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Gender differences in the modifiable risk factors associated with the presence of prediabetes: A systematic review.
Siddiqui, S, Zainal, H, Harun, SN, Sheikh Ghadzi, SM, Ghafoor, S
Diabetes & metabolic syndrome. 2020;(5):1243-1252
Abstract
BACKGROUND Prediabetes is a risk state for the future development of type 2 diabetes. Previously, it was evident that the risk factors for diabetes differ by gender. However, conclusive evidence regarding the gender difference in modifiable risk factors associated with the presence of pre-diabetes is still lacking. AIMS To systematically identify and summarize the available literature on whether the modifiable risk factors associated with prediabetes displays similar relationship in both the genders. METHODS A systematic search was performed on electronic databases i.e. PubMed, EBSCOhost, and Scopus using "sex", "gender", "modifiable risk factors" and "prediabetes" as keywords. Reference list from identified studies was used to augment the search strategy. Methodological quality and results from individual studies were summarized in tables. RESULTS Gender differences in the risk factor association were observed among reviewed studies. Overall, reported association between risk factors and prediabetes apparently stronger among men. In particular, abdominal obesity, dyslipidemia, smoking and alcohol drinking habits were risk factors that showed prominent association among men. Hypertension and poor diet quality may appear to be stronger among women. General obesity showed stringent hold, while physical activity not significantly associated with the risk of prediabetes in both the genders. CONCLUSIONS Evidence suggests the existence of gender differences in risk factors associated with prediabetes, demands future researchers to analyze data separately based on gender. The consideration and the implementation of gender differences in health policies and in diabetes prevention programs may improve the quality of care and reduce number of diabetes prevalence among prediabetic subjects.
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Recommendations for Management and Treatment of Nonalcoholic Steatohepatitis.
Ratziu, V, Ghabril, M, Romero-Gomez, M, Svegliati-Baroni, G
Transplantation. 2019;(1):28-38
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Abstract
The prevalence of nonalcoholic liver disease (NAFLD) is increasing worldwide in conjunction with the epidemic increase in obesity and metabolic risk factors. Consequently, NAFLD has become a leading indication for liver transplantation. Although genetic factors play an important role in the pathogenesis of NAFLD, detrimental lifestyle trends favoring a calorically unrestricted diet rich in carbohydrates and unsaturated fat, prolonged sedentary periods or limited physical activity have major metabolic implications. In aggregate these physiological dysregulations constitute the main risk factors for the metabolic syndrome and NAFLD. The cornerstone of the treatment of NAFLD, is lifestyle changes, including modifications to diet and physical activity, to reduce body weight and liver fat, however adherence is notoriously poor and the epidemic of NAFLD continues to grow unimpeded. In the face of this unmet clinical need, the pharmacologic therapy of NAFLD has been expanding as the varied mechanistic pathways of NAFLD are elucidated. Beyond these approaches to treating NAFLD, the prevention of other liver diseases is additionally important. Chief among these is alcoholic liver disease, and heavy use is detrimental irrespective of underlying NAFLD. However, the impact of mild to moderate alcohol use in patients with mild or nonadvanced forms NAFLD is undefined. This article summarizes the results of the International Liver Transplantation Society consensus meeting on NAFLD in liver transplantation. It describes the available evidence and provides consensus guidance on the lifestyle and pharmacologic therapies of NAFLD, and the consensus position on alcohol use in patients with NAFLD.
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Prevalence of risk factors for liver disease in a random population sample in southern Germany.
