Kanokphong Suparan

Background: Metabolic dysfunction‐associated steatotic liver disease (MASLD) affects over one third of the global population and is closely linked to gastrointestinal, oncological, and cardiovascular diseases. As the most common cause of steatotic liver disease (SLD), MASLD is often referred to as “fatty liver” in general health information searches. With the Internet becoming a primary source of healthcare information, this study aimed to evaluate global and regional public interest in steatotic liver disease using Google Trends data from January 2004 to December 2024.Methods: A comprehensive analysis was performed using Google Trends with the search term “fatty liver disease.” Interest levels were quantified using Google Trends indices, and temporal patterns were evaluated using average annual percent change (AAPC). Regional variations were assessed to identify geographic hotspots of public interest.Results: Global interest in MASLD demonstrated significant growth (AAPC: 6.77%, 95% Confidence interval [CI]: 5.33–8.23), with a 264% increase from 2004 to 2024. Peak interest was observed in August 2024 (index: 100) compared to the lowest point in June 2007. Iran showed the highest country‐specific search volume (index: 100), while within the United States, West Virginia demonstrated the greatest relative interest (index: 100). Key topics associated with MASLD included “liver,” “symptoms,” “disease,” and “therapy.”Conclusions: Substantial growth in global public interest in MASLD, with distinct temporal and geographical patterns, provides insights to develop targeted awareness campaigns and educational interventions, particularly in regions with low search volumes. Future research should examine the relationship between online search patterns and clinical outcomes in MASLD.

Background/Objectives: The fern “Cyclosorus terminans” (C. terminans) or “Maiden Fern” contains interruptin A and interruptin B. This plant could attenuate obesity, insulin resistance, and fatty liver in rats fed a high-fat/calorie diet. However, the benefits of C. terminans to the gut remain unknown. We investigated the protective effect of C. terminans extract against gut dysfunction in rats exposed to a high-fat/calorie diet. Methods: Male Wistar rats were assigned to receive either (1) a normal diet treated with vehicle, (2) a high-fat/calorie diet treated with vehicle, (3) a high-fat/calorie diet treated with 100 mg per kg per day (mg·kg⁻¹·day⁻¹) of C. terminans extract, or (4) a high-fat/calorie diet treated with 200 mg·kg⁻¹·day⁻¹ of C. terminans extract. The rats were euthanized after 12 weeks of treatment to enable feces and colon tissue collection. Results: Both 100 and 200 mg·kg⁻¹·day⁻¹ of C. terminans extract reduced body weight (−10.49%; p = 0.030 and −10.54%; p = 0.037, respectively) and ameliorated gut inflammation, gut barrier disruption, changes in short-chain fatty acid levels, and gut dysbiosis caused by high-fat/calorie diet. Conclusions: C. terminans extract attenuated an increase in body weight and exerted prophylactic effects against gut pathologies induced by high-fat/calorie diet.

Background/Aims: Alcohol represents a leading burden of disease worldwide, including alcohol use disorder (AUD) and alcohol-related liver disease (ALD). We aim to assess the global burden of AUD, ALD, and alcohol-attributable primary liver cancer between 2000–2021.Methods: We registered the global and regional trends of AUD, ALD, and alcohol-related liver cancer using data from the Global Burden of Disease 2021 Study, the largest and most up-to-date global epidemiology database. We estimated the annual percent change (APC) and its 95% confidence interval (CI) to assess changes in age-standardized rates over time.Results: In 2021, there were 111.12 million cases of AUD, 3.02 million cases of ALD, and 132,030 cases of alcohol-attributable primary liver cancer. Between 2000 and 2021, there was a 14.66% increase in AUD, a 38.68% increase in ALD, and a 94.12% increase in alcohol-attributable primary liver cancer prevalence. While the age-standardized prevalence rate for liver cancer from alcohol increased (APC 0.59%; 95% confidence interval [CI] 0.52 to 0.67%) over these years, it decreased for ALD (APC –0.71%; 95% CI –0.75 to –0.67%) and AUD (APC –0.90%; 95% CI –0.94 to –0.86%). There was significant variation by region, socioeconomic development level, and sex. During the last years (2019–2021), the prevalence, incidence, and death of ALD increased to a greater extent in females.Conclusions: Given the high burden of AUD, ALD, and alcohol-attributable primary liver cancer, urgent measures are needed to prevent them at both global and national levels.

