Abstract
"non-alcoholic fatty liver disease" starts with hepatic lipid accumulation and is a dangerous factor for disease development.
 Thus, we aimed to determine the serum levels of haptoglobin,alpha2 macroglobulin, apolipoprotein A1, gamma-glutamyl transferase, hemoglobin A1c, Total bilirubin, Triglyceride, cholesterol, low-density lipoprotein, high-density lipoprotein, very low-density lipoprotein, urea, and creatinine among patients with nonalcoholic fatty liver disease and healthy individuals. This study was carried out on 60 patients with NAFLD and 30 healthy subjects who were attending the Gastroenterology and Hepatology Teaching Hospital/Baghdad from August /2019 to March /2020. Patients data included age, sex, BMI, and abdominal ultrasound with other medical information. Serum samples were collected and then some biochemical tests were done by an Autoanalyzer, while serum apolipoprotein A1, haptoglobin, and Alpha 2maacroglobulin were measured by ELISA technique.
 The study found that obesity (70%) and dyslipidemia (50%) are more common in NAFLD patients than another metabolic disease such as hypertension (20%) and diabetes mellitus (type 1 and 2) (3% and 30%) respectively. Also, the results showed a significant difference among the age group (p=0.006). NAFLD subjects had a highly significant elevation (p=0.000) in the mean ± SD of BMI, FBS, HbA1c, AST, ALP, cholesterol, triglyceride, LDL, VLDL, and Alpha 2 macroglobulin compared with the healthy control. Serum ALT and total bilirubin (mean ± SD) were significantly elevated (p=0.001) in NAFLD subjects (54.28±23.05IU/L and 14.47±9.65 µmole/l respectively) when compared with the mean± SD of healthy control. In addition, the results revealed a significant elevation (P=0.027) in the mean ± SD of serum albumin in NAFLD patients when compared with mean ± SD of healthy control and a significant elevation (P=0.002)in the mean ± SD of the LDL of the NAFLD patients as compared to the healthy control. However, the results showed a highly significant decrease (P=0.000) in the mean ± SD of serum HDL, Apolipoprotein, and haptoglobin. Furthermore, the present study observed that the optimal cut-off value was ≤67.13ng/ml for haptoglobin with a sensitivity and specificity of 80% and 93.33% respectively. In addition, the results revealed that the optimal cut-off value was >257ng/ml for Alpha 2Macroglobulin with a sensitivity and specificity of 73.33% and 86.67% respectively. The study found an optimal cut-off value of ≤86 ng/ml for Apolipoprotein A1 with a sensitivity and specificity of 85% and 90% respectively.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is one of the most public chronic hepatic diseases in the world and occurs in about 25% of individuals worldwide
The present study examined 60 patients with NAFLD and showed that obesity (70%) and dyslipidemia (50%) is more common in NAFLD patients than other metabolic diseases such as hypertension (20%) which was diagnosed if patients are on antihypertensive therapy or their blood pressure is 140/90 mmHg and diabetes mellitus type 1 and 2 (3% and 30%) respectively
Our study showed that only 20(33.3%) of NAFLD patient had no signs or symptom while other NAFLD patients have a weakness in all the body (43%), abdominal pain (40%) and extreme tiredness (36.7%) in addition to the other signs and symptoms, jaundice (23.3%), edema (6.7%) and loss of appetite (3.3%)
Summary
Nonalcoholic fatty liver disease (NAFLD) is one of the most public chronic hepatic diseases in the world and occurs in about 25% of individuals worldwide. The prevalence of NAFLD" is rapidly rising in addition to obesity and diabetes, advancing to the largest common cause of liver disease for adults, teenagers, and infants in developing nations. Despite the pathogenesis of "NAFLD" being not well understood, insulin resistance has long been reflected to play a key role in the progress of "nonalcoholic fatty liver disease" [5]. The diagnosis of "NAFLD" in most studies was dependent on abnormal levels of AST and ALT [5]. Apolipoprotein A1 is a protein encoded by the APOA1 gene in humans It plays a significant role in lipid metabolism[6]. Our study tried to recognize effective predictive indicators rather than specific diagnostic markers that may help reduce the occurrence of liver biopsy to estimate the development of nonalcoholic fatty liver disease
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