記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: This study aimed to clarify the impact of tirzepatide as a treatment for Type 2 diabetes mellitus (T2DM) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). METHODS: This single-arm, prospective, observational pilot study included 16 patients with MASLD and T2DM who were treated with tirzepatide. Of these, 13 patients completed 48 weeks of treatment. Tirzepatide was initiated at a dose of 2.5 mg once weekly for 4 weeks, and dose adjustments were left to the discretion of the attending physician based on efficacy and adverse events. RESULTS: Significant improvements in body weight, liver enzymes, and hemoglobin A1c were found at Week 12 and were sustained throughout the 48-week treatment period compared with baseline values (all p < 0.05). Controlled attenuation parameter significantly decreased from baseline to 48 weeks (p < 0.05). Changes in body weight were correlated with changes in alanine aminotransferase levels (r = 0.57, p < 0.05) but not with changes in controlled attenuation parameter (r = 0.45, p = 0.12). The results of noninvasive tests for fibrosis, including Type IV collagen 7s, Wisteria floribunda agglutinin-positive Mac-2-binding protein, the fibrosis-4 index, and the liver stiffness measurement, significantly decreased from baseline to 48 weeks (all p < 0.05). Most adverse events were transient Grades 1-2 gastrointestinal symptoms, including nausea (5 patients, 31.3%), diarrhea (3 patients, 18.8%), and constipation (2 patients, 12.5%). CONCLUSIONS: Tirzepatide treatment for T2DM in patients with MASLD significantly improved liver steatosis and injury, surrogate markers of liver fibrosis, and diabetes status, and reduced body weight.

DOI： 10.1111/hepr.14241

PubMed

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Ovid Technologies (Wolters Kluwer Health)  

INTRODUCTION:

High-risk stigmata (HRS) and worrisome features (WFs) are imaging findings that reflect malignant potential of intraductal papillary mucinous neoplasms (IPMNs). The aim of this study was to determine the potential utility of stratifying malignant potential of IPMNs using apolipoprotein-A2 isoforms (apoA2-i) as a blood biomarker.

METHODS:

A total of 212 patients with IPMNs diagnosed by either magnetic resonance cholangiopancreatography (MRCP) or contrast-enhanced CT, and endoscopic ultrasound (EUS) were retrospectively enrolled. ApoA2-i and CA19-9 of all patients and 295 healthy individuals were measured. The distributions of apoA2-i and CA19-9 were analyzed in association with the malignant potential evaluated by imaging.

RESULTS:

In 212 patients with IPMN, 17 had High-risk stigmata (HRS group), 70 had worrisome features (WF group), and 125 had no EUS findings of High-risk stigmata or worrisome features (non-WF group). The median of the apoA2-i Index in the HRS, WF, non-WF, and healthy groups were 57.7, 72.4, 87.5, and 87.9 μg/mL, respectively, with significantly lower levels in the HRS and WF groups (p &lt; 0.001). In contrast, CA19-9 showed no significant difference among the four groups. The area under the curve of the apoA2-i Index to differentiate patients in the HRS and WF groups from the non-WF group was significantly higher than that of the CA19-9 (0.676 vs 0.554, p = 0.029).

DISCUSSION:

The diagnostic performance of apoA2-i for detecting IPMN with malignant potential was superior to that of CA19-9. The apoA2-i Index could serve as a useful biomarker for risk stratification and surveillance of IPMNs. (247 words)

DOI： 10.14309/ctg.0000000000000856

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND AIM: This study aimed to clarify the efficacy and safety of 48-week pemafibrate treatment in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) complicated by dyslipidemia. METHODS: A total of 110 patients diagnosed with MASLD complicated by dyslipidemia received pemafibrate at a dose of 0.1 mg twice daily for 48 weeks. RESULTS: The participants were 54 males and 37 females, with a median age of 63 (52-71) years. Besides improvement in lipid profile, significant reductions from baseline to 48 weeks of treatment were found in liver-related enzymes, such as aspartate aminotransferase, alanine aminotransferase (ALT), gamma-glutamyl transpeptidase, and alkaline phosphatase (P < 0.001 for all). A significant decrease in the homeostasis model assessment-insulin resistance (HOMA-IR) was observed in patients with insulin resistance (HOMA-IR ≥ 2.5) (4.34 at baseline to 3.89 at Week 48, P < 0.05). Moreover, changes in ALT were weakly correlated with those in HOMA-IR (r = 0.34; p < 0.05). Regarding noninvasive liver fibrosis tests, platelets, Wisteria floribunda agglutinin-positive Mac-2-binding protein, type IV collagen 7s, and the non-alcoholic fatty liver disease fibrosis score significantly decreased from baseline to Week 48. Most adverse events were Grades 1-2, and no drug-related Grade 3 or higher adverse events were observed. CONCLUSION: This study demonstrated that 48-week pemafibrate administration improved liver-related enzymes and surrogate marker of liver fibrosis in patients with MASLD. The improvement of insulin resistance by pemafibrate may contribute to the favorable effect on MASLD complicated by dyslipidemia.

DOI： 10.1002/jgh3.13057

PubMed

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記述言語：日本語   出版者・発行元：日本消化器病学会-関東支部  

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記述言語：日本語   出版者・発行元：日本臨床生理学会  

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記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

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記述言語：日本語   出版者・発行元：日本消化器病学会-関東支部  

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記述言語：日本語   出版者・発行元：(一社)日本肝臓学会  

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