The role of endotoxin and nitric oxide in diagnosing of nonalcoholic fatty liver disease

Abstract

S 21 ANNUAL CONFERENCE—2013 N o n -a co h o lic Fa ty Lver D iea se liver and severity of steatosis, inflammation and fibrosis (0.01-0.001). In conclusion, our results show decreased serum levels of hepcidin in patients with nonalcoholic and alcoholic fatty liver diseases, and chronic hepatitis C. The relationships between the parameters of iron metabolism and the severity of liver disease prove the importance of serum hepcidin as a surrogate marker for evaluation of iron overload in patients with chronic liver diseases. 40.74 ng/ ml) compared to the controls (99.14 Abstract Content: Chronic liver diseases, especially alcoholic fatty liver disease (AFLD), nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C (CHC), are frequently associated with iron overload. Hepcidin is the iron-regulatory hormone, which is synthesized mainly in the liver and plays an important role in iron homeostasis. The aim of this study was to assess the serum levels of hepcidin and to evaluate its relationships with other parameters of iron metabolism in patients with various chronic liver diseases. Material and methods: A total of 186 patients with chronic liver disease (CLD), divided into six groups were studied (115male, 71 – female; mean age 50.41 12.85 y), and 60 healthy controls were studied. Laboratory parameters of liver function and indices of iron metabolism were evaluated. The presence of iron deposition and the histological grades of steatosis and inflammation, and stage of fibrosis were also evaluated in patients with CLD. The serum level of hepcidin was determined by ELISA test / DRG International Inc. (USA). Results: Hepcidin was significantly lower in the whole group of patients with CLD (82.9). Corresponding Author. Mariana Penkova. E-mail: mpenkovadoc@abv.bg HEPATIC STEATOSIS: CORRELATION OF BODY MASS INDEX AND CT FAT MEASUREMENT (LIVER ATTENUATION INDEX) Joy Varghese, R. L. Sunjay, Thomas Cherian, Srinivasa Mettu Reddy, Sunjay Vijaya, Venkataraman Jayanthi, Mohd Rela Department of Hepatology & Liver Transplantation, Global Hospitals & Health City, Chennai, India Introduction: Several studies have evaluated non-invasive methods of predicting the presence of fatty liver disease which utilizes complex imaging measures such as intra-abdominal mesenteric fat cross-sectional area measurements, magnetic resonance (MR) elastography, and MR spectroscopy.Most of themmay limit quick and practical clinical applications.Liver attenuation index (LAI) has beenwidelyused to predict steatosis in donor liver. More recently metabolic syndrome has also been used to predict hepatic steatosis. S30 Objective: To examine the relationship of bodymass index (BMI) with liver attenuation index (LAI), in predicting hepatic steatosis in donor liver. Methodology: All donors registered in the Liver Transplant Clinic had a detailed work up for fitness for donation. A retrospective study was done to compare the BMI of liver donors with the Liver Attenuation Index (LAI) noted at Contrast Enhanced Computed Tomography. The latter was considered as the gold standard for assessment of hepatic steatosis in this study. Liver Attenuation Index (LAI), was derived and defined as the difference between mean hepatic and mean splenic attenuation. The BMI standardized for south Asians (Western Pacific Region of WHO criteria pertaining to obesity (WPRO criteria, 2000) was used to categorise our patients. Normal BMI 18.5 to 22.9 kg/m2, underweight + 5, 0 to 5 as mild steatosis and less than 0 as severe steatosis. Only patients who had details of both BMI and LAI were included for the analysis.The Ethics Committee of the Institution approved the study. Statistical Analysis: The prediction value was determined using positive predictive value (PPV) and negative predictive value (NPV). Results: One hundred and forty donors were screened between Nov 2009 and April 2012 for 76 liver transplant recipients. There were 67 (47.8%) females. The median age of donors was 31 yrs (range 18 to 52 years). 101 donors had information on both BMI and LAI. There were 69 donors whose BMI was more than > 23; 21 of these donors had steatosis on LAI (PPV 30.4%). For 32 donors with BMI < 23 kg/m, only 2 (6.8%) had steatosis on LAI i.e. LAI was normal in 30 donors (NPV 93.8%). Conclusion: A normal BMI (18.5 to 22.9 kg/m 2) is a good predictor of steatosis and can be used as an initial screening parameter for screening patients for hepatic steatosis. However, this cannot be taken as the only parameter for predicting hepatic steatosis especially for donors with normal BMI. The study needs to be validated among larger number of donors. Corresponding Author. Joy Varghese. E-mail: joyvargese@gmail.com COMPARISON OF HISTOPATHOLOGICAL PROFILE BETWEEN YOUNG AND OLDER NAFLD PATIENTS Girish Kumar Pati, Shivaram Prasad Singh, Ayaskant Singh, BijayMisra, DebasisMisra, Pallavi Bhuyan, Niranjan Rout, Sanjib Kumar Kar, Manas Kumar Panigrahi, Chudamani Meher, Omprakash Agrawal