Fatty Liver Patients Research Articles

Clopidogrel ameliorates high-fat diet-induced hepatic steatosis in mice through activation of the AMPK signaling pathway and beyond.

Metabolic dysfunction-associated steatotic liver disease (MASLD) frequently confers an increased risk of vascular thrombosis; however, the marketed antiplatelet drugs are investigated for the prevention and treatment of MASLD in patients with these coexisting diseases. To determine whether clopidogrel could ameliorate high-fat diet (HFD)-induced hepatic steatosis in mice and how it works, mice were fed on normal diet or HFD alone or in combination with or without clopidogrel for 14weeks, and primary mouse hepatocytes were treated with palmitate/oleate alone or in combination with the compounds examined for 24h. Body weight, liver weight, insulin resistance, triglyceride and total cholesterol content in serum and liver, histological morphology, transcriptomic analysis of mouse liver, and multiple key MASLD-associated genes and proteins were measured, respectively. Clopidogrel mitigated HFD-induced hepatic steatosis (as measured with oil red O staining and triglyceride kit assay) and reduced elevations in serum aminotransferases, liver weight, and the ratio of liver to body weight. Clopidogrel downregulated the expression of multiple critical lipogenic (Acaca/Acacb, Fasn, Scd1, Elovl6, Mogat1, Pparg, Cd36, and Fabp4), profibrotic (Col1a1, Col1a2, Col3a1, Col4a1, Acta2, and Mmp2), and proinflammatory (Ccl2, Cxcl2, Cxcl10, Il1a, Tlr4, and Nlrp3) genes, and enhanced phosphorylation of AMPK and ACC. However, compound C (an AMPK inhibitor) reversed enhanced phosphorylation of AMPK and ACC in clopidogrel-treated primary mouse hepatocytes and alleviated accumulation of intracellular lipids. We concluded that clopidogrel may prevent and/or reverse HFD-induced hepatic steatosis in mice, suggesting that clopidogrel could be repurposed to fight fatty liver in patients.

102 - Tracking the fatty liver patient with Mode value of MRI images and data analysis

102 - Tracking the fatty liver patient with Mode value of MRI images and data analysis

Association of Adiponectin and Oxidized HDL with ABO Blood Groups in Fatty Liver Patients

Non-Alcoholic Fatty Liver Disease (NAFLD) is a group of liver diseases that are not brought on by alcohol usage and are defined by an excessive buildup of fat in the liver cells. Objective: To identify the relationship between the Body Mass Index (BMI) and liver function markers in the study group, as well as Oxidized High-Density Lipoprotein (oxHDL) levels. Methods: This study was conducted at the University of Lahore, for the duration of six months from January 2022 to June 2022. For determining the role of adiponectin and oxHDL, (n=200) patients and divided into two group, healthy group (n=100) and disease group (n=100) participants. Biochemical identification, liver function test, lipid profile test and ELISA was done for analyzing the association with NAFLD. SPSS software was used for statistical analysis. Results: In this study different parameters were used that’s values of parameters mean of cases according to blood group system were varied than normal range, such as adiponectin level, BMI, oxLDL, oxHDL, ALT, AST, ALP, Cholesterol level, d-LDL, Calculated LDL, sdLDL, V-LDL, Triglyceride level, Apolipoprotein-B level was significantly higher and AST/ALT Ratio values, albumin, HDL were slightly less than normal values. O Blood groups was reported very low risk of fatty liver patients due to high adiponectin. Conclusions: From analysis it was concluded, that adiponectin and oxHDL associated with high risk of non-alcoholic fatty liver disorder.

