scholarly journals Steatohepatitis in Children with Obesity

2021 ◽  
Author(s):  
Alexander A. Zvyagin ◽  
Natalya Yu. Fateeva ◽  
Timofey V. Chubarov ◽  
Olga A. Zhdanova
Keyword(s):  
Diagnostic Algorithm ◽  
Biologically Active ◽  
Biochemical Tests ◽  
Alcoholic Fatty Liver ◽  
Diet And Physical Activity ◽  
Essential Phospholipids ◽  
Instrumental Methods ◽  
Hepatoprotective Agents ◽  
Alcoholic Fatty Liver Disease ◽  
Active Substances

The article discusses the issues of steatohepatitis development, diagnosis, and management in children. Steatohepatitis is one of the forms of non-alcoholic fatty liver disease diagnosed in 12–26% of children with obesity. The major pathogenetic factors are the following: oxidative stress, genetic predisposition, microbiota disorders, vitamin D deficiency. The information on the diagnostic algorithm is presented in accordance with the guidelines of the European and North American Societies of Pediatric Gastroenterologists, Hepatologists and Nutritionists. The characteristics of instrumental methods of steatohepatitis diagnostics (biopsy, ultrasound, magnetic resonance and computed tomography, elastography, biochemical tests) are given, as well as indications for their use in children are determined. The data on steatohepatitis management (including diet and physical activity) is presented. The use of hepatoprotective agents (ursodeoxycholic acid, essential phospholipids) and biologically active substances in children is discussed.

EVALUATION OF THE EFFECT OF CARNOSINE AND ALPHA-LIPOIC ACID ON THE HEMATOLOGICAL PARAMETERS OF WISTAR RATS WITH INDUCED FATTY LIVER DISEASE

2020 ◽  
Author(s):  
Оксана Константиновна Мустафина ◽  
Элеонора Николаевна Трушина ◽  
Николай Александрович Ригер ◽  
Илья Владимирович Аксенов
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Lipoic Acid ◽  
Fatty Liver Disease ◽  
Hematological Parameters ◽  
Biologically Active ◽  
Alpha Lipoic Acid ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease ◽  
Significant Protective Effect

В исследовании установлено, что использование высококалорийного холинодефицитного рациона (ВКХДР) у крыс привело к снижению уровня гемоглобина и эритроцитарных показателей, лейкоцитозу. Не выявлено достоверного влияния ВКХДР на общее количество тромбоцитов и эритроцитов. Добавление в рационы крыс карнозина и альфа-липоевой кислоты не оказало протективного влияния на изменения гематологического статуса в условиях развития НАЖБП. Studies on the effect of minor biologically active substances on the hematological parameters of rats against the background of induced fatty liver dystrophy. The addition of carnosine and alpha-lipoic acid to rat diets did not have a significant protective effect on changes in the hematological status in conditions of non-alcoholic fatty liver disease.

Efficacy and Safety of a Fixed Combination of Glycyrrhizic Acid and Essential Phospholipids in Non-Alcoholic Fatty and Alcoholic Liver Disease: Results from Randomized Placebo-Controlled Trials

2021 ◽  
Vol 76 (6) ◽  
pp. 595-603
Author(s):  
Igor V. Maev ◽  
Alexey O. Bueverov ◽  
Artem V. Volnukhin
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Alcoholic Liver Disease ◽  
Fatty Liver Disease ◽  
Glycyrrhizic Acid ◽  
Fixed Combination ◽  
Efficacy And Safety ◽  
Alcoholic Fatty Liver ◽  
Essential Phospholipids ◽  
Alcoholic Fatty Liver Disease

Background. Drug treatment of non-alcoholic fatty and alcoholic liver disease remains an urgent, unsolved problem. Due to the commonality of many pathogenetic mechanisms and predictors of progression, a universal approach to the search for a therapeutic agent can be considered. Aims pooled analysis of the results of two multicenter, randomized, double-blind, placebo-controlled studies of a fixed combination of glycyrrhizic acid and essential phospholipids in two dosage forms to study its efficacy and safety in non-alcoholic fatty and alcoholic liver disease, in the presence and absence of predictors of disease progression. Methods. The pooled analysis included 180 patients with non-alcoholic fatty liver disease (Gepard study) and 120 patients with alcoholic liver disease (Jaguar study). Patients of the main group received a fixed combination of 5.0 g intravenous jet 3 times a week for the first 2 weeks; then 2 capsules 3 times a day for the next 10 weeks. Patients in the control group received placebo according to the same scheme. The total duration of treatment was 12 weeks in the Gepard study (1 course of stepwise therapy) and 24 weeks in the Jaguar study (2 courses of stepwise therapy). A comparative analysis of the efficacy and safety of a fixed combination and a placebo was carried out, in the presence and absence of predictors of progression, separately for each nosology and in a mixed sample. Results. In patients with non-alcoholic fatty and alcoholic liver disease who received the fixed combination, in contrast to the placebo group, there was a statistically more significant decrease in the level of biochemical markers of inflammation alanine aminotransferase, aspartate aminotransferase, adiponectin, and the value of the AktiTest index. There was no negative trend in the NAFLD fibrosis score; more significant positive dynamics of FibroTest is shown. Predictors of disease progression hyperglycemia, hyperlipidemia, age did not have a negative impact on the results in the study group. The efficacy of the study drug was noted in patients with non-alcoholic fatty liver disease and normal body weight; data were obtained indicating its possible effectiveness with a high activity of the inflammatory process associated with alcoholic liver damage. The frequency of adverse events in the study and control groups was comparable. Conclusions. Based on a generalized analysis of the results of two studies, promising directions for the study and use of a fixed combination of glycyrrhizic acid and essential phospholipids were identified: non-alcoholic fatty liver disease without obesity, alcoholic steatohepatitis of high activity (as an adjuvant); steatohepatitis of non-alcoholic and alcoholic etiology, combined with hyperglycemia and hyperlipidemia.

