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1.
Angiology ; 71(1): 77-82, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31018673

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of the metabolic syndrome and is associated with cardiovascular disease (CVD). The NAFLD Fibrosis Score (NFS) is an index used for the detection of liver fibrosis. We investigated the relationship between NFS and complexity of coronary artery disease (CAD). In this cross-sectional study, 109 patients with CAD and 50 patients without CAD were enrolled. Demographic data, laboratory parameters, epicardial fat thickness (EFT), NFS, and Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) score were recorded. Waist circumference, fasting glucose, low-density lipoprotein cholesterol (LDL-C), EFT, and NFS were significantly higher in the CAD group (P < .05). High-density lipoprotein cholesterol (HDL-C) and ejection fraction were significantly lower in the CAD group (P < .05). The SYNTAX score was positively correlated with fasting glucose, LDL-C, EFT, and NFS and negatively correlated with HDL-C (P < .05). The NFS was positively correlated with EFT (P = .019). Multivariate linear regression analysis revealed that NFS (P = .012), EFT (P < .001), and LDL-C (P = .001) were independently associated with the SYNTAX score. In conclusion, NFS, as a marker of NAFLD, could identify patients at higher risk of CVD.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Adiposidade , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Ecocardiografia , Cirrose Hepática/diagnóstico , Testes de Função Hepática , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Pericárdio/diagnóstico por imagem , Tecido Adiposo/fisiopatologia , Idoso , Biomarcadores/sangue , Índice de Massa Corporal , Doença da Artéria Coronariana/fisiopatologia , Estudos Transversais , Feminino , Humanos , Cirrose Hepática/sangue , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Pericárdio/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença
2.
Medicine (Baltimore) ; 98(46): e17945, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725651

RESUMO

The relationship of thyroid function parameters with nonalcoholic steatohepatitis (NASH) in patients with chronic hepatitis B (CHB) remains unknown. Hence, we assessed the impact of thyroid function parameters on NASH in patients with CHB.Consecutive patients with CHB with concurrent nonalcoholic fatty liver disease (NAFLD) were recruited. Liver histology and baseline examinations were carried out in each patient. The associated risk factors for NASH were evaluated.A total of 361 patients with CHB with biopsy-proven NAFLD were included. There was a significant difference in the serum thyroid-stimulating hormone (TSH) level between patients with NASH and non-NASH (3.24 ±â€Š2.00 vs 2.05 ±â€Š1.35 mIU/L, P < .01). Moreover, the NASH prevalence in patients with euthyroidism was significantly higher than in the subclinical hypothyroidism (SCH) patients (P < .001). In multivariate analyses, higher serum concentration of TSH was significantly correlated with NASH (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.24-2.31; P = .001). In particular, patients suffering from SCH had a higher risk of having NASH (OR: 4.28, 95% CI: 1.18-15.53; P = .027).Elevated serum TSH level was the independent predictive factor of incident NASH in patients with CHB. Whether the thyroid function parameters should be integrated into future diagnostic scores predicting advanced diseases requires further study.


Assuntos
Hepatite B Crônica/sangue , Hepatite B Crônica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Tireotropina/sangue , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Testes de Função Tireóidea
3.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(9): 1118-1121, 2019 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-31640966

RESUMO

OBJECTIVE: To investigate the relationship between serum 25(OH) vitamin D and liver fat content in nonalcoholic fatty liver disease (NAFLD). METHODS: A total of 120 patients with NAFLD admitted in our hospital between June and August, 2017 were enrolled and divided into 4 groups with different serum 25 (OH) vitamin D levels: >75 nmol/L (group A, n=25), 50-75 nmol/L (group B, n=35), 25-50 nmol/L (group C, n=32), and < 25 nmol/L (group D, n=28). For all the patients, serum 25 (OH) vitamin D level was measured by ELISA, and liver fat content was determined using in-phase opposed-phase T1WI sequences. The measurement data were compared among the 4 groups to assess the association between serum 25(OH) vitamin D level and liver fat content. RESULTS: The liver fat content appeared to be higher in group B (28.66±6.45%) and group C (38.74±11.47%) than in group A (22.79 ± 6.10%), but the difference was not statistically significant (P>0.05); the liver fat content in group D (54.79 ± 5.28%) was significantly higher than that in the other 3 groups (P>0.05). Liver fat content increased significantly as serum 25(OH) vitamin D level decreased, showing an inverse correlation between them in these patients (P < 0.05, r=-0.125). CONCLUSIONS: In patients with NAFLD, a decreased serum 25(OH) vitamin D level is associated with an increased liver fat content, suggesting the value of serum 25(OH) vitamin D as a predictor of NAFLD.


