scholarly journals Enzyme Activity and De Ritis Ratio in Alcoholic and Non Alcoholic Fatty Liver Patients based on Ultrasonography

2020 ◽  
Vol 8 (1) ◽  
pp. 9-13
Author(s):  
Sanju Rawal ◽  
Aakash Shahi ◽  
Narayan Gautam ◽  
Archana Jayan ◽  
Uday Sharma

INTRODUCTION: Fatty liver disease (FLD) refers to a wide clinical and histological spectrum from simple hepatic steatosis to steatohepatitis or cirrhosis, and FLD has been classified as nonalcoholic FLD (NAFLD) and alcoholic FLD (AFLD) based on etiology and ultrasonography (USG). MATERIAL AND METHODS: This Cross-sectional study was undertaken in the Department of Radiology, Universal College of Medical Sciences (UCMS), Bhairahawa, Nepal from March 2019 to February 2020. A total of 100 subjects involved where ultrasonographically graded for fatty liver and enzyme activity were assessed to observe their association. RESULTS: In 100 cases, 66% were male and 34% were female. Ultrasonography (USG) guided FLD grade 1 patients were 81%, FLD grade 2 patients were 19% where as no cases was observed for FLD grade 3. Fifty Six percent (56%) of the total cases presented with AFLD while remaining 44% with NAFLD. There was significant difference in serum glutamate oxaloacetate transaminase (SGOT) (p-value: 0.003), serum glutamate pyruvate transaminase (SGPT) (p-value: 0.011) and alkaline phosphatase (ALP) (p-value: 0.003) in AFLD and NAFLD. However, there was no significant association of enzyme activity with FLD grade (p-value >0.05). There was significant difference in SGOT (p-value: 0.004), SGPT (p- value: 0.025) between AFLD grade 1 (AFLDG1) and NFLD grade 1 (NAFLDG1), SGOT (p-value: 0.016) between AFLDG2 and NAFLDG2 and ALP (p-value: 0.01) between AFLDG1 and NAFLDG1. However, De Ritis ratio was not significantly associated with fatty liver disease. CONCLUSION: USG is a non-invasive simple tool for early detection of fatty liver in asymptomatic patients enabling clinicians to achieve early detection in conjunction with hepatic enzymes.

2020 ◽  
Author(s):  
Aakash Shahi ◽  
Narayan Gautam ◽  
Sanju Rawal ◽  
Uday Sharma ◽  
Archana Jayan

Abstract Background: Fatty liver disease is a common and major chronic liver disease. It has been implicated that patients have disorders of lipid metabolism and involved in the pathogenesis of fatty liver. Lipid profile plays a very important role in diagnosis of liver diseases hence it was designed to observe relationship between lipid profile and fatty liver disease (FLD) based on ultrasonography (USG).Method and methodology: This Cross-sectional and analytical study was undertaken in the Department of Internal Medicine with collaboration of Department of Radiology and Department of Biochemistry, Universal College of Medical Sciences-Teaching Hospital (UCMS-TH), Bhairahawa, Nepal from March 2019 to February 2020 in total 100 patients diagnosed with FLD by USG.Result: In 100 cases, the male to female ratio was 1.8:1. 56% of the total cases presented with alcoholic fatty liver disease (AFLD) while remaining 44% with non alcoholic fatty liver disease (NAFLD). The spectrum of lipid abnormality was observed with increased total cholesterol (TC), Low Density Lipoprotein (LDL), increased triglycerides (TG) and Very Low Density Lipoprotein (VLDL) in AFLD cases as compared to NAFLD cases. However, it has been observed that TG/HDL and Non-HDL/HDL were higher in NAFLD as compared to AFLD. There was statistical significant difference in HDL (p-value: 0.019) between alcoholic fatty liver disease grade 1 (AFLG1) and non-alcoholic fatty liver disease grade 1 (NAFLG1). Moreover, it was observed statistical significant difference in HDL between AFLG2 and NAFLG2 (p-value: 0.012).Conclusion:Elevated level of TG and decreased HDL has been implicated in the precipitation of the occlusive vascular disease. These parameters in conjunction with Non-HDL/HDL and TG/HDL can be useful in early screening and monitoring of dyslipidemia in the fatty liver patients to prevent cardiovascular diseases.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takuro Okamura ◽  
Yoshitaka Hashimoto ◽  
Masahide Hamaguchi ◽  
Akihiro Obora ◽  
Takao Kojima ◽  
...  

