scholarly journals Genetic Polymorphisms and Clinical Features in Diabetic Patients With Fatty Liver: Results From a Single-Center Experience in Southern Italy

2021 ◽  
Vol 8 ◽  
Author(s):  
Rosanna Villani ◽  
Grazia Pia Magnati ◽  
Giuseppe De Girolamo ◽  
Moris Sangineto ◽  
Antonino Davide Romano ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Genetic Polymorphisms ◽  
Clinical Features ◽  
Southern Italy ◽  
Risk Allele ◽  
Liver Stiffness ◽  
Diabetic Patients ◽  
Serum Triglycerides ◽  
Alcoholic Fatty Liver ◽  
Patients With Diabetes

Genetic background may be involved in the promotion and progression of non-alcoholic fatty liver disease (NAFLD). Previous studies have suggested that the single nucleotide polymorphisms (SNPs) may be associated with the specific clinical features in the patients with hepatic steatosis; however, data on the patients with diabetes from Southern Italy are lacking. We enrolled 454 patients and 260 of them had type 2 diabetes. We studied the PNPLA3 rs738409, LPIN1 rs13412852, KLF6 rs3750861, SOD2 rs4880, TM6SF2 rs58542926, and ZNF624 rs12603226 SNPs and their distribution in the study population. Lipid profile, liver stiffness, and kidney function were also studied to understand the potential role of the SNPs in the development of clinical phenotypes. No differences were observed in the distribution of polymorphisms between the diabetic and non-diabetic subjects. Carriers of risk allele G for PNPLA3 rs738409 SNP showed a lower mean value of serum triglycerides and a higher liver stiffness. Risk allele for KLF6 rs3750861 and SOD2 rs4880 polymorphism had a lower estimated glomerular filtration rate (eGFR) value, whereas no differences in the glucose and glycated hemoglobin level were observed in the subgroups by the different genotypes. Genetic polymorphisms are useful to identify the patients at higher risk of development of liver fibrosis and lower eGFR values in the patients with diabetes and NAFLD. Their use in clinical practice may help the clinicians to identify the patients who require a more strict follow-up program.

scholarly journals Reduction of Fat to Muscle Mass Ratio Is Associated with Improvement of Liver Stiffness in Diabetic Patients with Non-Alcoholic Fatty Liver Disease

2019 ◽  
Vol 8 (12) ◽  
pp. 2175 ◽  
Author(s):  
Takafumi Osaka ◽  
Yoshitaka Hashimoto ◽  
Takuro Okamura ◽  
Takuya Fukuda ◽  
Masahiro Yamazaki ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Muscle Mass ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Diabetic Patients ◽  
Mass Ratio ◽  
Liver Stiffness Measurement ◽  
Alcoholic Fatty Liver ◽  
Stiffness Measurement

Body weight reduction leads to improvement of nonalcoholic fatty liver disease (NAFLD), but the contributions of body composition modification on its improvement have not been clarified yet. We performed a retrospective cohort study in a Japanese university hospital to clarify the effect of body fat reduction on the improvement of hepatic stiffness as well as hepatic steatosis. The skeletal muscle mass index (SMI, kg/m2), fat to muscle mass ratio, and the change in fat to muscle mass ratio after 1 year from baseline were calculated. Controlled attenuation parameter (CAP, dB/m) and liver stiffness measurement (LSM, kPa) were evaluated by elastography. Primary outcome was set as the association of the change of fat to muscle mass ratio after 1 year from baseline with the change of liver stiffness measurement. One hundred and seventeen patients (59 men and 58 women) completed the study. The average age was 63.5 years, and baseline CAP and LSM were 273.4 ± 53.5 dB/m and 6.3 ± 3.4 kPa, respectively. After 1 year, body mass index (BMI), SMI, and LSM decreased. Multiple regression analyses demonstrated that change in fat to muscle mass ratio was associated with the change in CAP (ß = 0.38, p < 0.001) or LSM (ß = 0.21, p = 0.026). The reduction of fat to muscle mass ratio was associated with improvement in liver stiffness, but the reduction of BMI was not.

