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Association of fatty liver index with the risk of incident cardiovascular disease and acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature296183
Source
Eur J Gastroenterol Hepatol. 2018 09; 30(9):1047-1054
Publication Type
Journal Article
Date
09-2018
Author
Olubunmi O Olubamwo
Jyrki K Virtanen
Ari Voutilainen
Jussi Kauhanen
Jussi Pihlajamäki
Tomi-Pekka Tuomainen
Author Affiliation
Department of Public Health and Clinical Nutrition, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland.
Source
Eur J Gastroenterol Hepatol. 2018 09; 30(9):1047-1054
Date
09-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Algorithms
Cardiovascular Diseases - diagnosis - epidemiology
Decision Support Techniques
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - diagnosis - epidemiology
Non-alcoholic Fatty Liver Disease - diagnosis - epidemiology
Prognosis
Proportional Hazards Models
Prospective Studies
Risk assessment
Risk factors
Time Factors
Abstract
Fatty liver disease (FLD) has been identified as constituting cardiometabolic risk. However, evidence on the association of fatty liver index (FLI) with cardiovascular disease (CVD) is largely cross-sectional, with limited evidence on the predictability of incident CVD, and specifically, acute myocardial infarction (AMI). Therefore, we aimed to investigate the prospective associations between fatty liver as estimated by FLI and incident CVD, and specifically AMI, in the Kuopio Ischaemic Heart Disease Risk Factor Study cohort.
Our patients were 1205 middle-aged men free of CVD at baseline. The associations of baseline FLI with incident CVD and incident AMI were analyzed using multivariable-adjusted Cox regression models.
During a median follow-up of 17 years, a total of 690 incident cases of CVD and 269 cases of AMI were recorded through Finnish registries. For incident CVD, for the high (FLI=60) versus the low (=30) FLI category, the hazard ratio (HR) was 1.77 [95% confidence interval (CI): 1.46-2.14] in the minimally adjusted model. With increasing adjustment, the association was attenuated progressively. In the most adjusted model, the HR was 1.41 (95% CI: 1.10-1.79). For incident AMI, for the high FLI category, the HR was 1.65 (95% CI: 1.22-2.23) in the minimally adjusted model, but in most comprehensive models when we included metabolic factors, the HR was not significant (HR=1.136, 95% CI: 0.777-1.662).
FLI can predict incident CVD. However, the predictability of AMI using FLI is subject to interactions of metabolic factors. Individuals with FLI in the moderate to high category should be evaluated and monitored for subclinical or overt cardiovascular (including coronary) disease.
PubMed ID
29912803 View in PubMed
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Conjugated bile acids associate with altered rates of glucose and lipid oxidation after Roux-en-Y gastric bypass.

https://arctichealth.org/en/permalink/ahliterature124015
Source
Obes Surg. 2012 Sep;22(9):1473-80
Publication Type
Article
Date
Sep-2012
Author
M. Simonen
N. Dali-Youcef
D. Kaminska
S. Venesmaa
P. Käkelä
M. Pääkkönen
M. Hallikainen
M. Kolehmainen
M. Uusitupa
L. Moilanen
M. Laakso
H. Gylling
M E Patti
J. Auwerx
Jussi Pihlajamäki
Author Affiliation
Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
Source
Obes Surg. 2012 Sep;22(9):1473-80
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adipose Tissue - metabolism
Bile Acids and Salts - blood
Biological Markers - blood
Blood Glucose - metabolism
Body mass index
Energy Metabolism
Female
Finland
Gastric Bypass
Glucose - metabolism
Humans
Lipid Metabolism
Liver - metabolism
Longitudinal Studies
Male
Middle Aged
Obesity, Morbid - blood - surgery
Treatment Outcome
Abstract
Laparoscopic Roux-en-Y gastric bypass (RYGB) induces a more favorable metabolic profile than expected by weight loss alone. In this study, we investigated the effect of RYGB on serum bile acid levels and their relation to clinical outcomes.
We included 30 obese patients who underwent RYGB (BMI?=?46.1?±?5.9 kg/m(2)). Clinical measurements and laboratory determinations were performed before surgery and 1 year after surgery. Fasting serum bile acids were measured by an enzymatic method and individual bile acids were quantified by HLPC-tandem mass spectrometry. Indirect calorimetry was performed to measure the rates of energy expenditure and substrate oxidation.
