scholarly journals OPPORTUNITIES OF ADJUVANT THERAPY WITH PIOGLITAZONE OF NON-ALCOHOLIC FATТУ LIVER DISEASE СO-OCURRING WITH OBESITY

2020 ◽  
Vol 16 (1) ◽  
pp. 22-30
Author(s):  
V.P. Shypulin ◽  
N.G. Melnyk

Relevance. The «Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020» approved by the WHO is dedicated to noncommunicable diseases. Among them - diabetes mellitus, which is a consequence of overweight \ obesity and lack of exercise. Pioglitazone is the only drug on the pharmacological market for the treatment of non-alcoholic steatohepatitis (NASH), regardless of diabetic mellitus status. Currently, the treatment of early NASH in the prevention of both type 2 diabetes and CVD, and amelioration of NASH progression is a priority task. Objective – to study the effectiveness of treatment with pioglitazone in patients with obesity and non-alcoholic fatty liver disease (NAFLD). Materials that methods. 123 patients with obesity 1, 2, 3 classes in combination with NAFLD were included in our research during 3 months. The randomization method of patients was divided into two groups, comparable in age, sex, and body mass index. All patients were offered drug-free treatment that 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 case group adhered to the basic recommendations and received pioglitazone 15 mg / day additionally as a drug treatment. Patients in the control group adhered only to principles of drug-free treatment. Overall, the program consisted of 5 visits over 3 months period. All patients underwent anthropometric measurements, laboratory and instrumental examinations (Ultrasound steatometry) before and after 12 weeks of treatment. Also studied adherence to treatment in two groups of patients using self-report questionnaire. Results. A comparative analysis of the data obtained in patients with obesity and NAFLD from the group of pioglitazone (daily dose of 15 mg) revealed the best major metabolic markers, such as significantly decreased values in waist circumference (p<0,0001), uric acid (p=0,001), thriglycerides (p=0,02) and very low density lipoproteins cholesterol(p=0,003), atherogenic coefficient (p=0,002), fasting insulin (p=0,004) and C-peptide, HOMA-IR index (p=0,01) and increased level of high density lipoproteins cholesterol (p=0,009), respectively. A significant association was found between the target reduction of controlled attenuation parameter and treatment with pioglitazone 15 mg (OR 0,27, 95% CI 0,13–0,56, p=0,001). The dynamics of steatosis had a medium correlation with the final adherence level (r=0,52), regardless of the method of treatment. Conclusions. It was found that in Ukrainians with obesity and NAFLD, moderate steatosis occurs in 73% of cases. Pioglitazone is a significantly highly effective drug for the adjuvant therapy of NAFLD.

2008 ◽  
Vol 78 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Suano de Souza ◽  
Silverio Amancio ◽  
Saccardo Sarni ◽  
Sacchi Pitta ◽  
Fernandes ◽  
...  

Objectives: To evaluate the frequency of non-alcoholic fatty liver disease, the retinol serum levels, lipid profile, and insulin resistance in overweight/obese children. To relate these biochemical variables with the risk of this disease in the population studied. Methods: The study was cross-sectional and prospective, with 46 overweight/obese school children (28 female, 18 male; mean age 8.6 years). The control group consisted of 45 children, paired by age and gender. Hepatic steatosis, evaluated by ultrasound, was classified as normal, mild, moderate, or severe. Also evaluated were serum retinol levels; thiobarbituric acid reactive substances; lipid profile; and fasting glucose and serum insulin levels, used for the calculation of the Homeostasis Model Assessment. Results: Hepatic ultrasound alterations were found in 56.5% and 48,9% of the overweight/obese and control group children, respectively. Presence of obesity was associated with high levels of triglycerides (OR = 4.6; P = 0.002). In the studied children, the risk of steatosis was related to a trend to a higher percentage of retinol inadequacy (OR = 2.8; p = 0.051); there was no association with thiobarbituric acid reactive substances, lipid profile, or insulin resistance. Conclusions: The high frequency of non-alcoholic fatty liver disease in both groups, evaluated by hepatic ultrasound, in low-socioeconomic level children, independent of nutritional condition and without significant association with insulin resistance, emphasizes that especially in developing countries, other risk factors such as micronutrient deficiencies (e.g. vitamin A) are involved.