Perioperative outcomes after hepatectomy for hepatocellular carcinoma among patients with cirrhosis, fatty liver disease, and clinically normal livers

IntroductionDespite superior outcomes with liver transplantation, cirrhotic patients with HCC may turn to other forms of definitive treatment. To understand perioperative outcomes, we examined perioperative mortality and major morbidity after hepatectomy for HCC among cirrhotic and non-cirrhotic patients. Methodology: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database was queried for liver resection for HCC. Multivariable logistic regression was performed to determine the association between liver texture and risk of major non-infectious morbidity, post-hepatectomy liver failure (PHLF) and 30-day mortality. ResultsFrom 2014 to 2018, 2203 patients underwent hepatectomy: 58.6 % cirrhotic, 12.8 % fatty and 28.6 % normal texture. Overall 30 day-mortality was 2.1 % (n = 46), although higher among fatty liver (2.8 %) and cirrhotic (2.6 %; p = 0.025) patients. The incidence of PHLF was 6.9 %, with hepatectomy type, cirrhosis, and platelet count as major risk factors. Age, resection type, and platelet count were associated with major complications. Trisegmentectomy and right hepatectomy (OR = 3.60, OR = 3.46, respectively) conferred a greater risk of major noninfectious morbidity compared to partial hepatectomy. Among cirrhotics alone, hepatectomy type, platelet count, preoperative sepsis and ASA class were associated with major morbidity. DiscussionHepatic parenchymal disease/texture and function, presence of portal hypertension, and the extent of the liver resection are critical determinants of perioperative risk among HCC patients.

The association between vitamin E intake and hepatic steatosis in general and obese populations

PurposeUsing data from the National Health and Nutrition Examination Survey (NHANES) and employing Controlled Attenuation Parameter (CAP) measures, this study explores the correlation between vitamin E (VE) intake and hepatic steatosis and its impact on different subsets.Materials and methodsWe selected 5757 participants with CAP data from the 2017–2020 NHANES dataset. Daily VE intake was assessed by a 24-hour dietary recall. Hepatic fat content was quantified using transient elastography to measure CAP. Stratified multivariable regression analysis investigated relationships in different subsets, and a generalized additive model identified nonlinear relationships and thresholds.ResultsAfter adjusting for confounders, higher VE intake correlated with lower CAP levels. Subgroup analyses and tests for interaction revealed a significantly stronger negative correlation between VE intake and CAP in obese individuals. Further analysis indicated a curvilinear relationship between VE intake and the severity of liver fat degeneration in both the general study population and the obese subgroup, demonstrating a threshold effect. In the general population, VE intake below the threshold (6.58 mg/day) is positively correlated with CAP levels, whereas intake above this threshold shows a negative correlation. For obese individuals, the threshold is set at 7.37 mg/day, above which the negative correlation with CAP is even more pronounced.ConclusionOur study revealed a negative correlation between VE intake and hepatic fat content, highlighting the potentially crucial role VE plays in obese fatty liver patients. Importantly, we identified threshold effects of VE intake in both general and obese populations. Our results support clinical nutritional interventions, personalized dietary guidance, and the development of drugs to combat fatty liver.

TG: HDL, AST: ALT, A:G Ratios in Alcoholic and Non-alcoholic Fatty Liver patients

TG: HDL, AST: ALT, A:G Ratios in Alcoholic and Non-alcoholic Fatty Liver patients

Association of Fatty Liver with Severity and Clinical Outcomes in Patients with Acute Pancreatitis: A Prospective Study from a Tertiary Care Center in South India

Background and Objectives: Acute pancreatitis (AP) may be mild or severe, and early prognostication of severity is considered to be important. Fatty liver (FL) is a widely prevalent clinicopathologic entity that represents underlying chronic, systemic inflammation. This study was undertaken to determine whether the presence of FL was associated with severity outcomes of AP. Methods: Consecutive patients hospitalized with a diagnosis of AP were included. AP severity was graded as per the 2012 Revised Atlanta classification. FL was defined as a liver-to-spleen attenuation ratio <1 on noncontrast computed tomography of the abdomen. AP severity, length of hospital stay (LOHS), requirement of intensive care unit (ICU) admission, local complications, organ failure (OF), and mortality were compared between the FL and non-FL groups. Results: Of 88 recruited patients, 47.7% had FL. AP severity was significantly higher in the FL group (P < 0.05). The prevalence of local complications (52.4% vs. 19.6%, P < 0.05), OF (35.7% vs. 13%, P < 0.05), ICU admission (30.9% vs. 8.7%, P < 0.05) and mortality (11.9% vs. 0, P = 0.016) was significantly higher in patients with FL compared to non-FL. LOHS (11.6 ± 2.9 vs. 4.7 ± 0.3 days, mean ± standard deviation) was significantly higher in FL patients. Logistic regression analysis identified FL as a risk factor, independent of age and gender, severity, local complications, and OF in AP. Conclusion: FL is significantly associated with morbidity and mortality in AP. It can serve as a potential prognostic marker for integration into models for the prediction of AP severity.

