Fatty Liver Group Research Articles

Dynamic expression of carnitine palmitoyltransferase II in the mitochondrial inner membrane during hepatocyte malignant transformation induced by lipid accumulation

Objective: To investigate the dynamic expression of hepatic carnitine palmitoyltransferase-II (CPT-II) in the mitochondrial inner membrane during hepatocyte malignant transformation induced by lipid accumulation. Methods: Male Sprague-Dawley rats were divided randomly into control, fatty liver, and induced cancer groups, which were fed with normal, high-fat (HF), and HF containing 2-fluorenylacetamide (0.05%, 2-FAA) diets, respectively, for 14 weeks. One rat from each group was sacrificed every two weeks and the blood and liver samples were collected. Liver morphological changes were evaluated with hematoxylin and eosin staining, and the liver tissue samples were divided into control, fatty liver, degeneration, precancerous, and cancerous groups accordingly. Hepatic lipids were dyed by the oil red O method. The CPT-II expression was measured by immunohistochemistry and compared with the specific CPT-II concentration (ng/mg liver protein, ng/mg P) among different groups. Serum levels of circulating total cholesterol (Tch), triglyceride (TG), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were quantitatively analyzed. Results: Massive lipid accumulation hepatocytes was seen in rats on HF and HF containing 2-FAA diets. The lipid levels in the control group were significantly lower than those in the fatty liver (t = -11.556, P < 0.001), degeneration (t = -4.847, P = 0.04), precancerous (t = -13.652, P = 0.005), and cancerous groups (t = -10.896, P = 0.008). The serum TG and Tch levels in the degeneration, precancerous, and cancerous groups were 2-3 times higher than those in the control group (P < 0.05). After 2-FAA treatment, the morphological changes of rat hepatocytes showed the progression from degeneration and precancerosis to cancerosis, with hepatocyte injury. The serum AST and ALT levels in the degeneration, precancerous, and cancerous groups were significantly higher (4-8 times) than those in the control group (P < 0.05). The specific concentration of liver CPT-II expression was significantly reduced during hepatocyte malignant transformation, as confirmed by immunohistochemistry, with the CPT-II levels significantly lower in the cancerous group than in any of other groups (P < 0.05). Conclusion: Low hepatic CPT-II expression might lead to abnormal lipid accumulation in hepatocytes, which should promote the malignant transformation of hepatocytes.

The association of non-alcoholic fatty liver disease and metabolic syndrome in a Chinese population

Non-alcoholic fatty liver disease (NAFLD) is associated with features of metabolic syndrome. The aim of this study was to investigate the association between NAFLD and metabolic syndrome in a Chinese population. Data from subjects were retrospectively collected from 2006 to 2009. The exclusion criteria included significant consumption of alcohol and chronic hepatitis B and C. The patients were assigned to two groups according to ultrasound findings: normal group and fatty liver group. The liver function of patients was determined by assessing serum alanine aminotransferase (ALT). Metabolic syndrome was diagnosed based on the 2005 International Diabetes Federation criteria. A total of 7568 subjects were enrolled and 5736 (75.8%) and 1832 (24.2%) patients were assigned to the normal and fatty liver groups, respectively. The fatty liver group had significant male predominance (69.7% vs 56.0%), higher body mass index (mean, 26.67 vs 23.55 kg/m2) compared with the normal group. There were 441 (7.7%) and 377 (20.6%) cases with metabolic syndrome in the normal and fatty liver groups, respectively, with significant difference (P=0.001), and the subgroup of 385 cases with fatty liver and elevated ALT had higher prevalence (28.8%) of metabolic syndrome. The strongest association of an individual component of metabolic syndrome with NAFLD was hyperlipidemia (adjusted OR=2.55, 95% CI: 2.22-2.94). The individuals with NAFLD had a higher ratio of metabolic syndrome. Hyperlipidemia had the strongest positive association with NAFLD.

Noninvasive Strategy Based on Real-Time in Vivo Cataluminescence Monitoring for Clinical Breath Analysis.

The development of noninvasive methods for real-time in vivo analysis is of great significant, which provides powerful tools for medical research and clinical diagnosis. In the present work, we described a new strategy based on cataluminescence (CTL) for real-time in vivo clinical breath analysis. To illustrate such strategy, a homemade real-time CTL monitoring system characterized by coupling an online sampling device with a CTL sensor for sevoflurane (SVF) was designed, and a real-time in vivo method for the monitoring of SVF in exhaled breath was proposed. The accuracy of the method was evaluated by analyzing the real exhaled breath samples, and the results were compared with those obtained by GC/MS. The measured data obtained by the two methods were in good agreement. Subsequently, the method was applied to real-time monitoring of SVF in exhaled breath from rat models of the control group to investigate elimination pharmacokinetics. In order to further probe the potential of the method for clinical application, the elimination pharmacokinetics of SVF from rat models of control group, liver fibrosis group alcohol liver group, and nonalcoholic fatty liver group were monitored by the method. The raw data of pharmacokinetics of different groups were normalized and subsequently subjected to linear discriminant analysis (LDA). These data were transformed to canonical scores which were visualized as well-clustered with the classification accuracy of 100%, and the overall accuracy of leave-one-out cross-validation procedure is 88%, thereby indicating the utility of the potential of the method for liver disease diagnosis. Our strategy undoubtedly opens up a new door for real-time clinical analysis in a pain-free and noninvasive way and also guides a promising development direction for CTL.

