The Pattern of Elevated Liver Function Tests in Nonalcoholic Fatty Liver Disease Predicts Fibrosis Stage and Metabolic-Associated Comorbidities

2018 ◽  
Vol 37 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Dor Shirin ◽  
Noam Peleg ◽  
Orly Sneh-Arbib ◽  
Michal Cohen-Naftaly ◽  
Marius Braun ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Function Tests ◽  
Fibrosis Stage ◽  
Advanced Fibrosis ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

Background: Patients with nonalcoholic fatty liver disease (NAFLD) and with abnormal liver function tests (LFTs) most commonly present with elevated hepatocellular enzymes (H pattern), but a subset of patients is found to have elevated cholestatic enzymes (C pattern) or a mixed (M) pattern. Aims and Methods: To determine whether the epidemiologic background and comorbidities, as well as the degree of liver fibrosis, differ between NAFLD patients with different patterns of elevated LFTs by retrospectively analyzing data of 106 patients with a biopsy-proven diagnosis of NAFLD. The pattern of elevated LFTs was determined by adopting the “R-Ratio” formula commonly used for drug-induced liver injury. Results: Advanced fibrosis (F > 2) was found in 15 out of 48 (31.3%) patients with a C pattern of elevated LFTs as compared to 2 out of 44 (4.5%) in M patients and 2 out of 11 (18.2%) in H patients (p = 0.004). Group C patients are older and also had a higher prevalence of diabetes, a higher mean hemoglobin A1c, and a higher prevalence of hypertension, as well as a trend for a higher prevalence of hypertriglyceridemia. Conclusions: Using a simple formula incorporating routine LFTs can help to categorize NAFLD patients as low or high risk for advanced fibrosis stage and metabolic-associated comorbidities.

scholarly journals Author Reply—Bariatric Surgery and Liver Function Tests in Nonalcoholic Fatty Liver Disease

2017 ◽  
Vol 27 (4) ◽  
pp. 1060-1060
Author(s):  
Geraldine J. Ooi ◽  
Paul R. Burton ◽  
William W. Kemp ◽  
Stuart K. Roberts ◽  
Wendy A. Brown
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Function Tests ◽  
Author Reply ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

Effects of Bariatric Surgery on Liver Function Tests in Patients with Nonalcoholic Fatty Liver Disease

2016 ◽  
Vol 27 (6) ◽  
pp. 1533-1542 ◽  
Author(s):  
Geraldine J. Ooi ◽  
Paul R. Burton ◽  
Lisa Doyle ◽  
John M. Wentworth ◽  
Prithi S. Bhathal ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Function Tests ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

scholarly journals Alterations of liver function tests in diabetic obese and nonobese individuals

Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 781-786
Author(s):  
Avinash S. ◽  
Santhi Silambanan
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cost Effective ◽  
Liver Function Tests ◽  
P Value ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

Introduction and Aim: India has emerged as the diabetes capital in Southeast Asia having around 74 million with diabetes, with a prevalence of 9.8% in 18–99 years of age. In type 2 diabetes mellitus, triglycerides get deposited in liver thus altering its structure and function, which is the feature of nonalcoholic fatty liver disease. This study was undertaken to study the alterations in liver function tests in obese and nonobese diabetic individuals.   Materials and Methods: The Department of Biochemistry at Sri Ramachandra Institute of Higher Education and Research was chosen to conduct the retrospective study on 200 diabetic individuals from September 2019 to February 2020. The data obtained were serum liver function tests, HbA1c, plasma glucose and lipid profile. Before the study ethics approval was obtained from the Institutional Ethics Committee for studies involving human participants. The obtained data were subjected to statistical analysis using SPSS version 16 and a P value less than 0.05 was considered statistically significant.   Results: Transaminases and ALP were significantly altered in obese diabetics; were positively correlated with bilirubin. TGL was negatively correlated with AST/ALT ratio.   Conclusion: Liver enzymes and bilirubin were altered in obese diabetics. Measurement of liver function biomarkers are cost effective diagnostic markers of non-alcoholic fatty liver disease.

IMPACT OF TYPE 2 DIABETES ON NONALCOHOLIC STEATOHEPATITIS AND ADVANCED FIBROSIS IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE

2020 ◽  
Vol 26 (4) ◽  
pp. 444-453 ◽  
Author(s):  
Hua Bian ◽  
Xiaopeng Zhu ◽  
Mingfeng Xia ◽  
Hongmei Yan ◽  
Xinxia Chang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Nonalcoholic Steatohepatitis ◽  
Fatty Liver Disease ◽  
Fibrosis Stage ◽  
Advanced Fibrosis ◽  
Nonalcoholic Fatty Liver