Optimal body mass index for protecting middle-aged and elderly patients with fatty liver from future fractures.

Previous studies have suggested that body mass index (BMI) should be considered when assessing the relationship between fatty liver (FL) and osteoporosis. The aim of this study was to investigate future fracture events in people with FL, focusing on the effect of BMI in both sexes. This retrospective cohort study from 2011 to 2019 enrolled 941 people, including 441 women and 500 men, aged 50 years or older who underwent liver imaging (ultrasound, computed tomography, or magnetic resonance image) and dual-energy X-ray absorptiometry (DXA, for bone mineral density measurements). The study examined predictors of osteoporosis in both sexes, and the effect of different ranges of BMI (18.5-24, 24-27, and ≥27 kg/m2 in women; 18.5-24, 24-27, 27-30 and ≥30 kg/m2 in men) on the risk of future fractures in FL patients. The average follow-up period was 5.3 years for women and 4.2 years for men. Multivariate analysis identified age and BMI as independent risk factors for osteoporosis in both sexes. Each unit increase in BMI decreased the risk of osteoporosis by ≥10%. In both women and men with FL, a BMI of 24-27 kg/m2 offered protection against future fractures, compared to those without FL and with a BMI of 18.5-24 kg/m2. The protective effect of a higher BMI against future fractures in middle-aged and elderly women and men with FL is not uniform and decreases beyond certain BMI ranges.

Predicting Non-Alcoholic Steatohepatitis: A Lipidomics-Driven Machine Learning Approach.

Nonalcoholic fatty liver disease (NAFLD), nowadays the most prevalent chronic liver disease in Western countries, is characterized by a variable phenotype ranging from steatosis to nonalcoholic steatohepatitis (NASH). Intracellular lipid accumulation is considered the hallmark of NAFLD and is associated with lipotoxicity and inflammation, as well as increased oxidative stress levels. In this study, a lipidomic approach was used to investigate the plasma lipidome of 12 NASH patients, 10 Nonalcoholic Fatty Liver (NAFL) patients, and 15 healthy controls, revealing significant alterations in lipid classes, such as glycerolipids and glycerophospholipids, as well as fatty acid compositions in the context of steatosis and steatohepatitis. A machine learning XGBoost algorithm identified a panel of 15 plasma biomarkers, including HOMA-IR, BMI, platelets count, LDL-c, ferritin, AST, FA 12:0, FA 18:3 ω3, FA 20:4 ω6/FA 20:5 ω3, CAR 4:0, LPC 20:4, LPC O-16:1, LPE 18:0, DG 18:1_18:2, and CE 20:4 for predicting steatohepatitis. This research offers insights into the connection between imbalanced lipid metabolism and the formation and progression of NAFL D, while also supporting previous research findings. Future studies on lipid metabolism could lead to new therapeutic approaches and enhanced risk assessment methods, as the shift from isolated steatosis to NASH is currently poorly understood.

Demographic and Clinical Characteristics of Non Alcoholic Fatty Liver (NAFL) Patients: An Exploratory Study in a Tertiary Care Hospital