Background/Objectives: The incidence and mortality of early-onset cancers have been rising in recent decades. While epidemiological studies have examined various types of cancer, updated global data on alcohol-attributable primary liver cancer (PLC) in young adults remains limited. Methods: This study utilized data from the Global Burden of Disease (GBD) study spanning 2000 to 2021 to evaluate the age-standardized incidence, mortality, and corresponding rates of alcohol-attributable PLC among young adults aged 15–49 years. Results: In 2021, there were 8290 incidence cases and 6590 deaths from alcohol-attributable PLC in young adults. The age-standardized incidence rate has increased in Europe (annual percent change [APC]: 0.44%, 95%CI 0.35 to 0.54%), Southeast Asia (APC: 0.40%, 95% CI 0.37 to 0.44%), and the Western Pacific region (APC: 0.65%, 95% CI 0.44 to 0.86%). In 2021, alcohol-attributable PLC in young adults represented 11% (+2% from 2000) of incident cases and 11% of (+2% from 2000) deaths among all PLC in young adults. About half of the countries showed an increase in the age-standardized incidence rate of alcohol-attributable PLC among young adults between 2000 and 2021. Conclusions: The incidence rate of alcohol-attributable liver cancer in young adults has shifted significantly over the past two decades, with notable increases in Europe and the Asia–Pacific region. This trend underscores the need for global strategies to address the rising prevalence of alcohol use disorder and alcohol-associated liver disease and their impact on young adults.

Background: The incidence of cancer and the prevalence of metabolic disease and metabolic dysfunction–associated steatotic liver disease is increasing in young adults. However, updated global data on metabolic dysfunction–associated steatohepatitis (MASH)-associated primary liver cancer (PLC) in young adults remains scarce. Methods: This study analyzed data from the Global Burden of Disease study between 2000 and 2021 to assess the age-standardized incidence, mortality, and disability-adjusted life years rates from MASH-associated PLC in young adults (15–49 y). Results: In 2021, there were 4300 incidence cases, 3550 deaths, and 179,340 disability-adjusted life years from MASH-associated PLC in young adults. Among various etiologies of PLC in young adults, only MASH-associated PLC had increased incidence rates (annual percent change: +0.26, 95% CI: 0.16%–0.35%), with the Eastern Mediterranean region having the largest observed increase (annual percent change: 1.46%, 95% CI: 1.40%–1.51%). In 2021, MASH-associated PLC in young adults made up 6% (+1% from 2000) incident cases, 6% (+2% from 2000) deaths, and 6% (+2% from 2000) disability-adjusted life years of all PLC in this age group. Over half of the countries exhibited an increase in age-standardized incidence rate from MASH-associated PLC in young adults from 2000 to 2021. Conclusions: The incidence of MASH-associated PLC in young adults is significantly increasing, signaling likely future increases in PLC incidence among older adults as this cohort ages. This trend necessitates urgent strategies worldwide to mitigate the epidemics of MASH-associated PLC in young adults. Export

Background: Thalassemia is a hereditary disease with impaired red blood cell production, resulting in cumulative systemic iron burden. The life‐long therapeutic blood transfusion with or without iron chelators in those patients leads to the development of early‐onset neurocognitive decline. However, the effects of regularity of blood transfusion on the severity of iron burden, cognitive decline, and gut dysbiosis in thalassemia patients are still unclear.Method: Sixty participants, including 20 transfusion‐dependent (TDT) patients, 20 non‐transfusion‐dependent (NTDT) patients, and 20 healthy controls, underwent evaluation for neurocognitive function using the Montreal Cognitive Assessment (MoCA). The current systemic iron burden was determined by the levels of serum ferritin. Amplicon‐based sequencing of the bacterial 16s rRNA V3‐V4 regions of stool DNA was employed to delineate profiles of gut microbiota.Result: The TDT patients showed greater severity of systemic iron burden, cognitive decline and gut dysbiosis than the NTDT patients. The TDT group was particularly afflicted with systemic iron burden as indicated by the highest levels of serum ferritin (Fig. 1A). Compared to the controls, the TDT and NTDT groups had significantly lower MoCA scores (Fig. 1B). In addition, there was a negative correlation between MoCA scores and the levels of serum ferritin (Fig. 1C). The thalassemia patients also exhibited gut dysbiosis, with microbial compositions among the three groups being distinct from each other (Fig. 1D and 1E). Interestingly, an increase in abundance of Paraclostridium was associated with cognitive decline.Conclusion: These findings suggest that the severity of systemic iron burden, based on the regularity of blood transfusion, impacts on the magnitude of cognitive decline and gut dysbiosis in thalassemia patients. It is possible that systemic iron potentially serves as a dose‐dependent factor in the pathogenesis of neurodegeneration through gut dysbiosis. Therefore, therapeutic approaches via well‐control of systemic iron levels and balanced gut microbiota could prevent early‐onset cognitive decline in thalassemia patients.