Publications by authors named "Manuel Romero Gomez"
Background And Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) and its more severe subtype, metabolic dysfunction-associated steatohepatitis (MASH), are highly prevalent and strongly associated with obesity and type 2 diabetes (T2D). This study sought to identify challenges to the diagnosis, treatment and management of people living with MASLD and MASH and understand the key barriers to adopting relevant clinical guidelines.
Methods: A real-world, cross-sectional study (BARRIERS-MASLD) consisting of a quantitative survey and qualitative interviews of physicians in France, Germany, Italy, Spain and the United Kingdom was conducted from March to September 2023.
Metabolic dysfunction-associated steatohepatitis(MASH) is commonly seen in biopsy proven steatotic liver disease(SLD). Life-style intervention reaching a weight loss higher than 10% promotes MASH resolution, but this goal is only achieved by a small number of patients. Endoscopic sleeve gastroplasty(ESG) has recently emerged as a safe and effective option to promote weight loss in obese population.
View Article and Find Full Text PDFBackground & Aims: Expression of P21, encoded by the gene, has been associated with fibrosis progression in steatotic liver disease (SLD); however, the underlying mechanisms remain unknown. In the present study, we investigated the function of CDKN1A in SLD.
Methods: expression levels were evaluated in different patient cohorts with SLD, fibrosis, and advanced chronic liver disease (ACLD).
Article Synopsis
- * The study collected and analyzed 1,600 posts from various countries, revealing that the most common topics included patients' journeys (92%), comorbidities (38%), and their interactions with healthcare professionals (26%).
- * Major findings indicated that unhealthy diets and obesity are significant risk factors, with fatigue and abdominal pain being prevalent symptoms; meanwhile, the disease has a considerable negative impact on patients' quality of life, especially for those with comorbidities and more severe conditions.
Article Synopsis
- Metabolic liver disease is increasingly linked to hepatocellular carcinoma (HCC), but the molecular mechanisms remain poorly understood; this study focuses on DNA methylation's role in HCC associated with metabolic issues.
- The research involved 272 HCC patients and 316 control subjects, revealing 55 DNA methylation markers that effectively distinguished HCC cases from controls, achieving an AUC of 0.79 for accuracy.
- Combining these markers with demographic data improved sensitivity and specificity for identifying patients at risk for metabolic HCC.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant global health issue, affecting over 30% of the population worldwide due to the rising prevalence of metabolic risk factors such as obesity and type 2 diabetes mellitus (T2DM). This spectrum of liver disease ranges from isolated steatosis to more severe forms such as steatohepatitis, fibrosis, and cirrhosis. Recent studies highlight the role of gut microbiota in MASLD pathogenesis, showing that dysbiosis significantly impacts metabolic health and the progression of liver disease.
View Article and Find Full Text PDFHepatic encephalopathy: experimental drugs in development and therapeutic potential.
Expert Opin Investig Drugs
December 2024
Introduction: Hepatic encephalopathy (HE) presents a complex pathophysiology, creating multiple potential treatment avenues. This review covers current and emerging treatments for HE.
Areas Covered: Standard therapies, including non-absorbable disaccharides and rifaximin, are widely used but show inconsistent efficacy.
Article Synopsis
- A significant number of patients with metabolic dysfunction-associated steatotic liver disease (MASLD) show indeterminate results from vibration-controlled transient elastography (VCTE), prompting the need for better diagnostic methods for significant fibrosis.
- A large study, involving 1196 MASLD patients from various centers, developed an algorithm that used liver stiffness measurements (LSM) and controlled attenuation parameters (CAP) to accurately identify significant fibrosis.
- The algorithm demonstrated high sensitivity and specificity in diagnosing significant fibrosis, potentially helping to identify treatment candidates for MASLD by re-allocating patients based on their risk levels.
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.
Ammonia-induced stress response in liver disease progression and hepatic encephalopathy.
Nat Rev Gastroenterol Hepatol
November 2024
Article Synopsis
- * Hyperammonaemia is a key feature of hepatic encephalopathy and is linked to poor outcomes in patients with liver conditions like cirrhosis and liver failure.
- * The review highlights how ammonia impacts liver diseases, the significance of ammonia measurement for diagnosing conditions like hepatic encephalopathy, and the potential for new treatments based on our understanding of ammonia metabolism.
Article Synopsis
- The study investigates how well non-invasive tests (NITs) can diagnose metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis in patients over 50 with Type 2 Diabetes and obesity.
- Out of 124 patients, a significant portion was found to have either early MASH or MASH with significant fibrosis, with the OWLiver Panel accurately classifying 86.1% of cases.
- Results indicate that the OWLiver Panel is an effective one-step screening tool for identifying MASH in high-risk individuals, outperforming combinations of different NITs.
Article Synopsis
- Statins provide multiple benefits for patients with metabolic-associated steatotic liver disease (MASLD), particularly in reducing long-term risks of all-cause mortality and liver-related clinical events (LREs).
- A study followed 7988 patients for nearly 4.6 years, revealing that statin users had significantly lower risks of mortality (HR=0.233) and LREs (HR=0.380), as well as slower liver stiffness progression rates.
- While statin usage is linked to a decrease in the progression of liver stiffness, it did not significantly correlate with liver stiffness regression, suggesting a complex relationship in liver health management.
Background & Aims: Patients with nonalcoholic fatty liver disease (NAFLD)/metabolic dysfunction-associated steatotic liver disease (MASLD) face a multifaceted disease burden which includes impaired health-related quality of life (HRQL) and potential stigmatization. We aimed to assess the burden of liver disease in patients with NAFLD and the relationship between experience of stigma and HRQL.