Serum Paraoxonase as an Indicator for Fatty Liver in Sheep.

IntroductionA model of fatty liver in postpartum sheep was established to measure blood paraoxonase 1 (PON1) and other biochemical indicators, which were used to predict fatty liver in sheep.Material and MethodsSheep were assigned into two experimental groups: a fatty liver group (T, n = 10) and a healthy control group (C, n = 5). PON1 enzyme activity towards paraoxon as a substrate was quantified spectrophotometrically. The results were analysed by t-test and pearson correlation coefficient. Disease was predicted by binary logistic analysis, and diagnostic thresholds were determined by receiver operatingcharacteristic (ROC) analysis.ResultsThe activity of serum PON1 in group T was significantly decreased (P < 0.05) when compared with C group, and liver lipid content and the levels of serum BHBA, NEFA, and TG were significantly increased (P < 0.05). Thresholds were lower than 74.0 U/mL for PON1, higher than 0.97 mmol/L for β-hydroxybutyrate, higher than 1.29 mmol/L for non-esterified fatty acids, higher than 0.24 mmol/L for triglycerides, and lower than 71.35 g/L for total protein.ConclusionThis study verified that PON1, BHBA, NEFA, TG, and TP could be used to predict the risk of fatty liver in sheep.

Non-alcoholic Fatty Liver Disease Is a Risk Factor for Type 2 Diabetes in Middle-aged Japanese Men and Women

Objective Emerging studies have focused on the association between non-alcoholic fatty liver disease (NAFLD) and the risk of type 2 diabetes mellitus (T2DM). We aimed to investigate whether NAFLD diagnosed by ultrasonography could predict the risk of future T2DM in a Japanese middle-aged health check population.Methods We conducted a 10-year observational study in a health checkup population of middle-aged Japanese men and women at Hidaka Hospital from 2004 to 2013. We excluded cases with an alcohol intake exceeding 20 g/day and those with impaired glucose tolerance. The remaining 1,544 men and 864 women were classified into fatty liver and non-fatty liver groups based on the findings of abdominal ultrasonography. Both groups were followed for the development of diabetes. A multiple regression analysis was performed for each variable to predict the risk of future diabetes.Results The median age of the participants was 46.0 years at the entry, and the follow-up period was 10 years. The incidence of diabetes in the fatty liver group was 12.5% (29/232) in men and 26.3% (10/38) in women, whereas the incidence of diabetes in the non-fatty liver group was 2.5% (34/1,312) in men and 1.8% (15/826) in women. The relative risk of diabetes associated with fatty liver was 4.8 [95% confidence interval (CI) 3.0 -7.8, p<0.0001] in men and 14.5 (95% CI 7.0-30.1, p<0.0001) in women.Conclusion NAFLD was a significant predictor for future diabetes in a Japanese middle-aged health check population, especially in women.

Impact of Liver Fibrosis and Fatty Liver on T1rho Measurements: A Prospective Study.

ObjectiveTo investigate the liver T1rho values for detecting fibrosis, and the potential impact of fatty liver on T1rho measurements.Materials and MethodsThis study included 18 healthy subjects, 18 patients with fatty liver, and 18 patients with liver fibrosis, who underwent T1rho MRI and mDIXON collections. Liver T1rho, proton density fat fraction (PDFF) and T2* values were measured and compared among the three groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the T1rho values for detecting liver fibrosis. Liver T1rho values were correlated with PDFF, T2* values and clinical data.ResultsLiver T1rho and PDFF values were significantly different (p < 0.001), whereas the T2* (p = 0.766) values were similar, among the three groups. Mean liver T1rho values in the fibrotic group (52.6 ± 6.8 ms) were significantly higher than those of healthy subjects (44.9 ± 2.8 ms, p < 0.001) and fatty liver group (45.0 ± 3.5 ms, p < 0.001). Mean liver T1rho values were similar between healthy subjects and fatty liver group (p = 0.999). PDFF values in the fatty liver group (16.07 ± 10.59%) were significantly higher than those of healthy subjects (1.43 ± 1.36%, p < 0.001) and fibrosis group (1.07 ± 1.06%, p < 0.001). PDFF values were similar in healthy subjects and fibrosis group (p = 0.984). Mean T1rho values performed well to detect fibrosis at a threshold of 49.5 ms (area under the ROC curve, 0.855), had a moderate correlation with liver stiffness (r = 0.671, p = 0.012), and no correlation with PDFF, T2* values, subject age, or body mass index (p > 0.05).ConclusionT1rho MRI is useful for noninvasive detection of liver fibrosis, and may not be affected with the presence of fatty liver.

