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      Genetic Variations of AKT1 are Associated with Risk Screening for Non-Alcoholic Fatty Liver Disease

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          Abstract

          Purpose

          Protein kinase B (PKB/AKT) has shown a high profile in the research of metabolic diseases. This research sought to determine whether the AKT1 gene’s single nucleotide polymorphisms (SNPs) and the risk of developing non-alcoholic fatty liver disease (NAFLD) were related.

          Patients and Methods

          Recruited in this case–control study were 2693 subjects, including 815 with NAFLD and 1878 without NAFLD. Three SNPs of AKT1 (rs2494732, rs2494752 and rs1130233) were genotyped. To examine the correlation between SNPs and NAFLD susceptibility, logistic regression was performed.

          Results

          After adjusting for sex, age, triglyceride and glucose, AKT1 rs2494732-C (all P < 0.05 in co-dominant model, dominant model and additive model) and rs2494752-G ( P < 0.05 in co-dominant model) were linked to a lower risk of NAFLD. The combined effect of both SNPs on NAFLD risk was statistically significant, showing a dose dependence ( P trend = 0.010). Sex, body mass index, hypertension, hyperglycemia, hypertriglyceridemia, high-density lipoprotein-cholesterol, alanine aminotransferase, and beneficial alleles were all significant predictors of NAFLD risk (all P < 0.05). The prediction model achieved good discrimination, with an area under the receiver operating characteristic curve of 0.779. The Hosmer–Lemeshow test suggested an inadequate calibration of the model ( χ 2 = 21.073, P = 0.007).

          Conclusion

          AKT1 rs2494732 and rs2494752 may be related to Chinese NAFLD susceptibility. The prediction model combining both SNPs with clinical factors displays a strong ability to discriminate NAFLD patients. Both SNPs may be exploited to design new models for early screening of NAFLD high-risk population.

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          Most cited references49

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          Mechanisms of NAFLD development and therapeutic strategies

          There has been a rise in the prevalence of nonalcoholic fatty liver disease (NAFLD), paralleling a worldwide increase in diabetes and metabolic syndrome. NAFLD, a continuum of liver abnormalities from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), has a variable course but can lead to cirrhosis and liver cancer. Here we review the pathogenic and clinical features of NAFLD, its major comorbidities, clinical progression and risk of complications and in vitro and animal models of NAFLD enabling refinement of therapeutic targets that can accelerate drug development. We also discuss evolving principles of clinical trial design to evaluate drug efficacy and the emerging targets for drug development that involve either single agents or combination therapies intended to arrest or reverse disease progression.
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            MAFLD: A consensus-driven proposed nomenclature for metabolic associated fatty liver disease

            Fatty liver associated with metabolic dysfunction is common, affects a quarter of the population, and has no approved drug therapy. Although pharmacotherapies are in development, response rates appear modest. The heterogeneous pathogenesis of metabolic fatty liver diseases and inaccuracies in terminology and definitions necessitate a reappraisal of nomenclature to inform clinical trial design and drug development. A group of experts sought to integrate current understanding of patient heterogeneity captured under the acronym nonalcoholic fatty liver disease (NAFLD) and provide suggestions on terminology that more accurately reflects pathogenesis and can help in patient stratification for management. Experts reached consensus that NAFLD does not reflect current knowledge, and metabolic (dysfunction) associated fatty liver disease "MAFLD" was suggested as a more appropriate overarching term. This opens the door for efforts from the research community to update the nomenclature and subphenotype the disease to accelerate the translational path to new treatments.
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              AKT/PKB Signaling: Navigating the Network

              The Ser/Thr kinase AKT, also known as protein kinase B (PKB), was discovered 25 years ago and has been the focus of tens of thousands of studies in diverse fields of biology and medicine. There have been many advances in our knowledge of the upstream regulatory inputs into AKT, key multifunctional downstream signaling nodes (GSK3, FoxO, mTORC1), which greatly expand the functional repertoire of Akt, and the complex circuitry of this dynamically branching and looping signaling network that is ubiquitous to nearly every cell in our body. Mouse and human genetic studies have also revealed physiological roles for the AKT network in nearly every organ system. Our comprehension of AKT regulation and functions is particularly important given the consequences of AKT dysfunction in diverse pathological settings, including developmental and overgrowth syndromes, cancer, cardiovascular disease, insulin resistance and type-2 diabetes, inflammatory and autoimmune disorders, and neurological disorders. There has also been much progress in developing AKT-selective small molecule inhibitors. Improved understanding of the molecular wiring of the AKT signaling network continues to make an impact that cuts across most disciplines of the biomedical sciences.
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                Author and article information

                Journal
                Risk Manag Healthc Policy
                Risk Manag Healthc Policy
                rmhp
                Risk Management and Healthcare Policy
                Dove
                1179-1594
                26 July 2023
                2023
                : 16
                : 1365-1376
                Affiliations
                [1 ]Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University , Nanjing, Jiangsu, People’s Republic of China
                [2 ]The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong , Shatin, New Territories, Hong Kong (SAR), People’s Republic of China
                [3 ]Department of General Practice, Ninghai Road Community Health Service Center , Nanjing, Jiangsu, People’s Republic of China
                [4 ]Department of Epidemiology, Shanghai Cancer Institute , Shanghai, People’s Republic of China
                Author notes
                Correspondence: Jie Wang, Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University , 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People’s Republic of China, Tel +86-25-86869557, Fax +86-25-86868501, Email wangjienjmu@126.com
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0000-0001-5220-1726
                Article
                416592
                10.2147/RMHP.S416592
                10387243
                37525829
                97c2c022-e1a8-44d3-9af4-40f5f46e36f7
                © 2023 Ding et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 10 April 2023
                : 12 July 2023
                Page count
                Figures: 3, Tables: 4, References: 49, Pages: 12
                Funding
                Funded by: the Six Talent Peaks Project in Jiangsu Province, China;
                Funded by: “333 Project” of Jiangsu Province, and Connotation Construction Project of Nanjing Medical University for Priority Academic of Nursing Science (General Office, the People’s Government of Jiangsu Province;
                This work was supported by the Six Talent Peaks Project in Jiangsu Province, China (2019, WSN-049), “333 Project” of Jiangsu Province, and Connotation Construction Project of Nanjing Medical University for Priority Academic of Nursing Science (General Office, the People’s Government of Jiangsu Province <2018> No.87).
                Categories
                Original Research

                Social policy & Welfare
                nafld,susceptibility,akt1 gene,polymorphism,risk screening
                Social policy & Welfare
                nafld, susceptibility, akt1 gene, polymorphism, risk screening

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