<i>Introduction:</i> Non-alcoholic fatty liver disease (NLFD) is characterized by the accumulation of fat in the liver that exceeds 5% of hepatocytes, along with the development of progressive steatosis and related conditions such as hepatitis, cirrhosis, or hepatocellular carcinoma (HCC). Patients with non-alcoholic fatty liver disease (NAFLD) can display a diverse range of histological presentations, including simple accumulation of fat in the liver (steatosis), nonalcoholic fatty liver (NAFL), or nonalcoholic steatohepatitis (NASH). Non-alcoholic fatty liver disease (NAFLD) has a prevalence of 25%, impacting around 1 billion people globally. Objective: This study aimed to ascertain the demographic and clinical characteristics of non-alcoholic fatty liver disease (NAFLD). <i>Methodology:</i> This was a cross-sectional prospective study carried out in the Department of Radiology and imaging in IbnSina Hospital, Dhaka, Bangladesh during January, 2023 to June, 2023. A total of 189 confirmed non-alcoholic fatty liver cases by CT scan, aged above 18 years were enrolled in this study. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) software, version 23.0. The ethical clearance of this study was obtained from the Ethics Committee of School of Public Health & Life Science, University of South Asia, and Dhaka, Bangladesh. <i>Results:</i> A total of 189 confirmed non-alcoholic fatty liver cases were enrolled in this study. According to age distribution, the maximum 113 (54.49%) patients were above 52 years and minimum 3 (1.58%) were between (18-22) years, and followed by 38 (20.10%) (43-52) years, 25 (13.22%), (33-42) years and 10 (5.29%) (22-32) years. The maximum 105 (55%) were male and 84 (45%) were female. The majority 132 (70%) were from urban area and 57 (30%) were from rural area. The majority 82 (43.38%) were involved in indoor job and followed by 50 (26.45%) outdoor job, 28 (14.81%) business, 20 (10.58%) not applicable and 9(4.76%) others. The BMI of the male patients was observed 132 (33.6 ± 9.5) kg/m<sup>2</sup> and the BMI of the female was 57 (35.5 ± 8.7) kg/m<sup>2</sup> (p=0.157). The maximum of the patients 70 (89.94% had Diabetes mellitus (DM) and followed by 66 (87.83%) Hypertension (HTN), 9 (4.76%) Cirrhosis, 8 (4.23%) Hyperlipidemia and 45 (23.80%) had Thyroid. The patients were suffering from abdominal pain, Nausea-34 (17.98%) Abdominal pain, Vomiting- 27 (14.28%), Follow Up-36 (19.04%), U. Abdominal pain-56 (29.62%) U. Abdominal pain, Jaundice-31 (16.40%) and U. Abdominal pain, Nausea-5 (2.64%). <i>Conclusion:</i> This study investigated, the majority of the NLFD patients (54.49%) were >52 years. The maximum patients were male. The majority of the patients (70%) were from urban area. The maximum patients were involved in indoor jobs. 89.94% patients had diabetes (DM). The majority of the patients suffered from U, Abdominal pain, 56 (29.62%). The difference of BMI between male and female was not observed statistically significant but both male and female patients suffered from obesity.

High Concordance Between Nonalcoholic Fatty Liver Disease and Metabolic Dysfunction-Associated Steatotic Liver Disease in the TARGET-NASH Real-World Cohort.

This study investigates the applicability of the new metabolic dysfunction-associated steatotic liver disease (MASLD) nomenclature to the real-world TARGET-NASH US adult cohort. The new MASLD/metabolic steatohepatitis nomenclature was applied to patients enrolled with pragmatic diagnoses of nonalcoholic fatty liver and nonalcoholic steatohepatitis (NASH), and NASH cirrhosis and concordance were determined between the definitions. Approximately 99% of TARGET-NASH participants met the new MASLD diagnostic criteria. Approximately 1,484/1,541 (96.3%, kappa 0.974) nonalcoholic fatty liver patients (metabolic dysfunction-associated steatotic liver), 2,195/2,201 (99.7%, kappa 0.998) NASH patients (metabolic steatohepatitis), and 1,999/2,003 (99.8%, kappa 0.999) NASH cirrhosis patients met the new criteria. The new MASLD nomenclature is highly concordant with the previous TARGET-NASH pragmatic definitions.

Phthalate Biomarkers Composition in Relation to Fatty Liver: Evidence from Epidemiologic and in vivo studies