Hepatobiliary dysfunction in Type-2 diabetes mellitus.

Objective:Nonalcoholic fatty liver disease (NAFLD) and gallstones are frequently present in diabetics, but its exact prevalence is not well studied in India. We have done a prevalence study of hepatobiliary involvement in Type-2 diabetes mellitus (T2DM) and also studied the other risk factors of NAFLD.Materials and Methods:Two hundred diabetics and 200 controls underwent anthropometric measurements, abdominal ultrasonography, (USG) and biochemical tests at a tertiary care hospital. Univariate and multivariate logistic regression analyses were done.Results:One hundred and thirty (65%) diabetics and 47 (23.50%) controls were having USG evidence of fatty liver (odds ratio [OR] = 6.046, 95% confidence interval [CI]: 3.904–9.363 [P < 0.0001]). Raised liver enzymes were present in 42 (21%) diabetics and 16 (8%) controls [OR = 3.057, 95% CI: 1.654–5.648 [P < 0.004]). Gallstones were present in 32 (16%) diabetics and 10 (5%) controls (OR = 2.825; 95% CI: 1.850–4.315 P < 0.0001). In addition, waist circumference (WC) and body mass index (BMI) were significantly more in diabetics, but lipid profile was not significantly deranged as compared to controls. Then, all patients with fatty liver were compared with patients with normal liver, and we found that fatty liver group was having raised BMI, WC, liver enzymes, and more dyslipidemia. Multivariate analysis was done which shows the presence of T2DM, elevated liver enzymes, obesity, and elevated WC as independent risk factors of fatty liver.Conclusion:The prevalence of NAFLD and gallstones was higher in diabetics as compared to healthy population. In addition, the presence of T2DM, elevated liver enzymes, obesity, and elevated WC are independent predictors of NAFLD.

Mitochondrial carnitine palmitoyl transferase-II inactivity aggravates lipid accumulation in rat hepatocarcinogenesis.

AIMTo investigate the dynamic alteration of mitochondrial carnitine palmitoyl transferase II (CPT-II) expression during malignant transformation of rat hepatocytes.METHODSSprague-Dawley male rats were fed with normal, high fat (HF), and HF containing 2-fluorenylacetamide (2-FAA) diet, respectively. According to the Hematoxylin and Eosin staining of livers, rats were divided into control, fatty liver, degeneration, precancerous, and cancerous groups. Liver lipids were dyed with Oil Red O, CPT-II alterations were analyzed by immunohistochemistry, and compared with CPT-II specific concentration (μg/mg protein). Levels of total cholesterol (Tch), triglyceride (TG), and amino-transferases [alanine aminotransferase (ALT), aspartate aminotransferase (AST)] were determined by the routine methods.RESULTSAfter intake of HF and/or HF+2-FAA diets, the rat livers showed mass lipid accumulation. The lipid level in the control group was significantly lower than that in other groups. The changes of serum TG and Tch levels were abnormally increasing, 2-3 times more than those in the controls (P < 0.05). During the rat liver morphological changes from normal to cancer development process with hepatocyte injury, serum AST and ALT levels were significantly higher (4-8 times, P < 0.05) than those in the control group. The specific concentration of CPT-II in liver tissues progressively decreased during hepatocyte malignant transformation, with the lowest CPT-II levels in the cancer group than in any of the other groups (P < 0.05).CONCLUSIONLow CPT-II expression might lead to abnormal hepatic lipid accumulation, which should promote the malignant transformation of hepatocytes.

