Objective The therapeutic effect of pemafibrate on metabolic dysfunction-associated fatty liver disease (MAFLD) remains unknown. This retrospective, single-arm study investigated the efficacy and ...safety of pemafibrate in MAFLD patients with hypertriglyceridemia. Methods A total of 10 patients who received pemafibrate (oral, 0.1 mg, twice a day) at Gunma Saiseikai Maebashi Hospital between September 2018 and September 2019 were included. All patients underwent a liver biopsy, and the disease grade and stage were pathologically assessed based on the FLIP algorithm. Results The median age was 66.0 (53.8-74.8) years old, and 5 patients (50.0%) were men. All patients were diagnosed with non-alcoholic steatohepatitis (NASH). The fasting and non-fasting triglyceride (TG) levels were 175 (149-247) mg/dL and 228 (169-335) mg/dL, respectively. The AST and ALT values at 6 months were significantly lower than at baseline AST: 28.0 (22.0-33.8) U/L vs. 43.5 (24.0-55.0) U/L, p=0.008, ALT: 23.0 (14.8-26.5) U/L vs. 51.5 (23.0-65.3) U/L, p=0.005, respectively, especially in NASH patients with significant activity and advanced fibrosis (p=0.040 and 0.014, respectively). Fasting TG levels were significantly lower and HDL-C levels significantly higher at 6 months than at baseline (p=0.005 and 0.032, respectively). At six months, FIB-4, the aspartate aminotransferase-to-platelet ratio index, and the macrophage galactose-specific lectin-2 binding protein glycosylation isomer level were significantly improved compared with baseline (p=0.041, 0.005 and 0.005, respectively). Treatment-related adverse events were not observed. Conclusion Pemafibrate treatment may be safe and effective for MAFLD patients with hypertriglyceridemia.
A 66-year-old man, who had undergone plasma exchange 30 years previously in Egypt for the treatment of falciparum malaria, was referred to our hospital for treatment of chronic hepatitis C (HCV). An ...analysis of the 655-nucleotide 5′-untranslated region-core region sequence revealed infection with HCV subtype 1g. A phylogenetic analysis of the full-length HCV genome confirmed that the patient's HCV was subtype 1g, which was the first case identified in Japan. Although his HCV possessed several naturally occurring resistance-associated substitutions in the nonstructural (NS) 3 and NS5A regions, he was successfully treated by combination therapy with glecaprevir/pibrentasvir.
An 81‐year‐old man initially underwent right hepatic lobectomy for liver cancer and was pathologically diagnosed with combined hepatocellular and cholangiocarcinoma (CHC). At 13 months after ...resection, multiple lymph node metastases were observed. We started atezolizumab plus bevacizumab (Atez/Bev), achieving a 7.5‐month progression‐free survival. Atez/Bev might exhibit efficacy for CHC patients.
Although no standard systemic chemotherapy for combined hepatocellular and cholangiocarcinoma patients has yet been established, atezolizumab plus bevacizumab, which is a combination therapy of anti‐programmed death ligand‐1 and anti‐vascular endothelial growth factor, might exhibit good therapeutic outcome.
Type 2 diabetes mellitus (T2DM) is a complex endocrine and metabolic disorder. Recently, several genome-wide association studies (GWAS) have identified many novel susceptibility loci for T2DM, and ...indicated that there are common genetic causes contributing to the susceptibility to T2DM in multiple populations worldwide. In addition, clinical and epidemiological studies have indicated that obesity is a major risk factor for T2DM. However, the prevalence of obesity varies among the various ethnic groups. We aimed to determine the combined effects of these susceptibility loci and obesity/overweight for development of T2DM in the Japanese.
Single nucleotide polymorphisms (SNPs) in or near 17 susceptibility loci for T2DM, identified through GWAS in Caucasian and Asian populations, were genotyped in 333 cases with T2DM and 417 control subjects.
We confirmed that the cumulative number of risk alleles based on 17 susceptibility loci for T2DM was an important risk factor in the development of T2DM in Japanese population (P<0.0001), although the effect of each risk allele was relatively small. In addition, the significant association between an increased number of risk alleles and an increased risk of T2DM was observed in the non-obese group (P<0.0001 for trend), but not in the obese/overweight group (P=0.88 for trend).
Our findings indicate that there is an etiological heterogeneity of T2DM between obese/overweight and non-obese subjects.
