Review article: Hepatic steatosis and its associations with acute and chronic liver diseases.

BACKGROUND: Hepatic steatosis is a common finding in liver histopathology and the hallmark of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), whose global prevalence is rising. AIMS: To review the histopathology of hepatic steatosis and its mechanisms of development and to identify common and rare disease associations. METHODS: We reviewed literature on the basic science of lipid droplet (LD) biology and clinical research on acute and chronic liver diseases associated with hepatic steatosis using the PubMed database. RESULTS: A variety of genetic and environmental factors contribute to the development of chronic hepatic steatosis or steatotic liver disease, which typically appears macrovesicular. Microvesicular steatosis is associated with acute mitochondrial dysfunction and liver failure. Fat metabolic processes in hepatocytes whose dysregulation leads to the development of steatosis include secretion of lipoprotein particles, uptake of remnant lipoprotein particles or free fatty acids from blood, de novo lipogenesis, oxidation of fatty acids, lipolysis and lipophagy. Hepatic insulin resistance is a key feature of MASLD. Seipin is a polyfunctional protein that facilitates LD biogenesis. Assembly of hepatitis C virus takes place on LD surfaces. LDs make important, functional contact with the endoplasmic reticulum and other organelles. CONCLUSIONS: Diverse liver pathologies are associated with hepatic steatosis, with MASLD being the most important contributor. The biogenesis and dynamics of LDs in hepatocytes are complex and warrant further investigation. Organellar interfaces permit co-regulation of lipid metabolism to match generation of potentially toxic lipid species with their LD depot storage.

The impact of hepatocellular carcinoma diagnosis on patients' health-related quality of life.

BACKGROUND: Patients with hepatocellular cancer (HCC) are known to have worse health-related quality of life (HRQL) than the general population. However, the change in HRQL from before the diagnosis to after diagnosis remains unknown and is difficult to estimate. We aimed to compare HCC cases with matched controls to evaluate the differences in change in HRQL from before to after HCC diagnosis. METHODS: We performed propensity score-matched analysis using the self-reported HRQL data from the Surveillance, Epidemiology, and End Results registries (SEER) data linked with Medicare Health Outcomes Survey (MHOS) data (1998-2014). Cases were selected as Medicare beneficiaries (aged ≥65 years) who were diagnosed with HCC between their baseline assessment and follow-up assessment. Matched controls were selected from the same data resource and the same time period to include subjects without cancer diagnosis by propensity scores. HRQL was assessed using the Medical Outcomes Study Short Form-36 (SF-36). RESULTS: The study included 62 subjects who developed HCC and 365 matched controls. Compared to their baseline HRQL scores, after diagnosis of HCC, subjects were more likely to report declines in scores related to the mental component of HRQL. When stratified by time since diagnosis, mental component remained significantly lower as the disease advanced. In contrast, only general health aspects of physical health worsened after HCC diagnosis. CONCLUSIONS: Diagnosis of HCC has a profound negative impact on patients' HRQL. Mental health component deteriorated significantly over time. The need of including mental health services within a multidisciplinary HCC care model is clearly evident.

Racial Disparity, Depression, and Birth Outcomes Among Pregnant Teens.

Objectives To examine the risk of premature delivery (PD) and small for gestational age (SGA) among pregnant teens with depressive disorders (DD), and the impact of race/ethnicity on these birth outcomes. Design/Methods We examined the hospital discharge records of pregnant mothers between the age of 13-18 year old who gave birth in the years 1994, 2000, 2006, and 2012 in the National Inpatient Sample database. We calculated the risk for PD and SGA among pregnant teens with and without DD in the overall population and within each race/ethnicity. Results Weighted sample included 1,023,586 pregnant teenage women. Prevalence of DD among teens was 0.93%, with a significantly increasing trend from 0.29% in 1994 to 2.01% in 2012 (p < 0.001). Declining trend was observed in the proportion of pregnant younger teens from 1994 to 2012. Prevalence of depression among teenage mothers was highest among Caucasians compared to other races. Prevalence of SGA among pregnant teens was 2.23% that significantly increased from 1.63% in 1994 to 3.44% in 2012 (p < 0.001). African American teens with DD had decreased risk for PD compared to AA without DD (OR 0.70; CI 0.57 - 0.387, p < 0.001). Hispanic teens with DD had increased risk for SGA compared to Hispanics without DD (adjusted OR 1.53; CI 1.10-2.13, p < 0.001). Conclusions for Practice There is an increasing trend for diagnosing DD among pregnant teens. Less young teenage girls are giving birth in recent years. The impact of DD on PD and SGA differs according to race. More studies are warranted to examine underlining factors responsible for these findings.