جستجوی مقالات مرتبط با کلیدواژه « hepatic steatosis » در نشریات گروه « پزشکی »
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مقدمه
نقش وضعیت متابولیکی در بیماری های قلبی- عروقی، استیاتوز کبدی و تغذیه در بین گروه های چاقی متابولیکی مبهم است. این مطالعه با هدف مقایسه ی شاخص های کاردیومتابولیکی، کبدی و دریافت غذایی در بین گروه های چاقی متابولیکی انجام شد.
روش ها7464 شرکت کننده از شهر هویزه در این مطالعه ی مقطعی، به چهار گروه وزن طبیعی با وضعیت متابولیکی سالم (Metabolically healthy normal weight) MHNW و ناسالم (Metabolically unhealthy normal weight) MUNW، وزن غیرطبیعی (اضافه وزن-چاق) با وضعیت متابولیکی سالم (Metabolically healthy overweight/obese) MHOO و ناسالم (Metabolically unhealthy overweight/obese) MUOO تقسیم شدند. شاخص های کاردیومتابولیکی، کبدی و دریافت غذایی در بین گروه ها مقایسه شدند.
یافته هاگروه پرخطر MUOO، بیشترین فراوانی (57/36 درصد) را در بین گروه های چاقی متابولیکی داشت. نسبت دور کمر به لگن، شاخص چربی احشایی و شاخص دور کمر تعدیل شده برای وزن و اکثر شاخص های کاردیومتابولیکی در گروه های ناسالم متابولیکی به طور معنی دار مقادیر بیشتری داشتند. شاخص های کبدی در گروه های دارای اضافه وزن-چاق به طور معنی دار بزرگتر بودند. گروه های MUNW و MUOO بیشترین ارتباط مثبت را به ترتیب با شاخص ترکیب لیپوپروتیین و شاخص استیاتوز کبدی داشتند (0/001 > P). بیشترین دریافت چربی کل و اسید چرب تک غیر اشباع در گروه های MHNW و MHOO و بیشترین دریافت چربی اشباع در گروه MHNW بود.
نتیجه گیریگروه MUNW خطر بیشتری برای بیماری های قلبی- عروقی در مقایسه با گروه MHOO داشتند، پس ارتباط سلامتی متابولیکی با بیماری های قلبی- عروقی مهم تر از ارتباط چاقی با آن است. خطر استیاتوز کبدی و کبد چرب غیر الکلی در وزن غیرطبیعی بیشتر بود.
کلید واژگان: قلبی- عروقی, استئاتوز کبدی, چاقی, چاقی شکمیBackgroundThe role of metabolic status on cardiovascular disease, hepatic steatosis and, nutrition between metabolically obesity groups is unclear. This study aimed to compare the cardio-metabolic and hepatic indices and, dietary intake between metabolically obesity groups.
MethodsIn this cross-sectional study, 7464 participants in hoveyzeh city classified into four groups: MHNW: Metabolically Healthy Normal Weight, MUNW: Metabolically Unhealthy Normal Weight, MHOO: Metabolically Healthy Overweight/obese, MUOO: Metabolically Unhealthy Overweight/obese. Cardio-metabolic and hepatic indices and, dietary intake were compared among groups.
FindingsThe high risk MUOO group had the highest frequency (57.36%) among the metabolic obesity groups. The values of Waist to Hip Ratio (WHR), Visceral Adiposity Index (VAI) and Waist adjusted Weight Index (WWI) and, most of the cardio-metabolic indices in metabolically unhealthy groups were significantly higher but, hepatic indices in overweight-obese groups were significantly greater. The MUNW and MUOO groups had the most positive relation with Lipoprotein Combine Index (LCI) and Hepatic Steatosis Index (HSI), respectively. The highest intake of total fat and mono-unsaturated fatty acid was in the MHNW and MHOO groups, and the highest intake of saturated fat was in MHNW group.
ConclusionMUNW group had a higher risk for cardiovascular diseases than MHOO group. The association between metabolic health and cardiovascular diseases is more important than obesity with that. Hepatic steatosis and non-alcoholic fatty liver risk were higher in the individuals with abnormal weights.