Liver Function Tests and Ultrasonography Findings in Iranian Morbid Obese Patients Undergoing Bariatric Surgery

Background: Obesity, a major risk factor for fatty liver disease, is increasing worldwide. Morbid obese patients have a higher prevalence of fatty liver disease in addition to more severe complications, and high prevalence of abnormal liver function tests (LFTs). The aim of this study is to determine the pattern of LFT and liver ultrasonography of morbid obese Iranian patients undergoing bariatric surgery. Methods: The study population included 308 morbid obese patients who were candidates for Laparoscopic Roux-en-Y Gastric Bypass surgery. Body mass index (BMI), age, gender, weight, height, blood tests including alanine transaminase (ALT), aspartate transaminase (AST), direct bilirubin (Bil D), total bilirubin (Bil T), and liver ultrasound reports were recorded for all of the patients. Patients with alcohol intake or hepatitis or human immunodeficiency virus (HIV) were excluded from the study. The data were entered and analyzed using SPSS-16. The chi-square, ANOVA and Independent-sample t- test used in the study analysis. Results: Data analyses showed that alkaline phosphatase (ALKP) is the most elevated serum enzyme in morbid obese patients 26 (87.6%). ALT, AST, bilirubin total and bilirubin direct were more than upper normal range in 70 (24.1%), 80 (26%), 2 (1.5%) and 15 (11.4%) in all patients, respectively. Ultrasonography of the liver showed that fatty liver disease occurred in approximately 280 (91%) of our patients. In our study, the only liver enzyme that had significant difference with fatty liver and normal groups was AST (P: 0.027). The patients were divided into three groups on the basis of the BMI: BMI of 35 - 40 kg/m2, 40 - 50 kg/m2, and above 50 kg/m2. There is not any significant difference between the mean of ALKP, ALT, AST, bilirubin (direct and total) serum level and fatty liver in these three groups. Conclusions: The prevalence of abnormal LFTs in Iranian morbid obese patients is in high status especially the level of ALKP. Liver ultrasonography has high sensitivity for the fatty liver in morbid obese patients but LFTs rise only in few patients with fatty liver.

Clinicopathological characteristics of non-B non-C hepatocellular carcinoma without past hepatitis B virus infection.

Past hepatitis B virus (HBV) infection is considered a risk factor for hepatocarcinogenesis, but the clinicopathological characteristics of non-B non-C hepatocellular carcinoma (NBNC-HCC) excluding past HBV infection have not been investigated. This study aimed to clarify the clinicopathological features of strictly defined NBNC-HCC. Among HCC patients who underwent surgical resection at our affiliated hospitals in Nagano prefecture, Japan, between 1996 and 2012, 77 were negative for serum anti-HBV core/surface antibodies in addition to HBV surface antigen and anti-hepatitis C virus antibody without signs of autoimmune liver disease, Wilson disease, or hemochromatosis. These patients were divided into the alcohol intake-positive group (ethanol intake >20g/day, n = 31), non-alcoholic fatty liver group (steatosis >5% and ethanol intake <20g/day, n = 30), and cryptogenic group (no ethanol intake or steatosis, n = 16). Preoperative clinical parameters, tumor and background liver pathology, and prognosis were analyzed. Advanced fibrosis and steatosis were detected in 64% and 60% of all patients, respectively. Approximately 85% of the alcohol intake-positive patients had advanced fibrosis. Non-alcoholic fatty liver HCC subjects had the highest body mass index and prevalence of diabetes, but 30-40% had none to mild fibrosis. The cryptogenic group of HCC patients had the lowest incidence of accompanying hepatic inflammation/fibrosis but the largest tumor size. Recurrence/survival rates were comparable among the groups. Liver fibrosis and steatosis are risk factors of HCC regardless of past HBV infection and ethanol consumption. The present results also indicate the possibility of hepatocarcinogenesis independent of hepatic steatosis, inflammation and fibrosis, ethanol intake, and past HBV infection.

Factores de riesgo para hígado graso no-alcohólico en pacientes con colelitiasis sintomática.

Objetivo: identificar la prevalencia y los factores de riesgo asociados a la presencia de hígado graso no-alcohólico en pacientes con colelitiasis sintomática. Material y métodos: Se estudiaron pacientes con colelitiasis sintomática tratados mediante colecistectomía laparoscópica y en los que intencionadamente se realizó biopsia hepática. Los criterios de inclusión fueron: edad 18-65 años, biopsia hepática diagnóstica y firma del consentimiento informado. Las variables estudiadas fueron: edad, sexo, peso, talla, índice de masa corporal, circunferencia de cintura, circunferencia de cadera, índice cadera/cintura, tensión arterial, glicemia, perfil de lípidos y presencia de síndrome metabólico. Se dividieron dos grupos: grupo I con paciente con hígado graso no-alcohólico y el grupo II con paciente con hígado normal. Resultados: se incluyeron 248 pacientes, 85,5% fueron mujeres y 14,5% fueron hombres. La prevalencia de hígado graso no-alcohólico fue de 77,5%. Se observó una diferencia significativa en el grupo I en: peso (p=&lt;0,0001),índice de masa corporal (p=&lt;0,0001), circunferencia de cintura (p=&lt;0,0001) , circunferencia de cadera (p=&lt;0,0001), TA (p=&lt;0,0001), niveles de HDL (p=&lt;0,0001) y la presencia de síndrome metabólico (p=&lt;0,001) conclusiónes: el sobrepeso y obesidad determinados por el índice de masa corporal, así como niveles bajos de HDL y la presencia de síndrome metabólico, son factores de riesgo independientes que incrementan la aparición hígado graso no-alcohólico en pacientes con colelitiasis sintomática.