Assuntos
Hepatopatia Gordurosa não Alcoólica/patologia , Vitamina D/sangue , Humanos , Fígado/patologia , Hepatopatia Gordurosa não Alcoólica/sangue
4.
Zhonghua Nei Ke Za Zhi ; 58(10): 751-757, 2019 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-31594173

RESUMO

Objective: To investigate the characteristics of body composition (BC) in gout patients and its clinical significance. Methods: Consecutive gout patients were recruited between August 2017 and December 2018. Demographic information, clinical characteristics and comorbidities were collected. BC was assessed by bioelectric impedance analysis including body fat percentage (BF%), trunk and limb BF%, appendicular skeletal muscle index. Overfat was defined by BF% ≥25% for male and ≥35% for female. The association between BC and serum uric acid (sUA) was evaluated by multiple linear regression. Results: A total of 362 gout patients were recruited with median age 38 (30, 52) years, 96.1% (348/362) were male. Mean sUA was (551±133) µmol/L. The mean BF% was (25.8±6.4)% with 53.6%(194/362) patients overfat. Male gout patients with overfat showed more affected joints [4(2, 6) vs. 2(2, 5)], higher sUA [(576±126)µmol/L vs. (523±134) µmol/L], higher prevalence of dyslipidemia [70.1%(131/187) vs. 54.0%(87/161)], metabolic syndrome [60.8%(118/187) vs. 28.0%(47/161)], fatty liver [58.2%(113/187) vs. 35.1%(59/161)] and hypertension [44.4%(83/187) vs. 25.5%(41/161)] than male patients with normal fat (all P<0.05). Their BF%, trunk BF% and limb BF% were positively correlated with the numbers of affected joints, sUA, metabolic syndrome, fatty liver, and hypertension, respectively (r=0.154-0.435, all P<0.05). Multivariable linear regression suggested that BF% (ß=4.29, P=0.020) and trunk BF% (ß=9.11, P=0.007), but not limb BF%, were positively correlated with sUA. Conclusion: Overfat is very common in gout patients. The proportion of trunk fat in male patients is positively correlated with sUA. When assessing obesity in gout patients clinically, body composition analysis should be performed simultaneously.


Assuntos
Composição Corporal/fisiologia , Gota/diagnóstico , Obesidade/epidemiologia , Ácido Úrico/sangue , Adulto , Dislipidemias/epidemiologia , Feminino , Gota/sangue , Gota/epidemiologia , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/sangue , Prevalência
5.
BMC Res Notes ; 12(1): 496, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399137

RESUMO

OBJECTIVE: We recently reported that curcumin supplementation in a metabolically (i.e., Western diet [WD]) and chemically (i.e., CCl4) induced female rat model of non-alcoholic steatohepatitis (NASH) was associated with lower liver pathology scores and molecular markers of inflammation. This occurred when curcumin was given during induction of disease (preventative arm; 8-week WD with or without curcumin [8WD + C vs. 8WD]) as well as when given after disease development (treatment arm; 12-week WD with or without curcumin during weeks 9-12 [12WD + C vs. 12WD]). Herein, we sought to extend our findings from that study by determining the effects of curcumin supplementation on cytokine/chemokine expression in serum collected from these same rats. RESULTS: 24 cytokines/chemokines were assayed. IL-2 (+ 80%) and IL-13 (+ 83%) were greater with curcumin supplementation in the prevention arm. IL-2 (+ 192%), IL-13 (+ 87%), IL-17A (+ 81%) and fractalkine (+ 121%) were higher while RANTES was lower (- 22%) with curcumin supplementation in the treatment arm (p < 0.05 for all). RANTES concentrations also correlated significantly with hepatic pathology scores of inflammation (r = 0.417, p = 0.008). Select serum cytokines/chemokines were affected with curcumin supplementation in this female rat model of NASH. Moreover, curcumin's effect(s) on RANTES and its association with liver disease pathogenesis and progression may warrant further investigation.


Assuntos
Anti-Inflamatórios/farmacologia , Curcumina/farmacologia , Suplementos Nutricionais , Regulação da Expressão Gênica/efeitos dos fármacos , Fígado/efeitos dos fármacos , Hepatopatia Gordurosa não Alcoólica/dietoterapia , Animais , Tetracloreto de Carbono/administração & dosagem , Quimiocina CCL5/sangue , Quimiocina CCL5/genética , Quimiocina CX3CL1/sangue , Quimiocina CX3CL1/genética , Dieta Ocidental/efeitos adversos , Modelos Animais de Doenças , Esquema de Medicação , Feminino , Humanos , Interleucina-13/sangue , Interleucina-13/genética , Interleucina-17/sangue , Interleucina-17/genética , Interleucina-2/sangue , Interleucina-2/genética , Fígado/metabolismo , Fígado/patologia , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/genética , Ratos , Ratos Wistar , Resultado do Tratamento
6.
J Med Life ; 12(2): 168-172, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31406519

