2967 Post Prandial Lipemia: A Potential Diagnostic Modality for NAFLD

Abstract

INTRODUCTION: Clinically, NAFLD encompasses a broad spectrum of hepatic derangements ranging from fat accumulation (steatosis) to severe inflammation and fibrosis (NASH, nonalcoholic steatohepatitis) that can lead to cirrhosis and subsequently to hepatocellular carcinoma. NAFLD is now more common than alcoholic liver disease owing to the rapid rise in the prevalence of obesity, and NAFLD is the most common cause of abnormal liver function tests. METHODS: Twenty consecutive Patients with age range 30-60 yrs attending our OPD during the years 2014-2016 with ultrasonographically proven hepatic steatosis and satisfying following criteria were selected: Alcohol intake less than 20 g/day, absence of autoimmune hepatitis (on the basis of clinical findings, raised globulin, AST/ALT ratio), absence of viral hepatitis (on the basis of serology for viral markers of HBV, HCV), absence of history of intake of any hepatotoxic drug. RESULTS: Considering the fasting lipid profile, difference was observed between the groups in serum TG (177.15 ± 16.18 VS 128.3 ± 22.4), total cholesterol (221.45 ± 31.26 vs 179.35 ± 26.59) and HDL (42.2 ± 6.13 vs 49.8 ± 4.39). The difference found was statistically significant (P < 0.001). Summing up for the cases, a higher value was recorded for alkaline phosphatise which was statistically not significant. The postprandial lipemic response of the subjects were estimated using serum triglyceride (TG) level measurement considering the same being the most dynamic parameter considering fat challenge. The serial estimations of TG at 2 hourly interval have also shown a significant difference in serum TG levels between cases and control groups with (P < 0.001). In order to calculate the magnitude of lipaemia, the Area under the curve (AUC) was calculated for the two groups using trapezoid rule, which showed a statistically significant (P < 0.001) between the two groups (1814.20 ± 166.46 vs 1341.25 ± 153.36). CONCLUSION: We have observed that all subjects from the case group have had a TG surge of greater than 240 mg% as opposed to the healthy controls, this difference could possibly serve as a useful tool provided a standardized diet challenge is implemented prior to test.