Keywords: Cardiovascular, hepatic steatosis, Obesity, Abdominal obesity -
Non-alcoholic fatty liver disease (NAFLD) incidence and prevalence are rapidly increasing globally. The combined effects of metformin and quercetin (Que) have yet to be investigated. However, both have demonstrated the potential to reduce triglyceride (TG) levels and treat NAFLD by promoting autophagy. The objective of the present study was to elucidate the mechanism of action and assess the role of autophagy in the lipid-lowering effects of Que, both individually and in combination with metformin, in a HepG2 cell model of hepatic steatosis. Triglyceride levels and lipogenic gene expression were reduced in HepG2 cells exposed to palmitic acid (PA) when treated with Que-metformin, as evidenced by triglyceride measurements and real-time PCR. The LDH release assay also showed that this combination induced autophagy to protect HepG2 cells from PA-induced cell death. According to the Western blot analysis outcomes, Que-metformin increased LC3-I and LC3-II protein levels while decreasing p62 expression to induce autophagy. In HepG2 cells, the co-administration of Que-metformin elevated cAMP, phosphorylated AMP-activated protein kinase (p-AMPK), and Beclin-1 levels. Additionally, the inhibition of SIRT1 reversed the autophagy induced by Que-metformin. The findings of this study demonstrated for the first time that Que-metformin reduced hepatosteatosis by stimulating autophagy through the cAMP/AMPK/SIRT1 signaling pathway and diminishing inflammatory cytokines.
Keywords: Hepatic Steatosis, Metformin, Quercetin, Autophagy, SIRT1, cAMP, AMPK -
زمینه و هدف
مصرف پروبیوتیک قادر به تنظیم هموستاز سیستم گوارشی و کنترل بیماری های متابولیکی مرتبط با دستگاه گوارش می باشد. لذا هدف از این مطالعه تعیین و بررسی تغییرات هیستولوژیک و بیان ژن اینترلوکین 12، 8 و اینترفرون بتا بافت کبدی به دنبال مصرف 5 هفته ای پروبیوتیک لاکتوباسیلوس رامنوسوس GGدر رت های مدل استیاتوزیس بود.
روش بررسیدر این مطالعه تجربی که در سال 1398 انجام شد، 32 سر موش صحرایی نر ویستار با سن 8 هفته و وزن 180 تا 200 گرم وارد مطالعه شدند و به طور تصادفی به 4 گروه (هر گروه 8 سر)؛ کنترل (CON)، استیاتوزیس (ST)، پروبیوتیک (PRO) و استیاتوزیس+پروبیوتیک (ST+PRO) تقسیم شدند. رت ها با تزریق داخل صفاقی 140 میلی گرم بر کیلوگرم تتراسایکلین (آنتی بیوتیکی که برای ایجاد استیاتوز شناخته شده) مدل شدند. مقدار 107 واحد کلنی تشکیل دهنده(cfu) LGG برای گروه های پروبیوتیک به مدت 5 هفته (5 روز در هفته، به صورت گاواژ) در نظر گرفته شد. برای بررسی تغییرات هیستولوژی از رنگ آمیزی هماتوکسیلین ایوزین استفاده شد. هم چنین تغییرات بیان ژنی IL-12، IL-8 و IFN-β از روش RT-PCr استفاده شد. داده های جمع آوری شده با استفاده از نرم افزار آماری آنالیز واریانس یک طرفه تجزیه و تحلیل شدند.
یافته ها:
هیستولوژی بافت کبد پس از مدل ST به دنبال مصرف 5 هفته ای پروبیوتیک بهبود پیدا کرد. گروه ST افزایش معنی دار در بیان ژن IL-12، IL-8 و IFN-β را نشان داد (05/0<p). در مقایسه با گروه ST نیز گروه های PRO و ST+PRO کاهش معنی دار در بیان ژن IL-12، IL-8 و IFN-β را نشان دادند (05/0<p).
نتیجه گیری:
به نظر می رسد مصرف پروبیوتیک با تنظیم منفی برخی ریسک فاکتورهای سلولی قادر به بهبود سلولی و بافتی کبدی در افراد با مشکلات کبد چرب باشد. با این وجود نیاز به پژوهش های بیشتر به ویژه در نمونه انسانی است.
کلید واژگان: استئاتوزیس کبدی, پروبیوتیک, اینترلوکین, اینترفرون بتاArmaghane-danesh, Volume:27 Issue: 5, 2022, PP 551 -563Background & aimProbiotic consumption can regulate the homeostasis of the digestive system and control metabolic diseases related to the digestive system. Therefore, the purpose of the present study was to determine and investigate histological changes and gene expression of interleukin 12, 8 and interferon beta in liver tissue after 5 weeks of consumption of Lactobacillus rhamnosus GG probiotic in steatosis model rats.
