Lei Xu

Zhejiang University

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Chaohui Yu

First Affiliated Hospital Zhejiang University

Jiarong Xie

Ningbo University

Chengfu Xu

First Affiliated Hospital Zhejiang University

Min Miao

Ningbo University

Youming Li

First Affiliated Hospital Zhejiang University

Weihong Wang

Northeast Petroleum University

Xin‐Li Mao

Wenzhou Medical University

Youming Li

Zhejiang University

Zhe Shen

First Affiliated Hospital Zhejiang University

Xiaoyun Ding

Ningxia Medical University General Hospital

Cooperative Institutions

Zhejiang University

Ningbo First Hospital

Ningbo University

First Affiliated Hospital Zhejiang University

Chinese Academy of Medical Sciences & Peking Union Medical College

Sichuan University

Chinese Academy of Sciences

Sun Yat-sen University

Ningbo University Affiliated Hospital

National Clinical Research Center for Digestive Diseases

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Serum complement C3 levels are associated with nonalcoholic fatty liver disease independently of metabolic features in Chinese population

Scientific Reports (2016)

Chengfu Xu Yi Chen Lei Xu Min Miao Youming Li

Abstract Serum complement C3 levels are closely associated with obesity and related metabolic disorders. This study aimed to investigate the association between serum complement C3 levels with non-alcoholic fatty liver disease (NAFLD). A cross-sectional study was performed among adults who took their annual health examinations at Zhenhai Lianhua Hospital, Ningbo, China during 2014. We included 7540 participants (5069 men and 2471 women) in this study. NAFLD patients had higher serum complement C3 levels ( P < 0.001) and these levels were positively associated with both NAFLD prevalence and severity ( P < 0.001). The above association remains true among lean and metabolic syndrome-free participants. Multivariable regression analysis showed that serum complement C3 was independently associated with risk for NAFLD (OR = 5.231; 95% CI: 3.169–8.635). Serum complement C3 level is positively associated with prevalence and severity of NAFLD and this association is independent of obesity and metabolic syndrome.

Complement

10.1038/srep23279

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Citations (47)

Prevalence and Risk Factors for the Development of Nonalcoholic Fatty Liver Disease in a Nonobese Chinese Population: the Zhejiang Zhenhai Study

The American Journal of Gastroenterology (2013)

Chengfu Xu Chaohui Yu Han Ma Lei Xu Min Miao

The precise prevalence and risk factors for the development of nonalcoholic fatty liver disease (NAFLD) in nonobese adults remains unclear. The objective of this study was to investigate the prevalence of NAFLD and risk factors for its development in a nonobese Chinese population.We firstly investigated the prevalence and factors associated with the presence of NAFLD in nonobese (body mass index (BMI) <25 kg/m(2)) Chinese subjects via a cross-sectional study, and then analyzed the risk factors for the development of NAFLD via a subsequent prospective 5-year follow-up of the same population.A total of 6,905 nonobese subjects were enrolled in the cross-sectional study. Baseline evaluation revealed that the prevalence of NAFLD was 7.27%. A total of 5,562 subjects who were free of NAFLD at baseline completed the follow-up study, and 494 (8.88%) had developed NAFLD during the 5-year follow-up. Further analyses revealed that age, gender, BMI, waist circumference, triglyceride, high-density lipoprotein (HDL) cholesterol, serum uric acid, hemoglobin, and platelet count were independently associated with the presence and development of NAFLD.NAFLD is prevalent in the nonobese Chinese population, and a substantial proportion of subjects developed NAFLD over the 5-year follow-up period. Special attention should be paid to the factors associated with the presence and development of NAFLD in nonobese subjects, to improve prevention and management of NAFLD.

10.1038/ajg.2013.104

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Citations (170)

Association between Serum Growth Hormone Levels and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

PLoS ONE (2012)

Lei Xu Chengfu Xu Chaohui Yu Min Miao Xuequn Zhang

Growth hormone (GH) is an important regulator of metabolism and body composition. GH deficiency is associated with increased visceral body fat and other features of the metabolic syndrome. Here we performed a cross-sectional study to explore the association of GH levels with nonalcoholic fatty liver disease (NAFLD), which is considered to be the hepatic manifestation of the metabolic syndrome. A total of 1,667 subjects were diagnosed as NAFLD according the diagnostic criteria, and 5,479 subjects were defined as the controls. The subjects with NAFLD had significantly lower levels of serum GH than the controls. Those with low GH levels had a higher prevalence of NAFLD and the metabolic syndrome. A stepwise logistic regression analysis showed that GH levels were significantly associated with the risk factor for NAFLD (OR = 0.651, 95%CI = 0.574–0.738, P<0.001). Our results showed a significant association between lower serum GH levels and NAFLD.

