|By PR Newswire||
|April 10, 2014 01:01 AM EDT||
LONDON, April 10, 2014 /PRNewswire/ --
Two new studies presented today at the International Liver Congress[TM] 2014 have provided more evidence to clarify the role of non-alcoholic fatty liver disease (NAFLD) as an independent risk factor for the development of cardiovascular disease (CVD).
In the first long-term study[i], in patients at high CVD risk, NAFLD was shown to contribute to the progression of early atherosclerosis independently of traditional CVD risk factors. In a second long-term study[ii], NAFLD was confirmed as a significant long-term risk factor for the development of diabetes mellitus (DM). Importantly, those patients showing signs of an improvement in the fatty appearance of their liver in response to treatment then had a reduced risk of going on to develop diabetes.
NAFLD describes a range of conditions where there is a build-up of fat in the liver cells in people who do not drink alcohol excessively. It is rapidly becoming the most common liver disease worldwide, particularly so in the Western world with an estimated prevalence of 20 - 30%. In many cases, NAFLD is linked to being obese or overweight.
Presenting the results of these two studies, EASL's Educational Councillor Professor Jean-Francois Dufour of the University Clinic for Visceral Surgery and Medicine, University of Bern, Switzerland said: "We now have a strong body of evidence that NAFLD may pose a CVD risk above and beyond that conferred by traditional CVD risk factors, such as dyslipidemia, diabetes and smoking. This means that healthcare providers managing patients with NAFLD should take this factor into account in the CVD risk stratification, although the best way to implement this remains to be defined," he added.
NAFLD an early independent predictor of carotid atherosclerotic disease
In a long-term study, patients with NAFLD had a higher prevalence of carotid plaques (44 vs. 37%; p< 0.001), a higher carotid intima-media thickness (C-IMT) (0.64±0.14 vs. 0.61±0.13; p< 0.001), and a higher Framingham score, which measured their 10-year CVD risk (15±9% vs. 8±7%; p< 0.001).
The presence of NAFLD also predicted whether that patient had thickening of the carotid intima-media (beta=0.037; p=0.005), and evidence of early carotid plaques (OR=1.21; 95%CI: 1.03-1.42; p=0.02), independently of the patients' age, sex, BMI, hypertension and tobacco use.
C-IMT significantly increased in those patients who developed signs of NAFLD (0.60±0.13 to 0.64±0.14; p=0.01). Using a Cox model, NAFLD at baseline predicted the occurrence of carotid plaques (OR=1.27; 95%CI: 1.009-1.613; p< 0.05), independently of age, sex, diabetes and high BP.
"Whether NAFLD is incidentally or causally associated to early carotid atherosclerosis has previously been the subject of much debate," said Professor Dufour. "While there are case-control studies that have demonstrated a significant and independent relationship between NAFLD and carotid atherosclerotic disease, up until now, long-term follow-up data have been missing."
Patients recruited to this study had more than two CVD risk factors without previous CVD events, known liver disease, and drinking < 50g of alcohol/day. C-IMT was measured using carotid ultrasonography with carotid plaques defined as C-IMT>1mm at the carotid bifurcation. Results were validated in a long-term follow-up cohort of patients with two C-IMT measurements at >1-year interval.
The Fatty Liver Index (FLI), a surrogate marker of hepatic steatosis when ≥60 years old, and the Framingham cardiovascular risk score (FRS) were calculated.
5,671 patients underwent at least one C-IMT measurement: 52% males; mean age 52±11years; mean BMI = 26.1±4.7; 33% NAFLD; 39% CP, mean C-IMT 0.62±0.13mm. 1,872 patients had 2 C-IMT measurements.
During the 8±4 year follow-up, NAFLD occurred in 12% and carotid plaques in 22% of the patients.
Improvement of NAFLD is associated with a reduced risk of developing DM
A 10-year longitudinal study has confirmed that NAFLD is a significant risk factor for the development of diabetes, and improvement of NAFLD through treatment is associated with a reduced risk of developing diabetes (in submission).
In this study of 3,074 Japanese patients, 117 participants (16.1%) in the NAFLD group developed diabetes during a 10 year follow-up period, compared to only 72 participants (3.1%) in the non-NAFLD group (p< 0.001). The multivariate odds ratio was 2.82 (95% confidence interval: 1.91-4.15) in the NAFLD group compared to the non-NAFLD group.