Fasting total serum bile acid levels increased twofold after RYGB (pre, 3.68?±?2.03 vs. post, 7.06?±?9.65 µmol/l, +92 %, p?=?0.002). This increase in total bile acids was accompanied by a decrease in conjugated bile acids, which correlated with decreased glucose oxidation (r?=?0.571, p?=?0.002) and with increased lipid oxidation (r?=?-0.626, p?=?0.0004). The change in taurine-conjugated bile acids correlated with altered DIO2 mRNA expression in adipose tissue (r?=?-0.498, p?=?0.013) potentially linking bile acid conjugation to substrate oxidation through DIO2.
Fasting serum bile acid levels increase after RYGB. More specifically, changes in bile acid conjugation after RYGB associate with altered energy metabolism.
PubMed ID
22638681 View in PubMed
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Epigenetic Alterations in Human Liver From Subjects With Type 2 Diabetes in Parallel With Reduced Folate Levels.

https://arctichealth.org/en/permalink/ahliterature270426
Source
J Clin Endocrinol Metab. 2015 Nov;100(11):E1491-501
Publication Type
Article
Date
Nov-2015
Author
Emma Nilsson
Ashok Matte
Alexander Perfilyev
Vanessa D de Mello
Pirjo Käkelä
Jussi Pihlajamäki
Charlotte Ling
Source
J Clin Endocrinol Metab. 2015 Nov;100(11):E1491-501
Date
Nov-2015
Language
English
Publication Type
Article
Keywords
Adult
Biopsy
Body mass index
Cohort Studies
CpG Islands
DNA Methylation
Diabetes Mellitus, Type 2 - complications - genetics - metabolism - pathology
Epigenesis, Genetic
Female
Finland
Folic Acid - blood
Folic Acid Deficiency - complications
Gastric Bypass
Gene Expression Profiling
Gene Expression Regulation
Genome-Wide Association Study
Humans
Liver - metabolism - pathology
Male
Middle Aged
Nutritional Status
Obesity, Morbid - complications - surgery
Abstract
Epigenetic variation may contribute to the development of complex metabolic diseases such as type 2 diabetes (T2D). Hepatic insulin resistance is a hallmark of T2D. However, it remains unknown whether epigenetic alterations take place in the liver from diabetic subjects. Therefore, we investigated the genome-wide DNA methylation pattern in the liver from subjects with T2D and nondiabetic controls and related epigenetic alterations to gene expression and circulating folate levels.
Liver biopsies were obtained from 35 diabetic and 60 nondiabetic subjects, which are part of the Kuopio Obesity Surgery Study. The genome-wide DNA methylation pattern was analyzed in the liver using the HumanMethylation450 BeadChip. RNA expression was analyzed from a subset of subjects using the HumanHT-12 Expression BeadChip.
After correction for multiple testing, we identified 251 individual CpG sites that exhibit differential DNA methylation in liver obtained from T2D compared with nondiabetic subjects (Q
Notes
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PubMed ID
26418287 View in PubMed
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Fatty acid metabolism is altered in non-alcoholic steatohepatitis independent of obesity.

https://arctichealth.org/en/permalink/ahliterature275718
Source
Metabolism. 2016 May;65(5):655-66
Publication Type
Article
Date
May-2016
Author
Paula Walle
Markus Takkunen
Ville Männistö
Maija Vaittinen
Maria Lankinen
Vesa Kärjä
Pirjo Käkelä
Jyrki Ågren
Mika Tiainen
Ursula Schwab
Johanna Kuusisto
Markku Laakso
Jussi Pihlajamäki
Source
Metabolism. 2016 May;65(5):655-66
Date
May-2016
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Cholesterol Esters - blood - metabolism
Cohort Studies
Cross-Sectional Studies
Fatty Acid Desaturases - genetics - metabolism
Fatty Acids - blood - metabolism
Fatty Liver - complications - epidemiology - metabolism - pathology
Female
Finland - epidemiology
Gastric Bypass
Gene Expression Regulation, Enzymologic
Humans
Isoenzymes - genetics - metabolism
Liver - enzymology - metabolism - pathology
Male
Metabolic Syndrome X - complications - epidemiology - metabolism - pathology
Middle Aged
Non-alcoholic Fatty Liver Disease - complications - epidemiology - metabolism - pathology
Obesity, Morbid - complications - surgery
Risk
Triglycerides - blood - metabolism
Abstract
Non-alcoholic steatohepatitis (NASH) is associated with changes in fatty acid (FA) metabolism. However, specific changes in metabolism and hepatic mRNA expression related to NASH independent of simple steatosis, obesity and diet are unknown.