Huetter, ML, Fuchs, M, Hänle, MM, Mason, RA, Akinli, AS, Imhof, A, Kratzer, W, Lorenz, R, ,
Zeitschrift fur Gastroenterologie. 2014;(6):558-63
Abstract
BACKGROUND Chronic liver disease leads to fibrosis and cirrhosis of the liver. This may, in turn, result in chronic liver failure or the development of hepatocellular carcinoma (HCC). Main risk factors for chronic liver disease are viral hepatitis and alcoholism. The present study assessed a randomly selected population in southern Germany for risk factors for chronic liver disease such as fatty liver disease, viral hepatis infection and life-style factors. In addition, the potential association with elevated liver enzymes was investigated. METHODS A total of 2256 subjects (1182 females, 1074 males), aged 18 - 65 years, participated in the study. Each subject underwent a standardized ultrasound examination, and anthropometric and biochemical assessments. Test subjects were randomly selected from the general population of a town in southwestern Germany. Data were acquired from November to December 2002 without further follow-up. RESULTS Several factors were found to be associated with chronic liver disease in the study population. Alcohol consumption >20 g/d was seen in 18.1% (n=409). Metabolic syndrome was diagnosed in 5.9% (n=132). The number of people with a BMI greater than 25 kg/m(2) was 45.1% (n=1017). The prevalence of subjects with chronic hepatitis B was 0.7% (n=15), that of anti-HCV positive patients, 0.6%(n=15). Elevated gGT was seen in 10.4% (n=14) of the patients. Prevalence of hepatic steatosis was 25.0% (n=564). CONCLUSIONS Many cases of chronic liver disease could be prevented by healthy nutrition, optimized medical treatment of associated disorders, and prevention strategies such as routine vaccination, in particular, against hepatitis B virus (HBV).
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[Alcohol consumption and metabolic syndrome].
Fujita, N, Takei, Y
Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence. 2010;(3):157-66
Abstract
Drinking excessive amounts of alcohol regularly for years is toxic to almost every tissue of the body. On the other hand, epidemiological and clinical evidence shows that light-to-moderate drinking is associated with a reduced risk of coronary heart disease, total and ischemic stroke, and mortality. In the past two decades, metabolic syndrome, the combination of obesity, hypertension, dyslipidemia and hyperglycemia, all are also recognized as major cardiovascular risk factors, has given rise to much clinical and research attention, because of its high prevalence in the world. Therefore, it is of interest to evaluate the overall associations of alcohol consumption with the development of the metabolic syndrome. Recently, the protective, detrimental, or J-shaped associations have been reported between alcohol consumption and the metabolic syndrome. This controversy may be due to the complex mechanistic relation between alcohol consumption and each component of metabolic syndrome, and almost all studies have various limitations and problem points. Prospective studies are therefore needed to confirm the association between alcohol consumption and prevalence of metabolic syndrome, and to assess the influence of alcohol drinking patterns and other possible factors, such as smoking, physical activity, socio-economic status, education, occupation, diet, and exercise. This article reviews the relation of alcohol consumption and components of the metabolic syndrome, and discusses the epidemiological evidence for alcohol's putative vascular protective effects and plausible underlying biological mechanisms.
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[Practical strategies for lifestyle modification in people with hyperuricemia and gout treatment through diet, physical activity, and reduced alcohol consumption].
Mineo, I, Kamiya, H, Tsukuda, A
Nihon rinsho. Japanese journal of clinical medicine. 2008;(4):736-41
Abstract
There has been an explosive increase in the prevalence of hyperuricemia and gout in Japan, suggesting the recent lifestyle change may be a key factor leading to this pathophysiological condition. In addition, people with hyperuricemia are often associated with various morbid conditions constituting the metabolic syndrome, such as abdominal obesity, hypertension, dyslipidemia and impaired glucose tolerance. Therefore, healthy lifestyle interventions would be a basic therapeutic approach not only to hyperuricemia but to metabolic syndrome, though it is not easy to promote behaviour changes. This review focuses on strategies for lifestyle intervention for clinical practice, including how we advise patients on appropriate diets, physical activity and alcoholic beverage consumption.
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[Interactions between alcohol and work exposure to chemical substances].
