scholarly journals Combined use of metformin and Pioglitazone than metformin alone in Glucose intolerance patients with Nonalcoholic fatty liver disease showed significant Radiological and Biochemical improvement

2015 ◽  
Vol 22 (2) ◽  
pp. 188-194
Author(s):  
Mohammod Feroz Amin ◽  
Syeda Rezina Sultana ◽  
Indrajit Prasad ◽  
Muhammad Abdur Rahim ◽  
Md Anisur Rahman ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Final Visit ◽  
Open Label ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Study Population ◽  
Group 2 ◽  
Group 1

Context: Non Alcoholic Fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome. The pathogenesis of steatosis and cellular injury is thought to be related mostly to insulin resistance. Insulin sensitizing drugs showed promising results in number of trials. This was an open label clinical trial in newly detected glucose intolerant patients with NAFLD, to evaluate the effectiveness and superiority of pioglitazone and metformin combination to metformin alone. Methods: Forty nine patients with newly detected abnormal glucose tolerance, naïve to any anti diabetic drug, were randomly selected, from the gastroenterology out-patient department of BIRDEM Hospital, Dhaka, with the findings of ultasonographic changes of fatty liver and raised ALT and assigned to 6 months treatment with pioglitazone 30 mg plus metformin 1700 mg daily (Group 1, n=27) or only metformin 1700 mg alone (Group 2, n=22). Results: Mean age of the study population was 45.80±8.54 years, Male female distribution of the study subjects were 65.3% and 34.7% respectively. Significant reduction of ALT, F, ABF, HbA1c, cholesterol, triglyceride of the study population were achieved either by metformin alone or with combination after six months (visit 1 vs visit 3, ALT: 97.99+22. vs 55±17.49 u/ l; Fasting sugar: 9.1+1.9 vs6.64±0.94, mmol/l; ABF: 13.3±2.5 vs 8.69±1.21 mmol/l; HBA1c: 8.1±0.9 vs 6.87±0.57%; Cholesterol: 205.9±30.1 vs 186.12±22.26 mg/dl; TG: 230.4+48.1 vs 166.2±31.82). In comparison between two groups, Group 1 had found to be significantly better glycemic control compared to their counterpart at the end of 6 months (Group 1 vs Group 2, FBG: 6.37±0.56 vs 6.98±1.2; ABF: 8.34±0.84 vs 9.1±1.46; serum cholesterol, TG, and ALT levels were also found to be significant change as Cholesterol: 178.89±18.59 vs 195±23.55 mg/dl; TG: 155.85±20.99 vs 178.91±38.24 mg/ dl; ALT: 55±17.49 vs 45.74±12.63 u/L. In final visit, ultrasonographic change also found to be significantlyimproved from fatty change to normal in patients with both metformin and pioglitazone group than patients on metformin alone. Conclusion: Treatment of NAFLD of newly detected Type 2 DM or IGT patients with high ALT by both metformin and pioglitazone is more effective in reduction of ALT and lipids and also able to reverse the severity of fatty changes of liver towards normal significantly. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21540 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 188-194

scholarly journals Metabolic Syndrome in Adults with Nonalcoholic Fatty Liver Disease