Investigation of metabolic disorders in patients with familial fatty liver disease and their first-degree relatives

To investigate the metabolic disorders in patients of familial fatty liver disease and their first-degree relatives. The probands with fatty liver disease and normal control probands were randomly selected from 2 000 persons who participated in the survey of"endocrine and metabolic diseases"conducted by Provincial Hospital Affiliated to Shandong University in Taian, Shandong Province, China, and their first-degree relatives were enrolled. A normal control group and a group of sporadic fatty liver disease were established in order to eliminate the influence of environment and diet. A total of 191 subjects were enrolled after being matched for sex and age, including 73 families, 73 probands, and 118 first-degree relatives. According to the presence or absence of fatty liver disease in probands and first-degree relatives, these subjects were divided into normal control group, familial fatty liver group, and sporadic fatty liver group. Clinical and laboratory markers were obtained from each group and statistical analyses were performed. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups or any two groups, the rank sum test was used for comparison of non-normally distributed continuous data, and the chi-square test was used for comparison of categorical data. The probands in the familial fatty liver group and sporadic fatty liver group had significantly higher abdominal obesity indices (body mass index, waist circumference, and hip circumference) than those in the normal control group (all P < 0.05). The first-degree relatives in the familial fatty liver group had significantly higher abdominal obesity indices (body mass index, waist circumference, and hip circumference), serum uric acid, and fasting blood glucose than those in the normal control group and sporadic fatty liver group (all P < 0.05), while these parameters showed no significant differences between the normal control group and sporadic fatty liver group (P > 0.05). The first-degree relatives in the familial fatty liver group had significantly higher incidence rates of overweight and/or obesity and a significantly higher prevalence rate of hyperglycemia compared with the normal control group(overweight and/or obestity:χ (2)= 12.83, P < 0.01; hyperglycemia:χ (2)= 6.96, P < 0.01) and sporadic fatty liver group (overweight and/or obesity: χ (2)= 12.63, P < 0.01; hyperglycemia:χ (2)= 12.22, P < 0.01). Persons with a family history of fatty liver disease tend to develop metabolic disorders (obesity and abnormal blood glucose), and early intervention may prevent or delay the development of metabolic syndrome.

Relationship between serum osteocalcin levels and glucolipid metabolism in elderly type 2 diabetic patients with non-alcoholic fatty liver disease

Objective To explore the relationship between serum osteocalcin levels and glucolipid metabolism in elderly type 2 diabetic patients with non-alcoholic fatty liver disease(NAFLD). Methods Data collected from 97 patients with type 2 diabetes mellitus(T2DM)admitted to the Department of Geriatric Endocrinology of the First Affiliated Hospital of Zhengzhou University from June 2014 to April 2015 were retrospectively analyzed.Patients were divided into the T2DM group(type 2 diabetic patients without NAFLD, n=47)and the NAFLD group(T2DM patients with NAFLD, N=50). Healthy elderly subjects(n=30)from the same period served as the control group.Body mass index(BMI), osteocalcin, fasting blood glucose, fasting insulin, homeostasis model assessment for insulin secretion index(HOMA-β)and insulin resistance(HOMA-IR), glycosylated hemoglobin(HbA1c), total cholesterol, triglyceride, high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)were compared between the 3 groups. Results Levels of fasting blood glucose, fasting insulin, HbA1c, total cholesterol, triglyceride, LDL-C and HOMA-IR were higher, while levels of HDL-C, HOMA-β and osteocalcin were lower in the T2DM and NAFLD groups than in the control group(all P<0.05). Levels of BMI, fasting glucose, fasting insulin, HbA1c, total cholesterol, triglyceride, LDL-C and HOMA-IR were higher and levels of osteocalcin were lower in the T2DM group than in the NAFLD group(all P<0.05). Pearson correlation analysis showed that the osteocalcin level was negatively correlated with fasting blood glucose, HbA1C, HOMA-IR and BMI(r=-0.701, -0.442, -0.337 and -0.543, P<0.05 or P<0.01), and positively correlated with HOMA-β(r=0.341, P<0.05)in the NAFLD group. With serum osteocalcin as the dependent variable, multiple linear regression results showed that fasting blood glucose was an independent influencing factor for serum osteocalcin(β=-1.57, P<0.05)in the fatty liver group. Conclusions Serum osteocalcin levels significantly decrease in elderly T2DM patients with NAFLD, are closely correlated with glucolipid metabolism, and may have some important clinical significance in the prevention and treatment of NAFLD in elderly patients with type 2 diabetes. Key words: Osteocalcin; Diabetes Mellitus, Type 2; Fatty Liver

