scholarly journals Cluster Analysis as a Method of Assessing the Severity of Non-Alcoholic Fatty Liver Disease in Patients with Hypertension

2021 ◽  
Vol 6 (5) ◽  
pp. 239-246
Author(s):  
A. O. Rozhdestvenska ◽  
◽  
N. M. Zhelezniakova
Keyword(s):  
Blood Pressure ◽  
Liver Disease ◽  
Waist Circumference ◽  
Fatty Liver ◽  
Alanine Aminotransferase ◽  
Fatty Liver Disease ◽  
Interleukin 10 ◽  
Interleukin 1Β ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

The purpose of the study was to determine the possibilities of cluster analysis as a method for assessing the severity of Non-alcoholic fatty liver disease in its comorbidity with hypertension. Materials and methods. In the study, we examined 63 patients with non-alcoholic steatohepatitis and hypertension, 62 patients with isolated non-alcoholic steatohepatitis and 20 healthy individuals as a control group. All patients underwent anthropometric examinations, including determination of waist circumference, measuring systolic and diastolic blood pressure, performing routine laboratory tests, revealing plasma levels of kallistatin, interleukin-1β and interleukin-10 by enzyme-linked immunosorbent assay. Abdominal ultrasonography was performed to determine the thickness of the right, left and caudal lobes of the liver, and 2-dimensional shear wave elastography with calculating the liver parenchyma stiffness (E, kPa) was performed to determine the fibrotic changes of the liver. Cluster analysis was performed in the program "STATISTICA 8.0." using a hierarchical method and k-means algorithm with pre-standardized data. Results and discussion. According to the results of clustering, 3 subgroups of patients with non-alcoholic fatty liver disease and hypertension were identified. Cluster 1 was characterized by low systolic and diastolic blood pressure, waist circumference, low levels of alanine aminotransferase and aspartate aminotransferase, moderate interleukin-1β levels, low activity of kallistatin and interleukin-10, ultrasound signs of hepatomegaly and increased liver parenchyma stiffness. Cluster 2 included patients with the highest systolic and diastolic blood pressure, moderate waist circumference, highest alanine aminotransferase, aspartate aminotransferase and interleukin-1β levels, low activity of kallistatin and interleukin-10, the most pronounced ultrasound hepatomegaly signs and the worst liver elastography results. Cluster 3 was characterized by moderate systolic and diastolic blood, minimum alanine aminotransferase, aspartate aminotransferase and interleukin-1β content, highest kallistatin and interleukin-10 levels, minimum thickness of liver lobes and lowest liver parenchymal stiffness. Clusters differed significantly from the control group in all parameters, and from the isolated non-alcoholic fatty liver disease group, significant differences were found in all characteristics except waist circumference and interleukin-1β levels. The clusters varied in at least 4 parameters, and the maximum dissimilarity was found between clusters 2 and 3, which differed by 9 indicators. Conclusion. Thus, the clustering of examination results of the patients with non-alcoholic fatty liver disease and hypertension showed a statistically significant distribution of groups according to the severity of liver fibrosis. The elevated systolic and diastolic blood pressure, increased alanine aminotransferase and aspartate aminotransferase, decreased activity of kallistatin and interleukin-10 and signs of hepatomegaly according to ultrasound data could be considered as markers of severe liver fibrosis. The cluster distribution of patients with non-alcoholic fatty liver disease and hypertension opens prospects for the development of new integrated methods in assessment of liver parenchyma changes severity in patients with this comorbidity

scholarly journals Association of Non-Alcoholic Fatty Liver Disease with Metabolic Syndrome: A Single Center Study

2022 ◽  
Vol 8 (1) ◽  
pp. 310-317
Author(s):  
Debasish Dutta
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Waist Circumference ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
College Hospital ◽  
Alcoholic Fatty Liver ◽  
Grade Ii ◽  
Alcoholic Fatty Liver Disease

Background: NAFLD is a condition defined by excessive fat accumulation in the form of triglycerides (steatosis) in the liver (> 5% of hepatocytes histologically). Non-alcoholic fatty liver disease is increasingly being recognized as a major cause of liver-related morbidity and mortality among 15-40% of the general population. Aim of the study: To evaluate the clinical profile of patients with non-alcoholic fatty liver disease and its association with metabolic syndrome.Methods:The present cross-sectional, retro-spective study was conducted as outdoor patient basis in the Department of Medicine, Jashore medical college hospital & a private diagnostic centre, Jashore.. A total of 74 cases were included for the study. All patients in the study underwent routine investigations including complete blood counts, blood sugar, liver function tests, HBsAg, anti-HCV, lipid profile andUSG of whole abdomen. The data was collected during OPD treatment and was recorded in predesigned and pretested proforma and analyzed.Results:Mean age of the patient was 53.70±7.22 years. On physical examination findings showed the mean BMI was 27.6±4.39 kg/m2, mean waist circumference was 74.22±7.44 cm. Mean diastolic blood pressure (mm Hg) was 92.87±6.25 and mean systolic blood pressure (mm Hg) 132.0±18.17. Maximum 52% patients had triglycerides >150 mg/dl while low serum HDL level was seen in 37% patients and increased waist circumference was found in 32% patients. Altered ALT ≥41 IU was observed in 10 (62.50%) of Grade II of patients with NAFLD with metabolic syndrome. Central obesity was observed in 12 (75.00%) of Grade II patients with NAFLD with metabolic syndrome. While 14 (87.50%) Grade II of patients with NAFLD with metabolic syndrome showed impaired fasting glucose (>110 mg/dl). Hypertriglyceridemia (>150 mg/dl) in 12 (70.58%) seen in Grade I of patients with NAFLD without metabolic syndrome.Conclusion:Higher prevalence of all the components of metabolic syndrome in cases of NAFLD was observed. It can be concluded that symptoms and signs of NAFLD are non-specific and occur later in the course of the disease hence the physician should have a high index of suspicion in order to detect NAFLD early in the course of the disease.