2021 ◽  
Vol 5 (2) ◽  
pp. 34-37
Author(s):  
Zhahid Hassan ◽  
Muzamil Latief ◽  
Mahroosa Ramzan ◽  
Farhat Abbas ◽  
Summyia Farooq
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Care Hospital ◽  
Nonalcoholic Fatty Liver ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, obesity, and other features of metabolic syndrome. It is identified as the most common cause of liver enzyme derangement. Lately, NAFLD has generated interest in exploring treatment options, including weight loss and dietary interventions. An association of NAFLD with metabolic syndrome has been suggested in contemporary literature. In this study, we attempted to look into the association of NAFLD with metabolic syndrome. In this study, 80 adult NAFLD patients were recruited from a tertiary care hospital. Among these, 42 were males and 38 females with a mean age of 44.46±13.146 years (range 18–82 years). Grades of fatty liver and presence or absence of metabolic syndrome were studied in this patient population. Patients who did not qualify for the criteria of met-abolic syndrome were placed in Group 1 and those who fulfilled the stated criteria were considered in Group 2. There were 29 (36.25%) patients in Group 1 and 51 (63.75%) in Group 2. All the patients in Group 1 were having Grade I fatty liver whereas patients in Group 2 were found to having varying grades of fatty liver, with six patients having Grade III fatty liver. We found statistically significant difference in various parameters of study (liver enzymes, high-density lipoprotein (HDL), triglycerides, and blood pressure) between Group 1 and Group 2. Ultrasound evidence of a fatty liver should be considered as a predictor of metabolic syndrome, and these patients must be investigated for the different components of metabolic syndrome so as to have early diagnosis and intervention to alter development of long-term metabolic disorders and their inherent complications.

scholarly journals Preliminary results of dulaglutide treatment in patients with non-alcoholic fatty liver disease (DEMOS study)

2020 ◽  
pp. 4-10
Author(s):  
P. O. Bogomolov ◽  
A. O. Bueverov ◽  
A. V. Dreval ◽  
O. A. Nechaeva ◽  
A. Yu. Mayorov ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Open Label ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Fatty Liver Index ◽  
Glucose And Lipid Metabolism ◽  
Alcoholic Fatty Liver Disease

65 patients with nonalcoholic fatty liver disease (NAFLD) were included in open-label observative prospective cohort study. Mean age was 54.8 ± 10.5 y. o. All patients were treated with metformin before and during the study. All patients were treated by GLP-1 receptor agonist dulaglutide subcutaneously weekly 26 weeks. Patients of group with type 2 diabetes were treated with dulaglutide 0.75 mg weekly 2 weeks, than 1.5 weekly 24 weeks. Patients of group without diabetes were treated by dulaglutide 0.75 mg weekly 4 weeks, than 1.5 weekly 22 weeks. Both groups of patients were demonstrated significant reduce of body weight, BMI, waist circumference, glucose, HbA1c, insulin resistance indexes, transaminases and gamma-glutamyltranspeptidase activity. Fatty liver index and liver stiff ness also decreased after treatment. We can conclude that dulaglutide treatment in NAFLD patients decreases body wieight, improves glucose and lipid metabolism and decreases inflammatory activity of steatohepatitis.

scholarly journals Role of Insulin Sensitizers in Raised Alanine Aminotransferase in Non-alcoholic Fatty Liver Disease in Glucose Intolerance Patients: A Short-Term Experience with Metformin Plus Pioglitazone Versus Metformin Alone

2015 ◽  
Vol 32 (4) ◽  
pp. 194-199
Author(s):  
Syeda Rezina Sultana ◽  
Mohammod Feroz Amin ◽  
Muhammad Abdur Rahim ◽  
Md Mahbubur Rahman ◽  
Md Nazmul Hoque ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Alanine Aminotransferase ◽  
Fatty Liver Disease ◽  
Fasting Blood Glucose ◽  
Combination Group ◽  
Alcoholic Fatty Liver ◽  
Number Of Patients ◽  
Group 2 ◽  
Group 1