2019 ◽  
Vol 17 (1) ◽  
pp. 1328-1338
Author(s):  
Yufeng Xing ◽  
Chuantao Zhang ◽  
Fenfen Zhai ◽  
Tianran Zhou ◽  
Xiang Cui ◽  
...  

AbstractCells with non-alcoholic fatty liver disease (NAFLD) were studied to determine the mechanism of liver deficiency via the AdipoR2-PPARa pathway. NAFLD cells were randomly divided into a normal control group, blank control group, model group, low dose group, medium dose group, and high dose group. The NAFLD models were established by incubating the cells with linoleic acid (LA) and palmitic acid (PA) (2:1) for 24 h. The test groups were incubated with different doses of Shugan Xiaozhi Fang extract. The pathological changes in cells that accumulated lipids were detected by Oil Red O staining. Malondialdehyde (MDA) and triglyceride (TG) levels were measured. The apoptosis of cells was evaluated by flow cytometry. The levels of AdipoR2, PPARa, CD36, acyl-CoA mRNA, and protein were confirmed by RT- PCR and Western blot. The results of the Oil Red O staining demonstrated that the NAFLD cell model was successfully established. Compared with the model group, the levels of TG and MDA in the groups that received low, medium, and high doses of Shugan Xiaozhi were significantly lower (P<0.01), and a dose effect was evident. In addition, the expression of AdipoR2, PPARa, CD36, acyl-CoA protein, and mRNA in the Shugan Xiaozhi-treated groups was upregulated. Furthermore, the levels of AdipoR2, PPAR, CD36, acyl-CoA protein, and mRNA in all drug treatment groups that were extracted from L-O2 normal human hepatocytes were significantly upregulated (P<0.01). Moreover, the factor pattern of HepG2 human liver carcinoma cells was similar to that of L-O2. The levels of AdipoR, CD36, acyl-CoA, and AdipoR mRNA in the HepG2 low group were increased (P<0.05). AdipoR, PPAR, CD36, and acyl-CoA protein levels and AdipoR mRNA expression were significantly increased in the intermediate dose group and high dose group (P<0.01). Shugan Xiaozhi Fang attenuates hepatic lipid deposition in NAFLD induced by incubating with LA and PA for 24 h, which is associated with the activation of the AdipoR2-PPARα pathway.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takuya Kawamura ◽  
Hiroaki Tanaka ◽  
Ryota Tachibana ◽  
Kento Yoshikawa ◽  
Shintaro Maki ◽  
...  

AbstractWe aimed to investigate the effects of maternal tadalafil therapy on fetal programming of metabolic function in a mouse model of fetal growth restriction (FGR). Pregnant C57BL6 mice were divided into the control, L-NG-nitroarginine methyl ester (L-NAME), and tadalafil + L-NAME groups. Six weeks after birth, the male pups in each group were given a high-fat diet. A glucose tolerance test (GTT) was performed at 15 weeks and the pups were euthanized at 20 weeks. We then assessed the histological changes in the liver and adipose tissue, and the adipocytokine production. We found that the non-alcoholic fatty liver disease activity score was higher in the L-NAME group than in the control group (p < 0.05). Although the M1 macrophage numbers were significantly higher in the L-NAME/high-fat diet group (p < 0.001), maternal tadalafil administration prevented this change. Moreover, the epididymal adipocyte size was significantly larger in the L-NAME group than in the control group. This was also improved by maternal tadalafil administration (p < 0.05). Further, we found that resistin levels were significantly lower in the L-NAME group compared to the control group (p < 0.05). The combination of exposure to maternal L-NAME and a high-fat diet induced glucose impairment and non-alcoholic fatty liver disease. However, maternal tadalafil administration prevented these complications. Thus, deleterious fetal programming caused by FGR might be modified by in utero intervention with tadalafil.


