Risk factors for hepatocellular carcinoma in cirrhosis due to nonalcoholic fatty liver disease: A multicenter, case-control study

AIM To identify risk factors associated with hepatocellular carcinoma (HCC), describe tumor characteristics and treatments pursed for a cohort of individuals with nonalcoholic steatohepatitis (NASH) cirrhosis. METHODS We conducted a retrospective case-control study of a well-characterized cohort of patients among five liver transplant centers with NASH cirrhosis with (cases) and without HCC (controls). RESULTS Ninety-four cases and 150 controls were included. Cases were significantly more likely to be male than controls (67% vs 45%, P < 0.001) and of older age (61.9 years vs 58 years, P = 0.002). In addition, cases were more likely to have had complications of end stage liver disease (83% vs 71%, P = 0.032). On multivariate analysis, the strongest association with the presence of HCC were male gender (OR 4.3, 95%CI: 1.83-10.3, P = 0.001) and age (OR = 1.082, 95%CI: 1.03-1.13, P = 0.001). Hispanic ethnicity was associated with a decreased prevalence of HCC (OR = 0.3, 95%CI: 0.09-0.994, P = 0.048). HCC was predominantly in the form of a single lesion with regional lymph node(s) and distant metastasis in only 2.6% and 6.3%, respectively. Fifty-nine point three percent of individuals with HCC underwent locoregional therapy and 61.5% underwent liver transplantation for HCC. CONCLUSION Male gender, increased age and non-Hispanic ethnicity are associated with HCC in NASH cirrhosis. NASH cirrhosis associated HCC in this cohort was characterized by early stage disease at diagnosis and treatment with locoregional therapy and transplant

Erythritol, at insecticidal doses, has harmful effects on two common agricultural crop plants

<div><p>Erythritol, a non-nutritive polyol, is the main component of the artificial sweetener Truvia^<b>®</b>. Recent research has indicated that erythritol may have potential as an organic insecticide, given its harmful effects on several insects but apparent safety for mammals. However, for erythritol to have practical use as an insecticide in agricultural settings, it must have neutral to positive effects on crop plants and other non-target organisms. We examined the dose-dependent effects of erythritol (0, 5, 50, 500, 1000, and 2000 mM) on corn (<i>Zea mays</i>) and tomato (<i>Solanum lycopersicum</i>) seedling growth and seed germination. Erythritol caused significant reductions in both belowground (root) and aboveground (shoot) dry weight at and above the typical minimum insecticidal dose (500 mM erythritol) in tomato plants, but not in corn plants. Both corn and tomato seed germination was inhibited by erythritol but the tomato seeds appeared to be more sensitive, responding at concentrations as low as 50 mM erythritol (in contrast to a minimum damaging dose of 1000 mM erythritol for corn seeds). Our results suggest erythritol may have damaging non-target effects on certain plant crops when used daily at the typical doses needed to kill insect pests. Furthermore, if erythritol’s damaging effects extend to certain weed species, it also may have potential as an organic herbicide.</p></div

Seedling growth (measured as dry weight) and seed germination of corn and tomato exposed to 5 different erythritol treatments and a deionized water control.

<p>Dry weight: n = 11 replicates per treatment group for each species; seed germination: n = 3 replicate petri dishes (with 4 seeds per petri dish) per treatment group for each species.</p

Erythritol delays seed germination in corn.

<p>Mean (± 1 SE) number of days to seed germination for A) corn and B) tomato over 18 days at 6 different treatment concentrations of erythritol. For each species, seeds were treated in petri dishes (4 seeds per dish; 3 dishes per treatment group) and the mean days to germination was calculated for each petri dish. Note that no seeds germinated in the 2000 mM treatment group for corn and the 500 mM, 1000 mM, and 2000 mM treatment groups for tomato, so these treatment groups were not included in the analysis. Means with the same letter are not significantly different from each other (Tukey HSD test, p < 0.05).</p

Erythritol reduces tomato dry weight, but has no effect on corn dry weight.

<p>Mean (± 1 SE) root and shoot dry weight (biomass) for A) corn and B) tomato seedlings treated with erythritol spray at 6 different concentrations for 21 days (corn) or 28 days (tomato). There were 11 plants of each species per erythritol treatment group. Means with the same letter within a response variable are not significantly different from each other (Tukey HSD test, p < 0.05).</p

Erythritol causes dose-dependent inhibition of seed germination in corn and tomato.

<p>Median (IQR) A) corn and B) tomato seed percent germination over 18 days at 6 different treatment concentrations of erythritol. For each species, seeds were treated in petri dishes (4 seeds per dish; 3 dishes per treatment group) and the percent germination was calculated for each petri dish. Medians with the same letter are not significantly different from each other (Mann-Whitney U test, p < 0.05).</p

Seedling growth (measured as dry weight) and seed germination of corn and tomato exposed to 5 different erythritol treatments and a deionized water control.

<p>Dry weight: n = 11 replicates per treatment group for each species; seed germination: n = 3 replicate petri dishes (with 4 seeds per petri dish) per treatment group for each species.</p