Non-Alcoholic Fatty Liver Disease and COVID-19–Two Pandemics Hitting at the Same Time

The COVID-19 pandemic was and still is a global burden with more than 178,000,000 cases reported so far. Although it mainly affects respiratory organs, COVID-19 has many extrapulmonary manifestations, including, among other things, liver injury. Many hypotheses have been proposed to explain direct and indirect impacts of the SARS-CoV-2 virus on the liver. Studies have shown that around 15–30% of patients with COVID-19 have underlying liver disease, and 20–35% of patients with COVID-19 had altered liver enzymes at admission. One of the hypotheses is reactivation of an underlying liver disease, such as non-alcoholic fatty liver disease (NAFLD). Some studies have shown that NAFLD is associated with severe COVID-19 and poor outcome; nevertheless, other studies showed no significant difference between groups in comparing complications and clinical outcomes. Patients with NAFLD may suffer severe COVID-19 due to other comorbidities, especially cardiovascular diseases. The link between NAFLD and COVID-19 is not clear yet, and further studies and research are needed.

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Clinical characteristics and longitudinal changes of patients with non-alcoholic fatty liver disease in 2 decades: the NAGALA study

BMC Gastroenterology ◽

10.1186/s12876-021-01809-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Takuro Okamura ◽

Yoshitaka Hashimoto ◽

Masahide Hamaguchi ◽

Akihiro Obora ◽

Takao Kojima ◽

...

Keyword(s):

Body Mass Index ◽

Liver Disease ◽

Fatty Liver ◽

Body Mass ◽

Fatty Liver Disease ◽

Abdominal Ultrasonography ◽

Alcoholic Fatty Liver ◽

The Past ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

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.

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Polymorphisms 677C > T and 1298A > C in the MTHFR gene and homocysteine levels in patients with non-alcoholic fatty liver disease as a component of the ontological model

Modern Gastroenterology ◽

10.30978/mg-2021-5-21 ◽

2021 ◽

Author(s):

N. A. Nosko ◽

O. M. Rud

Keyword(s):

Logistic Regression ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Mthfr Gene ◽

Scientific Data ◽

Multiple Logistic Regression ◽

Alcoholic Fatty Liver ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

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.

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A study of Interleukin 6 as a predictive biomarker for development of nonalcholic steatohepatitis in patients with Nonalcholic fatty liver disease

QJM ◽

10.1093/qjmed/hcaa052.048 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

K A Mohamed ◽

E E Mohamed ◽

D M Ahmed ◽

M A Sayed ◽

A R Hussien

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Interleukin 6 ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Simple Steatosis ◽

Obesity And Diabetes ◽

Significant Difference ◽

And Control ◽

Alcoholic Fatty Liver Disease

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 > 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.

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Omentin-1 Levels and Non-alcoholic Fatty Liver Disease in Obese Adolescents

Iranian Journal of Pediatrics ◽

10.5812/ijp.117353 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Emine Turkkan ◽

Huseyin Dag ◽

Okan Dikker ◽

Nevin Cetin Dag ◽

Alper Kacar ◽

...

Keyword(s):

Insulin Resistance ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Density Lipoprotein ◽