Toffoletto, F, Crippa, M, Torri, D
La Medicina del lavoro. 2007;(6):513-20
Abstract
BACKGROUND AND OBJECTIVES The quite diffused habit of a significant assumption of alcohol drinks, can interfere with the professional exposure to chemical substances. The interaction may result in increasing their toxicity and/or modifying the parameters of the biological monitoring. It may also act as a confounding factor, not only in epidemiologic researches but also at individual level when the assessment of the occupational exposure and/or the diagnosis of an occupational diseases, is under consideration. We review available references in the literature summarizing major scientific evidences. RESULTS The interaction between the alcohol assumption and industrial chemicals may be toxicokinetic or toxicodynamic. Alcohol can interfere in the processes of biotransformation of xenobiotics and modify the doses and the effect indicators used for the biological monitoring, causing wrong interpretations of the results. The metabolism of ethanol can be altered by the exposures to toxic industrial materials, creating some clinical pictures of alcohol intolerance, like an "antabuse syndrome" or an "degreaser flush syndrome". Professional exposure to carbon sulfide or to dimethylformamides, trichloroethylene as well as to nitroglycerin and nitroglycole ethylenic can produce similar syndromes. Interactions are reported between alcohol and solvents: on toxicokinetic bases for methanol, isopropanol, glycol ether, trichloroethylene, methyl ethyl ketone and toluene; and on toxicodynamic bases for CNS. Also between alcohol and metals there can occur toxicokinetic interactions, like in the case of lead and mercury. Alcohol can also interfere with the biological monitoring of solvents, producing an over-estimation of the exposure. CONCLUSIONS For the biological monitoring of reported chemical substances, it is suitable to evaluate the biologic indicators in the days in which there is not assumed alcohol. If this cannot be guaranteed, it is necessary to know at least the quantity of the alcohol consumed or at least if the subject is an alcohol abuser.
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[Alcohol-induced gastrointestinal diseases].
Szalay, F
Orvosi hetilap. 2003;(34):1659-66
Abstract
UNLABELLED Alcohol induced gastrointestinal diseases are common and significant, and may lead to early death. The annual death caused by alcoholic liver disease and pancreatitis in Hungary is up to 8000. Metabolites, mainly acetaldehyde and free radicals are responsible for the injury. Although the alcohol itself is not carcinogenic, some maligancies are more common among alcoholics. AIM AND METHODS In this review the hepatic and extrahepatic metabolism of alcohol, the epidemiology, pathomechanism, clinical signs of the alcohol induced organ damages and the treatment options are summarized. RESULTS Type IV alcoholdehydrogenase in the stomach has a role in the first pass metabolism. The liver is the main place of the metabolism. If the amount of alcohol exceeds the metabolising capacity, the toxic substances cause lipidperoxidation, membrane and organ injury. Alcohol metabolism is different in the pancreas, the activity of fatty acid ethanol ester synthase activity is more pronounced. In alcoholics the leukoplakia, oropharingeal carcinoma, oesophagitis, Mallory-Weiss syndrome, liver cirrhosis related oesophageal variceal bleeding, chronic gastritis, liver diseases, pancreatitis, bowel motility disorders, malabsorption and colorectal carcinoma are more frequent. The fatty liver remains reversible for a long. Following steatohepatitis, fibrosis, cirrhosis and liver carcinoma may develop. Despite growing knowledge of the role of endotoxins, cytokines, nutritional, immunological and genetic factors, it is still unknown why the given disease will develop in a patient, and there is no parameter for determining the point of irreversibility of the alterations. The possibilities for medical treatment are limited, since some patients do not cooperate properly, and on the other hand, the drugs and measurements can control only a part of the whole process (antioxidants, anti-inflammatory drugs, monoclonal anti-cytokine antibodies), and are appropriate only for the treatment of complications as ascites, portal hypertension, oesophageal varices, portosystemic encephalopathy, malabsortion, infections, vitamin deficiency. CONCLUSIONS Therefore the prevention and abstinence are very important. The task of the general practitioner and the role of the cooperation among the patient, the physician, the family and the community are very important.