RESUMO

There is evidence that infection by H. pylori can have a critical proportion in the development of hepatocyte injury and both noncancerous and malignant liver conditions including non-alcoholic fatty liver disease (NAFLD). This is attributed to several mechanisms, the most important one being the toxic products of the bacterium H. pylori and oxidative injury for hepatocytes which promotes hepatic injury. The present research was aimed at determining the association between H. pylori infection and the prevalence of NAFLD in Birjand, Iran. Two groups were included in this cross-sectional study at the outpatient university clinic. One group had NAFLD (65 patients) and the other group was healthy controls without NAFLD (65 subjects). The diagnosis of NAFLD was performed using abdominal ultrasound examination and the absence of taking steatogenic medications or alcohol. Serum anti-H. pylori IgG and fecal H. pylori antigen were tested for diagnosing of H. pylori infection using ELISA method. H. pylori infection diagnosis was made if both tests were positive. None of the subjects in either group had symptoms related to the digestive system including dyspepsia, GERD (gastroesophageal reflux disease), or epigastric pain suspicious of peptic ulcer disease. There were 37 patients (28.5%) in both NAFLD (22 cases, 33.8%) and control (15 cases, 23.1%) groups whose H. pylori tests (both IgG and fecal antigen) were positive. Statistically, no significant difference was observed between the two studied groups regarding H. pylori infection frequency (p = 0.37). Asymptomatic H. pylori infection rate was not significantly different between NAFLD patients and control subjects in Birjand, Iran.


Assuntos
Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/fisiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Infecções por Helicobacter/sangue , Humanos , Irã (Geográfico)/epidemiologia , Lipídeos/sangue , Fígado/enzimologia , Fígado/patologia , Masculino , Hepatopatia Gordurosa não Alcoólica/sangue , Transaminases/metabolismo
7.
Biol Pharm Bull ; 42(8): 1295-1302, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31366865

RESUMO

Obesity is characterized by abnormal or excessive fat accumulation, which leads to the development of metabolic syndrome. Because oxidative stress is increased in obesity, antioxidants are regarded as suitable agents for preventing metabolic syndrome. Here, we examined the impact of cranberry, which contains various antioxidants, on metabolic profiles, including that during the progression of non-alcoholic fatty liver disease (NAFLD), in high-fat diet (HFD)-fed C57BL/6 mice. We observed that oxidative stress was diminished in mice that were fed HFD diets supplemented with 1 and 5% cranberry powder as compared with that in HFD-fed control mice. Notably, from 1 week after beginning the diets to the end of the study, the body weight of mice in the cranberry-treatment groups was significantly lower than that of mice in the HFD-fed control group; during the early treatment phase, cranberry suppressed the elevation of serum triglycerides; and adipocytes in the adipose tissues of cranberry-supplemented-HFD-fed mice were smaller than these cells in HFD-fed control mice. Lastly, we examined the effect of cranberry on NAFLD, which is one of the manifestations of metabolic syndrome in the liver. Histological analysis of the liver revealed that lipid-droplet formation and hepatocyte ballooning, which are key NAFLD characteristics, were both drastically decreased in cranberry-supplemented-HFD-fed mice relative to the levels in HFD-fed control mice. Our results suggest that cranberry ameliorates HFD-induced metabolic disturbances, particularly during the early treatment stage, and exhibits considerable potential for preventing the progression of NAFLD.


Assuntos
Antioxidantes/uso terapêutico , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Preparações de Plantas/uso terapêutico , Vaccinium macrocarpon , Animais , Antioxidantes/farmacologia , Glicemia/análise , Dieta Hiperlipídica , Expressão Gênica/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Masculino , Camundongos Endogâmicos C57BL , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/genética , Hepatopatia Gordurosa não Alcoólica/patologia , Estresse Oxidativo/efeitos dos fármacos , Preparações de Plantas/farmacologia , Pós , Proteína de Ligação a Elemento Regulador de Esterol 1/genética , Triglicerídeos/sangue
8.
Biomed Res Int ; 2019: 7643542, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31380438

RESUMO

Background: The relationship between vitamin D level and NAFLD has not been investigated in children and adolescents. We performed a meta-analysis of published observational studies to assess this association between vitamin D levels (measured as serum 25-hydroxy vitamin D [25(OH)D]) and NAFLD in this age group. Methods: Relevant studies conducted before May 20, 2018, were identified from the following electronic databases: PubMed, the Cochrane Library, Embase, and the Chinese CNKI databases. The quality of the included studies was evaluated using the Newcastle Ottawa Scale, and associations between vitamin D levels and NAFLD were estimated using standardised mean differences (SMD) and 95% confidence interval (CI). Subgroup and sensitivity analysis were used to identify sources of heterogeneity, and publication bias was evaluated using funnel plots. Results: Eight articles were included in this meta-analysis. A significant difference was observed between low 25(OH)D levels and NAFLD in children and adolescents (SMD = -0.59, 95%CI = -0.98, -0.20, P <  0.01). Subgroup analysis revealed no differences in the study type, geographic location, BMI, and age subgroups. Conclusions: Low vitamin D levels were associated with NAFLD in children and adolescents.


