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74 result(s) for "Uribe, Misael"
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Metabolic-Dysfunction-Associated Steatotic Liver Disease: Molecular Mechanisms, Clinical Implications, and Emerging Therapeutic Strategies
Metabolic-dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is a highly prevalent metabolic disorder characterized by hepatic steatosis in conjunction with at least one cardiometabolic risk factor, such as obesity, type 2 diabetes, hypertension, or dyslipidemia. As global rates of obesity and metabolic syndrome continue to rise, MASLD is becoming a major public health concern, with projections indicating a substantial increase in prevalence over the coming decades. The disease spectrum ranges from simple steatosis to metabolic-dysfunction-associated steatohepatitis (MASH), fibrosis, cirrhosis, and hepatocellular carcinoma, contributing to significant morbidity and mortality worldwide. This review delves into the molecular mechanisms driving MASLD pathogenesis, including dysregulation of lipid metabolism, chronic inflammation, oxidative stress, mitochondrial dysfunction, and gut microbiota alterations. Recent advances in research have highlighted the role of genetic and epigenetic factors in disease progression, as well as novel therapeutic targets such as peroxisome proliferator-activated receptors (PPARs), fibroblast growth factors, and thyroid hormone receptor beta agonists. Given the multifaceted nature of MASLD, a multidisciplinary approach integrating early diagnosis, molecular insights, lifestyle interventions, and personalized therapies is critical. This review underscores the urgent need for continued research into innovative treatment strategies and precision medicine approaches to halt MASLD progression and improve patient outcomes.
Artificial Light at Night, Sleep Disruption, and Liver Health: Implications for MASLD Pathogenesis
This narrative review explores the role of artificial light at night (ALAN) as an emerging environmental determinant of liver and metabolic health, with particular emphasis on its contribution to metabolic dysfunction-associated steatotic liver disease (MASLD). The objective was to synthesize and critically evaluate experimental and epidemiological evidence linking nocturnal light exposure, circadian disruption, and hepatic metabolic alterations. Literature was retrieved from PubMed, Scopus, Web of Science, and Google Scholar databases covering the period 1980–2025 using predefined search terms related to ALAN, circadian rhythm disturbance, melatonin suppression, sleep disruption, and MASLD. Relevant experimental studies in animal models and observational studies in humans were included. Evidence indicates that blue-enriched light (~460–480 nm) suppresses melatonin, desynchronizes central and hepatic circadian clocks, and disrupts glucose–lipid metabolism, leading to insulin resistance, oxidative stress, and hepatic steatosis. Chronic ALAN exposure also alters gut microbiota composition and increases intestinal permeability, suggesting a light–gut–liver axis in MASLD pathogenesis. Human epidemiological studies associate higher environmental ALAN exposure with obesity, metabolic syndrome, and poor sleep quality—recognized risk factors for MASLD. Recognizing ALAN as a modifiable environmental exposure highlights the need for public health strategies and clinical guidelines to mitigate its metabolic impact through improved lighting design and sleep hygiene.
Immunonutrition: Another Player on the MASLD Field
Immunonutrition is a nutritional strategy where the bioactive properties of nutrients from the diet are used to modulate metabolic pathways, inflammation signals, and oxidative stress regulators. Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic degenerative disease with increasing prevalence over the past decade. In MASLD, where inflammation and oxidative stress play key roles in the progression of liver disease, immunonutrition becomes even more important. The impact of different dietary patterns has been studied in the MASLD context; however, current guidelines emphasize the Mediterranean Diet, which, in terms of included food groups, provides a high level of immunonutrients. Nonetheless, adherence, monitoring, and implementation based on geographic areas, availability, and economic factors make this type of diet ultimately less accessible. The main benefit of the diet pattern is in maintaining the positive effects of new pharmacological treatments, alongside physical activity, which are crucial to prevent recurrence. A diet strategy designed for MASLD needs to be adapted to local food availability and should promote the inclusion of immunonutrients. In the treatment of MASLD, dietary recommendations should be individualized based on the sociodemographic, clinical, and nutritional characteristics of the patients.