scholarly journals Use of an in vitro model of hepatic steatosis for studying the anti-oxidant and antisteatotic effects of fucoidan polysaccharides

2020 ◽  
Author(s):  
Zeinab El Rashed ◽  
Hala Khalife ◽  
Adriana Voci ◽  
Elena Grasselli ◽  
Laura Canesi ◽  
...  
Keyword(s):  
Marine Algae ◽  
In Vitro Model ◽  
Biological Effects ◽  
Biologically Active ◽  
Terrestrial Plants ◽  
Alcoholic Fatty Liver ◽  
Anti Oxidant ◽  
Vitro Model ◽  
Alcoholic Fatty Liver Disease

Non Alcoholic Fatty Liver Disease (NAFLD) is characterised by fat accumulation in hepatocytes in the form of triacyglycerols (TAGs) within cytosolic lipid droplets. Fucoidans (FUs) are biologically active polysaccharides usually isolated from brown marine algae, but recently identified also in terrestrial plants. In this study, we aimed to investigate the anti-oxidant and anti-steatotic effects of FUs purified from C. compressa, F. hermonis, and E. globulus. To this aim, we used a validated NAFLD in vitro model consisting of rat hepatoma FaO cells exposed to an oleate/palmitate mixture. Such a model is suitable for rapid investigation of direct effects of natural and artificial compounds, together with satisfying the strategy of 3Rs for laboratory use of animals. Our results indicated that all FUs display anti-oxidant and anti-steatotic activities. Steatotic FaO cells may be employed to further study the biological effects of FUs.

scholarly journals Ultrasound steatometry in patients with non-alcoholic fatty liver disease: pilot results

2019 ◽  
Vol 10 (1) ◽  
pp. 23-29
Author(s):  
Darya Yu. Venidiktova ◽  
Alexey V. Borsukov ◽  
Anna V. Alipenkova ◽  
Alina V. Eremkina ◽  
Anton O. Tagil ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Diagnostic Algorithm ◽  
Information Value ◽  
Ultrasound Measurement ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Alcoholic Fatty Liver Disease

Objective. To evaluate the effectiveness of the ultrasound steatometry technique in patients with non-alcoholic fatty liver disease. Materials and methods. 68 patients aged 19–62 years (median age 40.5 years) were examined, 30 men (44.1%) and 38 women (55.9%), who underwent a single diagnostic algorithm of 7 (8) stages: questioning, clinical examination, noninvasive bioimpedance, biochemical blood test, liver ultrasound in B-mode, determination of hepatorenal index, ultrasound steatometry, liver biopsy. Results. In 4 patients (5.88%), a remote clinical picture of the metabolic syndrome, fatty liver infiltration was diagnosed. Signs of steatohepatitis were present in 19 (27.9%) patients, signs of cirrhosis — in 2 (2.9%). The sensitivity and specificity were 60.3% and 72.6%, respectively, for the B-mode, 44.3% and 51.9%, respectively, for the ultrasound measurement of the hepatorenal index, 90.6% and 92.2%, respectively, for ultrasonic steatometry. Conclusion. Ultrasound steatometry is an informative method for screening of patients with non-alcoholic fatty liver disease. Correlation (r) of the ultrasound diagnosis of steatosis with biopsy at the stage S0 corresponds to 0.81, at the stage S1 — to 0.68, at the stage S2 — to 0.74, at the stage S3 — to 0.88, that indicates a high information value of this method.

scholarly journals Non-alcoholic fatty liver disease: current aspects of diagnosis in real clinical practice

2021 ◽  
Vol 2 (4) ◽  
pp. 40-50
Author(s):  
Dmitry I. Trukhan ◽  
Keyword(s):  
Clinical Practice ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Metabolic Diseases ◽  
Diagnostic Algorithm ◽  
Malignant Neoplasms ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease ◽  
Real Clinical Practice