Obese Patients ◽

Alcoholic Fatty Liver ◽

Obese Adolescents ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

Background: Omentin-1 is an adipocytokine secreted from visceral adipose tissue that is thought to increase insulin sensitivity. Non-alcoholic fatty liver disease (NAFLD) is a comparatively extensive problem in obese adolescents. Decreased omentin-1 levels have been reported in obese patients, but the relationship between NAFLD and omentin-1 is contradictory. Objectives: We aimed to evaluate the omentin-1 levels in the sera of obese adolescents with and without NAFLD and compare them with each other. Methods: In this study, a total of 88 adolescents (56 obese and 32 normal-weight) were enrolled. Abdominal ultrasonography (US) identified 28 obese adolescents with grade 2-3 hepatosteatosis constituting the NAFLD group and 28 without hepatosteatosis on US constituting the non-NAFLD group. The control group included 32 age- and gender-matched cases without hepatosteatosis and with normal percentile body mass index (BMI). Serum omentin-1 levels were evaluated and compared. Results: The mean age of the research group was 12.72 ± 1.91 years. Unsurprisingly, BMI, glycated hemoglobin (HbA1c), liver transaminases (AST, ALT), total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin rates were noticeably elevated in obese adolescents compared to controls (P < 0.05). However, omentin-1 and high-density lipoprotein cholesterol (HDL) levels were remarkably lower in the obese group (P < 0.05). No significant difference was found between the NAFLD and non-NAFLD groups regarding omentin-1, HbA1c, glucose, urea, creatinine, AST, C-reactive protein (CRP), total cholesterol, triglyceride, HDL, LDL, thyroid stimulating hormone, 25-hydroxyvitamin D3, HOMA-IR, and insulin. The BMI and ALT grades of the non-NAFLD group were notably lower than the NAFLD group (P < 0.05). While there was no significant difference between omentin-1 and other parameters in obese adolescents without NAFLD (P > 0.05), we found a significant difference between omentin-1 and BMI, AST, ALT, HOMA-IR, and insulin values in obese adolescents with NAFLD (P < 0.05). Conclusions: Omentin-1 levels were decreased in obese adolescents regardless of the presence of NAFLD. However, in obese patients with NAFLD, there was a significant difference between omentin-1 and several markers of obesity and insulin resistance.

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Comparison of Body Mass Index, Smoking, Vitamin E and Type of Oil Consumed Between Patients Suffering From Non-alcoholic Fatty Liver Disease versus Non-affected Patients: A Case-Control Study

Jundishapur Journal of Chronic Disease Care ◽

10.5812/jjcdc.108713 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Mehran Naghibeiranvand ◽

Atefeh Visskaramian ◽

Fatemeh Mehrabirad ◽

Zahra Mohammadi

Keyword(s):

Liver Disease ◽

Vitamin E ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Case Control Study ◽

Case Control ◽

Alcoholic Fatty Liver ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease ◽

Control Study

Background: Non-alcoholic fatty liver disease (NAFLD) has an increasing trend in the world and can lead to liver failure and death if left untreated. Lifestyle modification is very important in the treatment of this disease. Objectives: This study aimed to determine the comparison of body mass index (BMI), smoking, vitamin E consumption, and type of oil consumed by patients with NAFLD with non-alcoholic patients. Methods: The present study was a retrospective case-control study that was performed on 120 patients referred to the ultrasound unit of Nomadic Martyrs Hospital in Khorramabad. The participants were divided into two groups, including case (61 people) and control (59 people). The questionnaire consisted of three parts: (1) the first part was related to demographic information; (2) the second part was related to liver ultrasound results; (3) and the third part was related to height, weight, BMI, weekly vitamin E intake, daily smoking status, and type of oil consumed. Data were analyzed using SPSS-23 software and descriptive and inferential statistical methods. Results: Most of the participants in the study were 69 (55.8%) and 92 (76.66%) were married. The mean BMI of patients with NAFLD was significantly higher than non-alcoholic patients (P = 0.003). There was no statistically significant difference in daily smoking and weekly intake of vitamin E in patients with and without non-alcoholic fatty liver disease (P < 0.05). According to Fisher's exact test, it was found that there was a statistically significant difference in the frequency by patients with NAFLD and non-alcoholic (P = 0.014). Also, a statistically significant difference was observed in the frequency of the type of oil consumed by patients with NAFLD (P = 0.014). Conclusions: Consumption of olive and sesame oil along with weight loss is recommended. Smoking as a risk factor, as well as the use of vitamin E to prevent and treat NAFLD, require further studies with a larger sample size.

