The European NAFLD Registry

Обзор

The European NAFLD Registry is a prospectively recruited, observational study supporting the study of the clinical phenotype, natural history, disease outcomes and pathophysiology of Non-Alcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis. The ultimate goals are to better understand the drivers of interpatient variation in disease pathophysiology and severity and to utilise this information to develop and validate biomarkers that, singly or in combination, enable detection and monitoring of disease progression and/or from NAFL through NASH to fibrosis and cirrhosis.

Подробное описание

The European NAFLD Registry is a major international collaboration between clinical academics at leading universities across Europe, initially established with funding from the European Association for the Study of the Liver and through the EU FP7, H2020 and IMI2 schemes to the projects FLIP (Fatty Liver Inhibition of Progression), EPoS (Elucidating Pathways of Steatohepatitis) and LITMUS (Liver Investigation: Testing marker Utility in Steatohepatitis).

The Registry is a non-interventional, observational study collecting cross-sectional and longitudinal clinical data (including clinical biochemistry/haematology, liver histology, comorbidities, prescribed medication and imaging data) and linked biological samples (Blood \[Serum, Plasma\], Liver Tissue, Urine, Stool) from prospectively recruited patients with NAFLD. Its purpose is to support clinical and translational research into disease pathophysiology (through development of comprehensive genetic, epigenetic, transcriptomic, metabolomic, proteomic and metagenomic datasets) and biomarker development/validation. It supports collaborative discovery science and serves as the basis for a broad international project to discover and validate biomarkers for NAFLD and associated medical conditions (LITMUS). Out-with the current study, following separate ethical approval and after separate consent, patients who have agreed to join the European NAFLD Registry may also agree to participate in a number of nested sub-studies with bi-directional sharing of data. These include the LITMUS Imaging Study, which will acquire additional imaging data across a range of modalities including, amongst others, MR-PDFF and MR-Elastography. The Registry population comprises adult patients (aged ≥18 years) with risk factors for non-alcoholic fatty liver disease (NAFLD) prospectively recruited primarily in hepatology and diabetology clinics and/or bariatric surgery units at centres across Europe. After receiving informed consent, patients will be assigned a unique study identifier (which will be used to identify all data and samples collected) which will allow all information to be recorded in a link-anonymised form.

Первичные конечные точки

• Detailed Characterisation of the NAFLD Patient Phenotype [Срок оценки: 1 day]

Вторичные конечные точки (6)

• Disease Natural History [Срок оценки: Through to study completion, an average of 5 years]
• Lifestyle factors: Dietary Habits [Срок оценки: Through study completion, an average of 5 years]
• Lifestyle factors: Activity/Exercise [Срок оценки: Through study completion, an average of 5 years]
• Health Related Quality of Life: CLDQ [Срок оценки: Through study completion, an average of 5 years]
• Health Related Quality of Life: EQ5D5L [Срок оценки: Through study completion, an average of 5 years]
• Health Related Quality of Life: NASH-CHECK [Срок оценки: Through study completion, an average of 5 years]

Критерии участия

Критерии включения

• Age ≥18 years.
• Clinically suspected NAFLD based on any of:

• Patient with historical liver biopsy providing histological evidence of NAFLD or,
• Patient undergoing liver biopsy for suspected NAFLD with biochemical and/or radiological findings consistent with NAFLD or,
• Patient with radiological evidence of cirrhosis (in absence of an alternative aetiology) plus presence of ≥2 features indicative of the 'metabolic syndrome':

• Increased waist circumference by ethnically adjusted criteria (e.g. Europid male/female ≥94cm/80cm) or overweight/obese (BMI ≥25);
• Raised fasting glucose ≥100 mg/dL \[5.6 mmol/L\], HbA1c ≥48mmol/mol (6.5%) or previously diagnosed insulin resistance/type 2 diabetes mellitus (or on treatment);
• Dyslipidaemia (fasting TG level ≥150 mg/dL \[1.7 mmol/L\]; or fasting HDL <40 mg/dL \[1.03 mmol/L\] in males and <50 mg/dL \[1.29 mmol/L\] in females; or on treatment);
• Hypertension (systolic BP ≥130 or diastolic BP ≥85 mmHg, or on treatment).
• Average alcohol consumption less than 21/14 units/week (males/females) in preceding 6 months and no history of sustained excessive consumption of alcohol in past 5 years.