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.


2021 ◽  
Vol 6 (8) ◽  

Background and Aim: Non-Alcoholic Fatty Liver Disease (NAFLD) has become the most common liver disorder with increased liver related and non-related complications and mortality as a result of increasing obesity, type 2 diabetes and metabolic syndrome (MetS). The current study aims to evaluate the efficacy of adjuvant phosphatidylcholine in treating patients with NAFLD. Methods: This interventional randomized controlled study recruited 100 patients with NAFLD and MetS randomized into: a control group (n=50) that received standard care of life style modifications and an intervention group (n=50) that received phosphatidylcholine (2100 gm/day) plus standard care. Both groups received health education through clinical pharmacist for achieving sustainable weight loss for 6 months. Body mass index (BMI), waist and hip circumference, liver function, lipid profile, homeostasis model of assessment-insulin resistance (HOMA-IR) score, NAFLD-fibrosis score, steatosis score and liver stiffness measurement by transient elastography were recorded at baseline, 3 and 6 months. Results: Intervention group showed significantly (p<0.05) higher number with normalized; alanine aminotransferase, total cholesterol and low density lipoprotein at midpoint and endpoint, aspartate amiontransferase at midpoint and high density lipoproteins and malondaldehyde at endpoint. Intervention group showed a significantly higher participants’ number who shifted to more favorable category of NAFLD-fibrosis score (p=0.02), radiological fibrosis stage (p=0.015) at endpoint, radiological steatosis grades and HOMA-IR score at midpoint and endpoint (p<0.05). Additionally, significant number of participants in intervention group (34%) lost MetS components compared to (10%) in control group at endpoint (p=0.004). Conclusion: Adjuvant phosphatidylcholine has shown laboratory, radiological and clinical benefits in the management of Egyptian patients with NAFLD and ameliorate MetS parameters.


2016 ◽  
Vol 23 (4) ◽  
pp. 2016416
Author(s):  
Iryna Vakalyuk ◽  
Nataliya Virstyuk ◽  
Vitaliy Petryna

Quality of life assessment is an integral part of a comprehensive treatment in modern medical practice. Analysis of quality of life of patients with comorbidities is an interesting and poorly understood issue. The objective of the research was to evaluate the quality of life of patients with postinfarction cardiosclerosis depending on the presence and progression of non-alcoholic fatty liver disease (NAFLD).Material and methods. The research included 300 patients with stable coronary artery disease (CAD). They included 160 patients without NAFLD (Group I) and 140 patients with NAFLD (Group II). 89 patients of Group II suffered from non-alcoholic liver disease (NALD) and 51 patients from non-alcoholic steatohepatitis (NASH). The control group consisted of 20 apparently healthy individuals. SF-36 and MacNew questionnaires were used to assess the quality of life. Results. The overall estimate according to SF-36 questionnaire detected a significant decrease in the patient’s quality of life due to their low physical activity, mental ill-being, limitation of daily activities, significant effect of pain and low assessment of their health. Decrease in the quality of life was clearly dependent on NAFLD stage and was the lowest in case of NASH. The overall estimate of quality of life according to MacNew questionnaire was 1.5 times lower in patients of Group I compared to the control group, decreased almost by 1.4 times in patients with NALD compared to Group I and was 1.5 times lower in case of NASH compared to the patients with NALD (p<0.05). Conclusions. Patients with stable CAD combined with NAFLD were characterized by decrease in quality of life due to its physical, psycho-emotional and social components. Quality of life of patients with postinfarction cardiosclerosis depended on NAFLD progression and was the lowest in case of NASH.


