Publications by authors named "Han A Lee"
Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with incident cardiovascular disease (CVD). However, CVD risk could vary across and within individuals with MASLD. We investigated the cardiovascular implications of MASLD, cardiometabolic risk factor count, and their longitudinal changes.
View Article and Find Full Text PDFBackground & Aims: Various hepatocellular carcinoma (HCC) prediction models have been proposed for patients with chronic hepatitis B (CHB) using clinical variables. We aimed to develop an artificial intelligence (AI)-based HCC prediction model by incorporating imaging biomarkers derived from abdominal computed tomography (CT) images along with clinical variables.
Methods: An AI prediction model employing a gradient-boosting machine algorithm was developed utilizing imaging biomarkers extracted by DeepFore, a deep learning-based CT auto-segmentation software.
Background: We explored the changes in metabolic dysfunction-associated steatotic liver disease (MASLD) severity over time by analyzing data from the placebo arms of randomized controlled trials (RCTs), focusing on the presence of diabetes.
Methods: RCTs on MASLD that included a placebo arm were identified using a systematic search of the literature. Primary outcomes were changes in hepatic steatosis and fibrosis.
Article Synopsis
- * Researchers analyzed data from nearly 4,800 patients and found that their model, named PLAN-B-CURE, outperformed existing prediction models significantly in various metrics.
- * The results indicate that the PLAN-B-CURE model can be utilized for personalized monitoring of patients post-HBsAg seroclearance, improving long-term health management.
Background & Aims: We compared the effects of a 12-week intermittent calorie restriction (ICR) and standard-of-care (SOC) diet on liver fat content (LFC) in metabolic dysfunction-associated steatotic liver disease patients.
Methods: This randomized controlled trial included patients with magnetic resonance imaging-proton density fat fraction ≥8%. Patients were randomly assigned to the ICR (5:2 diet) or SOC (80% of the recommended calorie intake) groups and stratified according to the body mass index (≥25 or <25 kg/m).
Backgrounds/aims: This meta-analysis examined whether preoperative vibration-controlled transient elastography (VCTE) can predict postoperative complications and recurrence in patients undergoing hepatic resection for hepatocellular carcinoma (HCC).
Methods: A systematic literature search was conducted using Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases. Out of 431 individual studies, thirteen published between 2008 and 2022 were included.
Background/aims: Opinions differ regarding vibration-controlled transient elastography and magnetic resonance elastography (VCTE/MRE) cut-offs for diagnosing advanced fibrosis (AF) in patients with non-alcoholic fatty liver disease (NAFLD). We investigated the diagnostic performance and optimal cut-off values of VCTE and MRE for diagnosing AF.
Methods: Literature databases, including Medline, EMBASE, Cochrane Library, and KoreaMed, were used to identify relevant studies published up to June 13, 2023.
Article Synopsis
- The study evaluates the effectiveness of vibration-controlled transient elastography (VCTE) in diagnosing liver fibrosis in autoimmune liver diseases like primary biliary cholangitis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC).
- A meta-analysis of 14 studies involving 1,098 patients showed that VCTE performs well for fibrosis staging, with strong area under the curve (sAUC) values for different stages of fibrosis across all three diseases.
- The findings suggest that VCTE is a reliable non-invasive tool for assessing and monitoring liver fibrosis in patients with autoimmune liver diseases.
Article Synopsis
- Despite advancements in hepatitis C therapy, hepatocellular carcinoma (HCC) can still occur after patients achieve sustained viral response (SVR), prompting a study on the predictive capabilities of vibration-controlled transient elastography (VCTE) and fibrosis 4-index (FIB-4) for HCC development post-SVR.
- The meta-analysis included 27 studies with a total of 169,911 patients, assessing the tests' performance in predicting HCC using pooled estimates of sensitivity, specificity, and area under the curve (AUC).
- The results indicated that both VCTE and FIB-4 have good predictive capabilities for HCC development after SVR, with optimal cut-off values identified for risk assessment, highlighting
Article Synopsis
- Researchers aimed to determine the prevalence of clinically significant liver fibrosis in the general population using noninvasive tests (NITs).
- They analyzed data from four major databases and included 45 studies, finding the prevalence rates of advanced liver fibrosis to be 2.3% and significant liver fibrosis to be 7.3%.
- The highest prevalence rates were observed in the American region, indicating a need for further research to identify at-risk individuals in the general population.
Article Synopsis
- - The Fibrosis-4 index (FIB-4) is a noninvasive test used to assess advanced liver fibrosis (AF) in patients with nonalcoholic fatty liver disease (NAFLD), though its effectiveness in those with type 2 diabetes mellitus (T2DM) is debated due to high AF rates in this group.
- - A meta-analysis of 12 studies involving 5,624 NAFLD patients with T2DM revealed that FIB-4 has moderate sensitivity and specificity, particularly showing better performance at high cutoffs (high specificity but lower sensitivity).
- - While FIB-4 can be useful for diagnosing AF, the current evidence is limited and varied, suggesting a need for more research to
Backgrounds/aims: Accurate diagnosis of significant liver fibrosis in patients with chronic hepatitis B (CHB) is crucial when determining whether to initiate antiviral treatment (AVT). We conduct a meta-analysis to assess the diagnostic performance of vibration-controlled transient elastography (VCTE) for significant liver fibrosis in AVT-naïve CHB patients with serum alanine transaminase (ALT) levels within 5-fold the upper limit of normal (ULN).