Objectives:To evaluate and compare the effectiveness of metformin plus pioglitazone versus metformin alone in treatment of raised alanine aminotransferase (ALT) in nonalcoholic fatty liver disease (NAFLD) in patients with newly detected diabetes mellitus (DM) and impaired glucose tolerance (IGT).Materials and methods: In this open label clinical trial, newly detected DM and IGT patients with raised ALT and ultrasound proven NAFLD were treated with either metformin and pioglitazone combination (group 1) or metformin alone (group 2). They were followed up upto 6 months.Results:Total number of patients was 49 (27 in group 1 and 22 in group 2) and there was male predominance in either group. Age was almost identical between two groups (46±9.3 and 45.4±5.7 years in group 1 and group 2 respectively). Significant reduction in values of fasting blood glucose (FBG), 2 hours post breakfast values (ABF), HbA1c, cholesterol (CHOL), triglycerides (TG) and ALT of the study subjects were achieved in either group after six months (Group 1: FBG 8.89±1.4 vs 6.37±0.5 mmol/l, ABF 13.2±2.07 vs 8.34±0.84 mmol/l, HbA1c 8.15±0.87 % vs6.7±0.40%, CHOL 205.26±30.74 vs 178.89±18.59 mg/dl, TG 226.15±50.06 vs 155.85±20.99 mg/dl, ALT 91.52±23.14 vs 45.74±12.63 mg/dl and in Group 2 : FBG 9.39±2.26 vs 6.98±1.20 mmol/l, ABF 13.38±2.93 vs 9.13±1.46 mmol/l, HbA1c 8.10±0.92 % vs7.03±0.71%, CHOL 206.55±29.9 vs 195±23.55 mg/dl, TG 235.59±46.22 vs 178.91±38.24 mg/ dl, ALT 105.59±18.63 vs 66.36±16.02 mg/dl).In comparison between two groups, Group 1 had better metabolic control compared to their counterpart of Group 2 at the end of 6 months [Group 1 vs Group 2: FBG (p=0.024), ABF (p=0.022), CHOL (p = 0.010), TG (p =0.010)]. There was significant reduction in ALT as well (p = 0.000).Conclusion:Combination of metformin and pioglitazone is more effective than metformin alone in reducing ALT in NAFLD in newly detected DM and IGT patients.J Bangladesh Coll Phys Surg 2014; 32: 194-199

New therapy for fatty liver

2018 ◽  
Vol 1 (2) ◽  
pp. 24-28
Author(s):  
Tanita Suttichaimongkol
Keyword(s):  
Oxidative Stress ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Lifestyle Modifications ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Liver Insulin Resistance ◽  
Alcoholic Fatty Liver Disease ◽  
Related Mortality

Non-alcoholic fatty liver disease (NAFLD) is a leading cause of death from liver cirrhosis, endstage liver disease, and hepatocellular carcinoma. It is also associated with increased cardiovasculardisease and cancer related mortality. While lifestyle modifications are the mainstay of treatment,only a proportion of patients are able to make due to difficult to achieve and maintain, and so moretreatment options are required such as pharmacotherapy. This review presents the drugs used inmanaging NAFLD and their pharmacologic targets. Therapies are currently directed towards improvingthe metabolic status of the liver, insulin resistance, cell oxidative stress, apoptosis, inflammation orfibrosis. Several agents are now in large clinical trials and within the next few years, the availability oftherapeutic options for NAFLD will be approved.     Keywords: nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, fibrosis, cirrhosis  

Natural Aldose Reductase Inhibitor: A Potential Therapeutic Agent for Non-alcoholic Fatty Liver Disease

2020 ◽  
Vol 21 (6) ◽  
pp. 599-609 ◽  
Author(s):  
Longxin Qiu ◽  
Chang Guo
Keyword(s):  
Oxidative Stress ◽  
Liver Disease ◽  
Fatty Liver ◽  
Aldose Reductase ◽  
Fatty Liver Disease ◽  
Acid Oxidation ◽  
Peroxisome Proliferator ◽  
Peroxisome Proliferator Activated Receptor ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver

Aldose reductase (AR) has been reported to be involved in the development of nonalcoholic fatty liver disease (NAFLD). Hepatic AR is induced under hyperglycemia condition and converts excess glucose to lipogenic fructose, which contributes in part to the accumulation of fat in the liver cells of diabetes rodents. In addition, the hyperglycemia-induced AR or nutrition-induced AR causes suppression of the transcriptional activity of peroxisome proliferator-activated receptor (PPAR) α and reduced lipolysis in the liver, which also contribute to the development of NAFLD. Moreover, AR induction in non-alcoholic steatohepatitis (NASH) may aggravate oxidative stress and the expression of inflammatory cytokines in the liver. Here, we summarize the knowledge on AR inhibitors of plant origin and review the effect of some plant-derived AR inhibitors on NAFLD/NASH in rodents. Natural AR inhibitors may improve NAFLD at least in part through attenuating oxidative stress and inflammatory cytokine expression. Some of the natural AR inhibitors have been reported to attenuate hepatic steatosis through the regulation of PPARα-mediated fatty acid oxidation. In this review, we propose that the natural AR inhibitors are potential therapeutic agents for NAFLD.

