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1.
Medicine (Baltimore) ; 98(48): e18189, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770275

RESUMO

Sparse is the research on the relationship between iron metabolism and mild cognitive impairment (MCI) in adults aged over 60 years with non-alcoholic fatty liver disease (NAFLD). The soluble transferrin receptor (sTfR), serum iron (SI), serum ferritin (SF), transferrin (TRF) and hemoglobin (HB) are indicators of iron metabolism.This study examined whether iron metabolism is associated with cognitive impairment in older individuals.A cross-sectional study was held in patients from a Chinese center. Individuals with NAFLD aged over 60 years were included if they did not have excessive alcohol intake and were free of stroke or dementia. Their cognitive function was assessed by the same neurologist. 3.0T H proton magnetic resonance spectroscopy (H-MRS) was performed to evaluate the hippocampus of the participants without contraindication. t test and Chi-square test were used to analyze the data. Binary logistic regression was used for correlation analysis.Fifty four (54%) of participants were diagnosed with MCI by the psychiatrist. MCI was significantly associated with higher sTfR after adjustment of all the covariates (OR = 2.565, 95%CI: 1.334∼4.934; P = .005). No statistically significant associations were observed between MCI and age or blood glucose or choline (Cho) /creatine (Cr) of theright hippocampus head.Increased age and low levels of sTfR and HB were associated with MCI in NAFLD individuals aged over 60 years.


Assuntos
Disfunção Cognitiva , Hemoglobinas/análise , Hipocampo/diagnóstico por imagem , Ferro , Hepatopatia Gordurosa não Alcoólica , Receptores da Transferrina/sangue , Idoso , China/epidemiologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/metabolismo , Correlação de Dados , Estudos Transversais , Feminino , Ferritinas/análise , Humanos , Ferro/sangue , Ferro/metabolismo , Espectroscopia de Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/psicologia , Transferrina/análise
2.
BMC Gastroenterol ; 19(1): 133, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31345163

RESUMO

BACKGROUND: The aim of the present study was to evaluate the effects of curcumin supplementation on inflammatory indices, and hepatic features in patients with non-alcoholic fatty liver disease (NAFLD). METHODS: Fifty patients with NAFLD were randomized to receive lifestyle modification advice plus either 1500 mg curcumin or the same amount of placebo for 12 weeks. RESULTS: Curcumin supplementation was associated with significant decrease in hepatic fibrosis (p < 0.001), and nuclear factor-kappa B activity (p < 0.05) as compared with the baseline. Hepatic steatosis and serum level of liver enzymes, and tumor necrosis-α (TNF-α) significantly reduced in both groups (p < 0.05). None of the changes were significantly different between two groups. CONCLUSION: Our results indicated that curcumin supplementation plus lifestyle modification is not superior to lifestyle modification alone in amelioration of inflammation. TRIAL REGISTRATION: IRCT20100524004010N24, this trial was retrospectively registered on May 14, 2018.


Assuntos
Curcumina/administração & dosagem , Inflamação , Fígado , Hepatopatia Gordurosa não Alcoólica , Comportamento de Redução do Risco , Anti-Inflamatórios não Esteroides/administração & dosagem , Feminino , Humanos , Inflamação/tratamento farmacológico , Inflamação/patologia , Fígado/efeitos dos fármacos , Fígado/patologia , Testes de Função Hepática/métodos , Masculino , Pessoa de Meia-Idade , NF-kappa B/análise , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/patologia , Hepatopatia Gordurosa não Alcoólica/psicologia , Hepatopatia Gordurosa não Alcoólica/terapia , Resultado do Tratamento , Fator de Necrose Tumoral alfa/análise
3.
Prog Cardiovasc Dis ; 62(2): 127-134, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30796942

RESUMO

PURPOSE: Sedentary behaviour (SB) and low physical activity (PA) are independently associated with non-alcoholic fatty liver disease (NAFLD). Compared to PA, high cardiorespiratory fitness (CRF) has been associated with a higher protection against all-cause mortality and a number of specific diseases. However, this relationship has not been investigated in NAFLD. This study examined the roles of SB and CRF on: i) the likelihood of having NAFLD in the general population, and ii) the risk of mortality over 9 years within individuals having NAFLD. METHODS: A cross-sectional analysis of 15,781 adults (52% female; age range 19-95 years) was conducted. Self-reported SB was divided into tertiles. CRF was estimated using validated non-exercise models, and the presence of NAFLD from the Fatty Liver Index. Adjusted Odds Ratios and 95% Confidence Intervals for NAFLD were estimated using logistic regression analyses. Hazard Ratios for all-cause mortality were estimated using Cox proportional hazard regression in individuals with NAFLD. RESULTS: For each additional 1 h/d of SB, the likelihood of having NAFLD was significantly increased by 4% (CI, 3-6%). In combined analyses, compared with the reference group [high CRF and low (≤4 h/d) SB], individuals with low CRF had a markedly higher likelihood of having NAFLD (OR, 16.9; CI 12.9-22.3), even if they had SB ≤ 4 h/d. High CRF attenuated the negative role of SB up to 7 h/d on NAFLD. Over 9.4 ±â€¯1.3 years of follow-up, individuals with NAFLD and low CRF had the risk of mortality increased by 52% (CI, 10-106%) compared to those with high CRF, regardless of SB or meeting PA guidelines. CONCLUSIONS: Low CRF increases the risk of premature death in individuals with NAFLD, and is strongly associated with higher likelihood of having NAFLD, outweighing the influence of SB.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Doenças Cardiovasculares , Exercício/fisiologia , Hepatopatia Gordurosa não Alcoólica , Comportamento Sedentário , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/psicologia , Noruega/epidemiologia , Prevalência , Serviços Preventivos de Saúde/métodos , Modelos de Riscos Proporcionais , Medição de Risco/métodos , Fatores de Risco , Autorrelato
4.
Psychosomatics ; 60(1): 10-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30318268

