Types Of Liver Disease Research Articles

To Study the Prevalence of Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes and to Correlate it with Lipid profile and Glycated Hemoglobin in a Hospital

To Study the Prevalence of Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes and to Correlate it with Lipid profile and Glycated Hemoglobin in a Hospital

Occurrence over time and regression of nonalcoholic fatty liver disease in type 2 diabetes.

This analysis was aimed to assess the incidence, regression, and correlated factors of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes, which are poorly known. Nonalcoholic fatty liver disease (defined as fatty liver index [FLI] score≥60) in patients with type 2 diabetes, and related factors was investigated in a nationwide database containing information from the Italian network of diabetes clinics. A 10% variation of FLI was the cut-off considered in the analyses of a cohort of 5030 patients, which was separately conducted for those who developed, maintained, or recovered from FLI-assessed NAFLD (FLI-NAFLD) over a 3-year period. At baseline, FLI-NAFLD was diagnosed in 61.3% of patients. Within the 3-year study period, FLI-NAFLD occurred in 313 patients and remitted in 410. The FLI score remained unchanged in 4307. Body-mass index (odds ratio, 1.45 95%; confidence interval, 1.35-1.55), abdominal obesity (2.11; 1.64-2.72), low HDL cholesterol levels (1.38; 1.02-1.87), and triglycerides (1.20; 1.12-1.28) all emerged as notable negative prognostic factors for the development or maintenance of FLI-NAFLD. The regression rate of FLI-NAFLD was higher among patients who managed to partially control these factors. Male sex and established organ damage, especially kidney function (1.64; 1.12-2.42), were independent risk predictors. Unlike other diabetes complications, FLI-NAFLD was more frequent among younger patients or those with a shorter duration of diabetes. FLI-assessed NAFLD is a dynamic condition, with about 5% of diabetic patients entering or leaving the status every year. Younger male patients with insulin resistance or organ damage have a higher risk of presenting with FLI-NAFLD at baseline, developing FLI-NAFLD within 3years, and a lower probability of regression.

Alcohol Consumption in Diabetic Patients with Nonalcoholic Fatty Liver Disease.

Aim To examine the association between lifetime alcohol consumption and significant liver disease in type 2 diabetic patients with NAFLD. Methods A cross-sectional study assessing 151 patients with NAFLD at risk of clinically significant liver disease. NAFLD fibrosis severity was classified by transient elastography; liver stiffness measurements ≥8.2 kPa defined significant fibrosis. Lifetime drinking history classified patients into nondrinkers, light drinkers (always ≤20 g/day), and moderate drinkers (any period with intake >20 g/day). Result Compared with lifetime nondrinkers, light and moderate drinkers were more likely to be male (p = 0.008) and to be Caucasian (p = 0.007) and to have a history of cigarette smoking (p = 0.000), obstructive sleep apnea (p = 0.003), and self-reported depression (p = 0.003). Moderate drinkers required ≥3 hypoglycemic agents to maintain diabetic control (p = 0.041) and fibrate medication to lower blood triglyceride levels (p = 0.044). Compared to lifetime nondrinkers, light drinkers had 1.79 (95% CI: 0.67–4.82; p = 0.247) and moderate drinkers had 0.91 (95% CI: 0.27–3.10; p = 0.881) times the odds of having liver stiffness measurements ≥8.2 kPa (adjusted for age, gender, and body mass index). Conclusions In diabetic patients with NAFLD, light or moderate lifetime alcohol consumption was not significantly associated with liver fibrosis. The impact of lifetime alcohol intake on fibrosis progression and diabetic comorbidities, in particular obstructive sleep apnea and hypertriglyceridemia, requires further investigation.

Study on non Alcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus with Clinical Correlation

Study on non Alcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus with Clinical Correlation

Prevalence of nonalcoholic fatty liver disease in type 2 diabetes mellitus and its relation with insulin resistance in South Gujarat Region

Background: Nonalcoholic fatty liver disease (NAFLD) is commonly associated with type 2 diabetes mellitus (DM) though its prevalence is not well studied. We conducted a prospective study of prevalence of NAFLD in patients with type 2 DM and its relation with Insulin Resistance. Materials and Methods: 100 patients of Type 2DM attending Tertiary care center in South Gujarat were evaluated. Abdominal ultrasonography was performed to determine the presence of fatty liver. For assessment of Insulin Resistance, Homeostasis Model Assistant - Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated. A probability value of P < 0.05 was considered statistically significant. Results: The study group (n = 100) was divided into a NAFLD group (n = 45) and a non-NAFLD group (n = 55). The prevalence of NAFLD was 45%. The NAFLD subgroup had higher prevalence of obesity (measured by BMI), central obesity (measured by waist circumference and waist hip ratio), higher HbA1c, higher triglyceride levels. HOMA-IR and QUICKI indexes for Insulin Resistance were significantly higher in NAFLD group than Non NAFLD group (P value 0.03, 0.04). Conclusion: The prevalence of NAFLD is high in patients of Type 2 DM. Insulin resistance seems to be correlated with the presence of NAFLD among T2DM patients.