scholarly journals Prevalence and Predictor of Nonalcoholic Steatohepatitis (NASH) in Nonalcoholic Fatty Liver Disease (NAFLD)

2015 ◽  
Vol 32 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Shahinul Alam ◽  
Mahabubul Alam ◽  
Sheikh Mohammad Noor E Alam ◽  
Ziaur Rahman Chowdhury ◽  
Jahangir Kabir
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Biopsy ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Resistance Index ◽  
Histopathological Study ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Fatty liver is a common cause of chronic liver disease in developed as well as developing countries.We have designed this study to estimate the prevalence and predictors for non alcoholic steatohepatitis (NASH) in non alcoholic fatty liver disease (NAFLD). We have included 493 patients with sonographic evidence of fatty change in liver and 177 of them had done liver biopsy for histopathological study. Other causes of liver disease and alcohol consumption were excluded. Metabolic syndrome and biochemical and anthropometric evaluation was done. Females were predominating 250 (57.0 %). Centrally obese 422 (96.2 %) was more than over all obesity330 (75.1%). NASH was absent in 10 (5.6%) cases and diagnostic of NASH was 75 Journal of Bangladesh College of Physicians and Surgeons Vol. 32, No. 2, April 2014 (42.4 %).Presence of diabetes could significantly (p = 0.001) predicted NASH. Age, sex, BMI, waist circumference, Serum HDL,triglyceride, insulin resistance index, hypertension, metabolic syndrome could not predict NASH. Serum GGT level was significantly (p = 0.05) higher in NASHwith a sensitivity of 45 % and specificity of 68 % only. Serum ALT and AST level could not detect NASH. Females were predominant sufferer of NAFLD in Bangladesh. Prevalence of NASH was much higher42.4%. Diabetes was the main predictor of NASH. GGT was the only biochemical indicator of NASH. We recommend liver biopsy in NAFLD with diabetes and raised GGT.J Bangladesh Coll Phys Surg 2014; 32: 71-77

scholarly journals GOUT AND NONALCOHOLIC FATTY LIVER DISEASE: EFFECT OF ENTEROSORPTION’S ADDITION TO COMMON TREATMENT

2020 ◽  
Vol 5 (2) ◽  
pp. 40-46
Author(s):  
U. O. Mudra
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Pathological Process ◽  
Control Group ◽  
Nonalcoholic Fatty Liver ◽  
Group 2 ◽  
Disease Effect ◽  
Basic Treatment

Background. Gout is still one of the major health problems despite significant advances in treatment in recent years. It has been proved that pathogenetic mechanisms of development and progression of gout are associated with nonalcoholic fatty liver disease. Complex pathogenic treatment of patients aimed at different parts of the pathological process has recently been supplemented with the enterosorbents. Objective. The aim of the research is to study the clinical features of gout with concomitant nonalcoholic fatty liver disease (NAFLD) and to evaluate the effect of carbon enterosorbent on its course. Methods. 123 patients were involved in the study. They were divided into 2 groups: group 1 included patients with gout without liver damage, and group 2 included patients with concomitant NAFLD. Each of these groups was divided into subgroups, in which the patients received carbon enterosorbent carboline plus basic treatment. The control group consisted of 30 healthy persons. Anamnesis, physical examination, uric acid (UA), C-reactive protein (CRP) content, erythrocyte sedimentation rate (ESR) in serum were determined. Gout activity was evaluated using the Gout Activity Score (GAS). Results. Basic treatment in combination with carbon enterosorbent contributed to faster cure of intoxication, pain and joint syndromes, as well as decrease of the inflammatory process activity. Conclusions. The course of gout in the patients with concomitant NAFLD is more severe. Adding of carbon granular enterosorbent carboline in the complex treatment of patients with gout with or without concomitant NAFLD in the exacerbation phase contributes to a faster cureing dynamics of clinical and laboratory manifestations of the disease.

