Publications by authors named "Wong Yu Jun"
Background: The global burden of metabolic diseases is increasing, but estimates of their impact on primary liver cancer are uncertain. We aimed to assess the global burden of primary liver cancer attributable to metabolic risk factors, including high body mass index (BMI) and high fasting plasma glucose (FPG) levels, between 1990 and 2021.
Methods: The total number and age-standardized rates of deaths and disability-adjusted life years (DALYs) from primary liver cancer attributable to each metabolic risk factor were extracted from the Global Burden of Disease Study 1990-2021.
Article Synopsis
- The study examines the link between liver disease type (alcohol-related vs non-alcohol-related) and 6-week mortality following acute variceal bleeding (AVB) in patients with cirrhosis.
- Researchers analyzed data from two large cohorts in the U.S. and Singapore, including 1,349 patients, and found that non-ALD patients had a significantly higher risk of mortality compared to ALD patients.
- Incorporating the etiology of cirrhosis into existing mortality prediction models improved accuracy, highlighting the importance of considering the type of liver disease for patient care.
Background: Fibrosis 4 (FIB-4) is widely used to triage patients with metabolic dysfunction-associated steatotic liver disease. Given that age is part of FIB-4, higher scores may be expected in the elderly population. This led to the proposal of using a higher threshold of FIB-4 to triage patients aged ≥65.
View Article and Find Full Text PDFIntroduction: The safety of continuing anticoagulation therapy during endoscopic variceal ligation (EVL) remains controversial. We performed a systematic review and meta-analysis to evaluate the safety of anticoagulation therapy in EVL.
Methods: We systematically searched four electronic databases from their inception until 1 June 2024, for studies that evaluated anticoagulation use and risk of rebleeding among patients undergoing EVL.
Background: Metabolic risk factors are a significant cause of global burden among adolescents and young adults, but there is a lack of attention to the burden attributable to these metabolic risk factors globally.
Aims: This study aims to provide comprehensive estimates of five important metabolic risk factors and the attributable disease burden in people aged 15-39 years from 1990 to 2021, based on the Global Burden of Disease Study (GBD) database.
Methods: Global total deaths and disability-adjusted life years (DALYs) were used to describe the burden attributable to five common metabolic risk factors, including high fasting plasma glucose (FPG), high low-density lipoprotein cholesterol (LDL-C), high systolic blood pressure (SBP), high body mass index (BMI), and kidney dysfunction, in adolescents and young adults.
To review the findings of a multiparametric MRI (the "liver triple screen") solution for the non-invasive assessment of liver fat, iron, and fibrosis in patients with chronic liver disease (CLD). A retrospective evaluation of all consecutive triple screen MRI cases was performed at our institution over the last 32 months. Relevant clinical, laboratory, and radiologic data were analyzed using descriptive statistics.
View Article and Find Full Text PDFBackground: In patients with metabolic dysfunction-associated steatotic liver disease (MASLD), there are limited data on how changes in FIB4 and liver stiffness measurement (LSM) correlate in non-biopsy cohorts.
Aims: Our objective was to evaluate associations between changes in FIB4 and LSM in MASLD patients.
Methods: We included MASLD patients with serial VCTE from 2015-2022.
Article Synopsis
- - Obesity is a major global health concern, with a significant rise in deaths and disability-adjusted life years (DALYs) linked to high body mass index (BMI) from 1990 to 2021, notably increasing by over 2.5 times for both genders.
- - The main health issues associated with high BMI in 2021 included diabetes, heart disease, and stroke, with low-middle socio-demographic index (SDI) countries experiencing the largest increase in disease burden.
- - The findings call for urgent monitoring and intervention efforts to address the growing health impact of high BMI from 1990 to 2021, especially given the stable death rates for women and rising rates for men.
Article Synopsis
- - This study evaluated the effectiveness of various liver stiffness measurement (LSM) scores, including AGILE3 + and AGILE4, in predicting liver-related events in patients with nonalcoholic fatty liver disease (NAFLD), particularly focusing on those with diabetes and obesity.
- - Data was analyzed from 1903 adult NAFLD patients who underwent vibration-controlled transient elastography (VCTE) over seven years, with a total of 25 liver-related events recorded.
- - Results showed that AGILE3 + and AGILE4 scores significantly outperformed LSM and FAST scores in predicting liver-related events, especially in individuals with diabetes and obesity, highlighting their potential for better risk stratification in
The role of dietary modification in the prevention and management of metabolic dysfunction-associated fatty liver disease: An international multidisciplinary expert consensus.
Metabolism
December 2024
Article Synopsis
- Metabolic dysfunction-associated fatty liver disease (MAFLD) is a rising cause of chronic liver disease globally, prompting the need for dietary intervention strategies.
- A panel of 55 international experts conducted a study to reach a consensus on dietary modifications for preventing MAFLD, covering various aspects from epidemiology to management.