RESUMO

BACKGROUND: In recent years, the adoption of unhealthy dietary habits and a sedentary lifestyle has led to an alarming increase in the prevalence of non-alcoholic fatty liver disease (NAFLD) in pediatric populations. Hepatic steatosis is now considered the most common cause of chronic liver disease in children and adolescents and may progress to liver fibrosis and even cirrhosis, increasing long-term mortality rates. Apart from its severe medical co-morbidities, pediatric NAFLD is associated with a variety of psychosocial factors which act either as precipitants or consequences of the disease. OBJECTIVE: Studying these parameters might expand our understanding of NAFLD pathogenesis and provide a framework for more effective management. METHOD: In this context, we performed a literature review focusing on the associations of pediatric NAFLD with psychosocial parameters to detect and integrate the most recent data on this topic and provide a scaffold for further conceptualization and research. RESULTS: There are a limited number of studies addressing issues of psychosocial functioning in children with NAFLD. Pediatric NAFLD is frequently accompanied by neuropsychiatric symptoms and poor quality of life and the level of impairment does not correlate with the degree of hepatic damage. In addition, mentally and intellectually-impaired youth appear at greater risk for developing liver steatosis. CONCLUSIONS: Pediatric NAFLD is associated with psychosocial parameters in a bidirectional way. Further research is needed on NAFLD's psychosocial correlates and on the effect of treatment on patients' well-being.


Assuntos
Transtornos Mentais/psicologia , Hepatopatia Gordurosa não Alcoólica/psicologia , Obesidade Pediátrica/psicologia , Estresse Psicológico/psicologia , Adolescente , Criança , Comorbidade , Dieta , Humanos , Transtornos Mentais/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade Pediátrica/epidemiologia , Qualidade de Vida , Comportamento Sedentário , Estresse Psicológico/epidemiologia
5.
Adv Ther ; 36(2): 478-491, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30547371

RESUMO

INTRODUCTION: The aim of this work was to understand how patients with non-alcoholic steatohepatitis (NASH) perceive their disease, unmet needs, and expectations regarding future treatment through online bulletin board (OBB) qualitative research. METHODS: OBB is an asynchronous online qualitative market research tool that provides an open forum for interactive discussion among participants. Patients with NASH were recruited via physician referral and completed a screener questionnaire to ensure their eligibility and willingness to participate. A trained moderator managed the discussion that allowed open answers and responses to other participants' posts. Patient responses were analyzed using a combination of different qualitative analytical tools. RESULTS: The OBB ran for 4 days and included 16 patients (n = 8, UK; n = 8, US) with NASH (fibrosis stages F1-F3) and comorbidities including diabetes/prediabetes (n = 9) and obesity (n = 12). The key insights were (1) patients with NASH have a poor understanding of the disease, its progression, and management-they feel a lack of adequate educational support from their physicians; (2) diagnosis of NASH is incidental in most cases, mainly because patients fail to spontaneously associate their signs or symptoms with their liver condition; (3) comorbidities (obesity and diabetes) are more concerning to patients than NASH; and (4) patients perceive that NASH impacts their social life and work performance in more advanced stages. CONCLUSIONS: This OBB provided valuable patient insights into NASH disease perception and management and revealed unmet need areas. In light of no approved therapies, these patient insights can inform early drug development strategies and stakeholder discussions on NASH. FUNDING: Novartis Pharma AG, Basel.


Assuntos
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Comportamento de Busca de Informação , Hepatopatia Gordurosa não Alcoólica/psicologia , Participação do Paciente/psicologia , Preferência do Paciente/psicologia , Adulto , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/terapia , Pesquisa Qualitativa
6.
Dig Dis Sci ; 64(3): 708-717, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30483909

RESUMO

BACKGROUND: Prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing in China; however, awareness and knowledge of NAFLD is lacking among the Chinese public. AIMS: We investigated knowledge about NAFLD and the impact of a brief educational seminar among office employees in Beijing. METHODS: Educational seminar on knowledge about NAFLD and recommendations on diet and physical activity and a pre- and a post-survey in 8 offices in Beijing. RESULTS: A total of 420 participants (24.7% with a diagnosis of NAFLD) completed both the pre- and post-surveys. Median age was 42, 39.1% were men, 93.9% participants had some college education, 50.5% were overweight/obese, and 74.9% were inactive/minimally active. Only 31.2% had awareness of NAFLD. Median baseline knowledge score (of a total of 25) was 17 in participants with and 16 in those without a diagnosis of NAFLD. After the seminar, 30.9% of participants with and 50.8% without a diagnosis of NAFLD increased their knowledge score by ≥ 3 points, and 92.9% indicated they will improve their diet and physical activity. Multivariate logistic regression analyses found baseline knowledge score was associated with personal diagnosis of NAFLD and family history of dyslipidemia while improvement in knowledge was associated with lower baseline knowledge score and absence of a personal diagnosis of NAFLD. CONCLUSION: We found a high prevalence but a low awareness of NAFLD among office employees in Beijing. A brief educational seminar improved knowledge about NAFLD and motivated lifestyle changes. More educational efforts are needed to decrease the burden of NAFLD in China.