Author(s):  
Sara Ameen Nafeer ◽  
Munaf Zalzala

Non-alcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver diseases worldwide, which characterized by steatosis, inflammation, and fibrosis. The aim of this designed study is to evaluate the ability of guggulsterone to prevent high fat diet induced steatohepatitis in mice. Five groups of male mice were selected and treated as the following: group I, mice had free access to standard commercial diet and considered as control group, group II, mice were fed a specially formulated high-fat diet for 12 weeks to induce non-alcoholic liver disease, while groups III, IV and V the mice were administered high fat diet containing guggulsterone at 500, 1000 and 2000 ppm concentration respectively for 12 weeks. Maintaining mice on fat rich diet only resulted in inducing the metabolic and histological NAFLD associated. While the treatment with guggulsterone significantly improves the evaluated markers. These results demonstrate guggulsterone may be useful in preventing the development of steatohepatitis.


2019 ◽  
Vol 16 (1) ◽  
pp. 39-45
Author(s):  
Cemal Kemaloglu ◽  
Melek Didem Kemaloglu

Objective: The aim of this study is to identify the relationship between carotid intima-media thickness (c-imt) and non-alcoholic fatty liver disease (NAFLD), and to determine whether NAFLD is an independent predictor for the progression of atherosclerosis.  Method: This is a prospective randomized controlled study. 103 NAFLD patients who have hepatosteatosis with grade II and above were enrolled in this study. Patients were divided into NAFLD with metabolic syndrome (MS) and NAFLD without MS groups and compared with 50 healthy people. Basal demographic characteristics and C-imt of all patients and control group were measured.  Results: C-imt and carotid cross sectional area rates in the NAFLD groups were significantly higher than those in the control group. The mean and max. c-imt levels were significantly higher in the NAFLD group with metabolic syndrome (p<0,001). Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR) levels were increased in the group with metabolic syndrome than those in the group without metabolic syndrome, with statistical significance (p<0.001). There was no difference in c-imt levels between HOMA-IR positive and negative groups (p=0.254) in patients with NAFLD and without metabolic syndrome. There was only a mild positive corelation between c-imt levels and high sensitive C-Reactive protein (hs-CRP) levels in metabolic syndrome positive group (p=0.026 r=0.30).  Conclusion: NAFLD was a significant predictor to determine the increased risk of carotid atherosclerosis. 


2020 ◽  
Vol 124 (4) ◽  
pp. 450-456
Author(s):  
Abbas Ali Sangouni ◽  
Mohammad Reza Mohammad Hosseini Azar ◽  
Mohammad Alizadeh

AbstractNon-alcoholic fatty liver disease (NAFLD) includes a range of disorders from simple steatosis to non-alcoholic steatohepatitis. There is no proven drug treatment for NAFLD, and diet modification is considered part of the main line of treatment for this disease. The aim of this study was to investigate the efficacy of garlic supplementation in NAFLD patients. The effect of garlic powder supplementation on hepatic steatosis, liver enzymes and lipid profile was investigated in NAFLD patients. Ninety NAFLD patients were randomly assigned to take either a garlic powder supplement or a placebo for 12 weeks. The treatment group received four tablets of garlic daily (each tablet contained 400 mg garlic powder). The control group received four tablets of placebo (each placebo contained 400 mg starch). At the end of the study, hepatic steatosis was significantly reduced in the treatment group compared with the control group (P = 0·001). In addition, a significant decrease was seen in the serum concentration of alanine transaminase (P < 0·001), aspartate transaminase (P = 0·002), γ-glutamyltransferase (P = 0·003) as well as total cholesterol (P = 0·009), TAG (P < 0·001), HDL-cholesterol (P < 0·001) and LDL-cholesterol (P = 0·01) in the treatment group compared with the control group. No significant difference was seen between the two groups in serum concentration of alkaline phosphatase. Overall, garlic powder supplementation improved hepatic features and lipid profile among NAFLD patients.


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


Sign in / Sign up

Export Citation Format

Share Document