A new, long-term daily satellite-based rainfall dataset for operational monitoring in Africa
Rainfall information is essential for many applications in developing countries, and yet, continually updated information at fine temporal and spatial scales is lacking. In Africa, rainfall monitoring is particularly important given the close relationship between climate and livelihoods. To address this information gap, this paper describes two versions (v2.0 and v3.0) of the TAMSAT daily rainfall dataset based on high-resolution thermal-infrared observations, available from 1983 to the present. The datasets are based on the disaggregation of 10-day (v2.0) and 5-day (v3.0) total TAMSAT rainfall estimates to a daily time-step using daily cold cloud duration. This approach provides temporally consistent historic and near-real time daily rainfall information for all of Africa. The estimates have been evaluated using ground-based observations from five countries with contrasting rainfall climates (Mozambique, Niger, Nigeria, Uganda, and Zambia) and compared to other satellite-based rainfall estimates. The results indicate that both versions of the TAMSAT daily estimates reliably detects rainy days, but have less skill in capturing rainfall amount—results that are comparable to the other datasets. Design Type(s) observation design • data integration objective Measurement Type(s) hydrological precipitation process Technology Type(s) meterological observation Factor Type(s) Sample Characteristic(s) Mozambique • Niger • Nigeria • Uganda • Zambia Machine-accessible metadata file describing the reported data (ISA-Tab format)
Breast Cancer and Metabolic Dysfunction-Associated Steatotic Liver Disease
Breast cancer remains the most frequently diagnosed malignancy among women worldwide, while metabolic dysfunction-associated steatotic liver disease (MASLD) represents the leading cause of chronic liver disease, reflecting a global burden of metabolic dysfunction. Increasing evidence suggests that MASLD is associated with breast cancer development and progression; however, whether this relationship reflects an independent effect of hepatic metabolic dysfunction or the broader metabolic environment remains uncertain. This review synthesizes current epidemiological, clinical, and mechanistic data linking hepatic metabolic dysfunction to breast carcinogenesis. Population-based studies consistently demonstrate an association between hepatic steatosis and increased breast cancer incidence, particularly in postmenopausal and metabolically vulnerable populations, as well as poorer oncological outcomes. Mechanistically, MASLD promotes a systemic pro-tumorigenic environment through interconnected pathways, including insulin resistance, hormonal dysregulation with increased estrogen bioavailability, chronic inflammation, oxidative stress, lipid metabolic reprogramming, and gut-liver axis disruption. Hepatokines, particularly fibroblast growth factor 21 (FGF21), emerge as key mediators of tumor progression and potential biomarkers of metabolic vulnerability, while Fetuin-A and angiopoietin-like protein 8 (ANGPTL8) further support the liver's endocrine role in oncogenic signaling. Preclinical evidence highlights fatty acid oxidation as a metabolic dependency in aggressive breast cancer subtypes, suggesting novel therapeutic targets. Despite consistent associations, causality remains unproven. Future prospective studies are needed to determine whether targeting metabolic dysfunction can improve breast cancer prevention and outcomes.
Cross-sectional pilot study to assess primary healthcare workers’ knowledge of nonalcoholic fatty liver disease in a marginalized community in Mexico
The registered incidence of nonalcoholic fatty liver disease (NAFLD) in primary healthcare centers is lower than expected, suggesting a lack of awareness by primary care healthcare professionals. The implementation of educational tools for healthcare workers has been found to increase timely referral and treatment of patients. We aimed to determine healthcare workers’ knowledge of NAFLD to identify their educational needs in one marginalized region. We performed a cross-sectional survey of 261 healthcare professionals in Tlapa de Comonfort, Guerrero, Mexico from October 2019 to December 2019. We created a questionnaire that assessed domains most relevant to NAFLD knowledge. Two hundred and forty-six questionnaires were completed. Of the respondents, 38.3% were nurses and 63.4% were women. Most nurses identified NAFLD as a prevalent (89%) and preventable (93%) disease. Hypertension (33%) and obesity (84%) were recognized as risk factors. The associations between NAFLD and cancer, cirrhosis and cardiovascular disease were identified by 53%, 67% and 72% of respondents, respectively. The largest gaps were found in diagnostic workup, therapeutic approach and the current treatments. We identify modifiable knowledge gaps in NAFLD. Educational strategies for primary care workers could enhance the identification of patients with NAFLD and prevent complications.
Predictors for liver fibrosis in non-alcoholic patients with psoriatic diseases: A multicenter cross sectional-study
Psoriasis has been related to metabolic dysfunction-associated fatty liver disease and, liver fibrosis. This study aimed to evaluate the prevalence of liver fibrosis in psoriasis and identify predictors for fibrosis. This is a cross-sectional study conducted from December 2012 to June 2016 assessing psoriasis and psoriatic arthritis patients attended at four centers in Mexico City. Data regarding history of the skin disease, previous and current medication, and previously diagnosed liver disease was collected. Liver fibrosis was assessed with four different non-invasive methods (FIB4, APRI, NAFLD score and elastography). We compared data based on the presence of fibrosis. Adjusted-logistic regression models were performed to estimate OR and 95% CI. A total of 160 patients were included. The prevalence of significant fibrosis using elastography was 25% (n = 40), and 7.5% (n = 12) for advanced fibrosis. Patients with fibrosis had higher prevalence of obesity (60% vs 30.8%, P = 0.04), type 2 diabetes (40% vs 27.5%, P = 0.003), gamma-glutamyl transpeptidase levels (70.8±84.4 vs. 40.1±39.2, P = 0.002), and lower platelets (210.7±58.9 vs. 242.8±49.7, P = 0.0009). Multivariate analysis showed that body mass index (OR1.11, 95%CI 1.02–1.21), type 2 diabetes (OR 3.44, 95%CI 1.2–9.88), and gamma-glutamyl transpeptidase (OR 1.01, 95%CI1-1.02) were associated with the presence of fibrosis. The use of methotrexate was not associated. Patients with psoriasis are at higher risk of fibrosis. Metabolic dysfunction, rather than solely the use of hepatotoxic drugs, likely plays a major role; it may be beneficial to consider elastography regardless of the treatment used. Metabolic factors should be assessed, and lifestyle modification should be encouraged.