Objective: Type 2 diabetes mellitus (T2DM) is a risk factor for nonalcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the effect of T2DM on nonalcoholic steatohepatitis (NASH) and advanced fibrosis. Methods: A total of 221 NAFLD patients who had undergone a liver biopsy were included in this study. Subjects were divided into a non-T2DM group and a T2DM group based on glycemic control. NASH was diagnosed by the joint presence of steatosis, ballooning, and lobular inflammation. The steatosis, activity, and fibrosis (SAF) score and NAFLD activity score (NAS) were used to evaluate the severity of NAFLD. The severity of liver fibrosis was evaluated based on the fibrosis stage. Results: The total percentages of NASH and advanced fibrosis in this study were 95.0% and 50.2%, respectively. The percentages of NASH and advanced fibrosis in NAFLD patients with T2DM were 96.1% and 56.5%, respectively, which were higher than those in the non-T2DM group. SAF score (especially activity and fibrosis stage) and NAS (especially ballooning) were higher in NAFLD patients with T2DM than in NAFLD patients without T2DM. Glycemic control and insulin resistance were positively associated with SAF, NAS, and fibrosis stage. Additionally, T2DM elevated the risk of a high NAS and advanced fibrosis. Conclusion: T2DM increases the risk of serious NASH and advanced fibrosis in patients with NAFLD. Liver biopsy can be performed in NAFLD patients with T2DM to confirm the stage of NAFLD. Screening of NASH and advanced fibrosis in NAFLD patients with T2DM is needed. Abbreviations: ALT = alanine aminotransferase; APO = apolipoprotein; AST = aspartate aminotransferase; BMI = body mass index; CI = confidence interval; FPG = fasting plasma glucose; GGT = gamma-glutamyl transferase; HbA1c = hemoglobin A1c; HDL-c = high-density-lipoprotein cholesterol; 1H-MRS = proton magnetic resonance spectroscopy; HOMA-IR = homeostasis model assessment of insulin resistance; 2hPG = postprandial plasma glucose at 2 hours; LDL-c = low-density-lipoprotein cholesterol; LFC = liver fat content; NAFLD = nonalcoholic fatty liver disease; NAS = NAFLD activity score; NASH = nonalcoholic steatohepatitis; OGTT = oral glucose tolerance test; OR = odds ratio; T2DM = type 2 diabetes mellitus; TC = total cholesterol; TG = triglyceride; SAF = steatosis, activity, and fibrosis; US-FLI = ultrasonographic fatty liver indicator

The Relationship of Serum Hemojuvelin and Hepcidin Levels with Iron Overload in Nonalcoholic Fatty Liver Disease

2015 ◽  
Vol 24 (3) ◽  
pp. 293-300 ◽  
Author(s):  
Salih Boga ◽  
Huseyin Alkim ◽  
Canan Alkim ◽  
Ali Riza Koksal ◽  
Mehmet Bayram ◽  
...  
Keyword(s):  
Liver Disease ◽  
Iron Overload ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Clinical Characteristics ◽  
Serum Levels ◽  
Fibrosis Stage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Nonalcoholic Fatty Liver

Background & Aims: Mild iron overload is frequently reported in patients with nonalcoholic fatty liver disease (NAFLD). Hepcidin is the master iron-regulatory peptide and hemojuvelin (HJV) is the key regulator of iron-dependent secretion of hepcidin. The aims of this study were to evaluate serum HJV and hepcidin levels in patients with biopsy-proven NAFLD with and without hepatic iron overload, and to identify potential associations of HJV and hepcidin with the clinical characteristics of the patients enrolled. Methods: Serum levels of HJV and hepcidin were measured in 66 NAFLD patients with (n=12) and without (n=54) iron overload, and controls (n=35) by enzyme-linked immunosorbent assay. Hemojuvelin and hepcidin levels were assessed in relation to clinical characteristics and liver histologic evaluation of the participants. Results: Significantly lower serum HJV (281.1 [239.2-353.6] vs. 584.8 [440.3-661] ng/ml, p<0.001) and similar serum hepcidin levels (60.5±31.1 vs. 55.8±11.9 ng/ml, p=0.285) were found in NAFLD patients when compared to controls. İron-overloaded NAFLD patients had significantly lower HJV (249.9 [187.6-296.3] vs. 292.9 [243-435] ng/ml, p=0.032) and significantly higher hepcidin (78.4±35.5 vs. 56.5±28.9ng/ml, p=0.027) levels than NAFLD patients without iron overload. Fibrosis stage was significantly higher in iron overloaded NAFLD group (p<0.001). Ferritin levels correlated significantly both with HOMA-IR (r=0.368, p=0.002) and fibrosis stage (r=0.571, p<0.001). Conclusions: Our findings suggest that HJV levels are low in NAFLD and even lower in iron overloaded NAFLD, while hepcidin levels are higher in NAFLD with iron overload. The gradually decreased HJV and increased hepcidin concentrations in our patients most likely reflect the physiological response to iron accumulation in the liver.

Sign in / Sign up

Export Citation Format

Share Document