Phthalates, classified as environmental endocrine disruptors, pose potential toxicity risks to human health. Metabolic dysfunction-associated fatty liver disease is one of the most widespread liver diseases globally. Compared to studies focusing on metabolic disorders in relation to pollutants exposure, the impact of individual factors such as fatty liver on the in vivo metabolism of pollutants is always overlooked. Therefore, this study measured concentrations and composition of phthalate monoesters (mPAEs) in human urine samples, particularly those from fatty liver patients. Furthermore, we induced fatty liver in male Wistar rats by formulating a high-fat diet for twelve weeks. After administering a single dose of DEHP at 500 mg/kg bw through gavage, we compared the levels of di-2-ethylhexyl phthalate (DEHP), its metabolites (mDEHPs) and three hepatic metabolic enzymes, namely cytochrome P450 enzymes (CYP450), UDP glucuronosyltransferase 1 (UGT1), and carboxylesterase 1 (CarE1), between the normal and fatty liver rat groups. Compared to healthy individuals (n = 75), fatty liver patients (n = 104) exhibited significantly lower urinary concentrations of ∑mPAEs (median: 106 vs. 166 ng/mL), but with a higher proportion of mono-2-ethylhexyl phthalate in ∑mDEHPs (25.7 % vs. 9.9 %) (p < 0.05). In the animal experiment, we found that fatty liver in rats prolonged the elimination half-life of DEHP (24.61 h vs. 18.89 h) and increased the contents of CYP450, CarE1, and UGT1, implying the common but differentiated metabolism of DEHP as excess lipid accumulation in liver cells. This study provides valuable information on how to distinguish populations in biomonitoring studies across a diverse population and in assigning exposure classifications of phthalates or similar chemicals in epidemiologic studies.

U-Shaped relationship of insulin-like growth factor I and incidence of nonalcoholic fatty liver in patients with pituitary neuroendocrine tumors: a cohort study.

Although the role of insulin-like growth factor I (IGF-1) in nonalcoholic fatty liver disease (NAFLD) has garnered attention in recent years, few studies have examined both reduced and elevated levels of IGF-1. The aim of this study was to examine the potential relationship between IGF-1 levels and the risk of new-onset NAFLD in patients with pituitary neuroendocrine tumors (PitNET). We employed multivariable Cox regression models and two-piecewise regression models to assess the association between IGF-1 and new-onset NAFLD. Hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated to quantify this association. Furthermore, a dose-response correlation between lgIGF-1 and the development of NAFLD was plotted. Additionally, we also performed subgroup analysis and a series sensitivity analysis. A total of 3,291 PitNET patients were enrolled in the present study, and the median duration of follow-up was 65 months. Patients with either reduced or elevated levels of IGF-1 at baseline were found to be at a higher risk of NAFLD compared to PitNET patients with normal IGF-1(log-rank test, P < 0.001). In the adjusted Cox regression analysis model (model IV), compared with participants with normal IGF-1, the HRs of those with elevated and reduced IGF-1 were 2.33 (95% CI 1.75, 3.11) and 2.2 (95% CI 1.78, 2.7). Furthermore, in non-adjusted or adjusted models, our study revealed a U-shaped relationship between lgIGF-1 and the risk of NAFLD. Moreover, the results from subgroup and sensitivity analyses were consistent with the main results. There was a U-shaped trend between IGF-1 and new-onset NAFLD in patients with PitNET. Further evaluation of our discoveries is warranted.

Comparison of size of the liver between patients with non-alcoholic fatty liver disease and healthy controls.

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease across all age groups. Limited studies have been conducted to consider the relationship between NAFLD and liver size. This study aimed to compare the size of the liver between NAFLD patients and healthy controls. This case-control study was conducted on NAFLD patients (n = 300), and healthy subjects (n = 300) referred to the Golestan Hospital of Ahvaz from April to August 2021. All individuals underwent ultrasonography examination, and liver size was measured in the midclavicular line. Fatty liver was divided into three grades, I (mild), II (moderate), and III (severe), according to the disease severity. Anthropometric parameters, including age, sex, weight, height, and body mass index (BMI), were recorded. Finally, the size of the liver and its relationship with NAFLD and anthropometric parameters was evaluated. Patients had significantly higher weight, and BMI mean values than controls (P < 0.001). In comparison to controls, NAFLD patients had considerably larger livers on average. (149.05 ± 12.60 mm vs. 134.51 ± 12.09; P < 0.001). There was a significant tendency for larger liver size in normal to severe fatty liver patients (P < 0.001). In patients with mild, moderate, and severe NAFLD, the mean liver size was 144.34 ± 11.35, 154.21 ± 10.84, and 158.63 ± 13.45 mm, respectively. The mean liver size in both groups was significantly higher in males than females (P < 0.05). Age (P = 0.037), sex (P < 0.001), height (P < 0.001), BMI (P = 0.008), and steatosis (P < 0.001) were independent variables for predicting the liver size. The liver size of persons with fatty liver was substantially more considerable than healthy people. The size of the liver was substantially linked with sex, age, BMI, fatty liver, and hepatic steatosis grade. A straightforward way to predict fatty liver is to use ultrasonography to determine the size of the liver.

