Non-alcoholic fatty liver disease in HIV-positive patients predisposes for acute-on-chronic liver failure: two cases

Abstract Background Non-alcoholic Fatty Liver Disease (NAFLD) is one of the most prevalent chronic liver diseases particularly in Egypt. It is defined as accumulation of lipids inside the hepatocytes, in absence of other etiologies of hepatic damage. It is frequently associated with obesity, diabetes mellitus and metabolic syndrome. Objective To find out the correlation between the degree of liver fibrosis in Non-alcoholic Fatty Liver Disease patients and their serum Adiponectin level as a future non-invasive method for assessment of liver fibrosis to substitute liver biopsy to avoid its hazardous complication. Also to study the correlation between diabetes mellitus as well as obesity and serum Adiponetctin level. Patients and Methods 50 patients were selected to participate in our study based on our inclusion criteria. They were recruited from the Internal Medicine department, Gastro-intestinal clinic in AlDemerdash Hospital using a convenient sampling method. Diagnoses of NAFLD (Non-alcoholic fatty liver disease) was confirmed by laboratory markers (AST, ALT, Lipid profile), ultrasound as well as fibroscan examination. Results Analyzing adiponectin levels showed that -besides its significant correlation with BMI, hypertension, diabetes mellitus and dyslipidemia- it was significantly lower in high grade fibrosis group compared to low grade fibrosis group with P-value of (0.000) and a cutoff value for stage 3/4 fibrosis of about 2.31μg/ml which marked a promising hope of adeponictin being of protective value against liver fibrosis. However, more studies performed on populations of different sizes and characteristics are recommended to allow more accurate generalization of the results and hopefully exploring a new horizon for the follow up and treatment of patients with chronic liver disease especially NAFLD. Conclusion Adiponectin is an abundant adipocyte-derived protein with well-established antiatherogenic, insulin-sensitizing and anti-inflammatory properties. The liver is a major target organ for adiponectin especially in fatty liver diseases and this adipocytokine has the ability to control many liver functions including metabolism, inflammation and fibrosis. Both serum levels and hepatic adiponectin receptor expression are decreased in NAFLD. Therefore, either adiponectin itself or adiponectin-inducing agents might be of key therapeutic interest in the near future in the treatment of NAFLD.

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Metabolic associated fatty liver disease and acute-on-chronic liver failure

European Journal of Gastroenterology & Hepatology ◽

10.1097/meg.0000000000002335 ◽

2022 ◽

Vol Publish Ahead of Print ◽

Author(s):

Jacqueline Córdova-Gallardo ◽

Andrew P. Keaveny ◽

Xingshun Qi ◽

Nahum Méndez-Sánchez

Keyword(s):

Liver Disease ◽

Liver Failure ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Chronic Liver ◽

Chronic Liver Failure

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Acute on Chronic Liver Failure in Patients With Nonalcoholic Fatty Liver Disease: Trends in Mortality and Hospitalization Burden Over Time

The American Journal of Gastroenterology ◽

10.14309/00000434-201810001-00975 ◽

2018 ◽

Vol 113 (Supplement) ◽

pp. S549

Author(s):

Maureen Whitsett ◽

Violeta Popov ◽

Giulio Quarta ◽

Ira M. Jacobson

Keyword(s):

Liver Disease ◽

Liver Failure ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Chronic Liver ◽

Chronic Liver Failure ◽

Nonalcoholic Fatty Liver ◽

Over Time

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PTH-105 hospital admission in patients with advanced chronic liver disease due to non-alcoholic fatty liver disease

10.1136/gutjnl-2018-bsgabstracts.261 ◽

2018 ◽

Author(s):

Jessica Shearer ◽

Robert Driver ◽

Eleanor Taylor ◽

David Chizhande ◽

Rebecca Jones ◽

...