Assuntos
Hepatopatia Gordurosa não Alcoólica/sangue , Deficiência de Vitamina D/sangue , Vitamina D/sangue , Adolescente , Criança , Humanos , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/patologia , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/patologia
9.
Biomed Res Int ; 2019: 1246518, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31341886

RESUMO

Objective: Previous studies have shown that some metabolic risk factors are related to nonalcoholic fatty liver disease (NAFLD). This retrospective study was performed to investigate the associations between physical examinations and blood biochemistry parameters and NAFLD status and to identify possible risk factors of NAFLD. Methods: Study participants underwent general physical examinations, blood biochemistry, and abdominal ultrasound evaluations. In addition, data regarding sex, age, ethnicity, medical history, and alcohol consumption of participants were recorded. Among the study participants (N=1994), 57.8% were male, 41.2% over the age of 50, and 52.6% with BMI≥24. 986 patients had NAFLD and 1008 had no NAFLD. We used effect size analysis and logistic regression to determine which physical examinations and blood biochemistry parameters were significant for the association between these parameters and NAFLD status. Results: Both the effect size and logistic regression indicated that BMI, diastolic blood pressure (DBP), triglycerides (TG), and serum uric acid (SUA) show a significant association with NAFLD. Females are overall at a higher risk of NAFLD, but factors such as high BMI, DBP, TG, and SUA increase the associated risk for both sexes. Compared with males, females have a higher risk of NAFLD given that they are over 50, overweight and obese (BMI at or over 24), or have high SUA. In terms of age, people older than 50 with high SUA, and people younger than 50 with high DBP and low-density lipoprotein cholesterol (LDL-C) all increase the risk of NAFLD. For BMI, high DBP and low high-density lipoprotein cholesterol (HDL-C) are risk factors for NAFLD in overweight and obese people (BMI at or over 24), whereas in normal weight and underweight people (BMI under 24), elevated LDL-C increases the risk of NAFLD. Conclusions: Our results revealed sex, age, and BMI modulate the association of physical examinations and blood biochemistry parameters and NAFLD, which may facilitate the development of personalized early warning and prevention strategies of NAFLD for at-risk populations.


Assuntos
Índice de Massa Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Hepatopatia Gordurosa não Alcoólica , Obesidade , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Obesidade/sangue , Obesidade/diagnóstico por imagem , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco
10.
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
11.
BMC Gastroenterol ; 19(1): 126, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311491

RESUMO

BACKGROUND: This study aimed to evaluate the association between serum vitamin D levels and nonalcoholic fatty liver disease (NAFLD) parameters, such as metabolic syndrome (MS), inflammatory cytokines (tumor necrosis factor, high sensitive C-reactive protein) and adipokines (adiponectin, leptin). METHODS: From August 2013 to August 2016, a community-based study was performed in the north-eastern region of Taiwan. All subjects received a demographic survey, blood testing and abdominal ultrasonography (US). The vitamin D level was evaluated by quartile divide or used the classification of deficiency (< 20 ng/ml), insufficiency (20-30 ng/ml) and sufficiency (> 30 ng/ml). RESULTS: Subjects were divided into NAFLD group and normal control (subjects number = 564 in each group) following abdominal US study and matching age and gender. The mean age was 57.1 years in NAFLD group and 57.5 in control group. Subjects in NAFLD group had a lower mean vitamin D than those in the control group (28.5 ± 9.5 ng/ml vs. 29.9 ± 10.2 ng/ml, P = 0.018). Subjects with serum vitamin D deficiency or insufficiency had higher odds for MS than those with sufficient vitamin D levels [deficiency vs. sufficiency, adjusted odds ratio (aOR) =1.860 (95% CI = 1.234-2.804), P = 0.003; insufficiency vs. sufficiency, aOR = 1.669 (95% CI = 1.237-2.251), P = 0.001]. Similarly, subjects in the lowest quartile of vitamin D had higher odds for MS than those in the highest quartile of vitamin D (aOR = 2.792, 95% CI = 1.719-4.538, P < 0.001). Vitamin D level was positively correlated with age and male, but negatively correlated with serum leptin level. CONCLUSION: Subjects with low vitamin D level had higher odds for MS, but higher levels of leptin, compared to those with high vitamin D levels.


Assuntos
Leptina/sangue , Síndrome Metabólica , Hepatopatia Gordurosa não Alcoólica , Deficiência de Vitamina D , Proteína C-Reativa/análise , Feminino , Humanos , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Taiwan/epidemiologia , Fator de Necrose Tumoral alfa/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/etiologia
12.
Medicine (Baltimore) ; 98(30): e16565, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348282

RESUMO

BACKGROUND: We aimed to assess the association between red cell distribution width-to-platelet ratio (RPR) and hepatic fibrosis in nonalcoholic fatty liver disease. METHODS: The 388 subjects fulfilling the diagnostic criteria of Nonalcoholic fatty liver disease (NAFLD) were enrolled in this cross-sectional study. Red cell distribution, platelet, and other clinical and laboratory parameters were measured. RESULTS: NAFLD patients with advanced fibrosis had significantly higher RPR than those without fibrosis (P < .001). Spearman correlation analysis showed that RPR were significantly correlated with age, sex, creatinine, hemoglobin, white blood cell, and advanced fibrosis (all with P < .05). Multivariate logistic regression analysis showed that RPR was an independent factor predicting advanced fibrosis (fibrosis-4 calculator ≥1.3) in NAFLD patients (OR: 5.718, 95%CI: 3.326-9.830, P < .001). CONCLUSIONS: Our findings suggested that RPR were significantly associated with advanced fibrosis in nonalcoholic fatty liver disease patients.