Abstract Background In this study, to clarify the evolving background of people with non-alcoholic fatty liver disease (NAFLD), we compared the current prevalence of NAFLD with that of 2 decades ago. Methods We included two cohorts. The past cohort was from 1994 to 1997 and included 4279 men and 2502 women. The current cohort was from 2014 to 2017 and included 8918 men and 7361 women. NAFLD was diagnosed by abdominal ultrasonography. Results The prevalence of NAFLD increased in both genders throughout these 2 decades (18.5% in the past cohort and 27.1% in the current cohort for men; and 8.0% in the past cohort and 9.4% in the current cohort for women). The prevalence of hyperglycemia increased, whereas the prevalence of low high-density lipoprotein cholesterol levels and hypertriglyceridemia significantly decreased. There was no significant difference in the mean body mass index. Multivariate analysis revealed that the prevalence of obesity and body mass index were significantly associated with the prevalence of NAFLD in both the past and current cohorts. Conclusions The incidence of NAFLD significantly increased throughout these 2 decades, and obesity is the most prevalent factor. Thus, body weight management is an essential treatment option for NAFLD.


Author(s):  
N. A. Nosko ◽  
O. M. Rud

Objective — to systematize literature data on the presence of 677C > T and 1298A > C polymorphisms in the MTHFR gene and homocysteine levels in patients with non‑alcoholic fatty liver disease (NAFLD); to calculate the frequencies 677C > T and 1298A > C polymorphisms combinations in the MTHFR gene and their impact on NAFLD development; to compare homocysteine levels in patients with and without NAFLD. Materials and methods. The analysis has been performed for the results of investigation of 49 patients, from them 17 subjects with NAFLD and 32 without it. Clinical, laboratory, statistical and ontological methods were used in the study. The MTHFR 677C > T and MTHFR 1298A > C polymorphisms in the MTHFR gene were investigated with the use of real time polymerase chain reaction (RT‑PCR) technique. Homocysteine levels were determined with chemiluminescent immunoassay with reference values 3.7 — 13.9 µmol/L. Multiple logistic regression method was used to evaluate the effects 677C > T and 1298A > C polymorphisms in the MTHFR gene on NAFLD development. Results. The variant of combination of 667С/С/1298А/А polymorphisms in the MTHFR gene (absence of mutation) was reveled in 6 (12 %) persons, that showed a widespread prevalence of variants with the presence of mutations. The correlation between variants of 677C > T and 1298A > C polymorphism in the MTHFR gene has been established (r = 0.429; p < 0.05). The results of multiple logistic regression demonstrated absence of the significant effects of 677C > T and 1298A > C polymorphisms in the MTHFR gen on NAFLD development (p > 0.05). Comparison of the homocysteine levels in patients with and without NAFLD didn’t reveal significant difference (р > 0.05), as well as comparison in the groups with combinations of 677C > T and 1298А > С polymorphisms in the MTHFR gen (р > 0.05). This can be explained by the fact that NAFLD group consisted of manly young patients without hypertension, type 2 diabetes mellitus and severe liver fibrosis. Conclusions. Ontological systematization of the scientific data on NAFLD revealed that 677C > T and 1298A > C polymorphisms in the MTHFR gen are pathogenetically associated with the significant increase in homocysteine levels as a marker of cardiovascular pathology. Giving the multifactorial nature of hyperhomocysteinemia and wide spread of 677C > T and 1298A > C polymorphisms in the MTHFR gen in population, it seems to be impractical to use genetic investigations for MTHFR gen polymorphism in NAFLD patients routinely, but only for the purpose of differential diagnosis of hyperhomocysteinemia.  


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Essam Mohamed Byoumy ◽  
Moataz Mohamed Sayed ◽  
Shereen Abo Baker Abd El-Rahman ◽  
Sara Abd Elkader Al-Nakib ◽  
Mohamed Magdy Salama ◽  
...  

