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Arkoudis NA, Papadakos SP. Machine learning applications in healthcare clinical practice and research. World J Clin Cases 2025; 13:99744. [PMID: 39764535 PMCID: PMC11577516 DOI: 10.12998/wjcc.v13.i1.99744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 09/25/2024] [Accepted: 10/15/2024] [Indexed: 11/07/2024] Open
Abstract
Machine learning (ML) is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis, thus creating machines that can complete tasks otherwise requiring human intelligence. Among its various applications, it has proven groundbreaking in healthcare as well, both in clinical practice and research. In this editorial, we succinctly introduce ML applications and present a study, featured in the latest issue of the World Journal of Clinical Cases. The authors of this study conducted an analysis using both multiple linear regression (MLR) and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease (NAFLD). Their results implicated age as the most important determining factor in both groups, followed by lactic dehydrogenase, uric acid, forced expiratory volume in one second, and albumin. In addition, for the NAFLD- group, the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure, as compared to plasma calcium and body fat for the NAFLD+ group. However, the study's distinctive contribution lies in its adoption of ML methodologies, showcasing their superiority over traditional statistical approaches (herein MLR), thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.
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Affiliation(s)
- Nikolaos-Achilleas Arkoudis
- Research Unit of Radiology and Medical Imaging, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
- 2nd Department of Radiology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Chaidari 12462, Greece
| | - Stavros P Papadakos
- Department of Gastroenterology, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece
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Aksu Y, Uslu AU, Tarhan G, Tiryaki Ş. Renal Artery Resistive Index and Estimated Glomerular Filtration Rate in Patients with Non-alcoholic Fatty Liver Disease. Curr Med Imaging 2022; 18:1318-1324. [PMID: 35578862 DOI: 10.2174/1573405618666220516123519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/07/2022] [Accepted: 03/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Non-alcoholic fatty liver disease (NAFLD) may affect many organs and systems, especially the kidney as well as the liver. While NAFLD's renal impacts can be evaluated via the estimated glomerular filtration rate (eGFR), its effects on renal hemodynamic changes can be monitored with the renal resistive index (RRI). Our aim in this study is to evaluate RRI and eGFR in NAFLD patients. MATERIALS AND METHODS In this study, a total of 69 patients with NAFLD and 50 age- and gendermatched healthy controls were included. The basic clinical and laboratory parameters of patient and control groups were assessed and recorded. RESULTS In the patient group, the RRI was observed as 0.64±0.06 and eGFR value as 86±52 (mL/min/1.73m2), while in the control group, the RRI was 0.61±0.05 and eGFR was 95.40±20.21 (mL/min/1.73m2). Compared to the control group, the RRI and eGFR values were significantly different in the patient group (PRRI=0.003 and PeGFR=0.025). There was a negative correlation observed between the RRI and eGFR (r=-0.347, P=0.003). Receiver-operating characteristic curve analysis suggested that the optimum RRI cut-off value for patients with NAFLD is 0.62, with 65% sensitivity and 60% specificity (p=0.002). There was an independent relationship found between the RRI and eGFR according to the linear regression analysis (β=-0.301, P=0.015). CONCLUSION This study shows that RRI may be an indicator of renal functions, such as eGFR in patients with NAFLD.