Assuntos
Conscientização , Empregados do Governo/psicologia , Comunicação em Saúde/métodos , Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Ocupações , Saúde da População Urbana , Adulto , Pequim/epidemiologia , Exercício , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Humanos , Descrição de Cargo , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Motivação , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/psicologia , Prevalência , Fatores de Proteção , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco
7.
Nutrients ; 10(9)2018 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-30235828

RESUMO

The role of nutrition and diet in the development of non-alcoholic fatty liver disease (NAFLD) is still not fully understood. In the present study, we determined if dietary pattern and markers of intestinal permeability differ between overweight children with and without NAFLD. In addition, in a feasibility study, we assessed the effect of a moderate dietary intervention only focusing on nutrients identified to differ between groups on markers of intestinal barrier function and health status. Anthropometric data, dietary intake, metabolic parameters, and markers of inflammation, as well as of intestinal permeability, were assessed in overweight children (n = 89, aged 5⁻9) and normal-weight healthy controls (n = 36, aged 5⁻9). Sixteen children suffered from early signs of NAFLD, e.g., steatosis grade 1 as determined by ultrasound. Twelve children showing early signs of NAFLD were enrolled in the intervention study (n = 6 intervention, n = 6 control). Body mass index (BMI), BMI standard deviation score (BMI-SDS), and waist circumference were significantly higher in NAFLD children than in overweight children without NAFLD. Levels of bacterial endotoxin, lipopolysaccharide-binding protein (LBP), and proinflammatory markers like interleukin 6 (IL-6) and tumor necrosis factor α (TNFα) were also significantly higher in overweight children with NAFLD compared to those without. Total energy and carbohydrate intake were higher in NAFLD children than in those without. The higher carbohydrate intake mainly resulted from a higher total fructose and glucose intake derived from a significantly higher consumption of sugar-sweetened beverages. When counseling children with NAFLD regarding fructose intake (four times, 30⁻60 min within 1 year; one one-on-one counseling and three group counselings), neither alanine aminotransferase (ALT) nor aspartate aminotransferase (AST) activity in serum changed; however, diastolic blood pressure (p < 0.05) and bacterial endotoxin levels (p = 0.06) decreased markedly in the intervention group after one year. Similar changes were not found in uncounseled children. Our results suggest that a sugar-rich diet might contribute to the development of early stages of NAFLD in overweight children, and that moderate dietary counseling might improve the metabolic status of overweight children with NAFLD.


Assuntos
Bebidas , Comportamento Infantil , Açúcares da Dieta/efeitos adversos , Comportamento Alimentar , Frutose/efeitos adversos , Hepatopatia Gordurosa não Alcoólica/etiologia , Obesidade Pediátrica/etiologia , Bebidas/efeitos adversos , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Aconselhamento , Açúcares da Dieta/administração & dosagem , Açúcares da Dieta/metabolismo , Endotoxinas/sangue , Estudos de Viabilidade , Feminino , Frutose/administração & dosagem , Frutose/metabolismo , Humanos , Mediadores da Inflamação/sangue , Intestinos/microbiologia , Intestinos/fisiopatologia , Masculino , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Hepatopatia Gordurosa não Alcoólica/psicologia , Estado Nutricional , Obesidade Pediátrica/dietoterapia , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/psicologia , Permeabilidade , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Circunferência da Cintura
8.
Psychosomatics ; 59(6): 567-574, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30086995

RESUMO

BACKGROUND: Individuals with nonalcoholic fatty liver disease (NAFLD) share some common pathophysiological features with individuals with type 2 diabetes mellitus (T2DM). There is a well-established association between T2DM and cognitive decline, but no corollary data of people with NAFLD and without T2DM or whether combination of the 2 disorders is associated with additive deficits in cognitive performance. OBJECTIVES: The purpose of this investigation is to compare measures of cognitive performance for individuals with NAFLD, individuals with T2DM, individuals with both or neither. METHODS: Using NHANES data from 2011-2014, 1102 individuals were identified who had completed cognitive assessments. RESULTS: After controlling for demographics, comorbidities, and metabolic components, individuals with both NAFLD and T2DM scored significantly lower on a task that combines processing speed, sustained attention, and working memory (Beta = -3.44, 95% CI: -6.75 to -0.12) than individuals with neither. Individuals with T2DM without NAFLD scored significantly lower on verbal fluency (Beta = -1.47, 95% CI: -2.7 to -0.23) than individuals with neither. CONCLUSIONS: Data from this study suggests that individuals with T2DM and individuals with both NAFLD and T2DM have lower cognitive performance on various tasks. These data support an approach that aims to apply preventive strategies to optimize management of T2DM in patients with NAFLD.