Assuntos
Plaquetas/metabolismo , Índices de Eritrócitos , Cirrose Hepática/patologia , Hepatopatia Gordurosa não Alcoólica/sangue , Índice de Gravidade de Doença , Adulto , Estudos Transversais , Feminino , Humanos , Fígado/patologia , Cirrose Hepática/etiologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/patologia , Contagem de Plaquetas
13.
J Ethnopharmacol ; 242: 112029, 2019 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-31216433

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: ShengMai-Yin and Ganmaidazao decoction are classic formulas in traditional Chinese medicine. Individually, Shengmai-Yin is used to treat cardiovascular diseases, and Ganmaidazao decoction for therapy of mental disorders. The combination of Shengmai-Yin and Ganmaidazao decoction (SGD) is normally used as adjuvant therapy for type 2 diabetes mellitus (T2DM). AIM OF THE STUDY: The central aim is to elucidate the pharmacological efficacy of SGD and its mechanism in the treatment of T2DM with non-alcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS: Active ingredients in SGD and their drug targets were identified using network analysis followed by experimental validation. First, existing databases were mined for information relevant to SGD, including pharmacological actions, chemical components, physicochemical characteristics, potential targets, and implicated diseases. Candidate patterns obtained with the network analysis were then tested in a KKAy mouse model of T2DM with NAFLD. Various doses of SGD were administered, followed by measurements of fasting blood glucose, oral glucose tolerance tests, insulin tolerance tests, markers of lipid metabolism - including free fatty acids (FFA), triglycerides (TG), and total cholesterol (TC) - liver histology, and expression levels of implicated molecules including PI3K/AKT and PPARα. RESULTS: Over 300 potential active compounds with their physicochemical characteristics and 562 candidate targets were collected, and then the network of them was constructed. Follow-up pathway and functional enrichment analyses indicated that SGD influences metabolism-related signaling pathways including PI3K-Akt, AMPK, and PPAR. In validation experiments, treatment of KKAy mice with SGD reduced serum levels of glucose, TC, TG, and FFA, decreased numbers of crown-like structures in visceral adipose tissue, reduced adipocyte size, and lowered liver lipid deposits. Further, SGD improved liver metabolism by increasing the expressions of PPARα, HSL, and PI3K/Akt, and decreasing expressions of SREBP-1 and FASN, inhibiting lipid biosynthesis, and increasing insulin sensitivity. CONCLUSION: Experimental validation of network analysis revealed anti-diabetic effects of the plant product SGD, manifested most notably by improved serum profiles and diminished insulin resistance. These experimental results may have clinical implications.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Hipoglicemiantes/uso terapêutico , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Substâncias Protetoras/uso terapêutico , Animais , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/metabolismo , Combinação de Medicamentos , Medicamentos de Ervas Chinesas/química , Glucose/metabolismo , Hipoglicemiantes/química , Metabolismo dos Lipídeos/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Masculino , Camundongos , Terapia de Alvo Molecular , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Compostos Fitoquímicos/análise , Compostos Fitoquímicos/uso terapêutico , Substâncias Protetoras/química , Proteínas Proto-Oncogênicas c-akt/metabolismo
14.
Nutrients ; 11(6)2019 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-31208147

RESUMO

Glycine is the proteinogenic amino-acid of lowest molecular weight, harboring a hydrogen atom as a side-chain. In addition to being a building-block for proteins, glycine is also required for multiple metabolic pathways, such as glutathione synthesis and regulation of one-carbon metabolism. Although generally viewed as a non-essential amino-acid, because it can be endogenously synthesized to a certain extent, glycine has also been suggested as a conditionally essential amino acid. In metabolic disorders associated with obesity, type 2 diabetes (T2DM), and non-alcoholic fatty liver disease (NAFLDs), lower circulating glycine levels have been consistently observed, and clinical studies suggest the existence of beneficial effects induced by glycine supplementation. The present review aims at synthesizing the recent advances in glycine metabolism, pinpointing its main metabolic pathways, identifying the causes leading to glycine deficiency-especially in obesity and associated metabolic disorders-and evaluating the potential benefits of increasing glycine availability to curb the progression of obesity and obesity-related metabolic disturbances. This study focuses on the importance of diet, gut microbiota, and liver metabolism in determining glycine availability in obesity and associated metabolic disorders.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Glicina/farmacocinética , Doenças Metabólicas/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Obesidade/sangue , Disponibilidade Biológica , Diabetes Mellitus Tipo 2/etiologia , Dieta/efeitos adversos , Microbioma Gastrointestinal , Humanos , Fígado/metabolismo , Doenças Metabólicas/etiologia , Hepatopatia Gordurosa não Alcoólica/etiologia , Obesidade/complicações
15.
Medicina (Kaunas) ; 55(6)2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31163711