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Affiliation(s)
- Yusuf Aksu
- Yunus Emre State Hospital, Department of Radiology, Eskişehir, Turkey
| | - Ali Ugur Uslu
- Yunus Emre State Hospital, Department of Internal Medicine, Eskişehir, Turkey
| | - Gulten Tarhan
- Yunus Emre State Hospital, Department of Internal Medicine, Eskişehir, Turkey
| | - Şaban Tiryaki
- Kırşehir Ahi Evran University Medical Faculty, Department of Radiology, Kırşehir, Turkey
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Xu Z, Lin S, Gong J, Feng P, Cao Y, Li Q, Jiang Y, You Y, Tong Y, Wang P. Exploring the Protective Effects and Mechanism of Crocetin From Saffron Against NAFLD by Network Pharmacology and Experimental Validation. Front Med (Lausanne) 2021; 8:681391. [PMID: 34179049 PMCID: PMC8219931 DOI: 10.3389/fmed.2021.681391] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/18/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is a burgeoning health problem but no drug has been approved for its treatment. Animal experiments and clinical trials have demonstrated the beneficial of saffron on NAFLD. However, the bioactive ingredients and therapeutic targets of saffron on NAFLD are unclear. Purpose: This study aimed to identify the bioactive ingredients of saffron responsible for its effects on NAFLD and explore its therapy targets through network pharmacology combined with experimental tests. Methods: Various network databases were searched to identify bioactive ingredients of saffron and identify NAFLD-related targets. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment were conducted to enrich functions and molecular pathways of common targets and the STRING database was used to establish a protein-protein interaction network (PPI). The effect of crocetin (CCT) on NAFLD was evaluated in a mouse model of NAFLD by measuring the biomarkers of lipid, liver and renal function, oxidative stress, and inflammation. Liver histopathology was performed to evaluate liver injury. Nuclear factor erythroid-related factor (Nrf2) and hemeoxygenase-1 (HO-1) were examined to elucidate underlying mechanism for the protective effect of saffron against NAFLD. Results: A total of nine bioactive ingredients of saffron, including CCT, with 206 common targets showed therapeutic effects on NAFLD. Oxidative stress and diabetes related signaling pathways were identified as the critical signaling pathways mediating the therapeutic effects of the active bioactive ingredients on NAFLD. Treatment with CCT significantly reduced the activities of aspartate aminotransferase (AST), alanine transaminase (ALT), and the levels of total cholesterol (TC), triglyceride (TG), malondialdehyde (MDA), blood urea nitrogen (BUN), creatinine (CR), and uric acid (UA). CCT significantly increased the activities of superoxide dismutase (SOD), and catalase (CAT). Histological analysis showed that CCT suppressed high-fat diet (HFD) induced fat accumulation, steatohepatitis, and renal dysfunctions. Results of ELISA assay showed that CCT decreased the expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β), and increased the expression of HO-1 and Nrf2. Conclusion: This study shows that CCT is a potential bioactive ingredient of saffron that treats NAFLD. Its mechanism of action involves suppressing of oxidative stress, mitigating inflammation, and upregulating Nrf2 and HO-1 expression.
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Affiliation(s)
- Zijin Xu
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Susu Lin
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Junjie Gong
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Peishi Feng
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Yifeng Cao
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Qiaoqiao Li
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Yuli Jiang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Ya You
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Yingpeng Tong
- School of Life Sciences, Taizhou University, Taizhou, China
| | - Ping Wang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
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Mahmoud HEDA, Yousry WA, Saleh SA, El Badry M, Hussein A, Ali MH, El-Hariri HM. Renal resistive index in non-alcoholic fatty liver disease as an indicator of early renal affection. EGYPTIAN LIVER JOURNAL 2020. [DOI: 10.1186/s43066-019-0006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nonalcoholic fatty liver disease (NAFLD) is a possible risk factor for chronic kidney disease (CKD). Renal resistive index (RRI) which is a ratio of peak systolic and end diastolic velocity can test arterial stiffness and endothelial renal dysfunction. The aim of the work is to detect the relation between NAFLD and RRI as an indicator of early renal affection and its relation to the disease severity. This study included 150 subjects divided into 3 groups: patients with NASH, simple steatosis, and control group (50 patients each). All patients were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasound examination, and RRI measurement.
Results
6.0% of NASH patients had significant fibrosis by NAFLD fibrosis score. RRI was significantly higher in NASH patients with fibrosis (mean = 0.74) than NASH patients without fibrosis (mean = 0.65) and patients with simple steatosis (mean = 0.63). It was the lowest in normal controls (mean = 0.61). There were significant correlations between RRI and age, BMI, serum lipids, liver enzymes, and NAFLD fibrosis score. Multiple linear regression analysis found that age and serum cholesterol were significant independent factors of increased RRI (p < 0.0001). RRI showed low diagnostic performance in differentiation between NASH and simple steatosis using ROC curve.
Conclusion
RRI was significantly higher in NASH patients with and without hepatic fibrosis. RRI correlates significantly with NAFLD fibrosis score. RRI can be used as an indicator of early renal affection in patients with NAFLD.
