1) axis has been reported to modulate liver inflammation and progression to hepatocellular carcinoma (HCC) in patients with nonalcoholic fatty liver disease (NAFLD). Here, we examined whether the PDCD1 variation is associated with NAFLD severity in individuals with liver biopsy.

Methods: We examined the impact of PDCD1 gene variants on HCC, as robust severe liver disease phenotype in UK Biobank participants.

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Article Synopsis
  • * Findings showed that liver stiffness measurement (LSM) and AGILE 3+ tests were superior to traditional serum-based tests (like FIB-4 and NAFLD Fibrosis Score) for identifying advanced fibrosis and fibrotic NASH, while also reducing the number of necessary invasive tests.
  • * The study concluded that combining LSM and AGILE 3+ tests, particularly in low resource settings, provides reliable diagnostic accuracy for advanced
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Introduction: Autonomic nervous system activity in cirrhotic portal hypertension is linked to hyperdynamic circulation. Heart rate variability (HRV) is a validated noninvasive method to assess the sympathovagal balance. To investigate the correlation between HRV parameters and degree of portal hypertension, we studied a cohort of patients with cirrhosis accounting for etiology and treatments.

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Article Synopsis
  • Nonalcoholic fatty liver disease (NAFLD), now proposed to be called Metabolic dysfunction-Associated Fatty Liver Disease (MAFLD), affects about 25% of the general population and over 50% of people with metabolic issues, highlighting its significance as a chronic liver disease.
  • This rebranding aims to emphasize the complex relationship between fatty liver and metabolic problems, stressing the importance of evaluating fatty liver regardless of alcohol intake or other liver disease causes.
  • NAFLD/MAFLD is linked not only to liver-related issues but also to serious extrahepatic events like cardiovascular diseases and cancers, suggesting it may act as an independent risk factor for these conditions due to its influence on systemic inflammation and other metabolic
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