Magnetic Resonance Spectroscopy in Living-Donor Liver Transplantation

ObjectiveThe purpose of this study is to evaluate the accuracy rate of the one breath-hold single voxel hydrogen-1 magnetic resonance spectroscopy (MRS) in comparison with intraoperative biopsy for liver fat quantification in living-donor liver transplantation. Materials and MethodsA total of 80 living liver donors participated in this study. Each patient underwent both MRS and intraoperative biopsy for evaluation of liver fatty content. MRS was performed using 1.5-T magnetic resonance imaging and placed in segments 2–4, 5–8, and left lateral segment for each donor. Accuracy was assessed through receiver operating characteristic curve analysis. Sensitivity and specificity of MRS fat fractions were also calculated. ResultsEighty living-donor liver transplantation donors were enrolled in this study. There was no fatty liver in 59 subjects (73.8%), 5% to 10% fatty liver in 17 subjects, 11% to 15% fatty liver in 3 subjects, and >16% fatty liver in 1 subject. MRS fat fraction showed excellent parameters to predict between normal liver and fatty liver groups (1.85% ± 0.98, 8.13% ± 3.52, respectively; P < .0001). Linear regression between MRS fat fraction and pathology grading showed high correlation (R2 = 0.7092). Pearson correlation revealed high correlation between MRS and pathology results (r = 0.936), poor correlation between body mass index and pathology results (r = 0.390). The sensitivity and specificity for detection of liver steatosis in MRS fat fraction were 95.2% and 98.3%, respectively. Conclusion1H MRS fat fraction is a highly precise and accurate method in quantification of hepatic steatosis for the living donor and can be finished in a single breath-hold.

The clinical and pathological features of hepatic steatosis in patients with chronic hepatitis B based on a matched case-control study

Objective To study the clinical and pathological features of hepatic steatosis in patients with chronic hepatitis B (CHB) based on a matched case-control study. Methods Cross-sectional study was carried out on CHB patients who received liver biopsy in the Department of Infectious Diseases, Shunde First People's Hospital from January 2006 to December 2014.Clinical data of the patients were collected. A total of 216 matched pairs were created according to gender and age. The clinical and pathological feathers of both groups were compared and analyzed. Quantitative data with normal distribution were compared by t test and those with abnormal distribution were compared by nonparametric rank sum test of two- or multi-independent samples. Categorical data were compared by χ2 test. Results In matched pairs, rates of overweight/obesity were 84.2% in fatty liver group and 18.5% in non-fatty liver group (χ2=189.30, P=0.001), patients with high cholesterol in the two groups were 30.6% and 13.4%, respectively (χ2=18.47, P=0.001), high triglycerides were 27.3% and 9.7%, respectively (χ2=22.15, P=0.001), high low-density lipoprotein were 16.7% and 5.6%, respectively (χ2=13.50, P=0.001), high uric acid were 31.0% and 15.3%, respectively (χ2=15.04, P=0.001) and rates of alcohol history were 38.9% and 25.9%, respectively (χ2=8.08, P=0.001). The differences of hepatitis B virus (HBV) DNA and status of hepatitis B e antigen between the two groups were not statistically significant (both P>0.05). Compared to fatty liver group, rates of hepatic inflammation activity degree ≥3 (54.6% vs 37.5%, χ2=12.75, P<0.01) and fibrosis staging ≥3 (53.2% vs 41.7%, χ2=5.80, P=0.016) in non-fatty liver group were both significantly higher. Conclusions CHB patients with overweight/obesity, high cholesterol, high triglycerides, high low-density lipoprotein, high uric acid and drinking history are more likely to develop hepatic steatosis. The inflammatory grade and fibrosis stage in non-fatty liver group are more serious than those in fatty liver group. Key words: Hepatitis B; Fatty liver; Inflammation; Fibrosis; Case-control studies; Influential factor

NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD)

