Publications by authors named "Mark Muthiah"
There is a new awareness of the widespread nature of metabolic dysfunction-associated steatotic liver disease (MASLD) and its connection to cardiovascular disease (CVD). This has catalyzed collaboration between cardiologists, hepatologists, endocrinologists, and the wider multidisciplinary team to address the need for earlier identification of those with MASLD who are at increased risk for CVD. The overlap in the pathophysiologic processes and parallel prevalence of CVD, metabolic syndrome, and MASLD highlight the multisystem consequences of poor cardiovascular-liver-metabolic health.
View Article and Find Full Text PDFBackground: 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.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major public health threat globally. Management of patients afflicted with MASLD and research in this domain are limited by the lack of robust well-established non-invasive biomarkers for diagnosis, prognostication, and monitoring. The circulating metabolome reflects both the systemic metabo-inflammatory milieu and changes in the liver in affected individuals.
View Article and Find Full Text PDFSince the Asian Pacific Association for the Study of the Liver (APASL) published guidelines on non-cirrhotic portal fibrosis/idiopathic portal hypertension in 2007, there has been a surge in new information, especially with the introduction of the term porto-sinusoidal vascular disorder (PSVD). Non-cirrhotic intra-hepatic causes of portal hypertension include disorders with a clearly identifiable etiology, such as schistosomiasis, as well as disorders with an unclear etiology such as non-cirrhotic portal fibrosis (NCPF), also termed idiopathic portal hypertension (IPH). This entity is being increasingly recognized as being associated with systemic disease and drug therapy, especially cancer therapy.
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- This study investigates how metabolic dysfunction-associated steatotic liver disease (MASLD) affects long-term survival in patients who have suffered an acute myocardial infarction (AMI) across different body weight categories.
- The four patient groups analyzed were obesity MASLD, non-obesity MASLD, obesity non-MASLD, and non-obesity non-MASLD, with findings showing that non-obesity MASLD had the highest risk of heart failure and long-term mortality.
- The results indicate that both obesity and non-obesity MASLD are significant predictors of all-cause mortality post-AMI, particularly highlighting the greater risk associated with non-obesity MASLD.
Background & Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a spectrum of pathologies ranging from simple steatosis to steatohepatitis, fibrosis and cirrhosis. Patients with metabolic associated steatohepatitis (MASH) with fibrosis are at greatest risk of liver and cardiovascular complications. To identify such at-risk MASLD patients, physicians are still reliant on invasive liver biopsies.
View Article and Find Full Text PDFBackground & 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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- - 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.
Prevalence of Chronic Liver Disease in Cholangiocarcinoma: A Meta-Analysis.
Clin Gastroenterol Hepatol
October 2024
Article Synopsis
- 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.
Article Synopsis
- The study aims to project cardiovascular disease (CVD) mortality trends and risk factors from 2025 to 2050 to aid healthcare planning.
- Using historical data and Poisson regression, projections indicate a significant increase in CVD prevalence (90%), crude mortality (73.4%), and DALYs (54.7%), with ischaemic heart disease and high blood pressure as major contributors.
- Despite a stable age-standardized CVD prevalence, the study underscores a concerning rise in crude mortality due to an aging population, prompting the need for effective healthcare strategies.
The burden of cardiovascular disease in Asia from 2025 to 2050: a forecast analysis for East Asia, South Asia, South-East Asia, Central Asia, and high-income Asia Pacific regions.
Lancet Reg Health West Pac
August 2024
Article Synopsis
- A study forecasts a 91.2% increase in crude cardiovascular disease (CVD) mortality in Asia from 2025 to 2050, despite a 23.0% decrease in the age-standardized mortality rate.
- Ischaemic heart disease and stroke will remain the top causes of mortality, with Central Asia experiencing the highest mortality rates while high systolic blood pressure is identified as the leading risk factor across most of Asia.
- The research highlights the need for targeted health interventions due to the significant variations in CVD burden across different regions in Asia.
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.
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.
Background And Aims: Vibration-controlled transient elastography (VCTE) is used in clinical practice to risk-stratify liver transplant (LT) recipients; however, there are currently little data demonstrating the relationship between VCTE and clinical outcomes.
Methods: A total of 362 adult LT recipients with successful VCTE examination between 2015 and 2022 were included. Presence of advanced fibrosis was defined as liver stiffness measurement (LSM) ≥10.
Article Synopsis
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health issue, prompting a need for accurate preclinical models to study it.
- The liver disease progression aggravation diet (LIDPAD) is a new murine model that mimics human MASLD closely, showing significant similarities in disease features and progression within weeks.
- This model demonstrates responsiveness to dietary changes, making it valuable for researching therapeutic strategies while revealing important interactions between gut health and liver disease.
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.
Article Synopsis
- Malnutrition is linked to worse outcomes for patients with acute coronary syndrome (ACS), impacting their prognosis and survival rates.
- The study reviewed various nutritional assessment tools and analyzed data from 30 studies with over 37,000 patients, revealing that about one-third were malnourished, leading to a mortality rate of 20.59% among them.
- Results showed that malnutrition significantly increased the risk of all-cause mortality, regardless of ACS type, ethnicity, or income, highlighting the importance of addressing nutritional status in these patients.
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.
The Burden of Overweight and Obesity-Associated Gastrointestinal Cancers in Low and Lower-Middle-Income Countries: A Global Burden of Disease 2019 Analysis.
Am J Gastroenterol
June 2024
Article Synopsis
- * 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.
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.
Aim: Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) are at increased risk of incident cardiovascular disease. However, the clinical characteristics and prognostic importance of MASLD in patients presenting with acute myocardial infarction (AMI) have yet to be examined.
Methods: This study compared the characteristics and outcomes of patients with and without MASLD presenting with AMI at a tertiary centre in Singapore.
Article Synopsis
- Researchers studied how to tell if patients with chronic hepatitis B would benefit from an additional treatment called pegylated interferon.
- They found that certain blood tests (biomarkers) could help predict if patients would lose a specific marker (HBeAg) after treatment.
- The tests showed that lower levels of a certain biomarker at the start and during treatment could help identify patients who might respond well to the pegylated interferon therapy.