Критерии исключения

• Refusal or inability (lack of capacity) to give informed consent.
• Average alcohol ingestion greater than approximately 21/14 units/week (males/females) in preceding 6 months or history of sustained excessive consumption of alcohol in past 5 years.
• History or presence of Type 1 diabetes mellitus.
• Presence of any other form of chronic liver disease except NAFLD.
• Recent (within 12 months) or concomitant use of agents known to cause hepatic steatosis (long-term systemic corticosteroids \[>10 days\], amiodarone, methotrexate, tamoxifen, tetracycline, high dose oestrogens, valproic acid).
• Any contra-indication to liver biopsy.
• Recent (within 3 months) change in dose/regimen or introduction of Vitamin E (at a dose ≥400 IU/day), betaine, s-adenosyl methionine, ursodeoxycholic acid, silymarin or pentoxifylline.
• Non-English speaking/unable to access an interpreter. Due to the nature of the study, English language or access to a relevant interpreter is a necessary criterion to ensure lifestyle (diet and exercise) and symptom data are collated.
• Patients not meeting inclusion criteria or judged by the investigator to be unsuitable for inclusion in the study.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Великобритания · 11 центров

• University Hospitals Birmingham Nhs Foundation Trust — Birmingham
• Addenbrooke'S Hospital — Cambridge
• Queen Elizabeth Hospital — Gateshead
• Hull Royal Infirmary — Hull
• Royal London Hospital, Barts Health NHS Trust — London
• St George's University Hospitals — London
• The Newcastle Upon Tyne Hospitals Nhs Foundation Trust — Newcastle upon Tyne
• Queen'S Medical Centre — Nottingham
• … и ещё 3 центра

Испания · 6 центров

• Vall d'Hebron University Hospital — Barcelona
• Biodonostia Health Research Institute — Donostia / San Sebastian
• Puerta de Hierro University Hospital — Majadahonda
• Marqués de Valdecilla University Hospital — Santander
• Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocío University Hospital — Seville
• HU Clínico de Valladolid — Valladolid

Германия · 5 центров

• UNIVERSITÄTSKLINIKUM der RWTH Aachen — Aachen
• Charité University Hospital Berlin — Berlin
• Universitätsklinikum Freiburg — Freiburg im Breisgau
• UNIVERSITÄTSMEDIZIN der Johannes Gutenberg Universität Mainz — Mainz
• Universitätsklinikums Würzburg — Würzburg

Италия · 5 центров

• Polytechnic University of Marche — Ancona
• Università degli Studi Milano — Milan
• Università di Palermo — Palermo
• Università Cattolica del Sacro Cuore — Rome
• Department of Medical Sciences University of Torino — Turin

Франция · 2 центра

• Le Centre de Recherche Clinique (CRC) du CHU d'Angers — Angers
• Institut ICAN - Institute of Cardiometabolism And Nutrition Hôpital de la Pitié Salpêtrièr — Paris

Швеция · 2 центра

• Karolinska Universitetssjukhuset — Huddinge
• Linköping University Hospital — Linköping

Бельгия · 1 центр

• Universitair Ziekenhuis Antwerpen — Antwerp

Финляндия · 1 центр

• Helsinki University Hospital — Helsinki

Греция · 1 центр

• Laiko General Hospital of Athens — Athens

Нидерланды · 1 центр

• Amsterdam UMC — Amsterdam

Португалия · 1 центр

• Hospital de Santa Maria — Lisbon

Швейцария · 1 центр

• Inselspital, University Hospital — Bern

Публикации

• McGlinchey AJ, Govaere O, Geng D, Ratziu V, Allison M, Bousier J, Petta S, de Oliviera C, Bugianesi E, Schattenberg JM, Daly AK, Hyotylainen T, Anstee QM, Oresic M. Metabolic signatures across the full spectrum of non-alcoholic fatty liver disease. JHEP Rep. 2022 Mar 26;4(5):100477. doi: 10.1016/j.jhepr.2022.100477. eCollection 2022 May. PMID 35434590

Идентификаторы

NCT: NCT04442334 · 08759 · 634413 · 777377

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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