Abstract Background Ectopic hepatic lipid accumulation is closely related to the development of insulin resistance, which is regarded as one of the most significant risk factors of non-alcoholic fatty liver disease (NAFLD). The aim of the study was to evaluate and validate the diagnostic value of serum vaspin, NAFLD Fibrosis Score and sonograghic parameters in detection and quantification of liver steatosis and determining further need for liver biopsy or other means to establish NAFLD diagnosis. Methods This study was carried out on 60 patients having bright liver in ultrasonography and 30 healthy persons as controls. The subjects were divided into the following groups; group A: 30 age and sex matched healthy volunteers (control group), group B: 20 patients with fatty liver grade I, group C: 20 patients with fatty liver grade II and group D: 20 patients with fatty liver grade III. Results serum vaspine levels and NAFLD fibrosis score, were significantly higher in patients than in controls with p-value:&lt;0.001. There was a significant positive correlation between NAFLD fibrosis score and serum vaspin and ultrasonographic findngs of NAFLD with p-value: &lt;0.001. Conclusion Vaspin seem to be the most suitable non-invasive biomarker in predicting both intrahepatic lipid contents in NAFLD group.


2018 ◽  
Vol 6 ◽  
pp. 205031211774522 ◽  
Author(s):  
Arash Akhavan Rezayat ◽  
Malihe Dadgar Moghadam ◽  
Mohammad Ghasemi Nour ◽  
Matin Shirazinia ◽  
Hamidreza Ghodsi ◽  
...  

Background/aims: Non-alcoholic fatty liver disease is one of the most common chronic liver diseases. Some risk factors are known to influence the development of non-alcoholic fatty liver disease, but the effect of tobacco smoking on the progression of non-alcoholic fatty liver disease is controversial. The main goal of this systematic review and meta-analysis is to investigate the association between smoking and non-alcoholic fatty liver disease. Method: Electronic databases (PubMed, Scopus, and ISI Web of Science) were searched to find published articles on non-alcoholic fatty liver disease and smoking until December 2016. All relevant studies were screened by inclusion and exclusion criteria and compatible studies were chosen. The Newcastle–Ottawa Scale was used to assess the methodological quality of eligible articles. Subsequently, information was gathered based on the following: author, publication year, keywords, country, inclusion and exclusion criteria, main results, study design, conclusion, and confounder variables (age, body mass index, gender, ethnicity, and diabetes). Finally, analyses were performed using Comprehensive Meta-Analysis Software. Results: Data were extracted from 20 observational studies (9 cross-sectional, 6 case-control, 4 cohort studies, and 1 retrospective cohort study). A significant association was observed between smoking and non-alcoholic fatty liver disease with a pooled odds ratio of 1.110 (95% confidence interval, 1.028–1.199), p-value = 0.008. The statistical heterogeneity was medium with an I2 of 40.012%, p-heterogeneity = 0.074. Also there was a significant relation between non-alcoholic fatty liver disease and passive smoking with a pooled odds ratio of 1.380 (95% confidence interval, 1.199–1.588; p-value = 0.001; I2 = 59.41; p-heterogeneity = 0.117). Conclusion: Our meta-analysis demonstrated that smoking is significantly associated with non-alcoholic fatty liver disease. Further prospective studies exploring the underlying mechanisms of this association should be pursued. Also passive smoking increases the risk of non-alcoholic fatty liver disease about 1.38-fold. The effects of smoking cigarettes on active smokers (current smoker, former smoker, and total smoker) are less than passive smokers. Further studies are needed to compare the of effects of passive and active smoking on non-alcoholic fatty liver disease.


2018 ◽  
Vol 50 (4) ◽  
Author(s):  
Muhammad saad Jibran

OBJECTIVE: To determine the association between non alcoholic fatty liver disease and coronary artery disease. METHODOLOGY: This cross sectional study is conducted from July 2016 to December 2016, in cardiology unit, Lady reading hospital. By using non probability consecutive sampling, patients of all age groups and either gender, presenting to cath: lab for coronary angiography, indicated for angina CCS III, were included in the study. All patients fulfilling inclusion and exclusion criteria were subjected to screening for NAFLD by using ultrasonography. Patients were classified into having no, mild, moderate and sever NAFLD. Correlation between NAFLD and CAD, confirmed on cath: studies, was done using Spearman’s rho test. RESULTS: Total of 370 patients with mean age of 55.36 ± 10.07 years were enrolled in the study, of which 44.6% were females. Known risk factors for CAD like Diabetes mellitus, hypertension, and smoking were present in 63.5%, 64.9% and 23% respectively. 28.4% of patients had no NAFLD, 28.4% had mild, 28.4% had moderate and 14.4% had sever NAFLD. 12.2% had no CAD while mild, moderate and sever disease was present in 36.5%, 31.1% and 2.3% respectively. By using chi square test co relation co efficient between NAFLD and CAD was calculated and came out to be 285.536 ( p value <0.000). NAFLD also increased the odds of having CAD by 2.9 times with a p value for odd ratio <0.000. CONCLUSION: NAFLD is strongly associated as an independent risk factor with CAD and increases the odds of having CAD. KEY WORDS:  NAFLD= Non alcoholic fatty liver disease, CAD= Coronary artery disease, CCS= Canadian classification scale, Cath:= Cardiac catheterization