scholarly journals 5-Bis-(2,6-difluoro-benzylidene) Cyclopentanone Acts as a Selective 11β-Hydroxysteroid Dehydrogenase one Inhibitor to Treat Diet-Induced Nonalcoholic Fatty Liver Disease in Mice

2021 ◽  
Vol 12 ◽  
Author(s):  
Hongguo Guan ◽  
Yiyan Wang ◽  
Huitao Li ◽  
Qiqi Zhu ◽  
Xiaoheng Li ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Serum Insulin ◽  
Hydroxysteroid Dehydrogenase ◽  
Biologically Active ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Low Concentration

Background: 11β-Hydroxysteroid dehydrogenase one is responsible for activating inert glucocorticoid cortisone into biologically active cortisol in humans and may be a novel target for the treatment of nonalcoholic fatty liver disease.Methods: A series of benzylidene cyclopentanone derivatives were synthesized, and the selective inhibitory effects on rat, mouse and human 11β-hydroxysteroid dehydrogenase one and two were screened. The most potent compound [5-bis-(2,6-difluoro-benzylidene)-cyclopentanone] (WZS08), was used to treat nonalcoholic fatty liver disease in mice fed a high-fat-diet for 100 days.Results: WZS08 was the most potent inhibitor of rat, mouse, and human 11β-hydroxysteroid dehydrogenase 1, with half maximum inhibitory concentrations of 378.0, 244.1, and 621.1 nM, respectively, and it did not affect 11β-hydroxysteroid dehydrogenase two at 100 μM. When mice were fed WZS08 (1, 2, and 4 mg/kg) for 100 days, WZS08 significantly lowered the serum insulin levels and insulin index at 4 mg/kg. WZS08 significantly reduced the levels of serum triglycerides, cholesterol, low-density lipoprotein, and hepatic fat ratio at low concentration of 1 mg/kg. It down-regulated Plin2 expression and up-regulated Fabp4 expression at low concentration of 1 mg/kg. It significantly improved the morphology of the non-alcoholic fatty liver.Conclusion: WZS08 selectively inhibits rat, mouse, and human 11β-hydroxysteroid dehydrogenase 1, and can treat non-alcoholic fatty liver disease in a mouse model.

Abstract 454: High Density Lipoprotein Proteome Dynamics is Altered in Non-alcoholic Fatty Liver Disease

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Takhar Kasumov
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Oxidase Activity ◽  
Fatty Liver Disease ◽  
Metabolic Labeling ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Inflammatory Index ◽  
Complement 3 ◽  
Hdl Dysfunction