- Recommended strategies include following a balanced diet, increasing whole grains and plant-based foods, and reducing red meat and processed foods, along with advocating for physical activity and possibly maintaining Mediterranean or DASH diets.
Article Synopsis
- The study investigates the effects of prophylactic antibiotics in patients with alcohol-associated hepatitis (AH) undergoing steroid treatment, focusing on their impact on survival and various complications.
- A systematic review of six studies involving 510 patients found that prophylactic antibiotics reduced the risk of infections and hepatic encephalopathy (HE) but did not significantly improve 90-day survival rates or prevent acute kidney injury (AKI).
- The findings suggest that while prophylactic antibiotics can reduce certain risks, more extensive research is needed as the sample size required to establish a survival benefit is much larger than the studies reviewed.
Background: Common metabolic diseases, such as type 2 diabetes mellitus (T2DM), hypertension, obesity, hypercholesterolemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), have become a global health burden in the last three decades. The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) data enables the first insights into the trends and burdens of these metabolic diseases from 1990 to 2021, highlighting regional, temporal and differences by sex.
Methods: Global estimates of disability-adjusted life years (DALYs) and deaths from GBD 2021 were analyzed for common metabolic diseases (T2DM, hypertension, obesity, hypercholesterolemia, and MASLD).
Background: Pregnant women with hepatitis C virus (HCV) infection represent a special population in which treatment access remains limited despite its increasing prevalence. A reliable estimate of the burden and clinical outcomes of pregnant women with HCV infection is crucial for HCV elimination. We aimed to determine the prevalence, maternal-to-child transmission (MTCT), maternal and fetal complication rates, and direct acting antivirals (DAA) treatment outcomes of chronic HCV infection in pregnant women.
View Article and Find Full Text PDFBackground: Alcohol-associated hepatitis (AH) is associated with significant mortality. Model for End-Stage Liver Disease (MELD) score is used to predict short-term mortality and aid in treatment decisions. MELD is frequently updated in the course of AH.
View Article and Find Full Text PDFReal-world Effectiveness and Tolerability of Interferon-free Direct-acting Antiviral for 15,849 Patients with Chronic Hepatitis C: A Multinational Cohort Study.
J Clin Transl Hepatol
July 2024
Article Synopsis
- The study aimed to evaluate the effectiveness and tolerability of direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) across different genotypes (GTs) in a global, real-world context, focusing particularly on GT3 and GT6.
- Researchers analyzed data from 15,849 chronic hepatitis C patients across Asia, North America, and Europe over a seven-year period, noting demographic factors such as age, sex, and prior treatment history.
- Results showed a high sustained virological response (SVR12) rate of 96.9% overall, with variances by genotype, highlighting that independent factors like advanced age, cirrhosis, and previous treatment failures affected treatment outcomes, while being
Article Synopsis
- Patients with clinically significant portal hypertension (CSPH) should be treated with non-selective beta-blockers like carvedilol to prevent liver decompensation, especially using liver stiffness (LS) measurements as a less invasive alternative to hepatic venous pressure gradient (HVPG) measurements.
- A study is planned to determine if patients with compensated cirrhosis and LS≥25 kPa can benefit from carvedilol, focusing on a randomized, double-blind, placebo-controlled trial involving 446 adults.
- The primary outcome will be the incidence of decompensation events and liver-related deaths over three years, while secondary outcomes will include various complications of portal hypertension such as
Background & Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model.
Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG).
Background And Aims: Baveno VII consensus suggests that screening endoscopy can be spared in patients with compensated cirrhosis when spleen stiffness measurement (SSM) by vibration-controlled transient elastography (VCTE) is ≤40 kPa as they have a low probability of high-risk varices (HRV). Conversely, screening endoscopy is required in all patients with porto-sinusoidal vascular disorder (PSVD). This study aimed to evaluate the performance of SSM-VCTE to rule out HRV in patients with PSVD and signs of portal hypertension.
View Article and Find Full Text PDFPortal hypertension is the key mechanism driving the transition from compensated to decompensated cirrhosis. In this review, the authors described the pathophysiology of portal hypertension in cirrhosis and the rationale of pharmacologic treatment of portal hypertension. We discussed both etiologic and nonetiologic treatment of portal hypertension and the specific clinical scenarios how nonselective beta-blocker can be used in patients with cirrhosis.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates whether tracking changes in liver stiffness measurements (LSM) over time can better predict liver-related events (LRE) in patients with compensated advanced chronic liver disease (cACLD) compared to just looking at the most recent LSM.
- Analyzing data from 480 patients across five countries, researchers found that while a higher current LSM was linked to a higher risk of LRE, changes in LSM over time were not significantly predictive.
- The conclusion is that once the latest LSM value is available, previous LSM measurements do not provide any additional predictive benefit for LRE in cACLD patients.