Controlled attenuation parameter for the assessment of fatty liver in patients with type 1 diabetes mellitus: which cutoffs to choose?

Controlled attenuation parameter for the assessment of fatty liver in patients with type 1 diabetes mellitus: which cutoffs to choose?

Controlled attenuation parameter for the assessment of fatty liver in patients with type 1 diabetes mellitus: which cutoffs to choose? Authors' reply.

Controlled attenuation parameter for the assessment of fatty liver in patients with type 1 diabetes mellitus: which cutoffs to choose? Authors' reply.

Prognostic value of liver stiffness in metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis.

liver stiffness measurement, assessed by vibration-controlled transient elastography, has been recognized as a powerful tool for liver fibrosis assessment. The potential of liver stiffness measurement to predict clinically relevant outcomes in fatty liver disease has received considerable attention. This study aimed to investigate the prediction of liver-related events in metabolic dysfunction-associated steatotic liver disease patients by liver stiffness measurement value on transient elastography. the electronic databases including PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov until 6 September 2023 were systematically searched. The hazard ratios adjusted for confounders were extracted and pooled by random-effects model analysis. a total of 20,587 individuals from seven studies were included. The pooled hazard ratios (HRs) were 18.65 (95 % CI: 9.95-34.95, p < 0.01, I2 = 0 %) in the stratification analysis of the highest versus lowest liver stiffness measurement categories. In 1-kPa analysis, the risk of liver-related events was increased with 1 kPa increment (HR 1.05, 95 % CI: 1.03-1.07, p < 0.01, I2 = 74.47 %). metabolic dysfunction-associated steatotic liver disease patients with high liver stiffness measurement values were at an increased risk of liver-related events. Liver stiffness measurement can be used as a prognostic tool to achieve risk stratification in fatty liver patients.

The Combination of Noninvasive Tests and Fibroscan for the Assessment of Liver Fibrosis among Patients with Nonalcoholic Fatty Liver Disease

Background: Most prevalent chronic liver disease in developed and developing nations is non-alcoholic fatty liver disease. From fatty liver, which often has benign, non-progressive clinical history, to non-alcoholic steatohepatitis, a more serious variant of fatty liver that can lead to cirrhosis and end-stage liver disease, non-alcoholic fatty liver disease encompasses broad spectrum of diseases. The gold standard for determining extent of hepatic fibrosis is still liver biopsy; however, number of noninvasive tests have been established to make diagnosis and assess effectiveness of treatment. Objective: Aim of study was to assess effectiveness of the combination of fibroscan and noninvasive biochemical tests and scoring systems for assessing liver fibrosis. Subjects and Methods: Cross-sectional prospective study conducted at outpatient clinic of Baghdad Gastroenterology and Hepatology Teaching Hospital from October 2018-March 2020. One hundred patients with fatty liver selected and subjected to specific questionnaires. Results: One hundred patients with fatty liver studied; fifty-five (55%) males, forty-five (45%) females. Mean age was (45 ±12.24) years, females were significantly older. Mean stiffness score was 11.7(SD:5.29) KPa. Forty-six (46%) patients had advanced fibrosis. The Positive correlation between FibroScan examination results and the noninvasive scores results was significant, as well as there was significant positive correlation between age and stiffness score and significant negative correlation between platelet count and stiffness score. Conclusions: This study showed that half patients showed advanced fibrosis, highlighting the need for early detection and management of fatty liver patients. Implementation of FibroScan with noninvasive fibrosis scoring tools has been shown to be helpful in this situation.

Effects of curcumin/turmeric supplementation on the liver enzymes, lipid profiles, glycemic index, and anthropometric indices in non-alcoholic fatty liver patients: An umbrella meta-analysis.

Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease worldwide. The evidence for curcumin's effects on patients with NAFLD is accumulating; however, meta-analyses have reported mixed results. The current umbrella meta-analysis aimed to assess the present evidence and provide an accurate estimate of the overall effects of curcumin/turmeric on NAFLD patients. The Web of Science, Scopus, PubMed, ScienceDirect, and Google Scholar databases were searched till March 2023 using MeSH terms and related keywords based on the PICO criteria. Meta-analysis studies evaluating the effects of curcumin/turmeric supplementation on NAFLD patients that reported the effect sizes (ES) and corresponding confidence intervals (CI) were eligible for inclusion in this study. All articles were screened by considering the eligibility criteria by two independent reviewers and required data were extracted from the included meta-analyses. The meta-analysis was performed utilizing a random-effects model by STATA software. Findings of 11 meta-analyses of 99 randomized controlled trials comprising 5546 participants revealed that curcumin/turmeric supplementation reduced AST (ES = -1.072, 95% CI (-1.656, -0.488), p = 0.000), ALT (ES = -0.625, 95% CI (-1.170, -0.134), p = 0.014), and TG (ES = -0.469, 95% CI (-1.057, 0.119), p = 0.128) levels, and HOMA-IR (ES = -0.291, 95% CI (-0.368, -0.214), p = 0.000), BMI (ES = -0.205, 95% CI (-0.304, -0.107), p = 0.000), and WC (ES = -1.290, 95% CI (-2.038, -0.541), p = 0.001) in comparison to the control group. However, the effects of curcumin on GGT, ALP, TC, LDL-C, HDL-C, FBS, and HbA1C levels and body weight were not significant. The findings suggest the beneficial effects of curcumin/turmeric supplementation in patients with NAFLD, such as improving liver function, decreasing serum TG levels, ameliorating insulin resistance, and reducing general and central obesity. Nevertheless, high-quality research is further required to prove these achievements.

Assessment of sympathovagal balance by HRV analysis in alcoholic and nonalcoholic fatty liver disease patients

BACKGROUND: Heart rate variability (HRV) is the variation in the time intervals between continuous heartbeats also called interbeat intervals to give information related to the heart, blood pressure, gaseous exchange, and sympathetic and parasympathetic balance. Abnormalities in the conduction of the cardiac system alter the measurements of heart rate variability and lead to alteration in autonomic function with a higher risk of mortality. So, our objective includes the assessment of sympathovagal balance in AFLD and NAFLD patients. MATERIALS AND METHODS: The study included 78 alcoholic and 54 nonalcoholic fatty liver patients. A room temperature of 23°C with 25–35% humidity will be maintained in a recording room. Basal supine heart rate and BP will be recorded by the oscillometric method using an automated blood pressure monitor Omron MX3, India. Lead II ECG will be recorded for the next 5 minutes in total resting condition for short-term HRV analysis. Short-term HRV indices including time domain and frequency domain were recorded from each patient. Under time domain, SDNN, RMSSD, and average RR were noted. Under frequency domain, LF, HF, VLF, LF (nu), HF (nu), and LF/HF were calculated. The data were collected by using a 16-bit, power lab 8/30 data acquisition system (New South Wales, Australia) with acknowledge 3.8.2 software. Inferential analyses such as independent t-tests and Mann–Whitney tests were used to compare NAFLD and AFLD patient groups. Carl Pearson correlation analysis was performed to obtain a relationship between variables. RESULTS: SDNN in (ms) which represents the overall HRV found to be decreased in both alcoholic (32.84 ± 79.08) and nonalcoholic fatty liver disease (22.04 ± 13.85) compared to the normal range (50 ± 16)) from 27 studies. The value of RMSSD in (ms) was decreased in both alcoholic (17.00 ± 12.48) and nonalcoholic fatty liver disease patients (14.00 ± 9.44) with the normal range of (42 ± 15) from 15 studies. Pearson correlation analysis showed the age of AFLD patients significantly and positively correlated with average RR. Pearson correlation analysis for the age of NAFLD patients was significantly and positively correlated with the average RR, HF, SDNN, RMSSD, and LF. CONCLUSION: Altered autonomic activity was noted in both alcoholic and nonalcoholic fatty liver disease patients. An early prognosis of fatty liver is very necessary to prevent the disease progress into later fatal life-threatening stages.