Assuntos
Disfunção Cognitiva/complicações , Disfunção Cognitiva/psicologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/psicologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/psicologia , Idoso , Cognição , Disfunção Cognitiva/fisiopatologia , Estudos Transversais , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Humanos , Masculino , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Tempo de Reação , Fatores de Risco , Estados Unidos
9.
J Psychosom Res ; 112: 73-80, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30097139

RESUMO

OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent medical condition, which may lead to severe complications including cirrhosis and hepatocellular carcinoma. Its chronic course and its association with obesity and diabetes mellitus augment the long-term impact of NAFLD on patients' health and quality of life (QoL) and put great strain on healthcare systems worldwide. Research is growingly focusing on NAFLD patients' QoL in an attempt to describe the full spectrum of disease burden and tackle its future consequences. Relevant studies are characterized by sample heterogeneity and provide conflicting findings which should be interpreted with the use of a systematic and integrative approach. In this context, our aim was to conduct a systematic literature review on the topic of NAFLD patients' QoL. METHODS: We performed a systematic search of PubMed, ScienceDirect and GoogleScholar databases according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol. RESULTS: Our search yielded 14 suitable articles reporting data from almost 5000 patients. All authors agree that NAFLD patients' QoL is impaired especially in the physical sub-domain. In addition, several demographic, clinical and histopathological parameters have emerged as major determinants of patients' QoL. However, future studies are needed to further clarify these issues. CONCLUSIONS: NAFLD patients report poor physical QoL. QoL impairment is associated with a variety of disease-related parameters, mostly the presence of fatigue and cirrhosis.


Assuntos
Hepatopatia Gordurosa não Alcoólica/psicologia , Qualidade de Vida/psicologia , Humanos
10.
Am J Physiol Gastrointest Liver Physiol ; 315(3): G329-G338, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-29878845

RESUMO

The prevalence of obesity-related nonalcoholic fatty liver disease (NAFLD) is rising. NAFLD may result in nonalcoholic steatohepatitis (NASH), progressing to liver cirrhosis. Weight loss is recommended to treat obesity-related NASH. Lifestyle intervention may improve NASH; however, pertinent trials have so far focused on overweight patients, whereas patients with obesity are at highest risk of developing NAFLD. Furthermore, reports of effects on liver fibrosis are scarce. We evaluated the effect of lifestyle intervention on NAFLD in a real-life cohort of morbidly obese patients. In our observational study, 152 patients underwent lifestyle intervention, with a follow-up of 52 weeks. Noninvasive measures of obesity, metabolic syndrome, liver steatosis, liver damage, and liver fibrosis were analyzed. Treatment response in terms of weight loss was achieved in 85.1% of patients. Dysglycemia and dyslipidemia improved. The proportion of patients with fatty liver dropped from 98.1 to 54.3% ( P < 0.001). Weight loss >10% was associated with better treatment response ( P = 0.0009). Prevalence of abnormal serum transaminases fell from 81.0 to 50.5% ( P < 0.001). The proportion fibrotic patients, as determined by the NAFLD fibrosis score, dropped from 11.8 to 0% ( P < 0.05). Low serum levels of adiponectin correlated with degree of liver damage, i.e., serum liver transaminases ( r = -0,32, P < 0.05). Serum levels of adiponectin improved with intervention. In conclusion, lifestyle intervention effectively targeted obesity and the metabolic syndrome. Liver steatosis, damage and fibrosis were ameliorated in this real-life cohort of morbidly obese patients, mediated in part by changes in the adipokine profile. Patients with weight loss of >10% seemed to benefit most. NEW & NOTEWORTHY We demonstrate new evidence that lifestyle intervention is effective in treating NAFLD in the important group of patients with (morbid) obesity. Although current guidelines on the therapy of NASH recommend weight loss of 5-7%, weight reduction >10% may be favorable in morbid obesity. Serum levels of adipokines correlate with liver damage, which is indicative of their pathogenetic importance in human NASH. Our study adds to the limited body of evidence that NAFLD-associated liver fibrosis may resolve with lifestyle intervention.


Assuntos
Adiponectina/sangue , Dietoterapia/métodos , Cirrose Hepática , Hepatopatia Gordurosa não Alcoólica , Obesidade Mórbida , Perda de Peso/fisiologia , Adipocinas/sangue , Adulto , Índice de Massa Corporal , Feminino , Alemanha/epidemiologia , Comportamentos Relacionados com a Saúde/fisiologia , Estilo de Vida Saudável/fisiologia , Humanos , Estilo de Vida , Fígado/metabolismo , Fígado/patologia , Cirrose Hepática/metabolismo , Cirrose Hepática/patologia , Cirrose Hepática/prevenção & controle , Testes de Função Hepática/métodos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/patologia , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Hepatopatia Gordurosa não Alcoólica/psicologia , Obesidade Mórbida/fisiopatologia , Obesidade Mórbida/psicologia , Obesidade Mórbida/terapia
11.
Can J Gastroenterol Hepatol ; 2018: 9638797, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29682494

