scholarly journals EFFECTIVENESS OF TREATMENT WITH PІOGLITAZONE IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND CONCOMITANT METABOLIC SYNDROME DEPENDING ON PRESENCE RS 1801282 (PRO12ALA) POLYMORPHISM IN GENE PPAR-γ

2019 ◽  
Vol 15 (1-2) ◽  
pp. 25-33 ◽  
Author(s):  
V.P. Shypulin ◽  
L.M. Parunyan ◽  
V.V. Tishhenko ◽  
О.К. Kolyada ◽  
O.M. Ponomarov ◽  
...  
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Gene Polymorphism ◽  
Weight Loss Program ◽  
Pro12ala Polymorphism ◽  
Alcoholic Fatty Liver ◽  
Ppar Γ ◽  
Group 2 ◽  
Alcoholic Fatty Liver Disease ◽  
Group 1

Relevance. Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease on the one hand, and on the other, remains an unnoticed significant risk factor for cardiovascular disease. The course of NAFLD is often exacerbated by concomitant metabolic syndrome (MS). Existing medication for NAFLD has shortcomings in its efficacy and focus on non-alcoholic steatohepatitis (NASH). Given the lack of effective medication registered for NASH, optimizing NAFLD treatment is an urgent task. Pioglitazone (PPAR-γ agonist) is an insulin sensitizer recommended for the treatment of NASH after liver biopsy. The lack of efficiency of pioglitazone is probably due to the pleiotropic effect of PPAR-γ gene. Among the mutations of PPAR-γ gene, the most common Pro12Ala polymorphism. The PPAR-γ gene is a nuclear transcriptional regulation protein that affects adipocyte differentiation, fatty acid metabolism, and insulin sensitivity. Studies in Ukraine regarding the efficacy of pioglitazone in the treatment of NAFLD in combination with MS, depending on presence rs 1801282 (Pro12Ala) polymorphism in PPAR-γ gene, have not been performed previously. Objective - to study the effectiveness of treatment with pioglitazone in patients with NAFLD and MS, depending on presence rs 1801282 (Pro12Ala) polymorphism in gene PPAR-γ. Materials that methods. 93 patients with NAFLD and concomitant MS participated in the clinical-genetic intervention study. The randomization method of patients was divided into two groups, comparable in age, sex, and body mass index. All patients were offered a comprehensive weight loss program consisting of a 12-week follow-up. The comprehensive weight loss program included lifestyle modification: a reduction in diet of 500 kcal from the physiological daily energy expenditure and its physical activity for 150-200 min per week, the problems of adherence to recommendations were additionally discussed during the visits. The patients of the first group adhered to the comprehensive weight loss program and received pioglitazone 15 mg / day. Patients in the second group adhered only to comprehensive weight loss program. Overall, the program consisted of 5 visits over a 12-week period. All patients underwent a molecular genetic study of detecting rs 1801282 (Pro12Ala) polymorphism in PPAR-γ gene, as well as anthropometric measurements, laboratory and instrumental examinations (Ultrasound steatometry) before and after 12 weeks of treatment. Results. Comparative analysis revealed that patients with NAFLD and MS in group 1 who adhered to comprehensive weight loss program and received pioglitazone at a daily dose of 15 mg had a more significant decrease in controlled attenuation parameter (p <0.05) compared with patients in group 2, which only the comprehensive weight loss program complied. In group 1, liver steatosis rates had a direct correlation with BMI (r = 0.33), visceral fat (r = 0.475), ALT (r = 0.42), TG (r = 0.48), fasting insulin (r = 0.38). The prevalence of minor allele 12Ala rs 1801282 of the PPAR-γ gene polymorphism in patients with NAFLD in combination with MS is 15%. Group 1 patients showed an association (p = 0.03) of the presence of 12Ala rs 1801282 allele in PPAR-γ gene polymorphism with a decrease of controlled attenuation parameter score, OR = 8.6 (95% CI 1.0–78.7). Patients in Group 2 found no association (p = 0.59) in the reduction of steatosis score with the presence of  12Ala allele, HS = 1.6 (95% CI 0.3–8.0). Conclusions. In patients with NAFLD and concomitant MS, additional prescribing to the comprehensive weight loss program of pioglitazone (15 mg / day for 12 weeks) is likely to reduce steatosis. In patients with NAFLD in combination with MS, there is an association of the presence of 12Ala allele in PPAR-γ gene polymorphism and the effectiveness of pioglitazone 15 mg, OR = 8.6 (95% CI 1,0-78.7) compared to 12Pro allele.