MethodsIn the present experimental study conducted in 2018, 32 male Wistar rats aged 8 weeks and weighing 180 to 200 grams were included in the study and randomly divided into 4 groups (8 in each group); Control(CON), steatosis(ST), probiotic(PRO) and steatosis + probiotic(ST+PRO) were divided. Rats were modeled by intraperitoneal injection of 140 mg/kg of tetracycline (an antibiotic known to cause steatosis). The value of 107 colony forming units(cfu) of LGG was considered for probiotic groups for 5 weeks (5 days per week, by gavage). Hematoxylin and eosin staining was used to examine histological changes. Also, IL-12, IL-8 and IFN-β gene expression changes were used by RT-PCR method. The collected data were analyzed using one-way analysis of variance statistical software.
ResultsLiver tissue histology improved after 5 weeks of probiotic consumption after ST model. ST group showed a significant increase in IL-12, IL-8 and IFN-β gene expression (p<0.05). Compared to the ST group, the PRO and ST+PRO groups showed a significant decrease in IL-12, IL-8 and IFN-β gene expression (p<0.05).
ConclusionIt appeared that the consumption of probiotics is able to improve the cellular and tissue of the liver in people with fatty liver problems by negatively regulating some cellular risk factors. However, further studies are required, especially in human samples.
Keywords: Hepatic Steatosis, Probiotic, Interleukin, Beta Interferon -
Aims
The high-fat-low-carbohydrate diet is an efficient diet for reducing body weight, with increased satiety and diminishing energy consumption. This study aimed to determine the effects of a high-fat-low-carbohydrate diet on the metabolic function of the liver and pancreas in a mouse model.
Materials & MethodsThis experimental research was conducted in 2021 on 60 albino mice that were divided into 6 groups (each group containing 10 mice). At the beginning of the experiment, 40 mice were fed a high-fat-high-carbohydrate diet for 12 weeks to enhance gaining weight; then the 4 groups were fed a high-fat-low-carbohydrate diet, while the other two groups were considered as control groups. For sample collection, animals were sacrificed and blood samples were collected for biochemical analysis, tissue samples were taken for histopathological assay. Data were analyzed by SPSS 26 using the ANOVA.
FindingsThe result of this study showed that mice fed a high-fat-low-carbohydrate diet had high levels of aspartate aminotransferase, alanine aminotransferase, and cholesterol in the blood serum. In addition, the level of triglycerides and blood glucose decreased in the same groups. Histopathological study showed severe fatty changes that led to edema and degeneration of hepatocytes in the periportal area due to degeneration of the microvasculature and the formation of bridging fibrosis between the central hepatic lobes and the peripheral area in the high-fat-low-carbohydrate diet group. The tissue sections of the pancreas did not show any signs of pathology.
ConclusionLong-term administration of a high-fat-low-carbohydrate diet affects histologically and functionally in mice liver.
Keywords: High Fat Low Carbohydrate Diet, Hepatic Steatosis, Fibrosis -
Background
COVID 19 may affect organs other than lungs, including liver, leading to parenchymal changes. These changes are best assessed by unenhanced computed tomography (CT). We aim to investigate the effect of COVID 19 on liver parenchyma by measuring the attenuation in CT scan Hounsfield unit (HU).
Materials and MethodsA cohort of patients, who tested COVID 19 polymerase chain reaction positive, were enrolled and divided into two groups: fatty liver (FL) group (HU ≤ 40) and nonfatty liver (NFL) group (HU > 40) according to liver parenchyma attenuation measurements by high resolution noncontrast CT scan. The CT scan was performed on admission and on follow up (10–14 days later). Liver enzyme tests were submitted on admission and follow up.
ResultsThree hundred and two patients were enrolled. Liver HU increased significantly from 48.9 on admission to 53.4 on follow up CT scan (P<0.001) in all patients. This increase was more significant in the FL group (increased from 31.9 to 42.9 [P =0.018]) Liver enzymes were abnormal in 22.6% of the full cohort. However, there was no significant change in liver enzymes between the admission and follow up in both groups.
ConclusionThe use of unenhanced CT scan for assessment of liver parenchymal represents an objective and noninvasive method. The significant changes in parenchymal HU are not always accompanied by significant changes in liver enzymes. Increased HU values caused by COVID 19 may be due to either a decrease in the fat or an increase in the fibrosis in the liver.
Keywords: Computed tomography scan, COVID‑19, fatty liver, hepatic steatosis, Hounsfield unit, liver enzymes, liver fibrosis, liver parenchyma injury -
Background
Non-alcoholic fatty liver disease (NAFLD) is common in people with type 2 diabetes mellitus (T2DM). We aimed to explore predictive factors of NAFLD in T2DM and identify high risk subgroups.
MethodsThis was a cross-sectional study including 100 individuals with T2DM and 100 without diabetes matched for age, sex, and body mass index (BMI). Hepatic steatosis grades (calculated by controlled attenuation parameters-CAP score-3), and liver fibrosis stages (F0-F4) were determined using transient elastography.