RESUMO

Studies of psychological condition of patients suffering from nonalcoholic fatty liver disease are rather equivocal about the results: while some claim that NAFLD patients suffer from anxiety and depression more than non-NAFLD controls, others do not withstand those findings. Lower cognitive potentials have also been reported, both in patient related and in animal model-based investigations, and correlated with assessed brain tissue changes. We hypothesized that NAFLD, as a condition, affects the brain tissue and, subsequently, the cognitive state. So we compared findings in 40 NAFLD positive and 36 NAFLD negative patients and correlated their brain tissue volumes with the results of Montreal Cognitive Assessment (MoCA) test. Binomial logistic regression verified the influence of NAFLD state leading to lower cognitive potentials: odds ratio 0.096; 95% confidence interval (CI) 0.032-0.289; p < 0.001. Patients with NAFLD had a greater risk to suffer from the cognitive impairment and depression: RR = 3.9; 95% CI 1.815-8.381; p = 0.0005 and RR = 1.65; 95% CI 1.16-2.36; p = 0.006. NAFLD significantly influenced the cognitive deficit and tissue volume reduction and patients suffering from NAFLD had about four times higher risk of having a cognitive impairment.


Assuntos
Encéfalo/patologia , Cognição , Disfunção Cognitiva/etiologia , Hepatopatia Gordurosa não Alcoólica/psicologia , Adulto , Estudos de Casos e Controles , Disfunção Cognitiva/diagnóstico , Depressão/diagnóstico , Depressão/etiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Neuroimagem , Tamanho do Órgão , Escalas de Graduação Psiquiátrica , Fatores de Risco
12.
Eur J Gastroenterol Hepatol ; 30(8): 944-950, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29608442

RESUMO

OBJECTIVE: The aim of this study was to investigate cognitive performance for the first time in participants with nonalcoholic fatty liver disease (NAFLD) using the Montreal Cognitive Assessment (MoCA). PARTICIPANTS AND METHODS: In total, 70 participants with NAFLD and 73 age-matched and sex-matched healthy participants were enrolled in this prospective cross-sectional study. The diagnosis of NAFLD was made on the basis of abdominal ultrasonography findings. Anthropometric indices were calculated, and routine laboratory analyses were carried out for each participant. All participants provided sociodemographic data and completed the Beck Depression Inventory-II. Cognitive functions were evaluated using the Turkish version of the MoCA, with a cut-off score for mild cognitive impairment of less than 21 points. RESULTS: The MoCA scores were significantly lower in participants with NAFLD than in the healthy group (P<0.05). In addition, more NAFLD participants than healthy participants presented with deficits in the visuospatial (P<0.05) and executive function domains (P<0.05). In the multivariate model, education level [2.79 (1.12-6.96); P<0.05] and area of residence [5.68 (2.24-14.38); P<0.001] were associated independently with cognitive dysfunction in both the NAFLD and the healthy groups. The MoCA scores were correlated negatively with fibrosis 4 scores in NAFLD participants (r=-0.359; P<0.05). However, hepatosteatosis grade and the presence of metabolic syndrome were not correlated with MoCA scores in the NAFLD group (P>0.05). CONCLUSION: Our results show that NAFLD patients may have early or subtle cognitive dysfunction, including in the visuospatial and executive function domains, as indexed by scores on the MoCA test. Further targeted psychometric testing will be required to confirm the presence of cognitive impairment in this population.


Assuntos
Cognição , Disfunção Cognitiva/etiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Adulto , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Estudos Transversais , Função Executiva , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Testes Neuropsicológicos , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/psicologia , Razão de Chances , Prognóstico , Estudos Prospectivos , Fatores de Risco , Percepção Espacial , Percepção Visual
13.
Georgian Med News ; (263): 50-55, 2017 Feb.
Artigo em Russo | MEDLINE | ID: mdl-28452727

RESUMO

Purpose - to assess the impact of lifestyle on non-alcoholic fatty liver disease (NAFLD) activity by influencing the fibrotic processes and hepatic steatosis in patients with stable coronary heart disease (CHD). 105 patients with stable CHD, combined with NAFLD were observed: Group I - control group; Group II - basic group. In each group, patients with non-alcoholic steatosis (subgroup A) and non-alcoholic steatohepatitis (subgroup B) were isolated. General clinical examination, electrocardiography, coronary angiography, echocardiography, liver functional state, serum lipid profile, fasting glucose, markers of fibrosis were conducted to all patients. After treatment in patients of Group II positive changes in all parameters vs. basal levels and the control group were found: significantly decreased body mass index, alpha-2-macroglobulin and type IV collagen levels; increased apolipoprotein A1 and haptoglobulin levels; decreased severity of dyslipidemia; improved parameters of the liver functional state. Modification of lifestyle of patients with stable CHD influences positively on the NAFLD course, reducing disease activity by inhibiting fibrotic processes and hepatic steatosis that, in general, inhibits the progression of this comorbid disorder.


