Lipidomics in non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD),the most common chronic liver disorder in Western countries,comprises steatosis to nonalcoholic steatohepatitis(NASH),with the latter having the potential to progress to cirrhosis.The transition from isolated steatosis to NASH is still poorly understood,but lipidomics approach revealed that the hepatic lipidome is extensively altered in the setting of steatosis and steatohepatitis and these alterations correlate with disease progression.Recent data suggest that both quantity and quality of the accumulated lipids are involved in pathogenesis of NAFLD.Changes in glycerophospholipid,sphingolipid,and fatty acid composition have been described in both liver biopsies and plasma of patients with NAFLD,implicating that specific lipid species are involved in oxidative stress,inflammation,and cell death.In this article,we summarize the findings of main human lipidomics studies in NAFLD and delineate the currently available information on the pathogenetic role of each lipid class in lipotoxicity and disease progression.

Rationale,design and baseline patient characteristics of the optimal type 2 diabetes management including benchmarking and standard treatment study in Greece

AIM:To describe baseline data of the optimal type2 diabetes management including benchmarking and standard treatment(OPTIMISE)study in Greece.METHODS:"Benchmarking"is the process of receiving feedback comparing one’s performance with that of others.The OPTIMISE(NCT00681850)study is a multinational,multicenter study assessing,at a primary care level,whether using"benchmarking"can help to improve the quality of patient care,compared with a set of guideline-based reference values("non-benchmarking").In the Greek region,797 outpatients(457men,mean age 63.8 years)with type 2 diabetes were enrolled by 84 office-based physicians.Baseline characteristics of this population are presented.RESULTS:Hypertension was the most prevalent concomitant disorder(77.3%)and coronary heart disease was the most frequent macrovascular complication of diabetes(23.8%).Most patients were overweight or obese(body mass index 29.6±5 kg/m2),exhibiting mostly abdominal obesity(waist circumference102.6±13.6 cm).Biguanides were the most prevalent prescribed drugs for the management of diabetes(70.1%of all prescriptions),whereas statins(93.5%of all prescriptions)and angiotensin receptor blockers(55.8%of all prescriptions)were the most prevalent prescribed drugs for hyperlipidemia and hypertension,respectively.Only 37.4%of patients were on aspirin.Despite treatment,pre-defined targets for fasting plasma glucose(<110 mg/dL),glycated hemoglobin(<7%),systolic blood pressure(<130 mmHg and<125mmHg for patients with proteinuria)and low density lipoprotein cholesterol levels(<100 mg/dL and<70mg/dL for patients with coronary heart disease)were reached in a relatively small proportion of patients(29%,53%,27%and 31%,respectively).In a Greek population with type 2 diabetes,the control of glycemia or concomitant disorders which increase cardiovascular risk remains poor.CONCLUSION:Despite relevant treatment,there is a poor control of diabetes,hypertension and hyperlipidemia in Greek outpatients with type 2 diabetes.