ResultsThe frequency of NAFLD was comparable between the two study groups. However, CAP scores were significantly higher in individuals with diabetes (294.90 ± 53.12 vs. 269.78 ± 45.05 dB/m; P < 0.001). Fifty percent of individuals with diabetes had severe steatosis (S3), while this figure was 31.6% in those without diabetes (P < 0.05). Significant fibrosis (F2-F4) was more frequent in individuals with T2DM (13% vs. 4.1%, P = 0.02). Individuals with T2DM and advanced fibrosis had significantly higher BMI, waist circumference (WC), waist-hip ratio (WHR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and CAP score compared to those without fibrosis (P < 0.05). In the regression analysis, a model including BMI, WHR, AST and female gender explained 50% of the variation in CAP score in patients with diabetes (all P < 0.05, adjusted R2 : 0.508). CAP scores were also the major determinant of liver fibrosis in this group (OR: 1.04; CI: 1.017–1.063; P = 0.001).
ConclusionIndividuals with diabetes are more likely to have severe fibrosis. Obesity (especially central obesity), the female gender, elevated liver enzymes, and higher degree of insulin resistance are associated with more advanced liver disease in individuals with T2DM.
Keywords: Diabetes mellitus, Hepatic steatosis, Liver fibrosis, NAFLD, Non-alcoholic fatty liver disease, Type 2 -
Non-alcoholic fatty liver disease (NAFLD) is emerging as a major health problem worldwide. NAFLD is a continuum of disease ranging from mild liver steatosis to severe steatohepatitis, which will ultimately lead to end-stage liver disease with high morbidity and mortality rates. This disorder is considered as a silent liver disease. The metabolic syndrome and its components are accounted as the major risk factors for the progression of NAFLD to NASH and cirrhosis. Liver transplantation is considered as an appropriate treatment for the end-stage disease. For the last two decades, NASH has been the most common reason for liver transplantation, especially in the developed countries; however, the outcome of post-transplantation in these patients is of a great concern. The recurrent NASH and NAFLD seem to be the usual issues in LT. Steatosis appears in more than 80% of LTs; however, re-transplantation caused by steatohepatitis is rare. Recently, several risk factors of the recurrent NAFLD, including age, donor steatosis, metabolic syndrome, and immunosuppressant agents, have been introduced. Among the metabolic syndrome components, obesity seriously has negative effects on the outcomes of post-liver transplantation in patients. Unfortunately, there is no standard medicine to prevent or treat the recurrent NAFLD; however, it seems that weight loss and lifestyle modification play critical roles in controlling or inhibiting the recurrent NAFLD or NASH.
Keywords: Liver transplantation, Non-alcoholic fatty liver disease, Hepatic steatosis, Steatohepatitis, Liver cirrhosis, Metabolic syndrome, Insulin resistance, Obesity -
IntroductionNon-alcoholic fatty liver disease (NAFLD) is an important health problem globally that characterized as a disease spectrum which includes simple steatosis, non-alcoholic steatohepatitis and liver fibrosis and cirrhosis. The prevalence of NAFLD has significantly increased recently. The aim of this study was to investigate the relationship between anthropometric parameters and hepatic steatosis.MethodsThis cross-sectional study was performed on 415 eligible participants. Anthropometric parameters were evaluated by standard methods and fat mass was measured with bioelectrical impedance analysis. Hepatic steatosis was diagnosed using FibroScan.ResultsOf the 415 participants, 308 (74.2%) had hepatic steatosis. Body mass index and waist circumference were significantly higher in patients with hepatic steatosis. Hepatic steatosis had a significant and positive association with WC, body fat mass, and trunk fat mass. The trunk fat mass had the highest association with hepatic steatosis.ConclusionThe present study demonstrated that anthropometric measurements are related to increase hepatic steatosis even after adjustment for age and weight.Keywords: Non-alcoholic fatty liver disease, Hepatic steatosis, transient elastography, FibroScan, Anthropometric
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سابقه و هدف
سیترولین یک اسید آمینه غیرضروری مشتق شده از هندوانه می باشد که اثرات مثبت آن بر روی بهبود تحمل گلوکز، متابولیسم چربی و انرژی دیده شده است. هدف مطالعه حاضر بررسی اثر مکمل یاری با سیترولین بر سطح آنزیم های کبدی و درجه استئاتوز و فیبروز کبدی در بیماران مبتلا به کبد چرب غیرالکلی می باشد.