Aim The therapeutic effect of pemafibrate on metabolic dysfunction-associated fatty liver disease (MAFLD) remains unknown. This retrospective, single-arm study investigated the efficacy and safety of ...pemafibrate in MAFLD patients with hypertriglyceridemia. Methods A total of 10 patients who received pemafibrate (oral, 0.1 mg, twice a day) at Gunma Saiseikai Maebashi Hospital between September 2018 and September 2019 were included. All patients underwent a liver biopsy, and the disease grade and stage were pathologically assessed based on the FLIP algorithm. Results The median age was 66.0 (53.8-74.8) years old, and 5 patients (50.0%) were men. All patients were diagnosed with non-alcoholic steatohepatitis (NASH). The fasting and non-fasting triglyceride (TG) levels were 175 (149-247) mg/dL and 228 (169-335) mg/dL, respectively. The AST and ALT values at 6 months were significantly lower than at baseline (AST: 28.0 22.0-33.8 U/L vs. 43.5 24.0-55.0 U/L, p=0.008, ALT: 23.0 14.8-26.5 U/L vs. 51.5 23.0-65.3 U/L, p=0.005, respectively), especially in NASH patients with significant activity and advanced fibrosis (p=0.040 and 0.014, respectively). Fasting TG levels were significantly lower and HDL-C levels significantly higher at 6 months than at baseline (p=0.005 and 0.032, respectively). At six months, FIB-4, the aspartate aminotransferase-to-platelet ratio index, and the macrophage galactose-specific lectin-2 binding protein glycosylation isomer level were significantly improved compared with baseline (p=0.041, 0.005 and 0.005, respectively). Treatment-related adverse events were not observed. Conclusions Pemafibrate treatment may be safe and effective for MAFLD patients with hypertriglyceridemia.
A 66-year-old man, who had undergone plasma exchange 30 years previously in Egypt for the treatment of falciparum malaria, was referred to our hospital for treatment of chronic hepatitis C (HCV). An ...analysis of the 655-nucleotide 5'-untranslated region-core region sequence revealed infection with HCV subtype 1g. A phylogenetic analysis of the full-length HCV genome confirmed that the patient's HCV was subtype 1g, which was the first case identified in Japan. Although his HCV possessed several naturally occurring resistance-associated substitutions in the nonstructural (NS) 3 and NS5A regions, he was successfully treated by combination therapy with glecaprevir/pibrentasvir.
FibroScan-AST (FAST) score, which is calculated based on aspartate transaminase, controlled attenuation parameter, and liver stiffness measurement, was recently reported to be useful as a ...non-invasive assessment for non-alcoholic fatty liver disease (NASH) patients with significant activity non-alcoholic fatty liver disease (NAFLD) activity score of ≥4 and advanced fibrosis (F≥2). The aim of this retrospective study was to investigate the usefulness of FAST score for Japanese patients with NAFLD. A total of 34 patients who received liver biopsy between April 2018 and March 2020 at Gunma Saiseikai Maebashi Hospital were included. The cut-off value for FAST score was 0.43, with 92.9% sensitivity, 75.0% specificity, and area under the receiver operating characteristic curve (95% confidence interval) of 0.86 (0.74-0.99). In conclusion, FAST score is a useful tool for identifying NASH patients with significant activity and advanced fibrosis. Further study is warranted to establish the optimum cut-off value of FAST score in Japanese patients.
活動性の炎症（NAS≥4）と進行した線維化（F≧2）を伴う非アルコール性脂肪肝炎（NASH）症例を，非侵襲的に同定する方法としてFibroScan-AST（FAST）スコアの有用性が近年報告された．これはASTとFibroScanで測定された肝硬度とCAPを用いて算出される．本研究では日本人におけるFASTスコアの有用性を後ろ向きに検討した．2018年4月から2020年3月まで当院で経皮的肝生検で非アルコール性脂肪性肝疾患と診断した34例を対象とした．FASTスコアが0.43のとき，感度は92.9%，特異度は75.0%で，AUROCは0.86（95% CI 0.74-0.99）で，他の非侵襲的指標と比較して最も良好であった．FASTスコアは活動性の炎症と進行した線維化を伴うNASH症例の拾い上げに有用なツールであった．さらなる症例の集積で日本人の最適なカットオフ値の確立が望まれる．
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