scholarly journals PREVALENCE OF NAFLD AND IT’S ASSOCIATION WITH INSULIN RESISTANCE IN PATIENTS WITH DIABETES

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Ritu Gupta ◽  
Dr. Shivesh Thakur ◽  
Dr. Saurabh Nigam
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Glycemic Control ◽  
Fatty Liver ◽  
Fatty Infiltration ◽  
P Value ◽  
Diabetic Patients ◽  
Alcoholic Fatty Liver ◽  
Complications Of Diabetes ◽  
Patients With Diabetes

Objectives: Non Alcoholic Fatty Liver Disease (NAFLD) is characterized by fatty infiltration of the liver, mostly in the form of triglycerides (TG), which exceeds 5% of the liver weight.NAFLD is strongly associated with Insulin Resistance(IR).Patients with NAFLD also having type 2 diabetes carry added risk of progressive forms of the disease particularly cirrhosis. They also have poor glycemic control owing to IR. So it is logical to identifying the patients with diabetes having  NAFLD could estimates the future risk and help in prevention of chronic liver disease and delaying the progression to NASH  and cirrhosis and various complications of  Diabetes. Methods: This was a cross sectional observational study conducted in department of   medicine, N.S.C.B., MCH, Jabalpur in which 100 cases of diabetes were taken who satisfied inclusion and exclusion criteria. Abdominal USG was used for evidence of fatty liver and it’s grading and fasting serum levels of insulin (FIL) and fasting blood sugar(FBS) were used to calculate HOMA IR value to find presence of IR. Results:                Our study showed prevalence of  NAFLD was 56%(n-56),Among these,in 58.92%(n-33) cases NAFLD is associated with IR(chi square value-4.1,p value-0.041).Prevalence of  NAFLD was slightly more in females-56.6%(n-30) as compare to males-55.32%(n-26).Strong  association of  NAFLD with IR is found among females as compare to males (p-0.022 and p-0.79 respectively). Waist circumference, Mean BMI, FBS, Triglycerides, FIL and HOMA IR levels in cases with NAFLD (95.11±12.46, 24.83±2.42, 176.13±66.79, 180.07±51.35, 13.59±15.42, 5.33±5.21)were higher as compare to non NAFLD (85.84±9.86, 22.41±2.16, , 134.8±34.41,139.09±39.27, 6.79±4.49, 2.37±1.94)respectively. The mean AST and ALT levels were higher in NAFLD group than Non NAFLD group (t= 2.23,2.19) respectively with p value <0.05.Prevalence of NAFLD was 88.23%(n-15)in obese population. Conclusion: Given the high prevalence of NAFLD in patients with diabetes, the possibility of NAFLD should be suspected in all of them. These patients with NAFLD have high propensity of IR than Non NAFLD patients, so are at higher risk of developing complications of diabetes, NASH and cirrhosis. Also obese diabetic patients have higher incidence of NAFLD and IR as compared to non-obese patients. It seems reasonable to expect that early diagnosis of NAFLD and early intervention with strict glycemic control and weight loss would prevent complications.

scholarly journals When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis

2021 ◽  
Vol 7 (4) ◽  
pp. 298
Author(s):  
Teny M. John ◽  
Ceena N. Jacob ◽  
Dimitrios P. Kontoyiannis
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Clinical Features ◽  
The Other ◽  
Diabetic Patients ◽  
Epidemiological Factors ◽  
Uncontrolled Diabetes ◽  
Diagnostic Certainty ◽  
Patients With Diabetes ◽  
Perfect Storm

Mucormycosis (MCR) has been increasingly described in patients with coronavirus disease 2019 (COVID-19) but the epidemiological factors, presentation, diagnostic certainty, and outcome of such patients are not well described. We review the published COVID-19-associated mucormycosis (CAMCR) cases (total 41) to identify risk factors, clinical features, and outcomes. CAMCR was typically seen in patients with diabetes mellitus (DM) (94%) especially the ones with poorly controlled DM (67%) and severe or critical COVID-19 (95%). Its presentation was typical of MCR seen in diabetic patients (mostly rhino-orbital and rhino-orbital-cerebral presentation). In sharp contrast to reported COVID-associated aspergillosis (CAPA) cases, nearly all CAMCR infections were proven (93%). Treating physicians should have a high suspicion for CAMCR in patients with uncontrolled diabetes mellitus and severe COVID-19 presenting with rhino-orbital or rhino-cerebral syndromes. CAMR is the convergence of two storms, one of DM and the other of COVID-19.

