Ketogenic Diet-induced Elevated Cholesterol, Elevated Liver Enzymes and Potential Non-alcoholic Fatty Liver Disease

Non- alcoholic fatty liver disease (NAFLD) is also otherwise termed as Hepatic steatosis and Kaphaja yakrit dalludara in Ayurveda. 34 years male patient, highly educated from a high socio-economic group of Non vegetarian diet habit came to hospital with complain of anorexia, indigestion and distention for three months. The clinical findings revealed that he is slightly obese, hyperglycaemia and dyslipidimia along elevated liver enzymes with fatty liver in USG and Fibro scan. The case was treated with Patolakaturohinyadi Kwatham (PKK) in the dose was 30ml Kasaya with equal quantity of luke warm water twice daily in empty stomach preferable morning and evening for six months. This study proved that PKK can significantly reduced blood sugar, serum Lipids and liver enzymes within three months along with reduction weight and BMI, but change in liver architecture required six months in this therapy. The BARD score and NAFLD score changed to normal after six months of therapy. The patient was kept in observation for further one year without medication and advised to practice yoga, exercise and low carbohydrate and fat diet to study the recurrence of disease. The liver architecture as well as biochemical profile of liver is maintained after one year also. PKK may correct the metabolic dysfunction by increase Agni, digest Ama which helped in the correction of hyperglycaemia and dyslipidaemia. PKK is safe in for six months of use in recommended dose (30ml BID) as there was no adverse sign and symptom observed and no change in biochemical and Haematological profile of Patients.PKK is safe and effective in this case of Kaphaja Yakrit dalludara (NAFLD). It can study further in large population to generated evidence for its efficacy and efficacy in larger group.

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Characterization of Patients with Biopsy-Proven Non-Alcoholic Fatty Liver Disease and Normal Aminotransferase Levels

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-293 ◽

2019 ◽

Vol 28 (4) ◽

pp. 427-431 ◽

Cited By ~ 2

Author(s):

Celal Ulasoglu ◽

Feruze Yilmaz Enc ◽

Eda Kaya ◽

Yusuf Yilmaz

Keyword(s):

Diabetes Mellitus ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Liver Enzymes ◽

Normal Liver ◽

Advanced Fibrosis ◽

Alcoholic Fatty Liver ◽

Elevated Liver Enzymes ◽

Alcoholic Fatty Liver Disease

Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is one of the major causes of abnormal liver function tests in hepatology practice. However, not all patients with NAFLD have increased aminotransferase levels. The aim of this study was to compare the clinical and histologic characteristics of patients with biopsyproven NAFLD showing normal versus elevated aminotransferase levels. Methods: We retrospectively reviewed 515 patients with biopsy-proven NAFLD. Patients with ALT ≤ 40 U/L and AST ≤ 37 U/L were considered as having normal liver enzymes. A histological fibrosis score F ≥ 3 was used to define advanced fibrosis. Results: Of the 515 study participants, 107 (20.8%) had normal liver enzymes. Compared with patients showing elevated liver enzymes, those with normal aminotransferase levels were older and most commonly women. Moreover, they had a higher body mass index and more frequently showed metabolic risk factors (metabolic syndrome, diabetes mellitus, hypertension, higher waist and hip circumferences). Although liver histology tended to be less severe in patients with normal liver enzymes, the prevalence of advanced fibrosis was similar in the two groups. Diabetes mellitus (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.46−3.91, p < 0.001) and age (OR = 1.14, 95% CI = 1.07−1.24, p < 0.05) were identified as independent predictors of advanced fibrosis in patients with normal aminotransferase levels. Conclusions: NAFLD with normal aminotransferase levels is characterized by a severe metabolic profile and a prevalence of advanced fibrosis similar to that identified in cases with elevated aminotransferase levels.

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