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Bile acids serum levels in patients with nonalcoholic fatty liver disease

Kazan medical journal ◽

10.17750/kmj2015-354 ◽

2015 ◽

Vol 96 (3) ◽

pp. 354-358 ◽

Cited By ~ 1

Author(s):

Z Sh Minnullina ◽

S V Kiyashko ◽

O V Ryzhkova ◽

R G Sayfutdinov

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Bile Acids ◽

Hepatic Steatosis ◽

Fatty Liver Disease ◽

Serum Levels ◽

Healthy Individuals ◽

Alcoholic Fatty Liver ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

Aim. To estimate the blood levels of primary, secondary, tertiary and unconjugated bile acids in patients with non-alcoholic fatty liver disease.Methods. The study included 74 patients with non-alcoholic fatty liver disease (males - 30, females - 44) and 51 healthy individuals (males - 14, females - 37). All patients underwent anthropometry and complete clinical, biochemical and instrumental examination (measuring the subcutaneous fat layer). 64 patients had hepatic steatosis, 10 - steatohepatitis. Serum levels of bile acids (primary: cholic, chenodeoxycholic; secondary: lithocholic, deoxycholic and tertiary: ursodeoxycholic) were measured by gas-liquid chromatography on «Chromos GC-1000» (Russia) scanner.Results. Unconjugated primary, secondary and tertiary bile acids were detected in the blood of healthy individuals and patients with non-alcoholic fatty liver disease. In healthy individuals, there were no gender differences found in the bile acids levels. Patients with non-alcoholic fatty liver disease had higher level of bile acids compared to healthy controls. There was a significant difference in the concentrations of secondary and tertiary bile acids in patients with hepatic steatosis and steatohepatitis.Conclusion. Blood bile acids levels were significantly higher in patients with non-alcoholic fatty liver disease than in healthy individuals. At steatohepatitis, females had higher levels of cholic, chenodeoxycholic and deoxycholic acids and lower levels of lithocholic and ursodeoxycholic acids compared to males. Significant difference in patients with hepatic steatosis and steatohepatitis was revealed only in levels of secondary and tertiary bile acids.

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Comparison of the Nutrition of Patients with and without Non-alcoholic Fatty Liver in Tehran

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v3i4.170 ◽

2018 ◽

Vol 3 (4) ◽

Author(s):

Mahshid Akbari ◽

Sima Zohari-Anboohi

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Statistical Power ◽

Dietary Habits ◽

Control Group ◽

Case Group ◽

Alcoholic Fatty Liver ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

Introduction: A high prevalence of non-alcoholic fatty liver disease is associated with obesity and lifestyle disorders. The present study was conducted to compare the nutritional pattern of patients with and without non-alcoholic fatty liver disease referred to the hospitals affiliated to Tehran University of Medical Sciences in 2017.Materials and Methods: The present case-control study was performed on a total of 300 outpatients and inpatients, aged 18–65 years. These patients were referred to the ultrasonography section of the hospitals, and those recruited in the study were selected by the convenience method of sampling. According to the results of ultrasonography, these subjects were divided into two groups: case (100 patients) and control (200 subjects for increasing the statistical power of study). The data were analyzed using the Statistical Package for the Social Sciences (version 19), descriptive statistics, and the Mann–Whitney test. P<0.05 was considered significant.Results: A significant difference was detected between the mean consumption of unhealthy foods in the case group as compared to the control group (P=0.001), while those with fatty liver reported a low average intake of fruits and vegetables with a significant difference (P=0.001).Conclusion: The results showed that patients with fatty liver complied with poor dietary habits as compared to individuals without the disease.