2019 ◽  
Author(s):  
Felix Kanyi Macharia ◽  
Peter Waweru Mwangi ◽  
Abiy Yenesew ◽  
Frederick Bukachi ◽  
Nelly Murugi Nyaga ◽  
...  

ABSTRACTBackgroundNon-alcoholic fatty liver disease (NFLD) is the hepatic manifestation of the metabolic syndrome recognized as the most prevalent chronic liver disease across all age groups. NFLD is strongly associated with obesity, insulin resistance, hypertension and dyslipidemia. Extensive research efforts are geared, through pharmacological approach, towards preventing or reversing this.Erythrina abyssinicaLam ex DC is an indigenous tree used widely used in traditional medicine, including for the treatment of liver related diseases, and has been shown to possess hypoglycemic, anti-oxidant, antimicrobial and anti-plasmodia effects. The present study is aimed at establishing the effects ofE. abyssinicaon the development of Non-alcoholic fatty liver disease induced by a high-fat and high-sugar diet in rats,in-vivomodel.MethodsForty rats (40) were randomly divided into five groups: positive control (pioglitazone), Negative control (high fat/high sugar diet), low test dose (200 mg/kg), high test dose (400 mg/kg) and normal group (standard chow pellets and fresh water).The inhibitory effect of the stem bark extract ofE. abyssinicaon the development of NAFLD was evaluated by chronic administration the herb extracts to rats on a high-fat/high-sugar diet. Biochemical indices of hepatic function including serum lipid profile, serum aspartate transaminase and alanine transaminase levels were then determined. Histological analysis of liver samples was carried out to quantify the degree of steato-hepatitis. Liver weights were taken and used to determine the hepatic index. The data was analyzed using one-way ANOVA, and Tukey’s post-hoc tests were done in cases of significance. Histology data was analyzed using Kruskal-Wallis and Dunn’s post-hoc test was done in cases of significance. Significance was set at p<0.05.ResultsThe freeze dried extract ofE. abyssinicahad significant effects onfasting blood glucose[5.43 ± 0.17 (HF/HSD) vs 3.8 ± 0.15 (E 400 mg/kg) vs 4.54 ± 0.09 (E 200 mg/kg) vs. 4.16 ± 0.13 (PIOG) vs. 2.91 ± 0.16 (normal control): P value < 0.0001], andinsulin sensitivity[329.4 ± 13.48 mmol/L · min (HF/HSD) vs. 189.8 ± 12.11 mmol/L · min (E 400 mg/kg) vs. 233.8 ± 6.55 mmol/L· min (E 200 mg/kg) vs. 211.1 ± 7.35 mmol/L · min (PIOG) vs. 142.9 ± 11.94 mmol/L · min: P value < 0.0001],The extract had significant effects on hepatic indices including,hepatic triglycerides(P value < 0.0001),liver weights(P value < 0.0001),liver weight-body weight ratio(P value < 0.0001),serum ALT levels(P value < 0.0001),serum AST(P value < 0.0017),serum total cholesterol(P value < 0.0001),serum triglycerides(P value < 0.0001), andserum LDL-cholesterol(P value < 0.0001). The extracts however showed no significant effects onHDL-cholesterol(P value = 0.4759).Histological analysis showed that the extract appears to possess protective effects against steatosis, inflammation and hepatic ballooning, with the high dose (400mg/kg) being more hepato-protective.ConclusionThe freeze dried stem bark extract ofErythina abyssinicapossesses significant inhibitory effects against the development of NAFLD in Sprague Dawley rats.


Author(s):  
Narges Jani ◽  
Manizheh Azari ◽  
Sina Jafari Ghalekohneh ◽  
Mahdie Hemati ◽  
Javad Mohiti-Ardekani ◽  
...  