مواد و روش هادر یک مطالعه کارآزمایی بالینی، پنجاه بیمار مبتلا به کبد چرب غیر الکلی به طور تصادفی به دو گروه دریافت کننده مکمل سیترولین و دارونما تقسیم شدند. بیماران روزانه چهار عدد کپسول500 میلی گرمی سیترولین و یا دارونما را به مدت سه ماه مصرف کردند. تمامی افراد دو گروه برنامه ی غذایی و توصیه های فعالیت بدنی را در ابتدای مطالعه دریافت نمودند. آنزیم های کبدی، درجه استئاتوز و فیبروز کبد، میزان فعالیت بدنی و شاخص های تن سنجی در شروع و پایان مطالعه اندازه گیری شد. تجزیه و تحلیل داده ها با نرم افزار SPSS21 و آزمون های تی زوجی و تی مستقل انجام شد.
یافته هاتفاوت معنی داری در متغیرهای زمینه ای در ابتدای مطالعه بین دو گروه مشاهده نشد. در انتهای مطالعه سطح سرمی آنزیم کبدی ALT و استئاتوز کبدی در گروه مصرف کننده سیترولین در مقایسه با دارونما به طور معنی داری کاهش یافت (0/05>P). سطح سرمی آنزیم ALT به میزان(U/L) 7/26 در گروه مورد کاهش داشت در حالی که در گروه شاهد (U/L) 7/19 افزایش داشت. اما سطح سرمی AST و GGT و همچنین میزان فیبروز کبدی تفاوت معنی داری در بین دو گروه نشان نداد (0/05≤P).
نتیجه گیریاین مطالعه نشان داد که سیترولین می تواند موجب کاهش سطح سرمی ALT و درجه استئاتوز شود ، اگرچه تفاوت معنی داری بین دو گروه یافت نشد. همچنین سیترولین اثر معنی دار بر میزان فیبروز و سایر آنزیم های کبدی نداشت. لذا مطالعات بیشتری جهت بررسی نقش سیترولین بر روی کبد و حفاظت از آن با دوز و مدت زمان متفاوت مورد نیاز است.
کلید واژگان: کبد چرب غیر الکلی, سیترولین, آنزیم های کبدی, استئاتوز کبدیBackground and ObjectivesCitrulline (cit.) is a non-essential amino acid derived from watermelon, which affects improving glucose tolerance and lipid and energy metabolisms. The aim of this study was to investigate effects of citrulline supplementation on non-alcoholic fatty liver.
Materials & MethodsIn this randomized clinical trial, 50 patients with NAFLD were randomly assigned to receive either cit. or placebo. Patients received four capsules of 500 mg (cit. or placebo) daily. Both groups were advised to follow energy-balanced diets and physical activities. Liver enzymes and hepatic steatosis and fibrosis were assessed at the baseline and end of the study. Paired t-test, t-test and chi-2 were used for data analysis.
ResultsNo significant differences were observed for the monitored variables between the two groups at the baseline. After treatment, the experimental group consuming cit. supplementation showed a statistically significant decrease for ALT and hepatic steatosis, compared to control group (P<0.05). Furthermore, serum levels of AST and GGT and also hepatic fibrosis showed no significant differences between the two groups (P≥0.05).
ConclusionResults of this study showed that citrulline could decrease ALT and degrees of steatosis in cit. group with no significant differences between the two groups. In cit. group, liver enzymes of alanine aminotransferase decreased (7.26 IU/L), compared to control group (7.19 IU/L). Moreover, citrulline demonstrated no significant effects on hepatic fibrosis and other liver enzymes. To investigated effects of citrulline on liver, further studies with various doses and periods of time are necessary.