scholarly journals Beneficial effect of omarigliptin on diabetic patients with non-alcoholic fatty liver disease/non-alcoholic steatohepatitis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Sachiko Hattori ◽  
Kazuomi Nomoto ◽  
Tomohiko Suzuki ◽  
Seishu Hayashi
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Hepatic Insulin Resistance ◽  
Diabetic Patients ◽  
Alcoholic Fatty Liver ◽  
Dpp4 Inhibitor ◽  
Alcoholic Fatty Liver Disease

Abstract Background Dipeptidyl peptidase 4 (DPP4) is a serine exopeptidase able to inactivate various oligopeptides, and also a hepatokine. Hepatocyte-specific overexpression of DPP4 is associated with hepatic insulin resistance and liver steatosis. Method We examined whether weekly DPP4 inhibitor omarigliptin (OMG) can improve liver function as well as levels of inflammation and insulin resistance in type 2 diabetic patients with non-alcoholic fatty liver disease (NAFLD). Further, we investigated the effects of OMG in a diabetic patient with biopsy-confirmed nonalcoholic steatohepatitis (NASH). Results In NAFLD patients, OMG significantly decreased levels of aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, homeostatic model assessment of insulin resistance (HOMA-IR), and high-sensitivity C-reactive protein (hsCRP), while no significant change was seen in hemoglobin A1c or body mass index. In the NASH patient, liver function improved markedly, and levels of the hepatic fibrosis marker FIB-4 decreased in parallel with HOMA-IR and hsCRP. Slight but clear improvements in intrahepatic fat deposition and fibrosis appeared to be seen on diagnostic ultrasonography. Conclusion Weekly administration of the DPP4 inhibitor OMG in ameliorating hepatic insulin resistance may cause beneficial effects in liver with NAFLD/NASH.

scholarly journals Utility of Fibroscan XL to assess the severity of non-alcoholic fatty liver disease in patients undergoing bariatric surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrew Yang ◽  
Melinda Nguyen ◽  
Irene Ju ◽  
Anthony Brancatisano ◽  
Brendan Ryan ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Convincing Evidence ◽  
Alcoholic Fatty Liver ◽  
Post Surgery

AbstractSignificant weight loss can modify the progression of Nonalcoholic fatty liver disease (NAFLD) with the most convincing evidence coming from bariatric surgery cohorts. Effective ways to non-invasively characterise NAFLD in these patients has been lacking, with high Fibroscan failure rates reported. We prospectively evaluated the utility of Fibroscan using XL-probe over a two-year period. 190 consecutive patients undergoing bariatric surgery were followed as part of their routine care. All patients had Fibroscan performed on the day of surgery and at follow-up a mean of 13 months (± 6.3) later. The majority of patients were female (82%) with mean age of 42. Fibroscan was successful in 167 (88%) at baseline and 100% at follow up. Patients with a failed Fibroscan had higher body mass index (BMI) and alanine transaminase (ALT), but no difference in FIB-4/NAFLD score. Mean baseline Liver stiffness measurement was 5.1 kPa, with 87% of patients classified as no fibrosis and 4% as advanced fibrosis. Mean baseline controlled attenuation parameter was 291, with 78% having significant steatosis, 56% of which was moderate-severe. Significant fibrosis was associated with higher BMI and HbA1c. Significant steatosis was associated with higher BMI, ALT, triglycerides and insulin resistance. Mean follow up time was 12 months with weight loss of 25.7% and BMI reduction of 10.4 kg/m2. Seventy patients had repeat fibroscan with reductions in steatosis seen in 90% and fibrosis in 67%. Sixty-four percent had complete resolution of steatosis. Fibroscan can be performed reliably in bariatric cohorts and is useful at baseline and follow-up. Significant steatosis, but not fibrosis was seen in this cohort with substantial improvements post-surgery.

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