Assuntos
Doença das Coronárias/sangue , Estilo de Vida , Cirrose Hepática/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Doença das Coronárias/complicações , Doença das Coronárias/psicologia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/psicologia , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/psicologia
14.
PLoS One ; 12(4): e0174169, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28376101

RESUMO

Patients with non-alcoholic fatty liver disease (NAFLD) have impaired health-related quality of life including physical and mental state. Near-infrared spectroscopy (NIRS) is a useful tool for evaluation of brain activity and depressive state. This study aimed to determine the brain activity of female NAFLD patients using NIRS. Cerebral oxygenated hemoglobin (oxy-Hb) concentration during a verbal fluency task (VFT) was measured using NIRS in 24 female NAFLD patients and 15 female healthy controls. The Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire was administered to both groups before NIRS. There was no significant difference in CES-D score between groups. However, the oxy-Hb concentration and number of words during the VFT were less in NAFLD compared to healthy controls. The mean value of oxy-Hb concentration during 0-60 s VFT in the frontal lobe was also smaller in NAFLD patients compared to healthy controls (0.082 ± 0.126 vs. 0.183 ± 0.145, P < 0.001). Cerebral oxygen concentration is poorly reactive in response to VFT in female NAFLD patients. This may indicate an association between decreased brain activity and NAFLD regardless of depression.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Estudos de Casos e Controles , Depressão/diagnóstico por imagem , Depressão/fisiopatologia , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/fisiopatologia , Neuroimagem Funcional , Humanos , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/psicologia , Oxiemoglobinas/metabolismo , Qualidade de Vida , Espectroscopia de Luz Próxima ao Infravermelho , Análise e Desempenho de Tarefas , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/fisiopatologia , Comportamento Verbal/fisiologia
15.
BMC Complement Altern Med ; 17(1): 203, 2017 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-28388904

RESUMO

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) represents one of the most common forms of liver disease worldwide, and it is always regarded as a consequence of a sedentary, food-abundant lifestyle, sitting for an extended time, and a low physical activity level, which often coincide with chronic and long-lasting psychological stress. A Chinese medicine Sinisan (SNS) may be a potential formula for treating this kind of disease. METHODS: In this study, a long-term chronic restraint stress protocol was used to investigate the mechanism underlying stress-induced NALFD. To investigate the effect of SNS treatment on stress-induced NAFLD, we measured the liver and serum values of total cholesterol (TC), triglyceride (TG), liver free fatty acids (FFA), low-density lipoprotein, superoxide dismutase, tumor necrosis factor-α, malondialdehyde, interleukin (IL)-6, and serum values of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase. Results are shown as a mean ± standard deviation. Significant differences between the groups were evaluated using the Student t-test. For multiple comparisons, one-way analysis of variance (ANOVA) was used. If the results of ANOVA indicated significant differences, post hoc analysis was performed with the Tukey test or Dunnett test, and p < 0.05 was considered statistically significant. RESULTS: Long-term chronic stress led to steatosis and non-alcoholic steatohepatitis. Additionally, SNS treatment significantly increased body weight gain (p < 0.01) and sucrose preference (p < 0.001), and it reduced the liver values of TC, TG, and FFA (p < 0.05). SNS also reduced the serum values of AST and ALT (p < 0.001), and the liver value of IL-6 (p < 0.01). CONCLUSIONS: This study's results demonstrate that psychological stress may be a significant risk factor of NAFLD. Furthermore, the traditional Chinese medicine formula SNS may have some beneficial effect in antagonizing psychological stress and stress-related NAFLD.


Assuntos
Medicamentos de Ervas Chinesas/administração & dosagem , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Alanina Transaminase/metabolismo , Animais , Colesterol/metabolismo , Modelos Animais de Doenças , Composição de Medicamentos , Medicamentos de Ervas Chinesas/química , Humanos , Interleucina-6/metabolismo , Masculino , Malondialdeído/metabolismo , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/psicologia , Ratos , Ratos Sprague-Dawley , Estresse Psicológico , Superóxido Dismutase/metabolismo , Triglicerídeos/metabolismo
16.
World J Gastroenterol ; 23(10): 1881-1890, 2017 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-28348495

RESUMO

AIM: To describe the relationships between non-alcoholic fatty-liver disease (NAFLD) patient's disease consequences and treatment perceptions, self-efficacy, and healthy lifestyle maintenance. METHODS: A cross-sectional study among 146 ultrasound diagnosed NAFLD patients who visited the fatty liver clinic at the Tel-Aviv Medical Center. Eighty-seven of these individuals, participated in a clinical trial of physical activity and underwent fasting blood tests, analyzed at the same lab. Exclusion criteria included positivity for serum HBsAg or anti-HCV antibodies; fatty liver suspected to be secondary to hepatotoxic drugs; excessive alcohol consumption (≥ 30 g/d in men or ≥ 20 g/d in women) and positive markers of genetic or immune-mediated liver diseases. Patients were asked to complete a self-report structured questionnaire, assembled by the Israeli Center for Disease Control. Nutrition habits were measured using six yes/no questions (0 = no, 1 = yes) adopted from the national survey questionnaire. Participants in the clinical trial completed a detailed semi-quantitative food frequency questionnaire (FFQ) reporting their habitual nutritional intake during the past year. Self-efficacy was assessed by the Self-Efficacy Scale questionnaire, emotional representation, degree of illness understanding, timeline perception, treatment perception and symptoms were measured by the Brief Illness Perception questionnaire. Illness consequences were measured by the Personal Models of Diabetes Interview questionnaire. A path analysis was performed to describe the interrelationships between the patients' illness perceptions, and assess the extent to which the data fit a prediction of nutritional habits. RESULTS: The study sample included 54.1% men, with a mean age of 47.76 ± 11.68 years (range: 20-60) and mean body mass index of 31.56 ± 4.6. The average perceived nutrition habits score was 4.73 ± 1.45 on a scale between 0-6, where 6 represents the healthiest eating habits. Most of the study participants (57.2%) did not feel they fully understood what NAFLD is. Better nutritional habits were positively predicted by the degree of illness understanding (ß = 0.26; P = 0.002) and self-efficacy (ß = 0.25; P = 0.003). Perceptions of more severe illness consequences were related with higher emotional representation (ß = 0.55; P < 0.001), which was related with lower self-efficacy (ß = -0.17; P = 0.034). The perception of treatment effectiveness was positively related with self-efficacy (ß = 0.32; P < 0.001). In accordance with the correlation between self-efficacy and the perceived nutrition habits score, self-efficacy was also correlated with nutrient intake evaluated by the FFQ; negatively with saturated fat (percent of saturated fat calories from total calories) (r = -0.28, P = 0.010) and positively with fiber (r = 0.22, P = 0.047) and vitamin C intake (r = 0.34, P = 0.002). In a sub analysis of the clinical trial participants, objectively measured compliance to physical activity regimen was positively correlated with the self-efficacy level (r = 0.34, P = 0.046). CONCLUSION: Self-efficacy and illness understanding are major determinants of lifestyle-modification among NAFLD patients. This information can assist clinicians in improving compliance with lifestyle changes among these patients.


