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Introduction

Genetic predisposition to accumulate fat by carrying risk alleles of PNPLA3, TM6SF2 and HSD17B13, has been shown to influence the probability of developing cirrhosis and hepatocellular carcinoma (HCC) in several liver diseases characterized by hepatic steatosis including non-alcoholic steatohepatitis, chronic hepatitis C and alcoholic liver disease. Whether these variants have any role in the progression of chronic hepatitis B (CHB) disease, without hepatic steatosis, remains unknown.

Aims & Methods

In this cross-sectional case-control study, we determined PNPLA3 rs738409, TM6SF2 rs58542926, and HSD17B13 rs72613567 variants in a cohort of 148 healthy controls, 91 CHB (57 cirrhotic and 34 non-cirrhotic), and 84 CHB-related HCC patients from a tertiary center. Associations between control and case groups with the alleles and genotypes were investigated using logistic regression analyses, and adjustment for age and sex was applied. Survival analyses were performed using Kaplan-Meier Curves with the log-rank test in the CHB-related HCC cohort.

Results

The genotype and allelic distribution of PNPLA3, TM6SF2 and HSD17B13 were not different between healthy controls, CHB, cirrhosis and HCC groups. No genotype or allele, including the haplotype analysis, was found to be associated with susceptibility to CHB and increased risk for cirrhosis or HCC. Survival analysis revealed that none of the three variants has any influence on overall survival in patients with CHB-related HCC.

Conclusion

Our findings demonstrated that PNPLA3, TM6SF2, and HSD17B13 genetic variants, known for modulating liver fat and disease progression in hepatic steatosis, have no association with disease progression in patients with CHB and survival in CHB-related HCC.

References

1. Abul-Husn NS, Cheng X, Li AH, et al. A Protein-Truncating HSD17B13 Variant and Protection from Chronic Liver Disease. N Engl J Med. 2018 Mar 22;378(12):1096-1106.
2. Gellert-Kristensen H, Richardson TG, Davey Smith G, et al. Combined Effect of PNPLA3, TM6SF2, and HSD17B13 Variants on Risk of Cirrhosis and Hepatocellular Carcinoma in the General Population. Hepatology. 2020 Sep;72(3):845-856.
3. Kang Q, Xu J, Luo H, et al. Evaluation of the association of a variant in PNPLA3 and TM6SF2 with fibrosis progression in patients with chronic hepatitis C infection after eradication: A retrospective study. Gene. 2022 Apr 30;820:146235.
4. Stickel F, Buch S, Nischalke HD, et al. Genetic variants in PNPLA3 and TM6SF2 predispose to the development of hepatocellular carcinoma in individuals with alcohol-related cirrhosis. Am J Gastroenterol. 2018 Oct;113(10):1475-1483.

DOES PNPLA3, TM6SF2 AND HSD17B13 GENETIC VARIANTS HAVE ANY ROLE IN THE PROGRESSION OF CHRONIC HEPATITIS B VIRUS?

Coskun Ozer Demirtas 1, Fatih Eren 2, Demet Yılmaz 2, Feyza Gündüz 1

1 Marmara University, School of Medicine, Istanbul, Turkey

2 Marmara University, School of Medicine, Institute of Gastroenterology, Istanbul, Turkey

Conference

UEG Week Copenhagen 2023

Topics

Hepatobiliary

Submission format

Abstract

Session

PP 07 Liver & biliary (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Q&A Dysphagia: A bitter pill that’s hard to swallow - Neurogenic dysphagia

Shaheen Hamdy 1, Ayodele Sasegbon 2

1 Department of GI Science, Salford, United Kingdom

2 University of Manchester, Manchester, United Kingdom

Event

UEG Postgraduate Teaching Programme 2023

Topics

Neurogastroenterology & Motility Oesophagus

Session

Dysphagia: A bitter pill that’s hard to swallow

Published

2023

UEG Presentation

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H. pylori: Global Registry

Leticia Moreira Ruiz 1

1 Hospital Clinic de Barcelona, Gava, Spain

Event

UEG Week Copenhagen 2023

Topics

Hepatobiliary

Session

Hot topics from Pan America

Published

2023

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Introduction

Almost 80% of individuals with functional dyspepsia report meal-related symptoms and are classified as having postprandial distress syndrome (PDS). However, studies evaluating dietary modifications in PDS are sparse.

Aims & Methods

The aim of this study was to perform a single-centre randomized trial evaluating traditional dietary advice (TDA) in PDS.
Following a normal upper gastrointestinal endoscopy, patients with PDS were randomly assigned to a leaflet providing reassurance and diagnostic explanation (RADE) +/- TDA; the latter recommending smaller, regular meals and reducing the intake of caffeine/alcohol/fizzy drinks, fatty/processed/spicy foods, and fibre. Questionnaires were completed during the 4-week trial, including self-reported adequate relief of dyspeptic symptoms, and the validated Leuven Postprandial Distress Scale (LPDS), Gastrointestinal Symptom Rating Scale, and Nepean Dyspepsia Index for quality of life. The primary endpoint(s) to define clinical response were i) ≥50% adequate relief of dyspeptic symptoms, and ii) >0.5-point reduction in the PDS subscale of the LPDS (calculated as the mean scores for early satiety, postprandial fullness, and upper abdominal bloating).