Moreover, 7 participants (6.4%) in the improved group developed diabetes compared to 110 participants (17.8%) in the non-improved group. In the improved group, the multivariate odds ratio was 0.30 (95% CI: 0.13-0.66), in comparison to the non-improved group.
"Evidence from previous longitudinal studies has demonstrated a clear link between NAFLD and the development of DM," said Professor Dufour. "However, this is the first study to show that DM can be prevented if NAFLD is improved," he explained.
"A multidisciplinary approach is therefore required in the treatment of NAFLD patients, taking into account the presence of NAFLD as a critical part of diabetes prevention and care. New clinical trials to investigate the beneficial effects of anti-diabetes drugs on NAFLD histology, and the potential impact of anti-diabetes drugs on diabetes incidence and cardiovascular risk in non-diabetic patients with early-stage NAFLD are now underway," Professor Dufour concluded.
8,070 participants who had a health check twice between 2000 and 2012 with 10 years between each check were enrolled into this study. An inclusion criterion included having had abdominal ultrasounds during the first and second visits. Exclusion criteria included alcohol use ≧20g/day, positive HBs antigen, positive HCV antibody, and diabetes mellitus at baseline.
The 3,074 eligible participants were divided into the NAFLD group (n=728) and non-NAFLD group (n=2,346), according to ultrasonography-detected fatty liver.
The NAFLD group was then further categorised into the improved group (n=110) and non-improved group (n=618), based on fatty liver disappearance at the second health check. Multivariate odds ratios for the development of DM were estimated by a logistic regression model.
i. R.Pais et al. NAFLD IS AN INDEPENDENT PREDICTOR OF EARLY CAROTID ATHEROSCLEROSIS: RESULTS FROM A LARGE TRANSVERSAL STUDY AND LONG-TERM FOLLOW-UP VALIDATION COHORT. Abstract presented at the International Liver CongressTM 2014
ii. H.Yamazaki et al. DECREASED DEVELOPMENT OF DIABETES MELLITUS WITH IMPROVEMENT OF NONALCOHOLIC FATTY LIVER DISEASE: A 10-YEAR JAPANESE COHORT STUDY Abstract presented at the International Liver CongressTM 2014
For further information on the studies, or to request an interview, please do not hesitate to contact the EASL Press Office on:
Email: [email protected]
Helena Symeou +44-7976562430
Courtney Lock +44-7894-386-422
Today we can collect lots and lots of performance data. We build beautiful dashboards and even have fancy query languages to access and transform the data. Still performance data is a secret language only a couple of people understand. The more business becomes digital the more stakeholders are interested in this data including how it relates to business. Some of these people have never used a monitoring tool before. They have a question on their mind like “How is my application doing” but no id...
Aug. 26, 2016 11:15 PM EDT Reads: 1,739
Actian Corporation has announced the latest version of the Actian Vector in Hadoop (VectorH) database, generally available at the end of July. VectorH is based on the same query engine that powers Actian Vector, which recently doubled the TPC-H benchmark record for non-clustered systems at the 3000GB scale factor (see tpc.org/3323). The ability to easily ingest information from different data sources and rapidly develop queries to make better business decisions is becoming increasingly importan...
Aug. 26, 2016 10:45 PM EDT Reads: 2,054
SYS-CON Events announced today that 910Telecom will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Housed in the classic Denver Gas & Electric Building, 910 15th St., 910Telecom is a carrier-neutral telecom hotel located in the heart of Denver. Adjacent to CenturyLink, AT&T, and Denver Main, 910Telecom offers connectivity to all major carriers, Internet service providers, Internet backbones and ...
Aug. 26, 2016 10:00 PM EDT Reads: 1,837
Kubernetes, Docker and containers are changing the world, and how companies are deploying their software and running their infrastructure. With the shift in how applications are built and deployed, new challenges must be solved. In his session at @DevOpsSummit at19th Cloud Expo, Sebastian Scheele, co-founder of Loodse, will discuss the implications of containerized applications/infrastructures and their impact on the enterprise. In a real world example based on Kubernetes, he will show how to ...
Aug. 26, 2016 09:15 PM EDT Reads: 1,424
Traditional on-premises data centers have long been the domain of modern data platforms like Apache Hadoop, meaning companies who build their business on public cloud were challenged to run Big Data processing and analytics at scale. But recent advancements in Hadoop performance, security, and most importantly cloud-native integrations, are giving organizations the ability to truly gain value from all their data. In his session at 19th Cloud Expo, David Tishgart, Director of Product Marketing ...