Incremental levels of diagnostic information incentivize health-seeking in non-alcoholic fatty liver: a randomized clinical trial
Patients with chronic disorders like non-alcoholic fatty liver disease (NAFLD) face important challenges adhering to diagnostic and treatment tracks. As NAFLD increases, the need to incentivize health-seeking behaviors grows. No evidence-based interventions to address this gap exist. The aim of the study was to estimate the effect of providing increasing levels of diagnostic information on medical care-seeking in adults newly diagnosed with NAFLD. We randomly assigned adults with a sonographic diagnosis of NAFLD at a check-up unit in Mexico to one of five groups. All groups received medical consultation. A: no further interventions; B: received multimedia educational material (MEM); C: MEM + NAFLD-fibrosis-score (NFS); D: MEM + transient elastography (TE); E: MEM + NFS + TE. 1209 participants were randomized, follow-up rate 91%; 82% male, BMI 30.5 ± 4 kg/m 2 . There were no differences in the proportion of patients undergoing further diagnostic evaluation of liver fibrosis (A 0.4%, E 0.4%, P-for-trend = 0.269). Groups who received more information sought specialized medical care more frequently: A 22%, E 30% (P-for-trend = 0.047). A trend to receive treatment was also observed at higher levels of information: A 26.7%, E 36.3% (P-for-trend = 0.134). Increasing the amount of diagnostic information seemed to increase patient’s health-seeking. Tailoring the communication of information obtained for diagnosis could help to increase health-seeking in chronic disease patients. Trial registration: NCT01874249 (full date of first registration 11-06-2013).
Prevalence and Association of Liver Steatosis and Non-Alcoholic Pancreatic Steatosis in Very High Cardiovascular Risk
In the last decade, the prevalence of metabolic-associated fatty liver disease (17-46%) and non-alcoholic fatty pancreas disease (NAFPD) (16-33%) has increased due to their association with obesity, both predictors of early atherosclerosis and metabolic risk. Computed tomography (CT) has been proposed as a diagnostic method. Currently, the factors associated with NAFPD have not been fully described. The aim of this study is to describe the prevalence and association of NAFPD and liver steatosis in patients with very high cardiovascular risk. A retrospective evaluation was conducted on the medical records of patients classified as very high cardiovascular risk who had undergone a CT scan. NAFPD was determined by the difference in pancreatic and splenic attenuation (-1.9), while liver steatosis was identified by hepatic attenuation <40. Bivariate and multivariate analyses were performed to determine the independent factors associated with NAFPD. 169 medical records were collected; 68.6% ( = 116) were men, with a median age of 70 [IQR 61-78] years and 25.8 [IQR 23.7-28.7] kg/m of body mass index. According to the CT scans, 80.5% ( = 136) presented NAFPD, 24.3% ( = 41) had liver steatosis, and 21.3% ( = 36) had both. In the multivariate analysis, liver steatosis, abnormal levels of aspartate aminotransferase, and being overweight were independent factors associated with NAFPD. In a very high cardiovascular-risk population, the prevalence of NAFPD is high, and it is independently associated with the presence of liver steatosis.
COVID-19: Current status in gastrointestinal, hepatic, and pancreatic diseases-a concise review
The gastrointestinal tract plays an important role in the pathogenesis of COVID-19. The angiotensin-converting enzyme 2 receptor and the transmembrane protease serine 2 receptor bind and activate SARS-CoV-2 and are present in high concentrations throughout the gastrointestinal tract. Most patients present with gastrointestinal symptoms and/or abnormal liver function tests, both of which have been associated with adverse outcomes. The mechanisms of liver damage are currently under investigation, but the damage is usually transient and nonsevere. Liver transplantation is the only definitive treatment for acute liver failure and end-stage liver disease, and unfortunately, because of the need for ventilators during the COVID-19 pandemic, most liver transplant programs have been suspended. Patients with gastrointestinal autoimmune diseases require close follow-up and may need modification in immunosuppression. Acute pancreatitis is a rare manifestation of COVID-19, but it must be considered in patients with abdominal pain. The gastrointestinal tract, including the liver and the pancreas, has an intimate relationship with COVID-19 that is currently under active investigation.