Results

Of 53 patients with PDS, 27 were assigned RADE-alone and 26 to additional TDA. Baseline characteristics were similar between the groups, with a mean age of 39 years, 70% female, 83% white, and co-existent IBS in 66%. The primary endpoints of i) adequate relief of dyspeptic symptoms was met by 33% (n=9) assigned RADE-alone vs. 39% (n=10) with TDA; p-value=0.70, while ii) a reduction of >0.5 points in the PDS subscale was met by 37% (n=10) assigned RADE-alone vs. 27% (n=7) with TDA; p-value=0.43. Response rates did not alter according to IBS status. There were no significant between-group changes in the gastrointestinal symptom rating scale and dyspepsia quality of life.

Conclusion

The addition of TDA did not lead to greater symptom reduction in PDS compared with reassurance and diagnostic explanation alone. Alternate dietary strategies should be explored in PDS.

RANDOMIZED TRIAL OF TRADITIONAL DIETARY ADVICE IN POSTPRANDIAL FUNCTIONAL DYSPEPSIA

Rachel Buckle 1, Lydia Brown 1, Imran Aziz 1

1 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

Conference

UEG Week Copenhagen 2023

Topics

Oesophagus

Submission format

Abstract

Session

PP 01 Oesophageal, gastric and duodenal disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Whole diet interventions for DGBI: Beyond the low FODMAP diet

Heidi Staudacher 1

1 The University of Queensland, Melbourne, Australia

Event

UEG Week Copenhagen 2023

Topics

Small Intestine & Nutrition Education & Training Neurogastroenterology & Motility

Session

Dietary advice for functional gastrointestinal disorders

Published

2023

UEG Presentation

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How to create AI for Barrett's oesophagus and how to integrate it in its management

Jacques J. Bergman 1, Fons van der Sommen 2

1 Academic Medical Centre - Gastroenterology & Hepatology, Academic Medical Centre; Amsterdam/NL, Amsterdam, Netherlands

2 Eindhoven University of Technology, Eindhoven, Netherlands

Event

UEG Week Copenhagen 2023

Topics

Education & Training Endoscopy Histopathology

Session

Disease primer: AI - the new standard in endoscopy and pathology

Published

2023

UEG Presentation

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THE VALUE OF SERUM PRONEUROTENSIN AS A PREDICTOR OF CARDIOVASCULAR RISK IN NAFLD PATIENTS

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Introduction

Cardiovascular disease (CVD) is the leading cause of death in NAFLD patients. Increased plasma proneurotensin (pro-NT) levels were found to identify the presence and severity of NAFLD. The association between pro-NT and incident major cardiovascular events has been confirmed.

Aims & Methods

To evaluate the association of serum pro-neurotensin with cardiovascular risk in NAFLD patients. A cross-sectional cohort included sixty patients with NAFLD and documented CVD, sixty patients with NAFLD without documented CVD and 60 healthy controls. Liver function tests, liver enzymes, lipid profile, fasting blood glucose, abdominal ultrasound and serum proneurotensin were done.

Results

Proneurotensin was significantly higher in the NAFLD group as compared to controls, P <0.0001. Proneurotensin levels were significantly higher in patients with established CVD in addition to NAFLD as compared to NAFLD only patients P <0.0001. Serum proneurotensin showed significant positive correlation with Framingham score and NAFLD Fibrosis Score P <0.0001. Reciever operating characteristic (ROC) curve demonstrated a cut-off value >24.5 ng/L for proneurotensin as a predictor of NAFLD with 64.2% sensitivity and 96.7% specificity, (AUC) = 0.862, P < 0.001. And a cut-off value >28.5 ng/L for proneurotensin as a predictor of CVD in NAFLD patients, with 83.3% sensitivity and 78.3% specificity, (AUC) = 0.854, P < 0.001.

Conclusion

serum proneurotensin is significantly higher in NAFLD patients established CVD than NAFLD only patients and healthy subjects. It can be considered as a marker of CVD risk in such patients

References

Ilaria Barchetta, Flavia Agata Cimini, Frida Leonetti, Danila Capoccia, Claudio Di Cristofano, Gianfranco Silecchia, Marju Orho-Melander, Olle Melander, Maria Gisella Cavallo; Increased Plasma Proneurotensin Levels Identify NAFLD in Adults With and Without Type 2 Diabetes, The Journal of Clinical Endocrinology & Metabolism, Volume 103, Issue 6, 1 June 2018, Pages 2253–2260