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      Relationship Between Urolithiasis and Fatty Liver Disease: Findings in Computed Tomography

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          Abstract

          There are no studies that allow a joint diagnostic or therapeutic intervention for the treatment of fatty liver and urolithiasis, perhaps because it is not known if there is an association between these 2 diseases. We aimed to identify a relationship between renal lithiasis and fatty liver disease by examining for common factors that could be used to reduce their incidence and complications. Our study supports the association of fatty liver and urolithiasis. Given the increase in frequency of these 2 diseases, we believe there is a common pathway within the malabsorptive and metabolic syndromes, thus leading for a new field of research to find a mechanism that allows timely interventions.

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          Most cited references19

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          Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease.

          The Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) was formed to conduct multicenter studies on the etiology, contributing factors, natural history, and treatment of nonalcoholic steatohepatitis (NASH). The aim of this study was to determine the associations of readily available demographic, clinical, and laboratory variables with the diagnosis of NASH and its key histological features, and determine the ability of these variables to predict the severity of nonalcoholic fatty liver disease (NAFLD). A total of 1266 adults were enrolled in NASH CRN studies between October 2004 and February 2008, of whom 1101 had available liver histology. The median age was 50 years; 82% were white and 12% Hispanic. The median body mass index was 33 kg/m(2); 49% had hypertension and 31% had type 2 diabetes. On liver biopsy, 57% were judged to have definite NASH and 31% bridging fibrosis or cirrhosis. Using data from the 698 patients with liver biopsies within 6 months of clinical data, patients with definite NASH were more likely to be female and have diabetes, higher levels of aspartate and alanine aminotransferases, alkaline phosphatase, gamma glutamyl transpeptidase, and homeostasis model assessment of insulin resistance (HOMA-IR). Progressive models for predicting histological diagnoses performed modestly for predicting steatohepatitis or ballooning (area under receiver operating characteristic curves [AUROC] ranged from 0.70-0.79), and better for advanced fibrosis (AUROC 0.73-0.85). Readily available clinical and laboratory variables can predict advanced fibrosis in adults with NAFLD, but additional information is needed to reliably predict the presence and severity of NASH. Prospective studies of this well-characterized population and associated tissue bank samples offer a unique opportunity to better understand the cause and natural history of NAFLD and develop more precise means for noninvasive diagnosis.
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            Nonalcoholic steatohepatitis: definition and pathology.

            Nonalcoholic steatohepatitis (NASH) is a significant form of chronic liver disease in adults and children. The natural history of NASH ranges from indolent to end-stage liver disease. Current studies are focusing on identification of histologic and/or clinical markers of progression. NASH may be an underlying cause of cryptogenic cirrhosis, and the lesions of NASH may recur in allograft livers. An expanding array of clinical conditions and pathogenetic mechanisms have been identified, but many cases remain "idiopathic"; lack of significant alcohol use is, by definition, common to all cases. Neither clinical evaluation nor laboratory values can ensure either the diagnosis or the exclusion of NASH, and liver biopsy interpretation continues to be considered the "gold standard" for diagnosis. The lesions in NASH are similar but not identical to those of alcoholic steatohepatitis; exact, specific histologic criteria for the diagnosis are currently under discussion. The lesions most commonly accepted for NASH include steatosis, hepatocyte ballooning degeneration, mild diffuse lobular mixed acute and chronic inflammation, and perivenular, perisinusoidal collagen deposition. Zone 3 accentuation may be detected. Mallory's hyaline, vacuolated nuclei in periportal hepatocytes, lobular lipogranulomas, and PAS-diastase-resistant Kupffer cells are common. In biopsy specimens from children, portal inflammation may be more prominent than in adults. Progression of fibrosis may result in bridging septa and cirrhosis. The lesions of steatohepatitis may be noted concurrently with other forms of chronic liver disease. A histological "grading and staging" system has been developed to reflect the unique features of steatohepatitis, gradations of severity and fibrosis, and to promote uniform reporting of the histopathology.
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              Metabolic syndrome and uric acid nephrolithiasis: insulin resistance in focus

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                Author and article information

                Journal
                Tomography
                Tomography
                TOMOG
                Tomography
                Grapho Publications, LLC (Ann Abor, Michigan )
                2379-1381
                2379-139X
                March 2020
                : 6
                : 1
                : 1-4
                Affiliations
                [1 ]Medical Specialist in Radiology and Diagnostic Imaging, Foscal Clinic, Floridablanca, Colombia;
                [2 ]Specialist in Radiology and Diagnostic Imaging, Autonomous University of Bucaramanga, Bucaramanga, Colombia;
                [3 ]Medical and Surgeon, Industrial University of Santander, Bucaramanga, Colombia; and
                [4 ]Medicine Student, Autonomous University of Bucaramanga, Bucaramanga, Colombia
                Author notes
                Corresponding Author: Federico Guillermo Lubinus Badillo, MD Universidad Autonoma de Bucaramanga, Bucaramanga, Santander, Colombia, Calle 155A #23-60; E-mail: flubinus@ 123456hotmail.com
                Article
                TOMO.2020.00020.R1
                10.18383/j.tom.2020.00020
                7138524
                32280744
                7aa3c74f-5723-4d5b-8ed5-c30b771e5e62
                © 2020 The Authors. Published by Grapho Publications, LLC

                This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/).

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                Categories
                Image Reports

                nonalcoholic fatty liver disease,urolithiasis,metabolic syndrome

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