RESUMO

Background and objectives: Data suggests that nearly 30% of the general population have steatosis and up to 5% of this population develops nonalcoholic steatohepatitis (NASH). Liver biopsy is still considered to be the gold standard for the diagnosis of NASH. Great effort is being made toward the identification of sensitive diagnostic tests that do not involve invasive procedures to address a common concern in patients with the nonalcoholic fatty liver disease-whether they have NASH or simple steatosis. We aimed to investigate the independent predictors and develop a non-invasive, easy-to-perform, low-cost set of parameters that may be used in clinical practice to differentiate simple steatosis from NASH. Methods: А cross-sectional study of nonalcoholic fatty liver disease (NAFLD) patients divided into two groups: group I-simple steatosis (SS) and group II-biopsy-proven NASH. Strict inclusion criteria and stepwise analysis allowed the evaluation of a vast number of measured/estimated parameters. Results: One hundred and eleven patients were included-82 with simple steatosis and 29 with biopsy-proven NASH. The probability of NASH was the highest when homeostatic model assessment of insulin resistance (HOMA-IR) was above 2.5, uric acid above 380 µmol/L, ferritin above 100 µg/L and ALT above 45 U/L. An acronym of using first letters was created and named the HUFA index. This combined model resulted in an area under the receiver operator characteristic curve (AUROC) of 0.94, provided sensitivity, specificity, positive predictive value and a negative predictive value for NASH of 70.3%, 95.1%, 83.1% and 90.0%, respectively. Conclusion: We suggest a simple non-invasive predictive index HUFA that encompasses four easily available parameters (HOMA-IR, uric acid, ferritin and ALT) to identify patients with NASH, which may reduce the need for a liver biopsy on a routine basis in patients with NAFLD.


Assuntos
Fígado Gorduroso/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Adulto , Idoso , Análise de Variância , Biomarcadores/análise , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Estudos Transversais , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/fisiopatologia , Feminino , Ferritinas/análise , Ferritinas/sangue , Humanos , Resistência à Insulina/fisiologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Curva ROC , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Ácido Úrico/análise , Ácido Úrico/sangue
16.
Diabetes Metab Syndr ; 13(3): 1769-1771, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31235092

RESUMO

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is increasing recently due to increasing the prevalence of obesity. Insulin resistance (IR) is the mutual pathological cause for both T2DM and NAFLD. Vitamin D acts against IR by its anti-inflammatory and regulation of insulin secretion as pancreatic beta cells express vitamin D receptor (VDR). AIM: Assessment of relationship between Total vitamin D level and NAFLD a sample of Egyptian patients with and without T2DM. METHODS: The current study included 110 Egyptian subjects. They divided into 4 groups: Group 1: 30 diabetic patients with NAFLD Group 2: 30 diabetic patients without NAFLD Group 3: 30 NAFLD patients without diabetes Group 4: 20 healthy controls. Vitamin D level assessment, AST, ALT, GGT, total cholesterol, LDL, triglycerides, fasting and 2 h post prandial plasma glucose, glycosylated hemoglobin, albumin and creatinine calculation of FLI were assessed. RESULT: There was a statistical significant decrease in total vitamin D level in T2DM patients with NAFLD than either T2DM or NAFLD only patients.(15.5 ±â€¯7.46 vs 24.4 ±â€¯8.19 and 22.86 ±â€¯9.58 ng/ml respectively) also Total vitamin D level is negatively correlated with age, weight, BMI, WC, total cholesterol, LDL, TG, FPG, HbA1c and FLI. CONCLUSION: There is a decrease in total vitamin D in T2DM patients with NAFLD.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Hepatopatia Gordurosa não Alcoólica/etiologia , Deficiência de Vitamina D/fisiopatologia , Vitamina D/sangue , Humanos , Resistência à Insulina , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/patologia , Vitaminas/sangue
17.
Diabetes Metab Syndr ; 13(3): 2226-2229, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31235161

