Publications by authors named "Tsubota A"

Frailty and fractures are closely associated with adverse clinical outcomes. This retrospective study investigated the prognostic impact of frailty, prevalent fractures, and the coexistence of both in patients with cirrhosis. Frailty was defined according to the Fried frailty phenotype criteria: weight loss, weakness, exhaustion, slowness, and low physical activity.

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  • Sarcopenia and osteoporosis negatively affect patients with chronic liver disease (CLD), and this study compares two methods for assessing muscle mass: bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA).
  • The study included 173 patients and found strong correlation and agreement between ASMI values obtained from BIA and DXA for diagnosing sarcopenia and osteosarcopenia.
  • It concludes that DXA is a valuable tool for a thorough assessment of muscle and bone health in CLD patients, highlighting the need for effective diagnostics in managing these conditions.
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  • Patients with chronic liver disease (CLD) often experience malnutrition and increased risk of bone diseases, which can lead to worse health outcomes.
  • This study included 209 CLD patients and found that those in the "nutrition-related risk" group had a higher prevalence of osteoporosis compared to those without such risk.
  • The geriatric nutritional risk index (GNRI) was determined to be a strong predictor for osteoporosis and fracture risk, indicating its potential use as an important tool for managing bone health in these patients.
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Aims: To evaluate the efficacy and safety of oral semaglutide for type 2 diabetes mellitus (T2DM) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).

Materials And Methods: This was a single-arm, multicentre, prospective study. Among 80 consecutive patients with MASLD and T2DM who newly received oral semaglutide, 70 completed 48-week oral semaglutide treatment as scheduled and were included in an efficacy analysis.

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Hibernating animals undergo a unique and reversible decrease in their whole-body metabolism, which is often accompanied by a suppression of mitochondrial respiration. However, the precise mechanisms underlying these seasonal shifts in mitochondrial metabolism remain unclear. In this study, the effect of the serum from active and hibernating Japanese black bears on mitochondrial respiration was assessed.

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  • The study investigates how esophageal varices change in patients with cirrhosis after achieving sustained virological response (SVR) using direct-acting antivirals (DAAs).
  • 243 patients were examined before and after DAA treatment, revealing that 14.8% experienced worsened varices post-SVR and 11.9% showed improvement.
  • The ALBI score at SVR12 was identified as a significant predictor for both worsening varices and the development of new varices, with specific cut-off values highlighting the risk.
  • Despite achieving SVR, patients with high ALBI scores remain at risk for negative changes in their esophageal varices.
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Aim: An association between hepatitis B core-related antigen (HBcrAg) kinetics and hepatocarcinogenesis during nucleoside (t)id analog (NA) treatment has recently been reported. HBcrAg kinetics and factors associated with HBcrAg response during tenofovir alafenamide (TAF) administration remain unclear. In this multicenter retrospective study, we aimed to clarify the efficacy and safety of TAF in treatment-naïve patients with chronic hepatitis B, focusing on the reduction in HBcrAg levels.

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Background And Aim: This study aimed to clarify the efficacy and safety of 48-week pemafibrate treatment in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) complicated by dyslipidemia.

Methods: A total of 110 patients diagnosed with MASLD complicated by dyslipidemia received pemafibrate at a dose of 0.1 mg twice daily for 48 weeks.

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Sarcopenia frequently and progressively occurs in patients with chronic liver disease. This study aimed to clarify the relationship between vitamin D levels and muscle mass loss. A total of 166 patients with chronic liver disease were enrolled in this study.

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  • The study highlights the limitations of traditional liver cancer markers, α-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP), particularly in early-stage hepatocellular carcinoma (HCC) and in patients with liver issues.
  • Researchers evaluated serum protein kinase C delta (PKCδ) as a potential new biomarker for HCC diagnosis and found it to have high sensitivity and specificity, even in early stages of the disease.
  • PKCδ levels remained consistent regardless of hepatitis C virus (HCV) status, liver injury, or warfarin treatment, making it a promising alternative to conventional markers for more accurate HCC detection.
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The liver is a vital organ involved in nutrient metabolism, hormone regulation, immunity, cytokine production, and gut homeostasis. Impairment in liver function can result in malnutrition, chronic inflammation, decreased anabolic hormone levels, and dysbiosis. These conditions eventually cause an imbalance in osteoblast and osteoclast activities, resulting in bone loss.

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Background: HBV DNA integration into the host genome is frequently found in HBV-associated HCC tissues and is associated with hepatocarcinogenesis. Multiple detection methods, including hybrid capture-sequencing, have identified integration sites and provided clinical implications; however, each has advantages and disadvantages concerning sensitivity, cost, and throughput. Therefore, methods that can comprehensively and cost-effectively detect integration sites with high sensitivity are required.

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Aim: Malnutrition, which increases the risk of liver disease-related events and mortality, is a serious complication in cirrhosis. This study aimed to investigate whether the geriatric nutritional risk index (GNRI) could predict the long-term prognosis in patients with cirrhosis.

Methods: We retrospectively evaluated 266 patients with cirrhosis and classified them into two groups based on baseline GNRI scores: risk (≤98,  = 104) and no-risk groups (>98,  = 162).