Methods: Members of the Global NASH Council created a survey about disease burden in NAFLD.
Article Synopsis
- The term "non-alcoholic fatty liver disease" is being replaced by "metabolic dysfunction-associated steatotic liver disease (MASLD)" to avoid stigma and enhance patient awareness.
- MASLD is the most common cause of chronic liver disease, affecting 25% of the global population, and is linked to metabolic syndrome and lifestyle choices.
- Current treatment focuses on diet changes and exercise, as there are no approved drugs for MASLD in Europe, highlighting a significant need for effective therapies.
Evaluation of Google Search Trends for Liver Diseases in Europe.
J Gastrointestin Liver Dis
June 2024
Article Synopsis
- Chronic liver diseases, particularly metabolic dysfunction-associated steatotic liver disease (MASLD), are widespread but poorly understood by many, highlighting the need for better awareness and knowledge transfer.
- An analysis of Google search trends from 2004 to 2021 indicated that interest in MASLD has increased, while interest in its severe form (MASH) and viral hepatitis C has decreased; queries for viral hepatitis B remained stable but focused mainly on vaccination.
- The search habits show that most users favor simpler, native language terms over complex medical jargon, indicating that public interest is led by non-experts and not significantly influenced by new medical advancements.
Article Synopsis
- Healthy weight patients with metabolic dysfunction-associated fatty liver disease (MAFLD) show better metabolic profiles but paradoxically have higher mortality rates, a phenomenon not yet fully understood.
- In a study of 303 patients, researchers found that telomere length was significantly shorter in lean MAFLD patients, correlating with increased levels of reactive oxygen species and lower GDF-15 levels.
- The findings suggest that telomere shortening contributes to higher all-cause mortality in lean MAFLD patients, highlighting potential therapeutic targets through the management of oxidative stress and telomere integrity.
Fibroblast growth factor 21 is a hepatokine involved in MASLD progression.
United European Gastroenterol J
October 2024
Article Synopsis
- The study aimed to evaluate the role of FGF21 in metabolic dysfunction-associated steatotic liver disease (MASLD) by analyzing both human samples and animal models.
- Significant increases in FGF21 gene expression and circulating levels were found in MASLD patients as well as in cell and animal models exposed to fatty acids.
- Additionally, the A-allele from the FGF21 rs838133 variant was linked to a higher risk of severe liver conditions in MASLD patients, indicating genetic factors may contribute to disease severity.
Background: With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) and the publication of the metabolic dysfunction-associated fatty liver disease (MAFLD) nomenclature in 2020, it is important to establish consensus for the coding of MAFLD in ICD-11. This will inform subsequent revisions of ICD-11.
Methods: Using the Qualtrics XM and WJX platforms, questionnaires were sent online to MAFLD-ICD-11 coding collaborators, authors of papers, and relevant association members.
Article Synopsis
- * NAFLD not only affects liver function but is also linked to increased risks of cardiovascular disease (CVD), which is a leading cause of death in these patients, influenced by common risk factors like obesity and type 2 diabetes.
- * The review explores the relationship between NAFLD and CVD, highlighting potential mechanisms involving specific proteins, genetic factors, and the role of gut microbiota in this complex link.
Novel approaches in the medical management of compensated cirrhosis.
Expert Rev Gastroenterol Hepatol
June 2024
Article Synopsis
- This review focuses on improving the care for compensated cirrhotic patients, as previous guidelines mainly addressed decompensated patients in clinical settings.
- It examines recognition and management of liver function, portal hypertension, and complications like covert hepatic encephalopathy, along with a look at extrahepatic issues and palliative care, utilizing evidence-based practices.
- The authors argue for a more comprehensive approach to treatment that goes beyond standard monitoring and imaging to address overlooked aspects of cirrhosis care.
Article Synopsis
- The study aimed to evaluate how liver fibrosis (measured by the FIB-4 index) affects the prognosis of COVID-19 and associated liver injury.
- It analyzed data from 575 COVID-19 patients, finding that higher FIB-4 levels were linked to increased mortality—specifically, patients with FIB-4 > 3.25 had a significantly higher death rate.
- Post-infection, although liver injury markers (AST and ALT) and FIB-4 levels improved, elevated FIB-4 at admission remained a strong predictor of mortality related to COVID-19.
This is the summary report of the 5th Translational Hepatology Meeting, endorsed by the Spanish Association for the Study of the Liver (AEEH) and held in Seville, Spain, in October 2023. The meeting aimed to provide an update on the latest advances in the field of basic and translational hepatology, covering different molecular, cellular, and pathophysiological aspects of the most relevant clinical challenges in liver pathologies. This includes the identification of novel biomarkers and diagnostic tools, the understanding of the relevance of immune response and inflammation in liver diseases, the characterization of current medical approaches to reverse liver diseases, the incorporation of novel molecular insights through omics techniques, or the characterization of the impact of toxic and metabolic insults, as well as other organ crosstalk, in liver pathophysiology.
View Article and Find Full Text PDFArticle Synopsis
- * Results indicated that severe fibrosis correlated with increased fatigue and lower HRQoL, with significant predictors of HRQoL including body mass index (BMI) and gender for both cohorts.
- * UK participants experienced worse HRQoL compared to Spanish participants, influenced more strongly by gender-related factors, suggesting the need for tailored interventions in multinational studies on NAFLD.