Cross-sectional study

10.1371/journal.pone.0044136

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Association between past exposure to fine particulate matter (PM2.5) and peptic ulcer: A cross-sectional study in eastern China

Chemosphere (2020)

Zhebin Yu Xin‐Li Mao Mengling Tang Yi Chen Mengyin Wu

Ambient fine particulate matter (particle diameter < 2.5 μm, or PM2.5) is a major public health concern in China. Exposure to PM2.5 has been associated with a wide range of adverse health outcomes. The current study aimed to estimate the association between exposure to PM2.5 and the risk of peptic ulcer diseases (PUDs). We conducted a hospital-based cross-sectional study of seven major cities in Zhejiang Province, China (combined population > 57 million people), which included a total of 647,092 subjects who underwent gastroscopy examination (86,852 subjects were diagnosed with PUDs) recorded in 13 large hospitals from 2014 to 2018. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the relationship between PM2.5 and PUDs, including duodenal ulcers (DUs) and gastric ulcers (GUs). The overall estimated OR (95% CI) associated with every 10-μg/m3 increase in the 1-month average PM2.5 before the detection of PUDs was 1.050 (95% CI: 1.038, 1.063). The association between PM2.5 concentration and the prevalence of PUDs tended to be attenuated but remained significant when considering different exposure periods (OR = 1.030, 95% CI = 1.018–1.043 for the 3-month moving average; OR = 1.020, 95% CI = 1.005–1.037 for the 6-month moving average). Stronger associations were observed for DUs than GUs. The observed positive association of PM2.5 exposure with PUDs remained significant in the two-pollutant models after adjusting for other air pollutants. Our findings could provide scientific evidence for a more general adverse role of air pollution on PUDs.

Cross-sectional study

10.1016/j.chemosphere.2020.128706

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Citations (5)

No Association Between Nonalcoholic Fatty Liver Disease and Severe COVID-19? Something We Might Ignore

Clinical Gastroenterology and Hepatology (2022)

Huizhi Gao Lei Xu

Univariate analysis

Univariate

10.1016/j.cgh.2022.03.037

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Impact of a Telephone Intervention on Bowel Preparation Quality for Colonoscopy in the Elderly

Gastroenterology Nursing (2021)

Chunjiu Hu Linyan Jiang Linyin Sun Chunyan Hu Kemei Shi

Bowel preparation is the basis of colonoscopy, and adequate bowel preparation is essential to the success of colonoscopy. Studies have been reported that telephone intervention can improve the quality of bowel preparation, while it remains unclear regarding effectiveness with the elderly. The purpose of this study was to evaluate the effect of telephone intervention on the quality of bowel preparation for colonoscopy in elderly outpatients. In total, 162 outpatients older than 65 years were enrolled and randomly divided into a control group and a study group. Patients in the study group were re-educated through telephone by a specific nurse 2 days before colonoscopy, whereas participants in the control group received education only on the day of appointment. The Ottawa score was used to evaluate the quality of bowel preparation between the two groups. In this study, no significant differences were observed in age, gender, body mass index, educational level, smoking and/or alcohol drinking, waiting time to colonoscopy, reasons for colonoscopy, and colonoscopic findings between the control group and the study group. Participants in the study group had higher adequate bowel preparation and compliance than the control group (83.1% vs. 59.5%, p = .03; 96.4% vs. 74.7%, p < .001). Univariate analysis showed that only noncompliance with start time was significantly associated with satisfactory bowel preparation in elderly patients. In conclusion, telephone intervention 2 days before colonoscopy can improve the quality of bowel preparation in the elderly.

