Nonalcoholic fatty liver disease in chronic obstructive pulmonary disease

Nonalcoholic fatty liver disease (NAFLD) is independently linked to cardiometabolic morbidity and mortality. Low-grade inflammation, oxidative stress and ectopic fat, common features of chronic obstructive pulmonary disease (COPD), might contribute to the development of NAFLD.We aimed to investigate the prevalence of NAFLD and to evaluate the relationship between various types of liver damage and COPD severity, comorbidities and circulating inflammatory cytokines. Validated noninvasive tests (FibroMax: SteatoTest, NashTest and FibroTest) were used to assess steatosis, nonalcoholic steatohepatitis (NASH) and liver fibrosis. Patients underwent an objective assessment of COPD comorbidities, including sleep studies. Biological parameters included a complete lipid profile and inflammatory markers.In COPD patients the prevalence of steatosis, NASH and fibrosis were 41.4%, 36.9% and 61.3%, respectively. In multivariate analysis, SteatoTest and FibroTest were significantly associated with sex, body mass index (BMI), untreated sleep apnoea and insulin resistance, and, in addition, COPD Global Initiative for Chronic Obstructive Lung Disease stage for SteatoTest. Patients with steatosis had higher tumour necrosis factor-α levels and those with NASH or a combination of liver damage types had raised leptin levels after adjustment for age, sex and BMI.We concluded that NAFLD is highly prevalent in COPD and might contribute to cardiometabolic comorbidities.

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Markers of Immune Inflammation in Patients with Nonalcoholic Fatty Liver Disease in Combination with Chronic Obstructive Pulmonary Disease

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.04.119 ◽

2021 ◽

Vol 6 (4) ◽

pp. 119-125

Author(s):

I. O. Khramtsova ◽

◽

M. A. Derbak

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Pulmonary Disease ◽

Neutrophil Elastase ◽

Fatty Liver Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Nonalcoholic Fatty Liver

The purpose of the study was to determine markers of immune inflammation in patients with nonalcoholic fatty liver disease combined with chronic obstructive pulmonary disease. Materials and methods. The observation revealed 82 patients who were treated in the pulmonology and gastroenterology department of the Andriy Novak Transcarpathian Regional Clinical Hospital during 2018-2020 with a diagnosis of nonalcoholic fatty liver disease and chronic obstructive pulmonary disease II group B and C. Among the examined there were 61.0% (50) men and 40.0% (32) women. The average age was 57.8±1.5 years old. Results and discussion. As a result of the conducted research it is established that increased levels of chronic immune inflammation markers were observed in all examined with significant increase in patients with a comorbid condition. The highest concentrations of C-reactive protein were found in patients with nonalcoholic fatty liver disease combined with chronic obstructive pulmonary disease with frequent exacerbations and hospitalization, and exceeded the normal values by 8.3 times. The levels of tumor necrosis factor-α and neopterin in patients with frequent exacerbations of chronic obstructive pulmonary disease and hospitalization were by 2.7 times and 1.9 times higher than in patients with a small number of exacerbations and by 3.2 and 3.9 times higher than in patients with nonalcoholic fatty liver disease without chronic obstructive pulmonary disease. The indexes of interleukin-6, transforming growth factor-β, the number of IgG antibodies to neutrophil elastase and the level of tissue inhibitor of matrix proteinases-1 remain consistently high in all patients with combined pathology of nonalcoholic fatty liver disease and chronic obstructive pulmonary disease regardless of the frequency of exacerbations, thus supporting inflammation even in remission. Elastase antibody levels correlate directly with the levels of the tissue metalloproteinase-1 inhibitor and increase with the degree of severety of fibrosis, which may indicate a high level of serum neutrophil elastase activity in patients with nonalcoholic fatty liver disease in combination with chronic obstructive pulmonary disease and its participation in fibrosis. Conclusion. Patients with nonalcoholic fatty liver disease in combination with chronic obstructive pulmonary disease showed an increased level of chronic systemic inflammation of low intensity based on the analysis of C-reactive protein, tumor necrosis factor-α, neopterin and interleukin-6 compared with nonalcoholic fatty liver disease without chronic obstructive pulmonary disease even in remission, which indicates an aggravating course of the disease in combination of two pathologies. Stably high concentration of IgG antibodies to neutrophil elastase may indirectly indicate the maintenance of the activity of this enzyme in the serum of patients with nonalcoholic fatty liver disease in chronic obstructive pulmonary disease and confirms its participation in liver fibrogenesis

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FREQUENCY OF EXACERBATIONS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AS ONE OF THE FACTORS OF PROGRESSION OF NON-ALCOHOLIC FATTY LIVER DISEASE

InterConf ◽

10.51582/interconf.19-20.08.2021.024 ◽

2021 ◽

pp. 262-266

Author(s):

Мaria Derbak ◽

Iryna Khramtsova

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Liver Disease ◽

Fatty Liver ◽

Pulmonary Disease ◽

Fatty Liver Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease ◽

Severe Grade

This article presents the results of studies obtained by observing patients with non-alcoholic fatty liver disease (NAFLD) on the background of chronic obstructive pulmonary disease (COPD). As a result of the analysis it was found that the frequency of exacerbations of COPD with hospitalization in overweight patients in the presence of NAFLD leads to increased imbalance of adipose tissue hormones in the form of decreased adiponectin and increased leptin, and correlates with impaired lipid metabolism and severe grade of hepatic steatosis. In patients with frequent exacerbations, there is a significant positive correlation between leptin levels and TNF-a factor, which may be associated with an increase in overall inflammation. The revealed imbalance of adiponectin and leptin content in patients with COPD with overweight is a factor in the progression of NAFLD.

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Impact of non-alcoholic fatty liver disease on late cardiovascular events and death in Chronic Obstructive Pulmonary Disease

10.1183/13993003.congress-2018.pa4038 ◽

2018 ◽

Author(s):

Damien Viglino ◽

Anais Plazanet ◽

Sébastien Bailly ◽

Meriem Benmerad ◽

Ingrid Jullian-Desayes ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Liver Disease ◽

Fatty Liver ◽

Pulmonary Disease ◽

Fatty Liver Disease ◽

Cardiovascular Events ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Lipid Metabolism Disorders in the Comorbid Course of Nonalcoholic Fatty Liver Disease and Chronic Obstructive Pulmonary Disease

Cells ◽

10.3390/cells10112978 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2978

Author(s):

Stanislav Kotlyarov ◽

Aleksei Bulgakov

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Lipid Metabolism ◽

Liver Disease ◽

Fatty Liver ◽

Pulmonary Disease ◽

Fatty Liver Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Alcoholic Fatty Liver ◽

Lipid Metabolism Disorders

Non-alcoholic fatty liver disease (NAFLD) is currently among the most common liver diseases. Unfavorable data on the epidemiology of metabolic syndrome and obesity have increased the attention of clinicians and researchers to the problem of NAFLD. The research results allow us to emphasize the systemicity and multifactoriality of the pathogenesis of liver parenchyma lesion. At the same time, many aspects of its classification, etiology, and pathogenesis remain controversial. Local and systemic metabolic disorders are also a part of the pathogenesis of chronic obstructive pulmonary disease and can influence its course. The present article analyzes the metabolic pathways mediating the links of impaired lipid metabolism in NAFLD and chronic obstructive pulmonary disease (COPD). Free fatty acids, cholesterol, and ceramides are involved in key metabolic and inflammatory pathways underlying the pathogenesis of both diseases. Moreover, inflammation and lipid metabolism demonstrate close links in the comorbid course of NAFLD and COPD.

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