The Metabolic and Hepatic Impact of Two Personalized Dietary Strategies in Subjects with Obesity and Nonalcoholic Fatty Liver Disease: The Fatty Liver in Obesity (FLiO) Randomized Controlled Trial

The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. NAFLD management is mainly focused on weight loss, but the optimal characteristics of the diet demand further investigation. This study aims to evaluate the effects of two personalized energy-restricted diets on the liver status in overweight or obese subjects with NAFLD after a 6 months follow-up. Ninety-eight individuals from the Fatty Liver in Obesity (FLiO) study were randomized into two groups and followed different energy-restricted diets. Subjects were evaluated at baseline and after 6 months. Diet, anthropometry, body composition, and biochemical parameters were evaluated. Liver assessment included ultrasonography, Magnetic Resonance Imaging, elastography, and determination of transaminases. Both dietary groups significantly improved their metabolic and hepatic markers after the intervention, with no significant differences between them. Multivariate regression models evidenced a relationship between weight loss, adherence to the Mediterranean Diet (MedDiet), and a decrease in liver fat content, predicting up to 40.9% of its variability after 6 months. Moreover, the antioxidant capacity of the diet was inversely associated with liver fat content. Participants in the group with a higher adherence to the MedDiet showed a greater reduction in body weight, total fat mass, and hepatic fat. These results support the benefit of energy-restricted diets, high adherence to the MedDiet, and high antioxidant capacity of the diet for the management of NAFLD in individuals with overweight or obesity

Association between sleep disturbances and liver status in obese subjects with nonalcoholic fatty liver disease: a comparison with healthy controls

The relevance of sleep patterns in the onset or evolution of nonalcoholic fatty liver disease (NAFLD) is still poorly understood. Our aim was to investigate the association between sleep characteristics and hepatic status indicators in obese people with NAFLD compared to normal weight non-NAFLD controls. Ninety-four overweight or obese patients with NAFLD and 40 non-NAFLD normal weight controls assessed by abdominal ultrasonography were enrolled. Hepatic status evaluation considered liver stiffness determined by Acoustic Radiation Force Impulse elastography (ARFI) and transaminases. Additionally, anthropometric measurements, clinical characteristics, and biochemical profiles were determined. Sleep features were evaluated using the Pittsburgh Sleep Quality Index (PSQI). Hepatic status parameters, anthropometric measurements, and clinical and biochemical markers differed significantly in NAFLD subjects compared to controls, as well as sleep efficiency, sleep disturbance score, and sleep quality score. In the NAFLD group, a higher prevalence of short sleep duration (p = 0.005) and poor sleep quality (p = 0.041) were found. Multivariate-adjusted odds ratio (95% confidence interval) for NAFLD considering sleep disturbance was 1.59 (1.11–2.28). Regression models that included either sleep disturbance or sleep quality predicted up to 20.3% and 20.4% of the variability of liver stiffness, respectively, and after adjusting for potential confounders.Current findings suggest that sleep disruption may be contributing to the pathogenesis of NAFLD as well as the alteration of the liver may be affecting sleep patterns. Consequently, sleep characteristics may be added to the list of modifiable behaviors to consider in health promotion strategies and in the prevention and management of NAFLD

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Molecular diversity and conjugal transferability of class 2 integrons among escherichia coli isolates from food, animal and human sources

Integrons are genetic platforms able to excise, integrate and express antibiotic resistance gene cassettes. Here, we investigate the complete genetic organization, genetic environment, location and conjugative transferability of a collection of class 2 integrons carried by E. coli strains from different sources (poultry/pork-meat, animals, and humans). PCR cartography was conducted to determine the genetic arrangement of the integrons, their physical linkage to Tn7 and the chromosomal insertion at attTn7 site. Clonal relatedness of specific isolates was determined by MLST and OD-PCR. Transferability of class 2 integrons was tested by conjugation and the resulting transconjugants were characterized by antimicrobial resistance genotyping, S1-PFGE and replicon typing. Although a limited diversity of gene cassettes was shown, a high percentage of novel structures was identified due to the integration of insertion sequences at different sites (IS3/IS4/IS5/IS21 families). The insertion of an IS10 in the attI2 site of a class 2 integron, between Pc2B and Pc2C promoters, was likely mediated by a site-specific transposition event. Chromosomal insertion of the integrons at attTn7 was confirmed in 80% of the isolates. Conjugation experiments demonstrated that 29% of class 2 integrons could be mobilized to E. coli CHS26, demonstrating that they can be located in conjugative/mobilizable elements at a low frequency. Reported structures evidence how class 2 integrons have evolved by the activity of integron integrases and the invasion of ISs. Since most of them are chromosomally located, the dispersion is predominantly vertical, although conjugation events also contribute to the spread of class 2 integrons among bacterial communities