Association between the Pro12Ala polymorphism of PPAR-γ gene and the non-alcoholic fatty liver disease: A meta-analysis

Gene ◽  
2013 ◽  
Vol 528 (2) ◽  
pp. 328-334 ◽  
Author(s):  
Jun Wang ◽  
Xufeng Guo ◽  
Pengbo Wu ◽  
Jia Song ◽  
Chuncui Ye ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Meta Analysis ◽  
Pro12ala Polymorphism ◽  
Alcoholic Fatty Liver ◽  
Ppar Γ ◽  
Alcoholic Fatty Liver Disease

scholarly journals THE ISSUE OF ADHERENCE TO TREATMENT OF OBESE PATIENTS IN COMBINATION WITH NON-ALCOHOLIC FATTY LIVER DISEASE

2020 ◽  
Vol 2 (12) ◽  
pp. 62-70
Author(s):  
Vadym P. Shypulin ◽  
Nataliia G. Melnyk
Keyword(s):  
Weight Loss ◽  
Negative Correlation ◽  
Weight Loss Program ◽  
Self Report ◽  
Moderate Physical Activity ◽  
Adherence To Treatment ◽  
Strong Negative Correlation ◽  
Alcoholic Fatty Liver ◽  
Group 2 ◽  
Group 1

The aim – to study the effect of adherence to treatment in patients with obesity in combination with NAFLD on the effectiveness of treatment of NAFLD Materials that methods. 93 patients with obesity 1,2,3 degrees (BMI = 30-44.9 kg \ m2) in combination with NAFLD were examined. The patients were divided into two groups by randomization. They were offered a comprehensive weight loss program consisting of 5 visits over 12 weeks. The comprehensive weight loss program included: a reduction in the energy diet by 500 kcal from physiological daily energy expenditure and a moderate physical activity of 150-200 min per week. The patients of the first group adhered to the comprehensive weight loss program and received pioglitazone 15 mg / day. Patients of the second group adhered only to comprehensive weight loss program. We studied adherence to treatment in two groups of patients using self-report questionnare. The survey on Obesity WGO recommendations was also conducted. All patients underwent anthropometric measurements, laboratory and instrumental examination. Results. The comparative analysis revealed that patients with obesity and NAFLD in group 1, who followed a comprehensive weight loss program and received pioglitazone at a daily dose of 15 mg, had significantly better adherence rates (70.4%) (p <0, 05) compared with patients in Group 2 (59.6%) who followed only a comprehensive weight loss program. It was found that in patients of group 1, controlled attenuation parameter had a strong negative correlation with the level of adherence to treatment (r = -0,71), compared with patients in group 2, where there was an medium negative correlation (r = -0.56). It was found that the level of adherence to treatment had a medium negative correlation with the number of previous attempts to lose weight (r = -0.52) and the duration of obesity (r = -0.49). Conclusions. Patients who received pioglitazone 15 mg / day in addition to comprehensive weight loss program were likely to have better adherence rates and, as a consequence, a more significant decrease in steatosis. It is revealed that the level of adherence to treatment depends on the number of previous attempts to lose weight and the duration of obesity.

scholarly journals The effect of non-alcoholic fatty liver disease on the functional state of the kidneys in patients with chronic heart failure