Methods: The Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases were searched to identify studies that compared the performance of VCTE and liver biopsy (reference standard) when diagnosing significant liver fibrosis (≥F2) in AVT-naïve CHB patients with ALT within 5-fold the ULN.
Backgrounds/aims: Liver stiffness measurement (LSM) using vibration-controlled transient elastography (VCTE) can assess fibrotic burden in chronic liver diseases. The systematic review and meta-analysis was conducted to determine whether LSM using VCTE can predict the risk of development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients.
Methods: A systematic literature search of the Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases (from January 2010 to June 2023) was conducted.
Liver transplantation is a highly complex and challenging field of clinical practice. Although it was originally developed in western countries, it has been further advanced in Asian countries through the use of living donor liver transplantation. This method of transplantation is the only available option in many countries in the Asia-Pacific region due to the lack of deceased organ donation.
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- A study investigated the impact of high-dose proton pump inhibitors (PPIs) on the prognosis of cirrhotic patients, examining 1485 individuals with hepatic encephalopathy from several Korean centers.
- Results indicated that patients using high-dose PPIs had a significantly higher risk of death and complications such as recurrent hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome, and gastrointestinal bleeding compared to those on low or no PPIs.
- The findings suggest that high-dose PPI use in cirrhotic patients may pose serious health risks, indicating the need for careful consideration in their treatment plans.
Article Synopsis
- The study focuses on the prognosis of cirrhotic patients following their first acute decompensation (AD) episode, categorizing outcomes into four groups: stable decompensated cirrhosis (SDC), unstable decompensated cirrhosis (UDC), pre acute-on-chronic liver failure (pre ACLF), and ACLF.
- The research involved a cohort of 746 patients and identified risk factors for readmission after AD, revealing that pre ACLF has a worse prognosis than ACLF despite occurring later.
- Factors such as non-variceal gastrointestinal bleeding and hepatic encephalopathy significantly increase readmission risk, with viral causes linked to poorer outcomes compared to alcohol-related cases.
Background & Aims: Non-selective β-blockers (NSBBs) and endoscopic variceal-ligation (EVL) have similar efficacy preventing first variceal bleeding. Compensated and decompensated cirrhosis are markedly different stages, which may impact treatment outcomes. We aimed to assess the efficacy of NSBBs vs EVL on survival in patients with high-risk varices without previous bleeding, stratifying risk according to compensated/decompensated stage of cirrhosis.
View Article and Find Full Text PDFBackgrounds: It is unclear which patients benefit from resection in intermediate-stage-hepatocellular carcinoma (HCC). The authors aimed to identify high-risk patients for early recurrence among patients with resectable intermediate-stage HCC.
Methods: This multicenter retrospective study included patients who underwent resection or trans-arterial chemoembolization (TACE) for intermediate-stage HCC (2008-2019).
Trans-arterial radioembolization (TARE) is a form of radiation therapy performed for hepatocellular carcinoma (HCC) via selective intra-arterial injection of Yttrium-90-loaded microspheres. This was a multi-center retrospective study of consecutive patients with HCC who underwent TARE between July 2009 and May 2019. Using pre-treatment computed tomography imaging, the total cross-sectional area (cm) of the abdominal skeletal muscle at the third lumbar vertebra was measured.
View Article and Find Full Text PDFObjective: We explored clinical implications of the new definition of metabolic dysfunction-associated steatotic liver disease (MASLD) by assessing its prevalence and associated cardiovascular disease (CVD) risk.
Design: From nationwide health screening data, we identified 9 775 066 adults aged 20-79 who underwent health examination in 2009. Participants were categorised into four mutually exclusive groups: (1) MASLD; (2) MASLD with increased alcohol intake (MetALD); (3) MASLD with other combined aetiology (the three collectively referred to as MASLD/related steatotic liver disease (SLD)); and (4) no MASLD/related SLD.
Background: Data on patients switched to tenofovir alafenamide (TAF) from nucleos(t)ide analogues (NUCs) other than tenofovir disoproxil fumarate are limited.
Aims: To assess the treatment and renal/bone safety outcomes following the switch to TAF.
Methods: We prospectively enrolled adult patients with chronic hepatitis B (CHB) who switched from any NUC to TAF at 14 centres in Japan, Korea, Taiwan and the U.
Background & Aims: Recent studies reported that moderate HBV DNA levels are significantly associated with hepatocellular carcinoma (HCC) risk in hepatitis B e antigen (HBeAg)-positive, non-cirrhotic patients with chronic hepatitis B (CHB). We aimed to develop and validate a new risk score to predict HCC development using baseline moderate HBV DNA levels in patients entering into HBeAg-positive CHB from chronic infection.
Methods: This multicenter cohort study recruited 3,585 HBeAg-positive, non-cirrhotic patients who started antiviral treatment with entecavir or tenofovir disoproxil fumarate at phase change into CHB from chronic infection in 23 tertiary university-affiliated hospitals of South Korea (2012-2020).