Objectives: To assess the incidence of NAFLD and biochemical profile in nondiabeticand diabetic patients. Study Design: It was a cross sectional descriptive study. Setting:Shalamar Institute of Health Sciences (SIHS), Lahore. Period: Six months, Jan 2015 to Jun2015. Methods: The patients coming to the Radiology Department for abdominal ultrasoundwere age and sex matched into fatty liver and non-fatty liver groups and diabetic and nondiabeticgroups and were further evaluated on the basis of glucose, alanine aminotransferase(ALT) and triglycerides (TG) levels from the laboratory data. Results: The findings of allbiochemical parameters were raised in diabetic patients with fatty liver as well as in non-fattyliver diabetic group and the differences were found to be statistically (P value less than 0.05)significant. In non-diabetic group, out of 200 subjects 56.5% had NAFLD whereas 43.5% hadno NAFLD. In diabetic patients, out of 200 patients 69% had NAFLD and 31% had no NAFLDand the difference was significant statistically (P= &lt;0.05). The prevalence of NAFLD 12.5%was higher in type-2 diabetic patients as compared to non-diabetic group. In non-diabeticgroup, 113 subjects had TG value of 181±82.49, while 87 subjects had TG of 141±44.5. Indiabetic patients, 138 patients had TG value of 467±277.64 whereas 62 patients had TG valueof 178±46.52, which was statistically significant (P= &lt;0.05). Conclusion: Fatty liver is animportant marker for metabolic syndrome which is a pre-diabetic condition. The occurrenceof NAFLD was elevated in type II patients of diabetes. The traditional risk factors for NAFLDare considered to be female sex, type II diabetes mellitus, obesity and hypertriglyceridemia.Hyperglycemia, hypertriglyceridemia and elevated ALT were observed more repeatedly in fattyliver than in non-fatty liver (type II) diabetic patients

Reduced Glutathione suppresses Oxidative Stress in Nonalcoholic Fatty Liver Disease.

ABSTRACTBackground and aimsInsulin resistance and cytokine production are key mechanisms leading to fatty change in the liver and may produce nonalcoholic steatohepatitis (NASH). Oxidative stress may also contribute to clinical progression from simple fatty liver (FL) to NASH. A therapy for insulin resistance and antioxidant has been applied to treat NASH, yet these treatments are not fully established. In the present study, we have evaluated whether an antioxidant agent, glutathione, prevents the development of NASH from FL.Materials and methodsFive patients with FL and 10 with NASH were enrolled in the study. Three hundred milligrams per day of glutathione was given orally to patients with nonalcoholic fatty liver disease (NAFLD) every day, and an oxidative stress marker and biochemical tests were analyzed before treatment and 1 and 3 months after starting the treatment. We measured serum levels of 8-hydroxy-2-deoxyguanosine (8-OHdG) and gamma-glutamyltranspeptidase (GGT). Immunohistochemistry for glutathione was performed on formalin fixed liver specimens obtained from liver biopsies.ResultsBefore treatment, the NASH group had higher serum 8-OHdG and lower serum glutathione levels than the FL group. Immunohistochemistry revealed that a strong expression of glutathione was observed in zone 3 in both NASH and FL before treatment. Serum levels of alanine transaminase and 8-OHdG were significantly decreased after treatment in the NASH group. Gamma-glutamyltranspeptidase was decreased after treatment, although the decrease was statistically not significant.DiscussionThe present pilot study demonstrated that antioxidant therapy with glutathione may reduce the pathological oxidative stress in the liver in NASH, preventing the progression from NAFLD to NASH.How to cite this articleIrie M, Sohda T, Anan A, Fukunaga A, Takata K, Tanaka T, Yokoyama K, Morihara D, Takeyama Y, Shakado S, Sakisaka S. Reduced Glutathione suppresses Oxidative Stress in Nonalcoholic Fatty Liver Disease. Euroasian J Hepato-Gastroenterol 2016;6(1):13-18.

Nonalcoholic Fatty Liver Disease and its association with Insulin Resistance: A Study from Bangladeshi Newly Diagnosed Impaired Glucose Tolerance Subjects

Background: Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological condition strongly associated with obesity, type 2 diabetes, and metabolic syndrome. NAFLD is more prevalent in T2DM subjects but in the prediabetic state, particularly in impaired glucose tolerance (IGT) very, limited data are elucidated. The present study is aimed to examine the association of insulin resistance with NAFLD in subjects with newly diagnosed IGT. Methods: We studied 74 purposively recruited IGT [M/F, 34/40; age (ranges) in years, (25-64)] subjects whose NAFLD was confirmed by ultrasound assessment of the liver. IGT was diagnosed by 75 g OGTT as per WHO Group Study criteria. Serum glucose was measured by glucose-oxidase method. Serum insulin was measured by ELISA technique. Insulin resistance (HOMA-IR) was calculated by homeostasis model assessment (HOMA). Results: Compared to the without NAFLD counterparts, NAFLD subjects showed significantly higher levels of fasting serum insulin (17.26 ± 8.49 vs. 13.38 ± 4.40, p=0.015), postprandial serum insulin (90.06 ± 42.23 vs. 69.87 ± 38.10, p=0.034) and HOMA-IR (2.20 ± 1.0 vs. 1.73 ± 0.55, p=0.012) as well as significantly lower levels of HOMA%S (52.13 ± 20 vs. 63.92 ± 25.44, p=0.029). On multiple linear regression analysis, the fatty liver group showed significant positive association with HOMA-IR (β=0.270, p=0.020) after adjusting the effects of major confounders of sex, percent body fat (%BF) and body mass index (BMI). On binary logistic regression analysis, HOMA-IR was found to be a significant determinant of NAFLD (OR=2.679, 95% CI: 1.079-6.652, p=0.034) after adjusting the effects of %BF, BMI, and triglyceride (TG). Conclusions: High proportions (about forty seven percent) of IGT subjects are more likely to develop NAFLD. Altered glucose metabolism and fatty liver are associated with each other where insulin resistance plays linking role between their associations.