2021 ◽  
pp. 35-42
Author(s):  
M. E. Statsenko ◽  
S. V. Turkina ◽  
S. V. Fabritskaya ◽  
N. N. Shilina ◽  
M. N. Titarenko ◽  
...  
Keyword(s):  
Heart Failure ◽  
Insulin Resistance ◽  
Liver Disease ◽  
Chronic Heart Failure ◽  
Functional State ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Group 2 ◽  
Alcoholic Fatty Liver Disease ◽  
Group 1

Aim: to study the functional state of the kidneys in patients with chronic heart failure (CHF) and non-alcoholic fatty liver disease (NAFLD).Materials and methods. 144 patients with CHF aged 45-70 years were divided into two groups: group 1 — persons with CHF and NAFLD, group 2 — CHF without NAFLD. A clinical examination was performed, the indices of FLI steatosis and NFS liver fibrosis were calculated, the functional state of the kidneys and the adipokine status were evaluated.Results. The main group of patients with CHF and NAFLD is mainly represented by people with grade I obesity (73 (84%) vs 5 (9%), p<0.05). Among patients with CHF and NAFLD, a clinically significant decrease in GFR<60 ml/min/1.73 m2 was significantly more often detected compared to patients with CHF without NAFLD (37% vs 21% in groups 1 and 2, respectively). The level of albuminuria was significantly higher in the group of patients with CHF and NAFLD (200.7±22.3 [54.7;390] vs 92.6±23.4 [10.2;188.7] mg/g in groups 1 and 2, respectively). The percentage of individuals with an AU/CR. urine ratio >30 mg/g was statistically significantly higher in group 1 compared to group 2 (82.1 vs 51.1% in groups 1 and 2, respectively). The level of serum leptin was significantly higher and the concentration of serum adiponectin was significantly lower compared to group 2 in the main group of patients with CHF and NAFLD compared to the control group. There was a significantly higher occurrence of insulin resistance in patients with CHF and NAFLD. Correlation analysis revealed the presence of statistically significant associations between the parameters characterizing the functional state of the kidneys and the indices of FLI, NFD, adipokines, and the severity of insulin resistance.Conclusion. In patients with CHF and NAFLD, a significant deterioration in the functional state of the kidneys was found, in comparison with patients with “isolated” CHF with comparable FC.

scholarly journals Patient disease knowledge, attitudes and behaviours related to non-alcoholic fatty liver disease: a qualitative study

2021 ◽  
Vol 8 (1) ◽  
pp. e000634
Author(s):  
Monica A Tincopa ◽  
Jane Wong ◽  
Michael Fetters ◽  
Anna S Lok
Keyword(s):  
Social Support ◽  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Health Behaviour ◽  
Fatty Liver Disease ◽  
Primary Therapy ◽  
Alcoholic Fatty Liver ◽  
Medical Comorbidities ◽  
Alcoholic Fatty Liver Disease

ObjectiveDespite clear evidence that weight loss via nutritional and physical activity changes improves histological outcomes in non-alcoholic fatty liver disease (NAFLD), many patients struggle to implement and maintain these health behaviour changes. The aim of this study was to characterise disease knowledge, attitudes and behaviours among persons with NAFLD and to identify the factors driving these health behaviours and perceptions.DesignWe conducted semistructured interviews among patients with NAFLD. We used purposeful sampling to enroll equivalent percentages based on age and sex, and enrolled approximately one-third of patients with cirrhosis to capture those perspectives. Interviews were conducted until thematic saturation was achieved. Transcripts were coded using NVivo software to identify themes and subthemes.ResultsA total of 29 patient interviews were completed. Ambiguity about the diagnosis and aetiology of their liver disease was a key theme, though the vast majority of patients were aware that weight loss via nutrition and exercise was the primary therapy. Most patients were asymptomatic, diagnosed incidentally, and reported low level of concern regarding their diagnosis. The primary barriers and facilitators to health behaviour change were the presence of social support, competing medical comorbidities and low motivation to change behaviours.ConclusionsAlthough patients are aware that lifestyle interventions are the primary therapy for NAFLD, there is a gap in knowledge about the condition. The presence of social support and competing medical comorbidities were the most consistent facilitators and barriers to lifestyle change. Tailoring treatment recommendations to provide relevant disease education, specific nutrition and exercise regimens, and personalised approaches based on specific individual barriers and facilitators will likely aid in uptake and maintenance of first-line therapy for NAFLD.