Aug. 26, 2016 07:15 PM EDT Reads: 390
SYS-CON Events announced today Telecom Reseller has been named “Media Sponsor” of SYS-CON's 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Telecom Reseller reports on Unified Communications, UCaaS, BPaaS for enterprise and SMBs. They report extensively on both customer premises based solutions such as IP-PBX as well as cloud based and hosted platforms.
Aug. 26, 2016 07:00 PM EDT Reads: 649
As the world moves toward more DevOps and Microservices, application deployment to the cloud ought to become a lot simpler. The Microservices architecture, which is the basis of many new age distributed systems such as OpenStack, NetFlix and so on, is at the heart of Cloud Foundry - a complete developer-oriented Platform as a Service (PaaS) that is IaaS agnostic and supports vCloud, OpenStack and AWS. Serverless computing is revolutionizing computing. In his session at 19th Cloud Expo, Raghav...
Aug. 26, 2016 07:00 PM EDT Reads: 691
Aspose.Total for .NET is the most complete package of all file format APIs for .NET as offered by Aspose. It empowers developers to create, edit, render, print and convert between a wide range of popular document formats within any .NET, C#, ASP.NET and VB.NET applications. Aspose compiles all .NET APIs on a daily basis to ensure that it contains the most up to date versions of each of Aspose .NET APIs. If a new .NET API or a new version of existing APIs is released during the subscription peri...
Aug. 26, 2016 06:00 PM EDT Reads: 1,920
SYS-CON Events announced today that StarNet Communications will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. StarNet Communications’ FastX is the industry first cloud-based remote X Windows emulator. Using standard Web browsers (FireFox, Chrome, Safari, etc.) users from around the world gain highly secure access to applications and data hosted on Linux-based servers in a central data center. ...
Aug. 26, 2016 05:00 PM EDT Reads: 665
Smart Cities are here to stay, but for their promise to be delivered, the data they produce must not be put in new siloes. In his session at @ThingsExpo, Mathias Herberts, Co-founder and CTO of Cityzen Data, will deep dive into best practices that will ensure a successful smart city journey.
Aug. 26, 2016 04:45 PM EDT Reads: 1,529
DevOps at Cloud Expo, taking place Nov 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 19th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The widespread success of cloud computing is driving the DevOps revolution in enterprise IT. Now as never before, development teams must communicate and collaborate in a dynamic, 24/7/365 environment. There is no time to wait for long dev...
Aug. 26, 2016 04:30 PM EDT Reads: 2,305
The 19th International Cloud Expo has announced that its Call for Papers is open. Cloud Expo, to be held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, brings together Cloud Computing, Big Data, Internet of Things, DevOps, Digital Transformation, Microservices and WebRTC to one location. With cloud computing driving a higher percentage of enterprise IT budgets every year, it becomes increasingly important to plant your flag in this fast-expanding business opportuni...
Aug. 26, 2016 04:00 PM EDT Reads: 3,930
StarNet Communications Corp has announced the addition of three Secure Remote Desktop modules to its flagship X-Win32 PC X server. The new modules enable X-Win32 to safely tunnel the remote desktops from Linux and Unix servers to the user’s PC over encrypted SSH. Traditionally, users of PC X servers deploy the XDMCP protocol to display remote desktop environments such as the Gnome and KDE desktops on Linux servers and the CDE environment on Solaris Unix machines. XDMCP is used primarily on comp...
Aug. 26, 2016 03:45 PM EDT Reads: 560
There is growing need for data-driven applications and the need for digital platforms to build these apps. In his session at 19th Cloud Expo, Muddu Sudhakar, VP and GM of Security & IoT at Splunk, will cover different PaaS solutions and Big Data platforms that are available to build applications. In addition, AI and machine learning are creating new requirements that developers need in the building of next-gen apps. The next-generation digital platforms have some of the past platform needs a...
Aug. 26, 2016 03:15 PM EDT Reads: 427
DevOps at Cloud Expo – being held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA – announces that its Call for Papers is open. Born out of proven success in agile development, cloud computing, and process automation, DevOps is a macro trend you cannot afford to miss. From showcase success stories from early adopters and web-scale businesses, DevOps is expanding to organizations of all sizes, including the world's largest enterprises – and delivering real results. Am...
Aug. 26, 2016 01:30 PM EDT Reads: 3,419