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Purpose: The accumulation of advanced glycation end products (AGEs) is associated with various diseases and age-related impairments, including loss of muscle mass and function. We investigated the association between plasma pentosidine, which is one of the AGEs, and sarcopenia, low gait speed, and mortality in patients with cirrhosis.

Methods: This retrospective study divided 128 patients with cirrhosis into three groups by 25th and 75th quartiles of baseline plasma pentosidine levels: low (L)-, intermediate (I)-, and high (H)-pentosidine (Pen) groups.

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The vertical and horizontal broken lines indicate the pre-revised criteria, whereas the vertical and horizontal solid lines indicate the 2022 European Society of Cardiology/European Respiratory Society criteria.

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Aim: Insulin-like growth factor 1 (IGF-1), which is primarily produced in hepatocytes and is associated with liver functional reserve, plays a crucial role in the pathological condition of cirrhosis. This study aimed to investigate the usefulness of serum IGF-1 levels for predicting the long-term prognosis and decompensation development in patients with cirrhosis.

Methods: We retrospectively evaluated 148 patients with cirrhosis and divided them into three groups according to baseline IGF-1 levels: low (L)-, intermediate (I)-, and high (H)-IGF-1 groups.

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Background And Aims: The future development of hepatocellular carcinoma (HCC) in patients after sustained virologic response (SVR) is an important issue. The purposes of this study were to investigate pathological alterations in organelle of the liver of SVR patients and to characterize organelle abnormalities that may be related to carcinogenesis after SVR.

Methods: The ultrastructure of liver biopsy specimens from patients with chronic hepatitis C (CHC) and SVR were compared to cell and mouse models and assessed semi-quantitatively using transmission electron microscopy.

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Background: Osteosarcopenia, defined as the coexistence of sarcopenia and osteoporosis, is associated with adverse clinical outcomes. The present study investigated the prognostic significance of osteosarcopenia in patients with cirrhosis.

Methods: This retrospective study evaluated 126 patients with cirrhosis.

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  • The study examined how the combination of Child-Pugh class B/C cirrhosis, sarcopenia, and severe vitamin D deficiency affects the survival prognosis of cirrhosis patients.
  • The researchers evaluated 104 patients and found that those with both high-risk cirrhosis and either sarcopenia or severe vitamin D deficiency had significantly lower survival rates compared to those without these complications.
  • The findings suggest that assessing nutritional issues like sarcopenia and vitamin D levels is crucial for understanding and improving the prognosis of patients with cirrhosis.
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Patients with cirrhosis are at high risk for sarcopenia and malnutrition, which are associated with reduced quality of life and increased mortality. We investigated the relationship between the Geriatric Nutritional Risk Index (GNRI) and sarcopenia/gait speed and assessed the usefulness of the GNRI for predicting sarcopenia in patients with cirrhosis. We evaluated 202 patients with cirrhosis and divided them into three groups based on baseline GNRI values: low (L)-GNRI (< 94.

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  • Tricuspid regurgitation pressure gradient (TRPG) measurement via echocardiography is critical for diagnosing portopulmonary hypertension (PoPH) in cirrhotic patients, and this study focuses on identifying factors linked to high TRPG levels.
  • Among 486 patients analyzed, 10.5% had TRPG values of 35 mmHg or higher, with factors such as being female, experiencing shortness of breath, and higher levels of brain natriuretic peptide (BNP) being significant indicators.
  • A scoring model was developed to predict high TRPG risk, demonstrating good accuracy and could help select patients who would benefit from further echocardiography investigations.
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Aim: The association between thrombolytic therapy and the outcome in patients with portal vein thrombosis (PVT) remains controversial. This study aimed to evaluate the outcome in patients with PVT who received antithrombin III-based therapy.

Methods: This study was a retrospective, multicenter study to investigate the liver-related events and the survival rates in 240 patients with PVT who received the therapy.

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The aim of this retrospective multicenter study was to clarify the antifibrotic effect and long-term outcome of sodium glucose cotransporter 2 inhibitors (SGLT2-Is) in patients with nonalcoholic fatty liver disease (NAFLD) complicated by type 2 diabetes mellitus (T2DM). Of the 1262 consecutive patients with T2DM who recently received SGLT2-Is, 202 patients with NAFLD had been receiving SGLT2-Is for more than 48 weeks and were subjected to this analysis. Furthermore, 109 patients who had been on SGLT2-I therapy for more than 3 years at the time of analysis were assessed for the long-term effects of SGLT2-Is.

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Insulin-like growth factor 1 (IGF-1) plays an important role in bone growth and maintenance, and its decreased levels are associated with bone disorders. This study aimed to evaluate the association of serum IGF-1 levels with osteoporosis, prevalent fractures and fracture risk based on the Fracture Risk Assessment Tool (FRAX) in patients with primary biliary cholangitis (PBC). This study included 127 consecutive patients with PBC.

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Backgrounds And Aims: Hepatocellular carcinoma (HCC) is the most common cancer with a poor prognosis. Identification of an alternative biomarker that can detect early-stage and conventional tumor marker-negative HCC is urgently needed. We found that protein kinase C delta (PKCδ) is specifically secreted from HCC cell lines into extracellular space and contributes to tumor development and that its serum levels were elevated in HCC patients.

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