Keyword(s):

Liver Disease ◽

Hospital Admission ◽

Fatty Liver ◽

Chronic Liver Disease ◽

Fatty Liver Disease ◽

Chronic Liver ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Comparative analysis of indices of the metabolic syndrome in patients with and without non-alcoholic fatty liver disease at a teaching hospital in Nnewi, South-East, Nigeria

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i2.22050 ◽

2019 ◽

Vol 10 (2) ◽

pp. 40-45

Author(s):

Nneka S. Chukwurah ◽

Uchenna C. Okonkwo ◽

Anele E. Ihekwaba

Keyword(s):

Metabolic Syndrome ◽

Liver Disease ◽

Fatty Liver ◽

Chronic Liver Disease ◽

Fatty Liver Disease ◽

Chronic Liver ◽

Health Concern ◽

Alcoholic Fatty Liver ◽

The Metabolic Syndrome ◽

Alcoholic Fatty Liver Disease

Background: Non-Alcoholic fatty liver disease (NAFLD) has become a worldwide health concern with increase in the global incidence of obesity and it is now considered the hepatic component of the metabolic syndrome. Aims and Objective: The study’s aim was to compare the indices of the metabolic syndrome in compensated chronic liver disease patients with and without NAFLD at NAUTH, Nnewi. Materials and Methods: A total of 136 consecutive patients with compensated chronic liver disease were recruited into the study. A structured questionnaire was administered to obtain relevant socio-demographic data. NAFLD was diagnosed based on clinical, biochemical, ultrasonographic and in a few histological features. The Adult Treatment Panel III criteria were used to identify patients with the metabolic syndrome. Results: Of the 136 participants recruited into the study, 52 (38.2%) fulfilled 2 or more diagnostic criteria for NAFLD with a male: female ratio of 1:1.36. The mean (SD) age of persons with NAFLD was 45.12 (±8.07) years compared to 47.49(±11.79) years for persons without NAFLD. The difference was not statistically significant (p=0.2). Body mass index (BMI), central obesity (waist circumference), fasting blood sugar, blood pressure, total cholesterol and triglycerides were significantly higher in the NAFLD group (p= <0.05) respectively. Conclusion: Indices of the metabolic syndrome were more prevalent in persons with NAFLD. It is recommended that patients with NAFLD be screened for metabolic syndrome and appropriate therapy instituted to decrease the risk of both hepatic and cardiovascular complications.

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Prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) in Obese Type Two Diabetes Patients in an Endocrine Clinic

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.070 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A36-A36

Author(s):

Amna Ali Shaghouli ◽

Rola M Aranky

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Abdominal Ultrasound ◽

Chronic Liver ◽

Western World ◽

Obesity Prevalence ◽

Lifestyle Modifications ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Abstract Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver diseases that is expected to become the main cause for liver transplantation by 2030.1 Its prevalence is increasing globally and regionally, and it is set to become the leading cause of chronic liver disease in many parts of the world. However, the epidemiology and demographic characteristics of NAFLD vary worldwide.2About 20% to 30% of the patients progress to develop nonalcoholic steatohepatitis (NASH), a subtype of NAFLD, with features of hepatocyte injury such as hepatocyte ballooning. NASH can develop to fibrosis, cirrhosis, and even hepatocellular carcinoma.3 NAFLD is correlated with obesity and insulin resistance in most cases in the Western world.2In Kuwait, obesity prevalence is estimated to be 39% for adult males and 52% for adult females.4 There is no pharmacotherapy approved for NAFLD treatment, and the main treatment is lifestyle modifications focusing on body fat loss.5 Methods: In 18 months duration, a total number of 306 patients who attended an endocrine clinic in Kuwait for general health checkups with an average BMI of 33.6 (Kg/m2) were requested to do an abdominal ultrasound for fatty liver screening. And out of 306 patients, 218 patients (71% of the patients) were diagnosed with NAFLD, the rest 29% of the patients either didn’t come back for a follow up or were not diagnosed with NAFLD. Results: 218 patients have NAFLD, 153 of them are females and 65 are males with an average age and weight of 56.4 years and 87.9kg respectively. 78% of the patients were diabetic with an average HbA1c of 7.6%. The abdominal ultrasound showed the following result:83 patients had NAFLD grade 184 patients had NAFLD grade 2 21 patients had NAFLD grade 3While 30 patients had no grading, the results showed that they have a fatty liver with no grades mentioned. Also, reports showed that 27 patients had liver cirrhosis. The 218 patients were requested to do blood test and average results of the following parameter were as shown at baseline: Ferritin 98.3 ng/mLHemoglobin 13.5 g/dLPlatelets 274.5 x1000/cmmAST 23.8 U/LALT 27.9 U/LDirect Bilirubin 3.5 umol/LTotal Bilirubin 8.9 umol/LThe average calculated NAFLD, BARD and Fib-4 scores were -1.1, 3 and 1.1 respectively. All patients were unaware of NAFLD. Conclusion: 78% of the study population had NAFLD and were unaware of that. More researches on NAFLD awareness and occurrence in the region are required.

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