In the diagnosis and subsequent supervision of patients with non-alcoholic fatty liver disease (NAFLD) and obesity in real clinical practice, the role and importance of the doctor of first contact (therapist and general practitioner) increases. Non-alcoholic fatty liver disease is currently considered as the hepatic component of metabolic syndrome. A diagnostic algorithm for NAFLD at the stage of primary health care is presented. The most difficult question at 2–4 levels of the diagnostic algorithm is the differential diagnosis between NAFLD and alcoholic liver disease. During a pandemic of a novel coronavirus infection (COVID-19), patients with NAFLD or NASH, as a rule, have concomitant metabolic diseases such as diabetes mellitus, arterial hypertension and obesity, and also have to take a large number of potentially hepatotoxic drugs, it is advisable to classify them as elevated risk of infection with SARS-CoV-2, and the severe course of this infection. This allows us to consider NAFLD as dangerous in terms of the severe course of COVID-19, as viral hepatitis, autoimmune hepatitis and liver fibrosis / cirrhosis. It is known that NAFLD is an independent predictor of not only high cardiovascular risks, but also hepatocellular carcinoma and malignant neoplasms of various localization, as well as a number of other comorbid conditions. The review concludes with a clinical observation illustrating the difficulty of early diagnosis of intrahepatic cholangiocarcinoma in a patient with NAFLD and other metabolic risk factors.

scholarly journals Pediatric Fatty Liver and Obesity: Not Always Justa Matter of Non-Alcoholic Fatty Liver Disease

Children ◽  
2018 ◽  
Vol 5 (12) ◽  
pp. 169
Author(s):  
Renata Alfani ◽  
Edoardo Vassallo ◽  
Anna De Anseris ◽  
Lucia Nazzaro ◽  
Ida D'Acunzo ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Large Scale ◽  
Correct Diagnosis ◽  
Diagnostic Algorithm ◽  
Liver Imaging ◽  
Dietary Counseling ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Obesity-related non-alcoholic fatty liver disease (NAFLD) represents the most common cause of pediatric liver disease due to overweight/obesity large-scale epidemics. In clinical practice, diagnosis is usually based on clinical features, blood tests, and liver imaging. Here, we underline the need to make a correct differential diagnosis for a number of genetic, metabolic, gastrointestinal, nutritional, endocrine, muscular, and systemic disorders, and for iatrogenic/viral/autoimmune hepatitis as well. This is all the more important for patients who are not in the NAFLD classical age range and for those for whom a satisfactory response of liver test abnormalities to weight loss after dietary counseling and physical activity measures cannot be obtained or verified due to poor compliance. A correct diagnosis may be life-saving, as some of these conditions which appear similar to NAFLD have a specific therapy. In this study, the characteristics of the main conditions which require consideration are summarized, and a practical diagnostic algorithm is discussed.

scholarly journals INFLUENCE OF COMPLEX TREATMENT ON BIOCHEMICAL BLOOD PARAMETERS OF PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND CONCOMITANT PRE-DIABETES

2021 ◽  
Vol 74 (4) ◽  
pp. 986-991
Author(s):  
Snizhana V. Feysa ◽  
Svitlana O. Rudakova
Keyword(s):  
Fatty Acids ◽  
Liver Disease ◽  
Polyunsaturated Fatty Acids ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Complex Treatment ◽  
Omega 3 ◽  
Alcoholic Fatty Liver ◽  
Essential Phospholipids ◽  
Alcoholic Fatty Liver Disease

The aim: Of this research is to evaluate laboratory changes in the liver blood tests, carbohydrate and lipid metabolism in NAFLD patients with concomitant pre-diabetes, and to study the feasibility of their complex treatment with the inclusion of omega-3 polyunsaturated fatty acids and essential phospholipids. Materials and methods: We have examined 55 patients with non-alcoholic fatty liver disease on the background of pre-diabetes aged 40 to 75 years. Modification of lifestyle was recommended to all patients as a basic treatment. In addition, the patients were prescribed essential phospholipids in 2 capsules 3 times a day and omega-3 polyunsaturated fatty acids 1000 mg per day for 28 patients (group 1) or rosuvastatin 10 mg per day for 27 persons (group 2). The effectiveness of the treatment was evaluated in 3 months, and the long-term outcomes were evaluated in 12 months. Results: Under the influence of the prescribed treatment, a hypolipidemic effect was observed in both groups, but a significant decline in the activity of alanine aminotransferase and aspartate aminotransferase occurred only under the influence of a combination of essential phospholipids and omega-3 polyunsaturated fatty acids. Conclusions: Thus, the described results allow to recommend this combination of medicines to patients with non-alcoholic fatty liver disease and concomitant pre-diabetes.

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