scholarly journals A 12-week multi-component dietary intervention improves markers of non-alcoholic fatty liver disease in Irish patients in tertiary care

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Deirdre Ní Fhloinn ◽  
Ciara Wright ◽  
Sara Naimimohasses ◽  
Stephen Finn ◽  
Suzanne Norris ◽  
...  
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Dietary Intervention ◽  
Tertiary Care ◽  
Intervention Group ◽  
Post Intervention ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

AbstractNon-alcoholic fatty liver disease (NAFLD) is a significant public health concern closely linked to obesity, affecting an estimated 25% of adults in Europe. Understudied in Ireland, the aim of this research was to examine the effects of a 12-week multi-component dietary intervention on weight loss and markers of liver injury in Irish NAFLD patients in tertiary care. Biopsy confirmed NAFLD patients (n = 27) were recruited from St James’ Hospital in Dublin, Ireland. Consenting participants underwent a 12-week moderate-intensity intervention incorporating weekly group nutritional education, behavioural change and group support, as well as individualised advice and weigh-ins from a trained nutritionist. Control group participants were given routine clinical care. All participants were clinically reviewed before, immediately after, and 3 months post intervention. Individuals (n = 12) with histological evidence of steatohepatitis underwent a repeat liver biopsy on completion of the intervention. Detailed dietary assessment was performed using both a 4-day diet diary (4DDD) and a novel, recently validated, short food frequency questionnaire (SFFQ) designed specifically to assess habitual intakes of food items related to NAFLD. Nutrient intakes were analysed using myFood24TM dietary analysis software, and the Mediterranean diet quality score (MDQS) was used to assess the overall change in dietary patterns. Of the 15 participants who completed the intervention, 80% (n = 12) achieved a weight loss exceeding 5%, with 47% (n = 7) achieving > 7%. There were significant improvements from baseline to week 12 in the intervention group for the majority of clinical parameters including HbA1c (p = 0.0054), liver enzymes (ALT, p = 0.0108; GGT, p = 0.0001) and transient elastography (kPA, p = 0.0308; CAP, p = 0.0081). However, these results failed to maintain significance when analysed compared to controls. The overall dietary pattern was significantly improved after 12 weeks as assessed by the MDQS (p = 0.03), with no apparent compromise in micronutrient intake despite the energy reduction. Reductions in energy, saturated fat, carbohydrate and sugar intakes at 12 weeks, were maintained at three months follow up. Analysis of pre- and post-intervention liver biopsies in the intervention group demonstrated a clinically significant improvement in NAS score (p = 0.0273), attributable to reductions in hepatic steatosis (p = 0.0078). A significant correlation was observed between improvement in liver histology and change in sugar intake (r = 0.7534, p = 0.0093). Although results were somewhat limited by small sample size, nutritional education achieved beneficial dietary changes that persisted after the intervention ceased. Notably, achieving reductions in sugar intakes may be particularly beneficial in reducing the severity of hepatic steatosis in Irish adults with NAFLD.

scholarly journals KLB gene polymorphism is associated with obesity and non-alcoholic fatty liver disease in the Han Chinese

Aging ◽  
2019 ◽  
Vol 11 (18) ◽  
pp. 7847-7858 ◽  
Author(s):  
Fang Ji ◽  
Ye Liu ◽  
Jun-Gui Hao ◽  
Li-Ping Wang ◽  
Ming-Jia Dai ◽  
...  
Keyword(s):  
Liver Disease ◽  
Gene Polymorphism ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Han Chinese ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease
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