Keywords: Non-alcoholic fatty liver disease, Citrulline, Liver enzyme, Hepatic steatosis -
BackgroundNon-alcoholic fatty liver disease (NAFLD) is considered as the most common chronic liver disease, which can contribute to some clinical conditions varying from simple steatosis to hepatic cirrhosis. Consequently, the early diagnosis of NAFLD is vital. The present study aimed at investigating the ability of FLI (fatty liver index) in predicting NAFLD.MethodsA total of 212 individuals over the age of 18 years (103 males and 109 females) were recruited from those admitted to a gastrointestinal clinic in Mashhad, northeastern Iran. Anthropometric parameters were measured and blood samples were collected. Hepatic steatosis and fibrosis were identified by FibroScan. FLI from body mass index, waist circumference (WC), triglyceride, and gamma glutamyltransferase data were calculated. Logistic regression was applied to establish a relationship among FLI, hepatic steatosis, and fibrosis. The sensitivity and specificity of FLI and its optimal cut-off point were detected by receiver operating characteristic analysis.ResultsThe mean age of the participants was 39.26 ± 14.18 years. FLI was significantly associated with NAFLD (OR = 1.062, 95%CI: 1.042 - 1.082, PConclusionsFatty liver index (FLI) is a suitable and simple predictor for liver steatosis. However, performance of FLI in predicting NAFLD is not more effective than WC. Although FLI is a predictor for liver steatosis, it has a positive association with liver fibrosis and can perhaps predict liver fibrosis too.Keywords: Fatty Liver Index, Non, Alcoholic Fatty Liver Disease, Hepatic Steatosis, Hepatic Fibrosis, Waist Circumference
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BackgroundNon-alcoholic fatty liver disease (NAFLD) is a major worldwide public health problem with no effective treatment options. Green coffee bean extract (GCBE) is a rich source of bioactive phytochemicals with a variety of biochemical and physiological effects.ObjectivesThe aim of this study was to investigate the effects of GCBE on the management of patients with NAFLD.Methods44 patients with NAFLD were enrolled in a parallel, double-blind, placebo-controlled clinical trial. The participants were administered either GCBE or placebo (1 gram/day) for 8 weeks. They also were advised to follow a standard energy-balanced diet and physical activity. Liver ultrasonography, anthropometric variables, and biochemical parameters were compared at pre- and post-intervention.ResultsGCBE significantly improved the levels of aspartate aminotransferase (AST), triglyceride (TG), total cholesterol, free fatty acids (FFAs), fasting blood sugar (FBS), homeostasis model assessment insulin resistance (HOMA-IR) index, high-sensitivity C-reactive protein (hs-CRP), and total antioxidant capacity (TAC) compared to the placebo group. On the other hand, there were no significant differences between the two groups in body weight, HDL-cholesterol, LDL-cholesterol, LDL-C to HDL-C ratio, insulin, degree of steatosis, aspartate transaminase (AST), alkaline phosphatase (ALP), and tumor necrosis factor-alpha (TNF-α).ConclusionsGCBE supplementation may benefit patients with NAFLD. These beneficial effects may be due to the possible ability of GCBE to improve insulin sensitivity and its anti-inflammatory and antioxidant properties.Keywords: Non, Alcoholic Fatty Liver Disease, Green Coffee Bean Extract, Chlorogenic Acid, Polyphenols, Hepatic Steatosis, Phytochemicals
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BackgroundChronic hepatitis B (CHB) remains a major public health problem worldwide, and the prevalence of CHB patients with hepatic steatosis is gradually increasing. Noninvasive approaches for the assessment of hepatic steatosis have been developed as alternatives to liver biopsy.ObjectivesThis study evaluated the diagnostic performance of the fat attenuation parameter (FAP) measured by transient elastography (FibroTouch) and a new algorithm to assess hepatic steatosis in CHB patients, in comparison to liver biopsy as the gold standard.MethodsTwo hundred fifty-four CHB patients underwent simultaneous liver biopsy, biochemical blood testing, and FibroTouch examination. A new algorithm based on four factors (FAP; body mass index, BMI; high-density lipoprotein, HDL; apolipoprotein B, APOB) was defined as follows: fatty index = 10*ep/ (1), and P = -2.75 0.028 ln FAP (dB/m) 0.409 ln BMI (Kg/m2) - 2.482 ln HDL (mmol/L) 1.979 ln APOB (g/L). The performances of FAP and fatty index were assessed by area under the ROC curve (AUROC).ResultsThe difference in FAP was significant (P 0, ≥ 5%, ≥ 10%, ≥ 20%, and ≥ 30% were 224.1, 230.6, 235.5, 246.9, and 261.1 dB/m, and AUROCs were 0.833, 0.801, 0.915, 0.917, and 0.972, respectively. The optimal cutoff value of fatty index for the diagnosis of hepatic steatosis was 1.5 and the AUROC was 0.807.ConclusionsFAP is an accurate, reliable, and noninvasive approach that can also be combined with other metabolic biomarkers to comprehensively detect and quantify hepatic steatosis.Keywords: Chronic Hepatitis B, Hepatic Steatosis, Transient Elastography, Noninvasive Diagnosis, Fatty Index