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Ma YH. Renal dysfunction in patients with nonalcoholic fatty liver disease and risk factors. Shijie Huaren Xiaohua Zazhi 2018; 26:667-672. [DOI: 10.11569/wcjd.v26.i11.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the renal function in patients with nonalcoholic fatty liver disease (NAFLD) and to identify the risk factors for renal dysfunction.
METHODS A total of 856 volunteers who underwent health examination were initially enrolled in this study to identify those with NAFLD. The biochemical indexes of patients with NAFLD and healthy volunteers were statistically analyzed, and the renal function with estimated glomerular filtration rate was calculated. In addition, the risk factors for renal damage were identified.
RESULTS A total of 253 patients with NAFLD were identified, and the remaining 603 cases were used as a control group. There was no significant difference in serum BUN between the two groups (t = 1.678, P = 0.062), while other biochemical indexes differed significantly (P < 0.05). The prevalence of renal function impairment was higher in individuals with NAFLD compared to those without (28.8% vs 17.5%, P < 0.0001). Logistic regression analysis showed that NAFLD was associated with renal function impairment, even after adjustment for demographics and components of metabolic syndrome (OR = 2.85, 95%CI: 1.93-4.21, P = 0.000).
CONCLUSION The biochemical indexes of NAFLD patients are significantly abnormal, and renal function impairment is associated with NAFLD. Patients with NAFLD should be regularly assessed for renal function to avoid progressing into chronic kidney disease and increasing the medical burden.
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Affiliation(s)
- Yan-Hong Ma
- Department of Infectious Diseases, Binhai Hospital of Tianjin Medical University General Hospital, Tianjin 300480, China
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Zhou Z, Chen H, Ju H, Sun M. Circulating retinol binding protein 4 levels in nonalcoholic fatty liver disease: a systematic review and meta-analysis. Lipids Health Dis 2017; 16:180. [PMID: 28931435 PMCID: PMC5607593 DOI: 10.1186/s12944-017-0566-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 09/07/2017] [Indexed: 01/02/2023] Open
Abstract
Background Retinol binding protein 4 (RBP4) is implicated in obesity, insulin resistance and type 2 diabetes mellitus that are closely associated with nonalcoholic fatty liver disease (NAFLD). However, recent investigations regarding circulating RBP4 levels in NAFLD are conflicting. This meta-analysis is to determine whether NAFLD, non-alcoholic steatohepatitis (NASH) and simple steatosis (SS) patients have altered RBP4 levels. Methods We performed a systematic search in PubMed, EMBASE and The Cochrane Library up until 18 March 2017, and 12 studies comprising a total of 4247 participants (2271 NAFLD patients and 1976 controls) were included in the meta-analysis. Results There were no significant differences of circulating RBP4 levels in the following comparisons: (1) NAFLD patients vs controls (standardized mean differences [SMD]: 0.08; 95% CI: −0.21, 0.38); (2) NASH patients vs controls (SMD: −0.49; 95% CI: −1.09, 0.12); (3) SS patients vs controls (SMD: −0.72; 95% CI: −1.64, 0.20) and (4) NASH vs SS patients (SMD: −0.04; 95% CI: −0.32, 0.24). The results remained essentially unchanged in the comparisons between NAFLD patients and controls after excluding single individual study or bariatric studies (n = 2). No significant publication bias was detected. However, there was significant heterogeneity among studies and the subgroup and meta-regression analyses did not find the potential sources. Conclusions Circulating RBP4 levels may not be associated with NAFLD. Further prospective cohort studies are required to confirm these findings. Electronic supplementary material The online version of this article (10.1186/s12944-017-0566-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zhongwei Zhou
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, No. 75 Juchang Road, Tinghu, Yancheng, Jiangsu, 224001, People's Republic of China
| | - Hongmei Chen
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, No. 75 Juchang Road, Tinghu, Yancheng, Jiangsu, 224001, People's Republic of China
| | - Huixiang Ju
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, No. 75 Juchang Road, Tinghu, Yancheng, Jiangsu, 224001, People's Republic of China
| | - Mingzhong Sun
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, No. 75 Juchang Road, Tinghu, Yancheng, Jiangsu, 224001, People's Republic of China.
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