The social network of adolescents: The influence of friendship in the development of obesogenic habits

El presente artículo pretende justificar la relevancia de las relaciones sociales en el entorno del adolescente obeso. La motivación por este enfoque surgió debido al vacío que se ha encontrado en estudios que expliquen si los adolescentes comen mejor o peor y/o realizan más o menos ejercicio físico dependiendo de su red de amigos. Se realizó una búsqueda bibliográfica centrada en la obesidad y el análisis de las redes sociales de los jóvenes a través de la Biblioteca de la Universidad de León, en diferentes bases de datos tales como Web of Knowledge (WOK), Scielo, Scopus, entre otras. Se obtuvieron artículos y otros documentos de interés utilizando revistas pertenecientes a las disciplinas de la Sociología y de las Ciencias de la Salud. Tras realizar la lectura de los textos más relevantes se pudo obtener los siguientes resultados: (1) las relaciones influyen en los hábitos de los adolescentes, (2) la calidad y la cantidad de comida puede depender del tipo de red que le rodea, y (3) el nivel de ejercicio físico que tiene un individuo se puede ver influenciado por sus mejores amigos, por el grupo en general que le rodea e incluso por los amigos de sus amigos. De todo ello se deriva, que el estudio de la red social del individuo puede ser una herramienta útil a la hora de visualizar los patrones de comportamiento, y por tanto, aplicable a los programas de salud y salud pública contribuyendo, de esta forma, a la sostenibilidad del sistema.ABSTRACT This aim of this article is to demonstrate the importance of social networks in the obese adolescent's environment. This study emerged in response to the paucity of information encountered in the literature as regards whether adolescents eat better or worse and/or performs more or less physical exercise Enfermería Global Nº 38 Abril 2015 Página 250 depending on their friendship networks. We performed a literature search at the University of León library which focused on obesity and an analysis of young people's social networks, exploring databases such as the Web of Knowledge (WOK), SciELO and Scopus, among others. Articles and other documents of interest were identified using journals from the disciplines of Sociology and the Health Sciences. After the most relevant texts had been read in full, the following results were obtained: (1) relationships influence adolescents' habits, (2) the quality and quantity of food they consume can depend on the type of network to which they belong, and (3) the amount of physical exercise that adolescents do can be influenced by their best friends, by the wider group to which they belong and even by friends of friends. The foregoing suggests that the study of adolescents' social networks could be a useful tool for identifying behaviour patterns; it is therefore applicable to health and public health programmes and would contribute to the sustainability of the system

Risk factors for recurrence of hepatitis C after liver transplantation.

Recurrent hepatitis C is a frequent complication after liver transplantation for hepatitis C virus– related cirrhosis, but risk factors related to its development remain ill defined. Twenty-three patients receiving a primary liver graft for hepatitis C virus–related cirrhosis and with an assessable biopsy performed at least 6 months after liver transplantation were studied retrospectively. The end point of this study was to look for risk factors associated with the development of histologic hepatitis C in the graft. Thirty-six major variables were studied, and those reaching significance by univariate analysis were included in a multivariate analysis. Eighteen patients (78%) developed posttransplant hepatitis C. On univariate analysis, six variables showed significant predictive value: increased immunosuppression for treatment of acute rejection; pretransplant hepatocellular carcinoma; cumulative doses of prednisone at 3, 6, and 12 months after transplantation; and mean blood trough levels of cyclosporine in the first 6 months posttransplantation. On multivariate analysis, two variables retained independent statistical significance as predictors of hepatitis C recurrence, namely receipt of antirejection therapy (P 5 .0087) and lower mean cyclosporine levels in the first 6 months after transplantation (P 5 .0134). Therefore, recurrence of hepatitis C after liver transplantation seems to be at least partially related to posttransplantation immunosuppressive therapy

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