Histological changes in the liver of diabetic rats: A review of pathogenesis of nonalcoholic fatty liver disease in type 1 diabetes mellitus

AbstractAbundant knowledge is present over nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus but no attention has been given to the same aspect with type 1 diabetes mellitus (T1DM) in humans. However, various animal modeled studies are documented having induced T1DM using chemical induction by alloxan (ALX) or streptozotocin (SZ) to investigate and comprehend the nature and pathophysiology of NAFLD in T1DM. The objectives of this review were to assess whether T1DM induced by ALX or SZ could cause histological (morphological and ultrastructural) changes in rat liver to illustrate the effects of these drugs and diabetes, and pathophysiology of NAFLD in T1DM. To achieve these objectives, we systematically searched the studies from EconLit, Embase, Google Scholar, Medline, PubMed, ProQuest, Scopus, Springer Link, and Science Direct databases. Initially, 150 studies were retrieved. Out of these, 107 studies were removed as these failed to provide relevant details. Finally, 43 articles were ...

Mean Platelet Volume in Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus - A Marker of Cardiovascular Risk

Background: Non- alcoholic fatty liver disease (NAFLD) is a common liver disease associated with diabetes and cardiovascular risk. Platelets play a vital role in hemostasis and mean platelet volume (MPV) is a measure of average size and platelet activity. Larger platelets are highly thrombogenic. Increase in MPV is well documented in diabetes mellitus (DM). Hence, MPV can be used as simple and cost-effective hematological parameter for predicting cardiovascular events in metabolic syndrome. The present study was conducted to study significance of MPV in NAFLD in type 2 DM (T2 DM). Materials & methods: A case- control study was conducted on 97 T2 DM patients. They were divided into: group 1 which included T2 DM patients without NAFLD and group 2 with T2 DM patients with NAFLD. Healthy 78 individuals were taken as controls. Serum was used for estimation of fasting and post-prandial bood sugar (FBS & PPBS) and liver function test (LFT). EDTA anticoagulated blood was used for estimation of mean platelet volume (MPV). Results: Among 97 T2 DM patients, 62 were males (63.9%) and 35 were females (36%). Liver size, liver enzymes such as aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and gamma- glutamyl transferase (GGT) were significantly increased in T2DM patients compared to controls and same were significantly increased in T2DM patients with NAFLD compared to those without NAFLD. MPV was found to be increased in T2 DM patients compared to controls. It was also noted to be increased in T2 DM patients with NAFLD compared to T2 DM patients without NAFLD but there was no statistical significance. Conclusion: MPV should be included as screening test to predict cardiovascular events in T2 DM patients with NAFLD.

Sex-Specific Association between Serum Uric Acid and Nonalcoholic Fatty Liver Disease in Type 2 Diabetic Patients.

Across-sectional study was performed in 541 type 2 diabetic patients to determine the relationship between serum uric acid (SUA) and NAFLD in type 2 diabetic patients. Clinical parameters including SUA were determined and NAFLD was diagnosed by ultrasonography. SUA was significantly higher in type 2 diabetic subjects with NAFLD than in those without NAFLD in men, but not in women. Furthermore, the prevalence rate of NAFLD increased progressively across the sex-specific SUA tertiles only in men (37.9%, 58.6%, and 72.6%, resp., P for trend < 0.001). After adjusting for confounding factors, the odd ratios (95% CI) for NAFLD were 1 (reference), 2.93 (95%CI 1.25–6.88), and 3.93 (95% CI 1.55–9.98), respectively, across the tertiles of SUA in men. Contrastingly, SUA levels in women were not independently associated with the risk of NAFLD. Our data suggests that SUA is specifically associated with NAFLD in male type 2 diabetic subjects, independent of insulin resistance and other metabolic factors.

Protective Effects of Celastrol on Diabetic Liver Injury via TLR4/MyD88/NF-κB Signaling Pathway in Type 2 Diabetic Rats.

