[Association of insulin resistance with alanine aminotransferase activity in patients with nonalcoholic fatty liver disease]

Background: Nonalcoholic fatty liver disease [NAFLD] is a term with a wide spectrum of disorders ranging from simple steatosis to progressive nonalcoholic steatohepatitis [NASH], cirrhosis and hepatocellular carcinoma. Serum alanine aminotransferase [ALT] level is a well-recognized clinical marker of liver injury and may represent a consequence of the proinflammatory process accused in the pathogenesis of NAFLD. Insulin resistance seems to predispose lipid accumulation within the liver and progress to fibrosis in NAFLD

Aim of the study: to investigate the association of insulin resistance with ALT activity in NAFLD patients

Patients and Methods: 50 patients with NAFLD, diagnosed by abdominal ultrasonography, were included in this study. Full history, clinical evaluation, body mass index [BMI], waist circumference and laboratory tests including liver function tests, lipid profile, random blood glucose [RBG] and glycated Hemoglobin [HBA1c] were done. Also, fasting blood glucose and fasting insulin levels were determined for calculation of Homeostasis Model Assessment-Insulin Resistance [HOMA-IR]

Results: Patients were divided into two groups; group I included 28 patients with elevated serum ALT level and group II included 22 patients with normal serum ALT level. There was significant difference between the two groups as regard to prevalence of type 2 diabetes mellitus, elevated RBG level, HbAlc, HOMA-IR and waist circumference but no significant difference between the two groups regarding age, sex, BMI, lipid profile and incidence of hypertension and ischemic heart disease

Conclusion: Our findings suggested that increased ALT activity was associated with insulin resistance in patients with NAFLD

[Hepatitis associated aplastic anemia in relation to liver cell injury]

Background: Aplastic anemia [AA] is a disorder characterized by pancytopenia and injury or loss of pluripotent hematopoietic stem cells in the absence of infiltrative disease of the bone marrow. Hepatitis-associated aplastic anemia [HAAA] is a variant of AA

Aim of the study: To investigate the possible etiology responsible for the development of HAAA

Patients and methods: 42 patients were admitted to Assiut university hospital diagnosed as having AA. Data from history, physical examination and laboratory investigations, including complete blood count [CBC], viral serology and liver function tests were collected and statistically analyzed

Results: Patients were divided into group A [HAAA, 9 patients] 7 of them had hepatitis C virus, one with hepatitis A virus and one with cvtomegalovirus and group B [non-HAAA, 33 patients]. There was no significant difference as regard to CBC between HAAA patients and non-HAAA patients. There were significant negative correlations between alanine transaminase [ALT] and CBC findings in patients with HAAA

Conclusion: HAAA is caused by variable hepatotropic and non-hepatotropic viruses. The pathogenesis of hepatitis associated aplastic anemia HAAA may be attributed to liver cell injury, disturbed liver functions and its effects on hematopoiesis