Bowel preparation

Cathartic

Bowel management

Univariate analysis

10.1097/sga.0000000000000573

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Citations (5)

Light-to-Moderate Alcohol Consumption Is Associated With Increased Risk of Type 2 Diabetes in Individuals With Nonalcoholic Fatty Liver Disease: A Nine-Year Cohort Study

The American Journal of Gastroenterology (2020)

Lei Xu Jiarong Xie Shenghui Chen Yi Chen Hua Yang

OBJECTIVE: This study explored the association between light-to-moderate alcohol consumption (LMAC) and risk of type 2 diabetes mellitus (T2DM) in individuals with nonalcoholic fatty liver disease (NAFLD). METHODS: A 9-year cohort study was performed among Chinese men who underwent their annual health checkups between 2009 and 2018. NAFLD was diagnosed based on abdominal ultrasound with exclusion of excess alcohol intake and other causes of liver disease. Logistic regression and Cox proportional regression analyses were applied to identify the risk of prevalent and incident T2DM. RESULTS: Of the 7,079 participants enrolled, 243 had T2DM at baseline and 630 developed T2DM during the 45,456 person-years follow-up. Both at the baseline and by the end of the follow-up, LMAC was associated with a decreased risk of prevalent T2DM in NAFLD-free participants but with a significantly increased risk in patients with NAFLD. LMAC was also associated with a decreased risk of incident T2DM in NAFLD-free participants. The adjusted hazard ratios (95% confidence interval) of incident T2DM were 0.224 (0.115–0.437) and 0.464 (0.303–0.710) for NAFLD-free light drinkers and NAFLD-free moderate drinkers, respectively. Nondrinking, light-drinking, and moderate-drinking patients with NAFLD all showed significantly increased risks of incident T2DM. Compared with NAFLD-free nondrinkers, the adjusted hazard ratios (95% confidence interval) of incident T2DM were 1.672 (1.336–2.092), 2.642 (1.958–3.565), and 2.687 (2.106–3.427) for nondrinking, light-drinking, and moderate-drinking patients with NAFLD, respectively. DISCUSSION: LMAC decreased the risks of prevalent and incident T2DM in NAFLD-free participants. LMAC, however, was associated with an increased risk of T2DM in patients with NAFLD (ClinicalTrials.gov number: NCT03847116).

Lower risk

10.14309/ajg.0000000000000607

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Citations (28)

Nonalcoholic fatty pancreas disease is related independently to the severity of acute pancreatitis

European Journal of Gastroenterology & Hepatology (2019)

Jiarong Xie Lu Xu Yuning Pan Peifei Li Yi Liu

This study aimed to investigate the association between nonalcoholic fatty pancreas disease and the severity of acute pancreatitis (AP).Among the 1662 AP patients admitted between August 2010 and August 2017, 82 eligible patients with moderately severe acute pancreatitis (SAP) and SAP were selected. Meanwhile, 164 mild AP patients were age-matched, sex-matched, and BMI-matched at a ratio of 1 : 2. Nonalcoholic fatty pancreas disease was estimated by mean pancreas attenuation by unenhanced computed tomography. Finally, 1662 patients were screened and 246 patients were analyzed.For the 246 patients, the mean pancreatic attenuation and pancreas-to-spleen attenuation ratio (P/S ratio) were significantly lower in the moderately SAP and SAP groups compared with those in the mild AP group (both, P<0.001). Pancreatic attenuation decreased with an increase in the rate of ICU transfer, AP severity, systemic complications, and prognostic factors of AP (Acute Physiology and Chronic Health Evaluation II score≥8; P<0.001). A decreased P/S ratio was correlated positively with the increased mortality of patients with AP (hazard ratio: 0.000; 95% confidence interval: 0.000-0.012; P<0.001), as determined by Cox proportional regression analysis adjusted for creatinine, calcium, and albumin levels.The pancreatic attenuation level and P/S ratio are correlated independently to severity, mortality, and systemic complications in patients with AP.

Pancreatic Disease

10.1097/meg.0000000000001477

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Citations (13)

A Reassessment of Misclassifications in Metabolic Dysfunction–Associated Steatotic Liver Disease: Points to Consider

Clinical Gastroenterology and Hepatology (2024)

Shuhao Zheng Lei Xu

10.1016/j.cgh.2024.03.014

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Citations (0)

Coffee Consumption and Lower Liver Stiffness: The Risk for Residual Confounders Should be Considered

Clinical Gastroenterology and Hepatology (2021)