Immune and inflammatory pathways play a central role in the pathogenesis of diabetic liver injury. Celastrol is a potent immunosuppressive and anti-inflammatory agent. So far, there is no evidence regarding the mechanism of innate immune alterations of celastrol on diabetic liver injury in type 2 diabetic animal models. The present study was aimed at investigating protective effects of celastrol on the liver injury in diabetic rats and at elucidating the possible involved mechanisms. We analyzed the liver histopathological and biochemical changes and the expressions of TLR4 mediated signaling pathway. Compared to the normal control group, diabetic rats were found to have obvious steatohepatitis and proinflammatory cytokine activities were significantly upregulated. Celastrol-treated diabetic rats show reduced hepatic inflammation and macrophages infiltration. The expressions of TLR4, MyD88, NF-κB, and downstream inflammatory factors IL-1β and TNFα in the hepatic tissue of treated rats were downregulated in a dose-dependent manner. We firstly found that celastrol treatment could delay the progression of diabetic liver disease in type 2 diabetic rats via inhibition of TLR4/MyD88/NF-κB signaling cascade pathways and its downstream inflammatory effectors.

Evaluation of Significance of Liver Enzymes as Screening Tests for the Early Detection of Clinically Asymptomatic Non Alcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus Patients

Background: Type 2 diabetes mellitus has been linked with abnormal liver function tests. Increased activities of liver enzymes such as aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), ?-glutamyl transferase (GGT) are markers of liver cell injury. Increased activity of these markers is associated with metabolic syndrome, insulin resistance and type 2 diabetes mellitus. This study was aimed to evaluate the significance of liver enzymes such as aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), ?-glutamyl transferase (GGT) in type 2 diabetes mellitus patients. Materials & Methods: Total of 108 cases of type 2 diabetes mellitus patients, comprising of 68 males (62.9%) and 40 females (37%) were included in the study. 110 healthy subjects were includes as controls. Age of the subjects ranged between 27 to 75 years. Serum sample was used for the estimation of study parameters such as FBS, PPBS, AST, ALT, ALP, GGT, Total bilirubin, Direct bilirubin, Total proteins and Albumin. Results: In the present study, mean values of AST, ALT, ALP and GGT were statistically significantly increased in type 2 diabetes mellitus patients when compared to controls (P value 0.001). Conclusion: In this study, we found an association between the increased levels of liver enzymes such as AST, ALT, ALP and GGT in type 2 diabetes mellitus patients. Increased levels of ALT and AST are the surrogate markers for associated non alcoholic fatty liver disease in type 2 diabetes mellitus patients. Hence, testing for AST, ALT, ALP, and GGT should be carried out to screen for underlying non alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus patients.

Diagnostic accuracy of acyl-ghrelin and it association with non-alcoholic fatty liver disease in type 2 diabetic patients.

BackgroundGhrelin is a hormone produced mainly by the cells lining the fundus of the stomach, which is involved in regulation of lipid and glucose metabolism. Two major forms of ghrelin can be found in circulation: an acylated form, and non-acylated form. Serum acyl-ghrelin (AG) concentration is significantly increased in patients with visceral obesity and insulin resistance. This study was conducted to evaluate changes in serum AG levels, its diagnostic accuracy and association with NAFLD in patients with type two diabetes (T2D).MethodsIn this cross-sectional study, 91 T2D patients, age of 40–80 years, were included. All patients were divided into 3 groups. The control group included 28 T2D patients without NAFLD. The main group included 63 T2D patients with NAFLD, which was divided in 2 subgroups depending on transaminase levels: normal (n = 37) and elevated (n = 26) transaminases group. To assess the diagnostic accuracy of AG for NAFLD we used ROC-analysis.ResultsWe observed 1.5 (p = 0.016) and 2.5 (p < 0.001) fold increasing of serum AG levels in patients with NAFLD and normal or elevated transaminases compared to control groups. In multivariate logistic regression analysis high AG level was an independent, from transaminases activity, triglycerides (OR 1.791; 95 % CI 1.162–2.759; p = 0.008) and degree of IR (OR 1.599; 95 % CI 1.019–2.508; p = 0.044) predictor that associated with NAFLD. When serum AG used as non-invasive marker for NAFLD detection AUROC was 0.835 (95 % CI 0.752–0.918, p < 0.001). The cut-off value was >0.52 ng/ml, with sensitivity, specificity, PPV and NPV – 60.3 %, 92.8 %, 95.0 %, 50.9 % respectively. For distinguishing patients with NAFLD and elevated transaminases from patients with NAFLD and normal values AG was less effective.ConclusionsOur study has demonstrated that elevated AG level were associated with NAFLD. Patients with elevated transaminases had significantly higher AG levels. An increase of AG over 0.52 ng/ml can be used as a diagnostic marker for NAFLD detection in patients with T2D.