Liver histology, serum and liver FA composition and estimated enzyme activities based on the FA ratios in cholesteryl esters and triglycerides were assessed in 92 obese participants of the Kuopio Obesity Surgery Study (KOBS) divided to those with normal liver, steatosis or NASH (30 men and 62 women, age 46.8±9.5years (mean±SD), BMI 44.2±6.2kg/m(2)). Plasma FA composition was also investigated in the Metabolic Syndrome in Men (METSIM) Study (n=769), in which serum alanine aminotransferase (ALT) was used as a marker of liver disease.
Obese individuals with NASH had higher activity of estimated activities of delta-6 desaturase (D6D, p
PubMed ID
27085774 View in PubMed
Less detail
Source
Duodecim. 2016;132(18):1707-13
Publication Type
Article
Author
Ville Männistö
Jussi Pihlajamäki
Source
Duodecim. 2016;132(18):1707-13
Language
English
Publication Type
Article
Keywords
Diagnosis, Differential
Disease Progression
Fatty Liver - diagnosis - epidemiology - etiology
Finland - epidemiology
Humans
Incidental Findings
Overweight - epidemiology
Risk factors
Abstract
Approximately one third of the Finnish adult population are affected with overweight-related non-alcoholic fatty liver disease (NAFLD). NAFLD can appear as a simple fat accumulation in the liver of the liver, but in some individuals the condition may advance to non-alcoholic steatohepatitis (NASH) and even to liver cirrhosis. In many cases, NAFLD is detected as an incidental finding. In differential diagnosis, the most common alternatives are alcohol use, drugs and viral hepatites. For a patient with NAFLD, the risk factors of cardiovascular diseases should be investigated and the possibility of having NASH and liver fibrosis assessed. Targeted therapy for NASH is not yet available.
PubMed ID
29188949 View in PubMed
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Gene-diet interaction of a common FADS1 variant with marine polyunsaturated fatty acids for fatty acid composition in plasma and erythrocytes among men.

https://arctichealth.org/en/permalink/ahliterature277476
Source
Mol Nutr Food Res. 2016 Feb;60(2):381-9
Publication Type
Article
Date
Feb-2016
Author
Markus J Takkunen
Vanessa D de Mello
Ursula S Schwab
Johanna Kuusisto
Maija Vaittinen
Jyrki J Ågren
Markku Laakso
Jussi Pihlajamäki
Matti I J Uusitupa
Source
Mol Nutr Food Res. 2016 Feb;60(2):381-9
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Aged
Cross-Sectional Studies
Eicosapentaenoic Acid - blood
Erythrocytes - drug effects - physiology
Fatty Acid Desaturases - genetics
Fatty Acids - blood - genetics
Fatty Acids, Omega-3 - blood - pharmacology
Fatty Acids, Unsaturated - pharmacology
Finland
Fish Oils - pharmacology
Food Habits
Humans
Liver - physiology
Male
Metabolic Syndrome X - blood - genetics
Middle Aged
Obesity - blood - genetics - surgery
Abstract
Limited information exists on how the relationship between dietary intake of fat and fatty acids in erythrocytes and plasma is modulated by polymorphisms in the FADS gene cluster. We examined gene-diet interaction of total marine PUFA intake with a known gene encoding ?-5 desaturase enzyme (FADS1) variant (rs174550) for fatty acids in erythrocyte membranes and plasma phospholipids (PL), cholesteryl esters (CE), and triglycerides (TG).