scholarly journals Simple Resistance Exercise for 24 Weeks Decreases Alanine Aminotransferase Levels in Patients with Non-Alcoholic Fatty Liver Disease

2017 ◽  
Vol 01 (01) ◽  
pp. E2-E7 ◽  
Author(s):  
Atsushi Takahashi ◽  
Hiromichi Imaizumi ◽  
Manabu Hayashi ◽  
Ken Okai ◽  
Kazumichi Abe ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Resistance Exercise ◽  
Exercise Therapy ◽  
Alanine Aminotransferase ◽  
Fatty Liver Disease ◽  
Exercise Group ◽  
Control Group ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Abstract Exercise therapy is effective and recommended for non-alcoholic fatty liver disease (NAFLD) based on the efficacy of hepatic fat reduction. However, the efficacies of exercise therapy are based on short-term intervention. Moreover, no reports have examined whether significant reductions in serum levels of alanine aminotransferase (ALT) are achieved with exercise therapy in patients with NAFLD. The aim of this study is to assess the effects of simple resistance exercise for 24 weeks in NAFLD. 59 patients with NAFLD were assigned to a resistance exercise group (n=28) or a control group (n=31). The resistance exercise group performed 2 exercises (push-ups and squats) 3 times a week on nonconsecutive days for a trial periods of 24 weeks. Patients in the control group proceeded with regular physical activities under a restricted diet throughout the study. The effects of exercise were compared between groups after 24 weeks.Mean ALT level, homeostasis model assessment-estimated insulin resistance index and hepatic steatosis grade were all decreased in the resistance exercise group. Changes in ALT levels correlated negatively with changes in muscle:body weight ratio in the exercise group.These data demonstrate that 24 weeks of simple resistance exercise comprising squats and push-ups represents an effective treatment for NAFLD.

scholarly journals Association Between Hepatic Steatosis and Metabolic Syndrome in Patients With Non-alcoholic Fatty Liver Disease

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 858-858
Author(s):  
Victoria Quadros Pereira ◽  
Carine Panke ◽  
Leticia Eifler ◽  
Cristiane Tovo ◽  
Thaís Moreira
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Biopsy ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Fatty Liver Disease ◽  
Serum Triglycerides ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Abstract Objectives Evaluate the association between the degree of hepatic steatosis and the development of metabolic syndrome in outpatients care. Methods Prospective cross-sectional study with outpatients care at the Gastroenterology Service of a hospital in southern Brazil. The study was approved by the Ethics Committee with protocol 57,328,416.8.0000.5335. Patients aged over 18 years and with non-alcoholic fatty liver disease were included. Patients were excluded from hepatitis B and C, with significant alcohol consumption and hepatocellular carcinoma. Data collection occurred during nutritional consultations, where we collected data of age, gender, lifestyle, diagnosis of comorbidities and biochemical tests. The result of liver biopsy was evaluated for the degree of hepatic steatosis. Anthropometric parameters were assessed for the diagnosis of metabolic syndrome, in addition to electrical bioimpedance for body composition. Data were presented as mean, median, standard deviation, interquartile range and percentages according to distribution. Student T, ANOVA and Pearson correlation tests were applied. The significance level was 5%. Results We evaluated 71 patients with mean age 59.08 ± 8.92 years, 67.6% (n = 48) women, 60.6% (n = 43) sedentary, 52.2% (n = 37) no smoking and mean body mass index of 32.91 ± 5.27 kg/m2. Systemic arterial hypertension were diagnosed in 80.3% (n = 57), 73.2% (n = 52) were diabetic, 66.2% (n = 47) were dyslipidemic and 28.2% (n = 20) of patients with metabolic syndrome. As liver biopsy, 25.4% (n = 18) mild steatosis, 23.9% (n = 17) moderate and 26.8% (n = 19) intense. In the comparison between the levels of hepatic steatosis and the variables, it was observed that patients with severe steatosis had metabolic syndrome (p = 0.041). Patients with metabolic syndrome have higher fat mass (p = 0.044), diastolic blood pressure (p = 0.019) and higher levels of serum triglycerides (p = 0.043). Severe hepatic steatosis correlated with the diagnosis of metabolic syndrome (r = 0.319; p = 0.019). Conclusions Severe hepatic steatosis is related to the diagnosis of metabolic syndrome.Patients with metabolic syndrome had a higher amount of fat mass, increased diastolic blood pressure and serum triglycerides. Funding Sources This study was not funded.

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