Assuntos
Comportamento Alimentar/psicologia , Estilo de Vida , Hepatopatia Gordurosa não Alcoólica/psicologia , Cooperação do Paciente/psicologia , Autoeficácia , Adulto , Índice de Massa Corporal , Ensaios Clínicos como Assunto , Estudos Transversais , Ingestão de Energia , Exercício , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/terapia , Percepção , Inquéritos e Questionários , Resultado do Tratamento , Ultrassonografia , Adulto Jovem
17.
J Neuroendocrinol ; 29(4)2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28211103

RESUMO

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease, resulting not only in liver dysfunction, glucose and lipid metabolism disorder, but also in neuropsychiatric damage. In the present study, a NAFLD rat model was established via feeding of a high-fat diet, and behaviour was observed via the open field test (OFT), the sucrose preference test (SPT), the elevated plus maze (EPM), the forced swimming test (FST) and the Morris water maze (MWM). The plasma concentrations of alanine aminotransferase (ALT), glucose, free fatty acid (FFA), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were detected using chemiluminescence technique. The plasma levels of nesfatin-1, leptin and insulin were measured via enzyme-linked immunosorbent assay, and the protein expressions of p-glycogen synthase kinase-3ß (GSK-3ß), GSK-3ß, p-ß-catenin, ß-catenin, cyclinD and copine 6 in the hippocampus and prefrontal cortex (PFC) were detected using western blotting. After 4 consecutive weeks of feeding with a high-fat diet, the rats showed obesity; increased plasma concentrations of ALT, glucose, FFA, TC, TG, HDL-C and LDL-C; decreased plasma levels of leptin and insulin; and inflammation and mild hepatocyte steatosis in the liver. Although there was no significant difference between groups with regard to performance in the OFT, EPM or FST, the NAFLD rats showed a decreased sucrose preference index in the SPT and impaired learning and memory in the MWM task. Moreover, the present study provides the first evidence of an increased plasma nesfatin-1 concentration in NAFLD rats, which was significantly correlated with plasma lipid concentrations and behavioural performance. Furthermore, copine 6 and p-ß-catenin protein expression decreased and p-GSK-3ß increased in the hippocampus and PFC of NAFLD rats. These results suggest that consuming of a high-fat diet for 4 consecutive weeks could successfully induce a NAFLD rat model. More importantly, these results provide the first evidence that impaired learning and memory in NAFLD rats was, at least partly, associated with increased plasma nesfatin-1 concentration and decreased copine 6 expression in the hippocampus and PFC.


Assuntos
Proteínas de Ligação ao Cálcio/sangue , Proteínas de Transporte/metabolismo , Proteínas de Ligação a DNA/sangue , Dieta Hiperlipídica , Aprendizagem , Memória , Proteínas do Tecido Nervoso/sangue , Proteínas do Tecido Nervoso/metabolismo , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/psicologia , Animais , Comportamento Animal , Modelos Animais de Doenças , Hipocampo/metabolismo , Insulina/sangue , Leptina/sangue , Metabolismo dos Lipídeos , Fígado/patologia , Masculino , Córtex Pré-Frontal/metabolismo , Ratos Sprague-Dawley
18.
Liver Int ; 37(8): 1209-1218, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28211165