In this cross-sectional study, fatty acid compositions were measured using GC, and total intake of polyunsaturated fat from fish and fish oil was estimated using a food frequency questionnaire in a subsample (n = 962) of the Metabolic Syndrome in Men Study. We found nominally significant gene-diet interactions for eicosapentaenoic acid (EPA, 20:5n-3) in erythrocytes (pinteraction = 0.032) and for EPA in plasma PL (pinteraction = 0.062), CE (pinteraction = 0.035), and TG (pinteraction = 0.035), as well as for docosapentaenoic acid (22:5n-3) in PL (pinteraction = 0.007). After excluding omega-3 supplement users, we found a significant gene-diet interaction for EPA in erythrocytes (pinteraction
PubMed ID
26501394 View in PubMed
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Lipoprotein subclass metabolism in nonalcoholic steatohepatitis.

https://arctichealth.org/en/permalink/ahliterature267232
Source
J Lipid Res. 2014 Dec;55(12):2676-84
Publication Type
Article
Date
Dec-2014
Author
Ville T Männistö
Marko Simonen
Pasi Soininen
Mika Tiainen
Antti J Kangas
Dorota Kaminska
Sari Venesmaa
Pirjo Käkelä
Vesa Kärjä
Helena Gylling
Mika Ala-Korpela
Jussi Pihlajamäki
Source
J Lipid Res. 2014 Dec;55(12):2676-84
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Cholesterol - blood - metabolism
Cholesterol, VLDL - blood - metabolism
Female
Finland
Gastric Bypass
Hospitals, University
Humans
Hyperlipidemias - etiology - prevention & control
Lipids - analysis - blood
Lipoproteins, HDL - blood - metabolism
Lipoproteins, LDL - blood - metabolism
Lipoproteins, VLDL - blood - metabolism
Liver - immunology - metabolism - pathology
Liver Cirrhosis - etiology
Male
Middle Aged
Non-alcoholic Fatty Liver Disease - etiology - immunology - metabolism - pathology
Obesity, Morbid - physiopathology - surgery
Abstract
Nonalcoholic steatohepatitis (NASH) is associated with increased synthesis of triglycerides and cholesterol coupled with increased VLDL synthesis in the liver. In addition, increased cholesterol content in the liver associates with NASH. Here we study the association of lipoprotein subclass metabolism with NASH. To this aim, liver biopsies from 116 morbidly obese individuals [age 47.3 ± 8.7 (mean ± SD) years, BMI 45.1 ± 6.1 kg/m², 39 men and 77 women] were used for histological assessment. Proton NMR spectroscopy was used to measure lipid concentrations of 14 lipoprotein subclasses in native serum samples at baseline and after obesity surgery. We observed that total lipid concentration of VLDL and LDL subclasses, but not HDL subclasses, associated with NASH [false discovery rate (FDR)
Notes
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PubMed ID
25344588 View in PubMed
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Persistent organic pollutants and non-alcoholic fatty liver disease in morbidly obese patients: a cohort study.

https://arctichealth.org/en/permalink/ahliterature272721
Source
Environ Health. 2015;14:79
Publication Type
Article
Date
2015
Author
Panu Rantakokko
Ville Männistö
Riikka Airaksinen
Jani Koponen
Matti Viluksela
Hannu Kiviranta
Jussi Pihlajamäki
Source
Environ Health. 2015;14:79
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Alanine Transaminase - blood
Bariatric Surgery - statistics & numerical data
Biomarkers - blood
Cohort Studies
Environmental pollutants - blood
Female
Finland - epidemiology
Humans
Male
Middle Aged
Non-alcoholic Fatty Liver Disease - chemically induced - epidemiology - pathology
Obesity, Morbid - complications - epidemiology
Abstract
In animal experiments persistent organic pollutants (POPs) cause hepatosteatosis. In epidemiological studies POPs have positive associations with serum markers of nonalcoholic fatty liver disease (NAFLD) and together with obesity synergistic association with insulin resistance. Because insulin resistance and obesity are critical in NAFLD pathogenesis, we investigated the association of serum pollutant levels with liver histology and alanine aminotransferase (ALT) in morbidly obese.