RESUMO

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) was considered one of the most common causes of chronic liver disease and is considered the hepatic manifestation of type 2 diabetes mellitus (T2DM). The factors that lead to marked fibrosis and liver cell injury in NAFLD are still remaining undiscovered. PATIENTS AND METHODS: This study included (40) type 2 diabetic patients with NAFLD and (40) diabetic patients without NAFLD beside 15 healthy persons as a control group. All of them were subjected to full history taking, thorough clinical examination with especial stress on body weight (BW), height, body mass index (BMI), waist-hip ratio, blood pressure. Laboratory tests included serum total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL), fasting blood glucose (FBG) and 2-h postprandial blood glucose (PBG), serum Ferritin and urine microalbuminuria (MAU). RESULTS: Duration of diabetes, BW, BMI and blood pressure were significantly higher in NAFLD group (P = 0.001). FBG, PBG, TC, TG, LDL, serum Ferritin and MAU were significantly increased in NAFLD group with significant difference between two studied groups as regard HDL. There was a highly significant correlation between serum Ferritin with BW, BMI, duration of diabetes, TC, TG, LDL and MAU. There was a significant correlation between serum Ferritin with age, waist hip ratio, duration of diabetes, SBP, FBG, PBG and HDL. There was a significant correlation between MAU and age, weight, BMI, waist hip ratio, duration of diabetes, DBP, FBG TC, TG, LDL and HDL. CONCLUSION: NAFLD is a common liver disorder in diabetic patients. NAFLD is significantly associated with microalbuminuria and elevated serum Ferritin.


Assuntos
Albuminúria/epidemiologia , Biomarcadores/análise , Glicemia/análise , Diabetes Mellitus Tipo 2/fisiopatologia , Ferritinas/sangue , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adolescente , Adulto , Idoso , Albuminúria/metabolismo , Pressão Sanguínea , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Humanos , Lipoproteínas HDL , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Prognóstico , Fatores de Risco , Triglicerídeos , Adulto Jovem
18.
Acta Diabetol ; 56(11): 1199-1207, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31197470

RESUMO

AIMS: In patients with type 2 diabetes, non-alcoholic fatty liver disease (NAFLD) and liver fibrosis is frequent and presumably associated with increased cardiovascular disease risk and mortality. The objective was to investigate risk factors associated with hepatic fibrosis in patients with type 2 diabetes and NAFLD to provide a basis for the prevention and treatment. METHODS: Liver stiffness measurements (LSM) expressed in kilopascals (kPa) and controlled attenuation parameter (CAP) expressed in dB/m were diagnosed by transient elastography. Hepatic steatosis and significant fibrosis were defined as having a CAP score ≥ 260 dB/m and an LSM score ≥ 8 kPa, respectively. Associations between fibrosis categories with anthropometric and metabolic variables were determined; then, variables with statistical significance in the univariate analysis were included in multivariate model. RESULTS: A total of 108 participant with type 2 diabetes and NAFLD (mean age: 44.69 ± 5.57 years; mean duration of diabetes 4.68 ± 4.24 years) were recruited. In these patients, body mass index, obesity, fat mass, waist circumferences, resting energy expenditure, CAP score, fasting insulin, C-peptide, HbA1C, hs-CRP as well as liver enzymes and systolic blood pressure and diastolic blood pressure were positively associated with fibrosis (all p < 0.05). Using multivariate logistic regression, serum aspartate aminotransferase (OR 1.12; 95% CI 1.06-1.19), waist circumferences (odds ratio [OR] 1.15; 95% CI 1.05-1.25) and C-peptide (OR 3.81; 95% CI 1.5-9.7) remained as independently associated with liver fibrosis. CONCLUSION: For participants with type 2 diabetes with coexisting NAFLD, stratification by independent risk factors for fibrosis could have important prognostic value.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Cirrose Hepática/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Aspartato Aminotransferases/sangue , Pressão Sanguínea , Índice de Massa Corporal , Peptídeo C/sangue , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Insulina/sangue , Resistência à Insulina , Cirrose Hepática/sangue , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Circunferência da Cintura
19.
Zhonghua Gan Zang Bing Za Zhi ; 27(5): 369-375, 2019 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-31177662