Relationship between insulin resistance, incidence of fatty liver and serum ferritin level in adults with simple obesity

Objective To explore the relationship of serum ferritin with insluin resistance(IR) and incidence of fatty liver in adults with simple obesity. Methods According to body mass index (BMI), 78 adults with simple obesity were divided into three groups, including 34 cases in Ⅰ degree obesity group, 30 cases in Ⅱ degree obesity group and 14 cases in Ⅲ degree obesity group, and 35 adults with simple overweight and 67 healthy adults were also enrolled as control group.The height, weight, waistline, hip circumference, incidence of fatty liver, fasting blood glucose (FBG), fasting insulin (FIN), blood lipids and ferritin(SF) level were tested, and the body mass index (BMI), WHR and IR index (HOMA-IR) were calculated. Results When BMI increased, levels of SF, HOMA-IR, FBG, FIN, triglyceride(TG), cholesterol(TC), low density lipoprotein-cholesterol (LDL-C) were gradually increased(F=378.92, 12.01, 55.50, 123.96, 90.09, 127.65, 23.81, all P<0.01). However, high density lipoprotein-cholesterol (HDL-C) was gradually degraded(F=114.56, P<0.01). The incidence of fatty liver had significant differences in Ⅰ, Ⅱ, Ⅲ degree obesity groups((t=24.872, 7.885, all P<0.01), and with the degree of obesity increased, the rate of fatty liver increased significantly.SF range interquartile and level in fatty liver group was significantly greater than the non fatty liver group, the difference was statistically significant (t=22.99, P<0.01). SF was positively correlated with BMI, WRH, FBG, FIN, HOMA-IR, TC, TG, LDL-C (r=0.863, 0.719, 0.789, 0.703, 0.617, 0.785, 0.717, 0.771, all P<0.01), and negatively correlated with HDL-C(r=-0.530, P<0.01). Multiple stepwise regression analysis indicated that BMI, FIN, LDL-C, HOMA-IR were independent risk factors affecting SF(t=4.646, 2.595, -5.073, 6.666, all P<0.01). SF, BMI, FBG, FIN, LDL-C were independent risk factors influencing HOMA-IR(t=6.535, 3.254, 18.827, 61.227, 2.154, all P<0.05). Conclusion Simple obesity adults had obvious blood lipid disorders and IR, easy to complicated with fatty liver, the incidence of fatty liver associated with severity of obesity, the overexpression of SF is closely related to it. Key words: Obesity; Ferritin; Insulin resistance

Change in fatty liver status and 5-year risk of incident metabolic syndrome: a retrospective cohort study.

IntroductionFatty liver is associated with metabolic syndrome (MetS) but it may also occur without MetS. Whether resolution of fatty liver in the general population affects risk of MetS is unknown. Our aim was to determine whether a change in fatty liver status (either the development of new fatty liver or the resolution of existing fatty liver) would modify the risk of de novo MetS.MethodsTwo thousand eighty-nine people without hypertension, diabetes, and MetS were examined at baseline and at 5-year follow-up using a retrospective cohort study design. Fatty liver status was assessed at baseline and at follow-up by ultrasonography. Adjusted hazard ratios (aHR) and 95 % confidence intervals (CIs) for de novo MetS at follow-up were calculated controlling for the potential confounders, compared to the reference group (people who never had fatty liver at baseline and follow-up).ResultsDuring follow-up, fatty liver developed in 251 people and fatty liver resolved in 112 people. After the adjustment for multiple confounders, persisting fatty liver and incident fatty liver development were associated with de novo MetS, with aHR of 2.60 (95 % CIs [1.61,4.20]) and 3.31 (95 % CIs [1.99,5.51]), respectively. Risk of new MetS in resolved fatty liver group was attenuated with insignificant aHR of 1.29 accompanying 95 % CIs of 0.60 and 2.80.DiscussionDevelopment or maintenance of fatty liver is positively associated with occurrence of new MetS. Resolution of fatty liver status has similar risk of de novo MetS with those who never had fatty liver. Therefore, cautious management is needed with those with fatty liver.