Background and Aims: Obesity and hyperlipidemia, diabetes, and malnutrition are among the causes of fatty liver disease. This study compares blood biochemical markers and anthropometric parameters in different grades of fatty liver. Materials and Methods: In this descriptive cross-sectional study, 73 fatty liver patients were studied. The degree of fatty liver disease was divided into three grades on ultrasonography. Anthropometric parameters BMI, waist circumstance, height, weight in the fasting state were evaluated according to the standard protocols. The blood samples were taken and biochemical variables fasting blood sugar, serum glutamic-oxaloacetic transaminase (SGOT), Serum glutamic-pyruvic transaminase (SGPT), calcium, phosphorus, low density lipoprotein (LDL), cholesterol, triglyceride, and others were examined with photometric and HPLC methods. Results: Statistical analysis was significant between grades 1 and 3 of fatty liver (p = 0.006) and body mass index between grades 1 and 3 of fatty liver (p = 0.003). Comparing SGOT between different grades did not show any significant differences. However, comparing Bili Total indicated a significant difference between grades 1 and 2 and 1 and 3. Moreover, statistical analysis of qualitative variables, such as gender, hypertension, smoking, drug, alcohol, heart disease, stomach disease, and kidney disease, was not statistically significant between the three fatty liver groups. Median ± IQR had a significant difference for SGOT and Bili Total (p < 0.05). Conclusion: This study showed the significance of BMI, waist circumstance, and bilirubin factors in different grades of fatty liver. Monitoring BMI, waist circumstance, and bilirubin factors will be useful for susceptible people to non-alcoholic fatty liver disease.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K A Mohamed ◽  
E E Mohamed ◽  
D M Ahmed ◽  
M A Sayed ◽  
A R Hussien

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide, with a prevalence of 15%-30% in Western populations. Non-alcoholic fatty liver disease (NAFLD) has emerged as the most important cause of chronic liver disease related to the increase in incidence of obesity and diabetes mellitus type II in the population. Aim of the Work To predict nonalcholic steatohepatitis in patient with NAFLD through measurement of interleukin 6 to prevent progression of the disease into liver cirrhosis through early diagnosis. Patients and Methods This study was designed to be case control study; it was conducted on 70 patients selected from Internal Medicine and Hepatology outpatient clinics and inpatient wards at Ain Shams University Hospitals from (Jun/2017 to Jul 9/2018) and 20 healthy subjects as control group. Results NASH patients had more obesity (BMI 30) (83.3%) than both simple steatosis patients (57.5%) and control (55.0%). NASH patients had higher BMI as compared to simple steatosis patients and control (p value =0.01). The present study revealed that there is a statistically significant difference between groups according to IL6 (P &gt; 0.001) as IL6 was positive in 70% of patients with NASH while in patients with simple steatosis and control was positive in 25%, 20% respectively. Conclusion NAFLD is a highly prevalent condition, shares many features of the metabolic syndrome (MetS), a highly atherogenic condition. Recommendations Large scale multi-centre studies are recommended to study the prevalence of NAFLD in Egypt. Further studies on the effect of presence of steatosis and increased risk of hepatocellular carcinoma.


2017 ◽  
Vol 2 (2) ◽  
pp. 15-20
Author(s):  
Pooja Maharjan ◽  
Puspa Raj Khanal ◽  
Narayan Prasad Parajuli ◽  
Govardhan Joshi ◽  
Hridaya Parajuli ◽  
...  

Background: Non-alcoholic fatty liver disease (NAFLD) has emerged as the most common liver problem in the western world and is a clinicopathologic entity increasingly recognized as a major health burden in developed countries. Different laboratory tests are extremely useful in achieving a better understanding of diseases, and thereby, allow making decision for better management. The examination of different biochemical parameters usually provides excellent clues to the cause of the disease. The present study was conducted with the aim to assess the biochemical markers in Non alcoholic fatty liver disease (NAFLD) patients in Nepalese population.Methods: The biochemical parameters were investigated in 75 NAFLD patients, and 70 normal participants. The diagnosis of hepatic steatosis was established by abdominal ultrasound examination. All patients diagnosed as NAFLD were investigated for biochemical parameters and see the relationship between NAFLD and control was studied.Results: The findings of all biochemical parameters were raised in NAFLD patients in comparison with non-fatty liver control group and the differences were found to be statistically (P value less than 0.005) significant.Conclusions: NAFLD is associated with changes in biochemical parameters in cases of NAFLD. Its early detection will help in modifying the disease course, delaying complications and will also play a major role in preventive cardiology.Ann. Clin. Chem. Lab. Med. 2016:2(2);15-20


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