RESUMO

Objective: To investigate the relationship between gut microbiota structure and biochemical changes in patients with different types of nonalcoholic fatty liver disease (NAFLD), in order to provide evidence for clinical diagnosis and prevention of NAFLD. Methods: Forty-eight NAFLD cases (NAFLD group), 40 NAFLD cases with type 2 diabetes mellitus (NAFLD combined with type 2 diabetes mellitus group) and 30 healthy cases (healthy group) were randomly enrolled, and their body mass index, serum alanine aminotransferase, aspartate aminotransferase, total bilirubin, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein and uric acid were measured. Serum levels of TNF-alpha and fasting insulin were measured using ELISA, and then insulin resistance index was calculated. The gut microbiota of three groups of subjects was detected using 16S rDNA-based high-throughput sequencing. Lastly, the correlations between the various factors were analyzed. The comparison among groups was conducted by 2 test, and one-way ANOVA was used for comparison among groups with normal distribution and homogeneity of variance. Furthermore, the LSD method was used to compare the two groups. K-W rank sum test was used for comparison among groups without normal distribution or homogeneity of variance. Results: Body mass index, aspartate aminotransferase, triglyceride, total cholesterol, low density lipoprotein, uric acid, tumor necrosis factor-alpha, fasting insulin and insulin resistance index of NAFLD group were higher than healthy group, while the high-density lipoprotein was lower in the healthy group, and the difference was statistically significant (P< 0.05). Compared with NAFLD group, the life expectancy, fasting blood glucose and insulin resistance index of NAFLD combined with type 2 diabetes mellitus group were higher, while the body mass index, aspartic acid aminotransferase, total cholesterol and HDL levels were decreased, and the difference was statistically significant (P< 0.05). NAFLD group (P= 0.016) had decreased abundance of firmicutes than healthy group, and the abundancy of the firmicutes in the NAFLD combined with type 2 diabetes group was significantly lower (P< 0.001). The abundance of bacteroidetes in NAFLD combined with type 2 diabetes group was higher than healthy group, and the difference was statistically significant (P= 0.006). At the "genus level," the abundance of Roseburia and Subdoligranulum in the NAFLD group was decreased, while the Roseburia in the NAFLD group with type 2 diabetes group was significantly lower (P< 0.05). In addition, the abundance of Faecalibacterium, Blautia, Anaerostipes and Fusicatenibacter in NAFLD combined with type 2 diabetes group was lower than healthy group, and the difference was statistically significant (P< 0.001). Fusicatenibacter, Blautia, Anaerostipes, Faecalibacterium, and Roseburia were negatively correlated with fasting blood glucose and insulin resistance index levels (r< 0,P< 0.05), and positively correlated with high-density lipoprotein levels (r> 0,P< 0.05). Fusicatenibacter was negatively correlated with tumor necrosis factor-alpha (r= -0.211,P= 0.044), and Lachnoclostridium was positively correlated with body mass index, alanine aminotransferase, aspartate aminotransferase levels (r> 0,P< 0.05). Fusobacterium was positively correlated with aspartate aminotransferase level (r= 0.245,P= 0.019). Escherichia-shigella was positively correlated with fasting blood glucose, low-density lipoprotein, alanine aminotransferase, aspartate aminotransferase levels (r > 0,P< 0.05). Megamonas was negatively correlated with high-density lipoprotein levels (r= -0.231,P= 0.027). Conclusion: A structural change of gut microbiota had occurred in patients with NAFLD, suggesting changes in some of these bacterial genuses had relation to insulin resistance and inflammatory response, which may become a new target for the treatment of NAFLD.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/metabolismo , Microbioma Gastrointestinal , Resistência à Insulina , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/metabolismo , Alanina Transaminase , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/complicações , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações
20.
Nutrients ; 11(6)2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31185686

RESUMO

Abstract: Vitamin D deficiency and obesity are two public health problems extensively exacerbated over the last years. Among the several mechanisms proposed to account for the complex interplay between vitamin D and obesity, one that has gained particular attention is related to the emerging role of obesity-related changes in gut microbiota and gut-derived metabolites, such as Trimethylamine-N-oxide (TMAO). Vitamin D deficiency and high circulating TMAO levels are associated with body weight and the severity of non-alcoholic fatty liver disease (NAFLD). Considering the link of obesity with vitamin D on the one hand and obesity with TMAO on the other hand, and the central role of the liver in both the vitamin D and TMAO metabolism, the aim of this cross-sectional observational study was first, to confirm the possible inverse association between vitamin D and TMAO across different body mass index (BMI) classes and second, to investigate if this association could be influenced by the presence of NAFLD. One hundred and four adult subjects (50 males and 54 females; 35.38 ± 7.49 years) were enrolled. The fatty liver index (FLI) was used as a proxy for the diagnosis of NAFLD. Vitamin D deficiency was found in 65 participants (62.5%), while 33 subjects (31.7%) had insufficient levels, and the remaining subjects had sufficient levels of vitamin D. Subjects with both vitamin D deficiency and FLI-NAFLD had the highest TMAO levels (p < 0.001). By stratifying the sample population according to the BMI classes, vitamin D levels decreased significantly along with the increase of plasma TMAO concentrations, with the lowest vitamin D levels and highest TMAO, respectively, in class III obesity. Vitamin D levels showed significant opposite associations with circulating levels of TMAO (r = -0.588, p < 0.001), but this association was no longer significant after the adjustment for FLI values. The highest values of TMAO were significantly associated with the severity of obesity (OR 7.92; p < 0.001), deficiency of vitamin D (OR 1.62; p < 0.001), and FLI-NAFLD (OR 3.79; p < 0.001). The most sensitive and specific cut-off for vitamin D to predict the circulating levels of TMAO was ≤19.83 ng/mL (p < 0.001). In conclusion, our study suggests that high TMAO levels are associated with vitamin D deficiency and NAFLD. Further studies are required to investigate if there is a causality link or whether all of them are simply the consequence of obesity.


Assuntos
Metilaminas/sangue , Obesidade/sangue , Deficiência de Vitamina D/sangue , Vitamina D/sangue , Adulto , Biomarcadores/sangue , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade/complicações , Fatores de Risco , Deficiência de Vitamina D/complicações , Adulto Jovem
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