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NON-ALCOHOLIC FATTY LIVER DISEASE AND HYPERTENSION: CLINICAL VARIABILITY OF COMORBIDITY

Inter Collegas ◽

10.35339/ic.7.3.131-138 ◽

2020 ◽

Vol 7 (3) ◽

Author(s):

Anastasiia Rozhdestvenska ◽

Oleg Babak ◽

Natalia Zhelezniakova

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Clinical Manifestation ◽

Fatty Liver Disease ◽

Hdl Cholesterol ◽

Trigger Factor ◽

Control Group ◽

Alcoholic Fatty Liver ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

Introduction. Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases; and considerable attention is paid to the comorbidity of NAFLD with hypertension (HT), which affects around one-third of the world's population. The combination of NAFLD with hypertension has been suggested to have a mutual potentiating effect, and hypertension affects the severity of NAFLD. The purpose: to study the features of the clinical manifestation of NAFLD in patients with hypertension. Materials and methods. The study included 115 patients with NAFLD at the stage of nonalcoholic steatohepatitis. The main group consisted of 63 patients with NAFLD and HT, the comparison group included 52 patients with isolated NAFLD, and the control group was composed of 20 healthy volunteers. The patients underwent anthropometric measurements, evaluation of biochemical markers of liver functional activity, lipid profile and carbohydrate metabolism changes, C-reactive protein (CRP) levels. Results. A significant increase in the proportion of patients with active complaints in the group of patients with NAFLD with HT (subjective signs of liver damage, manifestations of dyspeptic and asthenic syndrome) was detected. Significant differences were found in almost all anthropometric indicators in both groups of patients with NAFLD in comparison with the control group. The level of CRP had significant differences and was 7.90 mg/l (95% CI = 7.96-8.75 mg/l), 6.55 mg/l (95% CI = 6.47-7.57 mg/l) and 2.07 (95% CI = 1.83-2.85 mg/l) in patients with NAFLD and HT, isolated NAFLD and the control group, respectively (p <0.001). Fasting glucose levels were significantly higher in both groups of examined patients with NAFLD compared with controls. Significant differences were found in the levels of total cholesterol, VLDL cholesterol, HDL cholesterol and atherogenic factor in patients with NAFLD depending on concomitant HT. There was no significant difference between LDL cholesterol and triglycerides in the two groups of patients with NAFLD. Conclusions. Based on the obtained data, it can be stated that GC in patients with NAFLD determines important deviations in the clinical manifestation of the disease and can be considered as a trigger factor for the progression of NAFLD.

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Study of the Association between Hypothyroidism and Non-Alcoholic Fatty Liver Disease

Journal of Drug Delivery and Therapeutics ◽

10.22270/jddt.v9i5-s.3604 ◽

2019 ◽

Vol 9 (5-s) ◽

pp. 4-6

Author(s):

Anoop Uniyal ◽

Prashant Mathur ◽

Yogesh Joshi

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Data Gathering ◽

Alcoholic Fatty Liver ◽

Increased Risk ◽

Significant Difference ◽

History Of ◽

Thyroid Profile ◽

Alcoholic Fatty Liver Disease

Aim: The aim of the present study was to investigate the association between hypothyroidism and non-alcoholic fatty liver disease (NAFLD). Methods: In a prospective observational study, the hypothyroidism patients were evaluated for NAFLD using ultrasonography. The participant’s characteristics such as age, gender, thyroid profile, history of diabetes, hypertension, ischemic heart disease (IHD) were recorded using a data gathering form. Results: A total of 51 participants were included in this study. From 51 participants, 47 (92.18%) individuals were females whereas 4 (7.82%) individuals were males. Out of 51 participants 27 individuals had NAFLD. There was statistically significant difference in FT4 levels with the participants with NAFLD. Conclusion: Results from this study suggested that low FT4 concentration is associated with increased risk of NAFLD. Keywords: Hypothyroidism, NAFLD, ultrasonography, FT4.

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Lipid Profile in Alcoholic and Non Alcoholic Fatty Liver Patients

10.21203/rs.3.rs-27765/v1 ◽

2020 ◽

Author(s):

Aakash Shahi ◽

Narayan Gautam ◽

Sanju Rawal ◽

Uday Sharma ◽

Archana Jayan

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Lipid Profile ◽

Fatty Liver Disease ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

P Value ◽

Alcoholic Fatty Liver ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

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.

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