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مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، سال هفتاد و چهارم شماره 5 (پیاپی 185، امرداد 1395)، صص 330 -336زمینه و هدفاستفاده از آنزیم های مرحله استرس اکسیداتیو روشی غیرتهاجمی در پیش بینی پاتولوژی کبد در مبتلایان به کبد چرب غیرالکلی است. پژوهش کنونی با هدف بررسی ارتباط سطح سرمی روی در بیماران مبتلا به کبد چرب غیرالکلی (NAFLD) با یافته های پاتولوژی کبد انجام شد.روش بررسیمطالعه به صورت کوهورت همراه با گروه کنترل در بیماران مبتلا به کبد چرب غیرالکلی مراجعه کننده به درمانگاه گوارش بیمارستان سینا، تهران در مدت یک سال (فروردین 1393 تا فروردین 1394) انجام شد. افرادی که فاقد بیماری در بالین و سونوگرافی کبدی و آزمایشات طبیعی بودند به عنوان گروه کنترل وارد مطالعه شدند. در افراد شرکت کننده سطح سرمی روی با روش اسپکترومتری جذب اتمی مورد بررسی قرار گرفت. سطح طبیعی روی μmol/L 9/22- 7/10 (μg/dL 70-150) بوده و سطوح کمتر از (μg/dL 46) μg/dl 7 به عنوان کمبود روی در نظر گرفته شد.یافته هادو گروه 60 نفری در این مطالعه شرکت کردند. در گروه مورد، شش نفر و در گروه شاهد 26 نفر به دلیل عدم رضایت به انجام آزمایشات حذف شدند. در نهایت 54 نفر در گروه مورد (35 مرد، 19 زن) و 34 نفر در گروه شاهد (22 مرد، 12 زن) در بررسی نهایی شرکت داده شدند. میانگین سنی بیماران در گروه مورد 82/9±02/37 سال و در گروه شاهد 01/12±24/33 سال بود (111/0P=). اختلاف آماری معناداری بین دو گروه از نظر سطح روی وجود نداشت (50/0P=).نتیجه گیرییافته های به دست آمده نشان داد که ارتباط آماری معناداری میان سطح سرمی روی و استئاتوز، التهاب لوبولار و فیبروز کبد در مبتلایان به کبد چرب غیرالکلی وجود ندارد.کلید واژگان: کبد چرب غیرالکلی, سطح سرمی روی, استرس اکسیداتیو, استئاتوز, التهاب لوبولار کبدی, فیبروز کبدیBackgroundNonalcoholic fatty liver disease (NAFLD) includes steatosis, nonalcoholic steatohepatitis, fibrosis and liver cirrhosis. The oxidative stress enzymes are the diagnostic markers to prediction of histologic status of liver in nonalcoholic steatohepatitis disease. The aim of the study was to assessment of relationship between serum Zinc (Zn) levels with pathologic manifestation in patients with nonalcoholic steatohepatitis.MethodsThis cohort study was done in patients with nonalcoholic steatohepatitis that had been visited in gastrointestinal clinic of Sina Hospital, Tehran, Iran from April, 2014 to April, 2015. Control group included the patients with no clinical manifestation of nonalcoholic steatohepatitis and normal liver ultrasonography, lab test and liver biopsy. Serum Zn level was measured with atomic absorption spectroscopy. Normal Serum level of Zn was considered 10.7-22.9 µmol/L (70-150 µg/dL) and less than 7 µg/dL was considered as Zn deficiency. Pathological findings were grading according to NAFLD activity score.ResultsOne hundred twenty patients were selected for the study in two equal groups. Six and 26 patients were excluded in case and control groups, respectively due to no consent to lab test. Finally, 54 patients (35 male/19 female) and 34 patients (22 male/12 female) in control group were participated in data analysis. The mean age on case and control group was 37.02±9.82 year and 33.24±12.01 year, respectively (P= 0.111). Zn level in case and control groups were 90.82±13.69 and 88.82±13.10, respectively. There were no statistically significant differences between two group in serum Zn level (P= 0.50). Also, there were no statistically significant differences between pathological grading in case group participants (steatosis: P= 0.640; Lobular inflammation: P= 0.882; fibrosis: P= 0.531).ConclusionThe finding of the study showed no significant association between serum zinc level and hepatic steatosis, lobular inflammation and fibrosis of the liver in nonalcoholic steatohepatitis.Keywords: hepatic steatosis, inflammatory liver, liver fibrosis, non, alcoholic fatty liver disease, oxidative stress, zinc