The relationship between vitamin D and non-alcoholic fatty liver disease in type 2 diabetic Egyptian patients

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Circulating dipeptidyl peptidase-4 activity correlates with measures of hepatocyte apoptosis and fibrosis in non-alcoholic fatty liver disease in type 2 diabetes mellitus and obesity: A dual cohort cross-sectional study.

Intrahepatic expression of dipeptidyl peptidase-4 (DPP4), and circulating DPP4 (cDPP4) levels and its enzymatic activity, are increased in non-alcoholic fatty liver disease (NAFLD) and in type 2 diabetes mellitus and/or obesity. DPP4 has been implicated as a causative factor in NAFLD progression but few studies have examined associations between cDPP4 activity and NAFLD severity in humans. This study aimed to examine the relationship of cDPP4 activity with measures of liver disease severity in NAFLD in subjects with diabetes and/or obesity. cDPP4 was measured in 106 individuals with type 2 diabetes who had transient elastography (Cohort 1) and 145 individuals with morbid obesity who had liver biopsy (Cohort 2). Both cohorts had caspase-cleaved keratin-18 (ccK18) measured as a marker of apoptosis. Natural log increases in cDPP4 activity were associated with increasing quartiles of ccK18 (Cohorts 1 and 2) and with median liver stiffness ≥10.3 kPa (Cohort 1) and significant fibrosis (F ≥ 2) on liver biopsy (Cohort 2). In diabetes and/or obesity, cDPP4 activity is associated with current apoptosis and liver fibrosis. Given the pathogenic mechanisms by which DPP4 may progress NAFLD, measurement of cDPP4 activity may have utility to predict disease progression and DPP4 inhibition may improve liver histology over time.

Comments on ‘Low serum sex hormone binding globulin is associated with nonalcoholic fatty liver disease in type 2 diabetic patients’

Comments on ‘Low serum sex hormone binding globulin is associated with nonalcoholic fatty liver disease in type 2 diabetic patients’

Think highly of the poor outcome of non-alcoholic fatty liver disease in type 2 diabetes

Researches in type 2 diabetes and non-alcoholic fatty liver disease have been made in recent years.The intimate connection between these two diseases has been analysed and explored.Whether non-alcoholic fatty liver disease is a hepatic complication of type 2 diabetes remains to be elucidated.The poor outcome of liver disease in patients with type 2 diabetes should be emphasized. Key words: Non-alcoholic fatty liver disease; Diabetes mellitus, type 2 ; Non-alcoholic steatohepatitis; Advanced fibrosis

Association of Micro and Macrovascular Complications with Fatty Liver in Patients with Type 2 Diabetes Mellitus

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: Fatty liver is a fairly common entity seen in the diabetic population. Studies showed that liver adiposity is independently associated with Insulin Resistance and can substantially increase the risk of various micro and macrovascular complications of diabetes mellitus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims:&lt;/strong&gt; Identifying various micro and macrovascular complications and finding their association with fatty liver disease in type 2 diabetes patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and Methods:&lt;/strong&gt; 141 diabetic patients admitted in a tertiary care center over a two year period were screened for fatty liver by ultrasonography of the abdomen and were classified into FL (fatty Liver) group and NFL (non fatty liver) group. All patients were investigated for complications like nephropathy, neuropathy, retinopathy, cardiac and peripheral vascular disease. Statistical analysis was done to find the association of complications with fatty liver.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; out of 141 patients, 49 (35%) had fatty liver. Leading complication was neuropathy (31.2%), followed by nephropathy (11.3%), retinopathy (10.6%), cardiac disease (9.2%) and peripheral vascular disease (3.55). Between FL and NFL groups, Diabetic neuropathy (40.8% vs. 23.9%) and cardiac disease (16.3% vs. 5.4%) showed statical significance (p&amp;lt;0.05), while other complications were more or less equally prevalent in the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Fatty liver is seen in one third of diabetic patients. vascular complications like neuropathy and cardiac disease are more commonly seen in diabetic patients with fatty liver than those without fatty liver.&lt;/p&gt;

Low serum sex hormone‐binding globulin is associated with nonalcoholic fatty liver disease in type 2 diabetic patients