RESUMO

BACKGROUND: Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis are the most common causes of chronic liver disease with known negative impact on patients' health-related quality of life. Our aim was to validate a disease-specific health-related quality of life instrument useful for efficacy trials involving patients with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. METHODS: From a long item selection questionnaire, we selected relevant items which, by factor analysis, were grouped into domains constituting Chronic Liver Disease Questionnaire-Non-Alcoholic Fatty Liver Disease version. The developed instrument was subjected to internal validity, test-retest reliability and construct validity assessment using standard methods. RESULTS: For development of the Chronic Liver Disease Questionnaire-Non-Alcoholic Fatty Liver Disease version instrument, a 75-item-long item selection questionnaire was administered to 25 patients with non-alcoholic fatty liver disease. After item reduction, factor analysis found that 98.7% of variance in the remaining items would be explained by six factors. Thus, the resulting Chronic Liver Disease Questionnaire-Non-Alcoholic Fatty Liver Disease version instrument had 36 items grouped into six domains: Abdominal Symptoms, Activity, Emotional, Fatigue, Systemic Symptoms, and Worry. The independent validation group included another 104 patients with non-alcoholic fatty liver disease. The Cronbach's alphas of 0.74-0.90 suggested good to excellent internal consistency of the domains. Furthermore, the presence of obesity and history of depression were discriminated best by Chronic Liver Disease Questionnaire-Non-Alcoholic Fatty Liver Disease version scores (P<.05). The domains' correlations with the most relevant domains of Short Form-36 exceeded 0.70. Test-retest reliability in a subgroup of patients (N=27) demonstrated no significant within-patient variability with multiple administrations (all median differences were zero, all P>.15, intraclass correlations .76-.88). CONCLUSION: The Chronic Liver Disease Questionnaire-Non-Alcoholic Fatty Liver Disease version is a disease-specific health-related quality of life instrument developed and validated using an established methodology and useful for clinical trials of non-alcoholic fatty liver disease.


Assuntos
Hepatopatia Gordurosa não Alcoólica/psicologia , Qualidade de Vida , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários
19.
Ter Arkh ; 88(8): 59-66, 2016.
Artigo em Russo | MEDLINE | ID: mdl-27636929

RESUMO

AIM: to analyze and summarize the data of the DIREG-2 study of the nonalcoholic fatty liver disease (NAFLD) register in Rostov-on-Don versus those in Russia. MATERIAL AND METHODS: The prospective disease registry study encompasses an epidemiologic, observational, cross-sectional, multicenter study estimating the prevalence of NAFLD in outpatients in Rostov-on-Don. A total of 3200 patients participated in this study. The investigators were 65 outpatient physicians. Epidemiological data were obtained during two patient visits to the research centers. RESULTS: The key result obtained from this study was the significantly higher prevalence of NAFLD in Rostov-on-Don than that in the general population (40.4 and 37.3%). In addition to the higher prevalence of NAFLD, there was also a higher spread of risk factors (RFs), such as abdominal obesity, female age of 45-55 years, and hyperlipidemia. CONCLUSION: The prevalence of NAFLD in the outpatients of Rostov-on-Don was 3.1% greater than that in Russia; this might be due to the significantly higher spread of some RFs (abdominal obesity, female age of 45-55 years, hyperlipidemia). The findings are undoubtedly necessary for the elaboration of measures for the primary and secondary prevention of NAFLD in Rostov-on-Don.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Qualidade de Vida , Idoso , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/psicologia , Pacientes Ambulatoriais/estatística & dados numéricos , Prevalência , Prognóstico , Fatores de Risco , Federação Russa/epidemiologia
20.
J Affect Disord ; 196: 109-16, 2016 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-26921863

RESUMO

BACKGROUND: High cholesterol intake in mice induces hepatic lipid dystrophy and inflammation, signs of non-alcoholic fatty liver disease (NAFLD), depressive- and anxiety-like behaviors, and the up-regulation of brain and liver Toll-like receptor 4 (Tlr4). Here, we investigated whether dicholine succinate (DS), an insulin receptor sensitizer and mitochondrial complex II substrate would interact with these effects. METHODS: C57BL/6J mice were given a 0.2%-cholesterol diet for 3 weeks, alone or along with oral DS administration, or a control feed. Outcomes included behavioral measures of anxiety/depression, and Tlr4 and peroxisome-proliferator-activated-receptor-gamma coactivator-1b (PPARGC1b) expression. RESULTS: 50mg/kg DS treatment for 3 weeks partially ameliorated the cholesterol-induced anxiety- and depressive-like changes. Mice were next treated at the higher dose (180mg/kg), either for the 3-week period of dietary intervention, or for the last two weeks. Three-week DS administration normalized behaviors in the forced swim and O-maze tests and abolished the Tlr4 up-regulation in the brain and liver. The delayed, 2-week DS treatment had similar effects on Tlr4 expression and largely rescued the above-mentioned behaviors. Suppression of PPARGC1b, a master regulator of mitochondrial biogenesis, by the high cholesterol diet, was prevented with the 3-week administration, and markedly diminished by the a 2-week administration of DS. None of treatments prevented hepatic dystrophy and triglyceride accumulation. LIMITATIONS: Other conditions have to be tested to define possible limitations of reported effects of DS. CONCLUSIONS: DS treatment did not alter the patho-morphological substrates of NAFLD syndrome in mice, but ameliorated its molecular and behavioral consequences, likely by activating mitochondrial functions and anti-inflammatory mechanisms.


Assuntos
Colina/análogos & derivados , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Receptor de Insulina/efeitos dos fármacos , Succinatos/farmacologia , Receptor 4 Toll-Like/efeitos dos fármacos , Animais , Ansiedade/tratamento farmacológico , Ansiedade/etiologia , Colesterol/efeitos adversos , Colina/farmacologia , Depressão/tratamento farmacológico , Depressão/etiologia , Dieta/efeitos adversos , Feminino , Inflamação , Camundongos , Camundongos Endogâmicos C57BL , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/psicologia , Succinilcolina , Triglicerídeos/metabolismo , Regulação para Cima/efeitos dos fármacos
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