Objectives: Nonalcoholic fatty liver disease (NAFLD) is associated with an increased rate of cardiovascular disease (CVD) related mortality. HDL protects against CVD through reverse cholesterol transport, anti-oxidant and anti-inflammatory functions. HDL functions and the proteome composition are altered in CVD. We used 2 H 2 O metabolic labeling approach to test hypothesis that altered HDL proteome dynamics is involved in HDL dysfunction in NAFLD. Methods: The kinetics of HDL proteins were measured in patients NAFLD (n=12) and healthy controls (n=8). Each subject consumed 2 H 2 O in their drinking water and blood samples were collected at different time points during one week. 2 H-enrichment of tryptic peptides from HDL proteins were analyzed by mass spectrometry. Oxidase activity of HDL-associated ceruloplasmin (Cp) and HDL’s inflammatory index were quantified using spectrophotometric assays. Results: Compared to control, NAFLD had higher BMI, Hba1c, HOMA-IR, plasma AST, ALT and triglycerides, but similar LDL and HDL cholesterol. NAFLD also had higher inflammatory index (1.8±0.5 vs 1.2±0.2 RUF/mgHDLc/min, p<0.05) and oxidase activity of Cp (93.7±61.2 vs 61.2 U/L, p<0.005). This was associated with increased serum actvity of MPO (6.2±1.2 vs 8.4±1.6, p<0.05), a nutrophile-derived protein involved in HDL dysfunction. HDL NAFLD was significantly enriched with proteins involved in the acute phase response (complement 3, Cp) but depleted in apoAII and PON1. These changes were associated with increased fractional catabolic rates (FCRs) of apoAI (1.6±0.2 vs 1.1±0.3 %/h), apoAII (1.6±0.2 vs 1.1±0.3 %/h), apoAIV (2.6±0.8 vs 3.9±0.7%/h) and increased relative production rate (RPR) of complement 3 (>4 fold). Oxidase activity of Cp was positively associated with FCR of apoAI (r=0.53, p=0.002) and RPR of C3 (r=0.32, p=0.03). Conclusions: HDL dysfunction in NASH could be related to the altered turnover of HDL proteins, including increased degradation of apoAI, apoAII, apoAIV and increased production of C3.

A Correlational Study of Hepatic Steatosis (Fatty Liver Disease) and Liver Enzymes (ALT, AST, GGT) In The Scenario of Insulin Resistance Among Young Medicos.

2021 ◽  
Vol 17 (4) ◽  
pp. 717-725
Author(s):  
Samarpita Mukherjee ◽  
Shubhrajit Saha ◽  
Ushasi Banerjee ◽  
Arup Kumar Banerjee ◽  
Ritam Banerjee
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Fatty Liver Disease ◽  
Lifestyle Modifications ◽  
Cross Sectional ◽  
Mean Values ◽  
Nonalcoholic Fatty Liver ◽  
Study Population

Background and Objectives In the last few decades,Nonalcoholic Fatty Liver Disease (NAFLD) has become a common health issue that leads to serious complications like cirrhosis, cardiovascular disease, etc. Insulin resistance (IR) is the key pathogenic factor for NAFLD. The young medicos being habituated in stressful and sedentary lifestyle and representative of the youth as well can fully justify their selection as study population and help to build social awareness by emphasizing the importance of early lifestyle modifications in preventing or delaying the severe complications of NAFLD. This study is aiming to find out if there is any correlation of hepatic steatosis with IR, Alanine Transaminases (ALT), Aspartate Transaminases (AST) or Gama Glutamyl Transferases (GGT) and also to identify if one enzyme is better correlating with hepatic steatosis than others in the scenario of Insulin Resistance among young medicos. METHODS: 132 medical students of North Bengal Medical College, aged between 18-25 years were included in this institution based observational cross-sectional study. Their Fasting Insulin, glucose, ALT, AST, GGT were measured, and IR was calculated by the Homeostatic Assessment of Insulin Resistance (HOMA-IR) calculator. Sonography was done to assess Hepatic steatosis. RESULTS: Among 132 subjects normal, grade 1 and grade 2 fatty changes have been found in 67.4%, 25%, and 7.6% of the study population respectively. The Grouping was done using the cut-off value of IR (i.e. subjects with IR<1.525 vs. IR≥1.525). Significant differences were found in the mean values of ALT, AST, GGT between groups. Significant positive concordances were found between enzymes ALT, GGT, and hepatic steatosis in subjects having IR ≥ 1.525.Regression analysis showed that higher GGT values have a stronger positive correlation with hepatic steatosis than ALT among the same. Interpretation and Conclusion From this study, we can interpret that subjects having higher GGT values are better associated with steatosis than those having higher ALT values and can lead us to the conclusion that GGT might be an important independent marker for NAFLD associated with IR. Furthermore, such observations may suggest considering GGT as a marker for assessing the severity of fatty liver irrespective of etiopathogenesis, though the population-based vivid evaluation is highly recommended.

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