Studies have indicated that low serum sex hormone-binding globulin (SHBG) and testosterone levels are associated with nonalcoholic fatty liver disease (NAFLD). However, it remains unclear whether an association exists between SHBG and NAFLD independent of testosterone. This study was aimed to investigate the relationship between SHBG and both total and free testosterone levels with NAFLD. One hundred and twenty patients with NAFLD and 120 age-, sex- and BMI-matched patients with non-NAFLD were enrolled into a case-control study. Serums SHBG, total testosterone (TT), liver enzymes, lipids, insulin, C-peptide and plasma glucose were measured. Free testosterone (FT) and fatty liver index were calculated. Serum SHBG levels were significantly lower in NAFLD group than in non-NAFLD group (24·5 ± 11·0 vs 37·6 ± 14·4 nm, P < 0·001). After adjustment for age, smoking status, alcohol use, duration of diabetes, BMI and fasting C-peptide, serum SHBG levels in men and women were inversely associated with NAFLD, with odds ratio (OR) and 95% confidence interval (CI) in the forth quartile as 0·05 (0·01-0·30) and 0·25 (0·08-0·77) compared with the first quartile (OR = 1·00). Additional adjustment for TT in men and FT in women did not materially alter the association. The relationship between serum TT (for men) and FT (for women) with NAFLD was attenuated and even diminished after multivariable adjustment for known risk factors and SHBG. Low serum SHBG levels, but not TT or FT, are associated with NAFLD in type 2 diabetic patients.

Glycogenic hepatopathy and non‐alcoholic fatty liver disease in type 1 diabetes patients

Patients with type 1 diabetes mellitus (T1DM) sometimes have hepatomegaly and increased transaminase. This is usually due to non-alcoholic fatty liver disease (NAFLD) or, rarely, glycogenic hepatopathy (GH). A 13-year-old boy with NAFLD who was diagnosed with T1DM at 8 years of age, and a 13-year-old girl with GH who was found to have T1DM at 9 years of age were observed to have hepatomegaly and elevation of transaminase (aspartate aminotransferase [reference value, 12–30 IU/mL]/ alanine aminotransferase [reference value: 3–18 IU/mL]: 48/100 and 181/191, respectively). Their blood glucose levels had been poorly controlled for the last few years (HbA1c 11–12%). Lowdensity liver on computed tomography (CT) is usually seen in NAFLD, but sometimes, in early stage NAFLD, low-density liver is not seen on CT. Gradient dual-echo magnetic resonance imaging (MRI) can effectively discriminate glycogen from fat in the liver (Fig. 1). Therefore, we believe that gradient dual-echo MRI is a powerful tool to distinguish GH from NAFLD in T1DM with hepatomegaly and elevated transaminase.

S-Allyl cysteine improves nonalcoholic fatty liver disease in type 2 diabetes Otsuka Long-Evans Tokushima Fatty rats via regulation of hepatic lipogenesis and glucose metabolism

It is important to prevent and improve diabetes mellitus and its complications in a safe and low-cost manner. S-Allyl cysteine, an aged garlic extract with antioxidant activity, was investigated to determine whether S-allyl cysteine can improve type 2 diabetes in Otsuka Long-Evans Tokushima Fatty rats with nonalcoholic fatty liver disease. Male Otsuka Long-Evans Tokushima Fatty rats and age-matched Long-Evans Tokushima Otsuka rats were used and were divided into two groups at 29 weeks of age. S-Allyl cysteine (0.45% diet) was administered to rats for 13 weeks. Rats were killed at 43 weeks of age, and detailed analyses were performed. S-Allyl cysteine improved hemoglobinA1c, blood glucose, triglyceride, and low-density lipoprotein cholesterol levels. Furthermore, S-allyl cysteine normalized plasma insulin levels. S-Allyl cysteine activated the mRNA and protein expression of both peroxisome proliferator-activated receptor α and γ, as well as inhibiting pyruvate dehydrogenase kinase 4 in Otsuka Long-Evans Tokushima Fatty rat liver. Sterol regulatory element-binding protein 1c and forkhead box O1 proteins were normalized by S-allyl cysteine in Otsuka Long-Evans Tokushima Fatty rat liver. In conclusions, these findings support the hypothesis that S-allyl cysteine has diabetic and nonalcoholic fatty liver disease therapeutic potential as a potent regulating agent against lipogenesis and glucose metabolism.

P 24: Non alcoholic fatty liver disease in type 2 diabetes patients

P 24: Non alcoholic fatty liver disease in type 2 diabetes patients