Liver biopsies were from 161 participants of the Kuopio Obesity Surgery Study (KOBS) who underwent bariatric surgery 2005-2011. Liver histology was categorized as normal, steatosis and non-alcoholic steatohepatitis (NASH). Liver phenotype at baseline and ALT at baseline and 12 months post-surgery were correlated to serum POP concentrations at respective time points. As lipophilic POPs concentrate to smaller fat volume during weight loss, serum levels before and 12 months after bariatric surgery were compared.
Baseline serum concentration of PCB-118, ?-HCH and several PFAAs had an inverse association with lobular inflammation possibly due to changes in bile acid metabolism. ALT had negative associations with many POPs at baseline that turned positive at 12 months after major clinical improvements. There was an interaction between some POPs and sex at 12 months, and in stratified data positive associations were observed mainly in females but not in males.
We found a negative association between serum concentrations of PCB-118, ?-HCH and several PFAAs with lobular inflammation at baseline. Positive POPs-ATL associations at 12 months among women suggest that increased POP concentrations may decrease the degree of liver recovery.
Notes
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PubMed ID
26420011 View in PubMed
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A population-based study on the prevalence of NASH using scores validated against liver histology.

https://arctichealth.org/en/permalink/ahliterature262860
Source
J Hepatol. 2014 Apr;60(4):839-46
Publication Type
Article
Date
Apr-2014
Author
Jenni Hyysalo
Ville T Männistö
You Zhou
Johanna Arola
Vesa Kärjä
Marja Leivonen
Anne Juuti
Nabil Jaser
Susanna Lallukka
Pirjo Käkelä
Sari Venesmaa
Marko Simonen
Juha Saltevo
Leena Moilanen
Eeva Korpi-Hyövalti
Sirkka Keinänen-Kiukaanniemi
Heikki Oksa
Marju Orho-Melander
Luca Valenti
Silvia Fargion
Jussi Pihlajamäki
Markku Peltonen
Hannele Yki-Järvinen
Source
J Hepatol. 2014 Apr;60(4):839-46
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Biopsy
Cohort Studies
Diabetes Mellitus, Type 2 - complications
Female
Finland - epidemiology
Humans
Insulin Resistance
Italy - epidemiology
Lipase - genetics
Liver - pathology
Male
Membrane Proteins - genetics
Metabolic Syndrome X - complications
Middle Aged
Non-alcoholic Fatty Liver Disease - epidemiology - etiology - pathology
Obesity - complications
Prevalence
Risk factors
Young Adult
Abstract
Non-alcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease in Western countries. Diagnosis of NASH requires a liver biopsy. We estimated the prevalence of NASH non-invasively in a population-based study using scores validated against liver histology.
Clinical characteristics, PNPLA3 genotype at rs738409, and serum cytokeratin 18 fragments were measured in 296 consecutive bariatric surgery patients who underwent a liver biopsy to discover and validate a NASH score ('NASH score'). We also defined the cut-off for NASH for a previously validated NAFLD liver fat score to diagnose NASH in the same cohort ('NASH liver fat score'). Both scores were validated in an Italian cohort comprising of 380, mainly non-bariatric surgery patients, who had undergone a liver biopsy for NASH. The cut-offs were utilized in the Finnish population-based D2D-study involving 2849 subjects (age 45-74 years) to estimate the population prevalence of NASH.
The final 'NASH Score' model included PNPLA3 genotype, AST and fasting insulin. It predicted NASH with an AUROC 0.774 (0.709, 0.839) in Finns and 0.759 (0.711, 0.807) in Italians (NS). The AUROCs for 'NASH liver fat score' were 0.734 (0.664, 0.805) and 0.737 (0.687, 0.787), respectively. Using 'NASH liver fat score' and 'NASH Score', the prevalences of NASH in the D2D study were 4.2% (95% CI: 3.4, 5.0) and 6.0% (5.0, 6.9%). Sensitivity analysis was performed by taking into account stochastic false-positivity and false-negativity rates in a Bayesian model. This analysis yielded population prevalences of NASH of 3.1% (95% stimulation limits 0.2-6.8%) using 'NASH liver fat score' and 3.6% (0.2-7.7%) using 'NASH Score'.
The population prevalence of NASH in 45-74 year old Finnish subjects is ~ 5%.
PubMed ID
24333862 View in PubMed
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