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BackgroundNonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. The pathogenesis of this disease is closely associated with obesity and insulin resistance. Ginger can have hypolipidemic and antioxidant effects, and act as an insulinsensitizer.ObjectivesThe aim of this study was to evaluate the effects of ginger supplementation in NAFLD management.Patients andMethodsIn a randomized, double-blind, placebo-controlled clinical trial, 44 patients with NAFLD were assigned to take either two grams per day of a ginger supplement or the identical placebo, for 12 weeks. In both groups, patients were advised to follow a modified diet and physical activity program. The metabolic parameters and indicators of liver damage were measured at study baseline and after the 12 week intervention.ResultsGinger supplementation resulted in a significant reduction in alanine aminotransferase, γ-glutamyl transferase, inflammatory cytokines, as well as the insulin resistance index and hepatic steatosis grade in comparison to the placebo. We did not find any significant effect of taking ginger supplements on hepatic fibrosis and aspartate aminotransferase.ConclusionsTwelve weeks of two grams of ginger supplementation showed beneficial effects on some NAFLD characteristics. Further studies are recommended to assess the long-term supplementation effects.Keywords: Nonalcoholic Fatty Liver Disease, Ginger, Hepatic Steatosis, Inflammatory Biomarkers, Lipid Profile
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زمینه و هدفبیماری کبد چرب غیر الکلی، یکی از معمول ترین عوامل آسیب مزمن کبد در جهان می باشد. هدف از این مطالعه، بررسی اثرات پیشگیرانه عصاره چای سبز از ایجاد کبد چرب در اثر رژیم غذایی پرچرب در موش صحرایی می باشد.مواد و روش هادر این مطالعه تجربی، موش های صحرایی نر ویستار به طور تصادفی به گروه های آزمایشی شاهد سالم، تغذیه با جیره پرچرب، تغذیه با جیره پرچرب و درمان با کلوفیبرات، تغذیه با جیره پرچرب و تیمار با عصاره چای سبز تقسیم شدند. موش ها به مدت 6 هفته توسط رژیم غذایی پرچرب برای ایجاد کبد چرب و درمان با کلوفیبرات یا عصاره چای سبز جهت پیشگیری از کبد چرب، تیمار گردیدند. در پایان، تغییرات چربی سرم، شاخص های سرمی آسیب کبد و فعالیت آنتی اکسیداتیوی کبد بین گروه ها با تحلیل واریانس یکطرفه و آزمون تعقیبی توکی مورد مقایسه قرار گرفتند. آسیب شناسی کبد برای تایید یافته های بیوشیمیایی انجام شد.یافته هادر موش هایی که با جیره پرچرب تغذیه شده بودند، هیپرتری گلیسریدمی و هیپرکلسترولمی ایجاد شد. در این موش ها افزایش سطح سرمی آنزیم های کبدی و کاهش معنی دار فعالیت آنتی اکسیدان ها و افزایش میزان شاخص پراکسیداسیون لیپیدی بافت کبد دیده شد (001/0=p). تیمار با عصاره چای سبز به طور معنی داری مقادیر افزایش یافته شاخص های آسیب کبد (023/0=p) و مالون دی آلدئید (032/0=p) را کاهش داد، همچنین، آنتی اکسیدان های کبد و لیپیدهای افزایش یافته سرم را به حالت طبیعی برگرداند (028/0=p). آسیب شناسی کبد، تغییرات ناشی از جیره پرچرب و اثرات پیشگیرانه عصاره چای سبز را مورد تایید قرار داد.نتیجه گیریتاثیر پیشگیرانه چای سبز از بروز کبد چرب در موش های صحرایی تغذیه شده با جیره پرچرب به خصوصیات آنتی اکسیدانی آن مربوط می گردد.
کلید واژگان: جیره غذایی پرچرب, چای سبز, آنتی اکسیدان ها, کبد چربBackground And ObjectiveNonalcoholic fatty liver disease is one of the most common causes of chronic liver injury throughout the world. In this study, the preventive effects of green tea extract on fatty liver disease induced by high fat diet is assessed in the rats.Materials And MethodsIn this experimental study, male Wistar rats were randomly divided to: Healthy control, Feeding with high fat diet, Feeding with high fat diet plus Clofibrate treatment and Feeding with high fat diet plus Green tea extract treatment groups. The rats treated with either high fat diet for induction of hepatic steatosis and high fat diet plus Clofibrate or Green tea extract for prevention of liver steatosis, at a period of 6 weeks. At the end of experiment, Serum lipid profile, serum biomarkers of liver tissue injury and hepatic antioxidant activity were statistically compared among the groups using one-way ANOVA and Tukey post-tests. The biochemical findings were matched with histopathological verifications.ResultsIn the rats fed with high-fat diet hypertriglyceridemia and hypercholesterolemia were created. In these animals, increased serum levels of hepatocellular enzymes and significant reduction in antioxidants as well as elevated hepatic lipid peroxidation index were encountered (p=0.001). Extract treatment significantly reduced elevated markers of liver tissue injury (p=0.023) and malondialdehyde (p=0.032), and brought back the liver antioxidants (p=0.028) and the over accumulation of serum lipids towards normal. Histopathology of the liver confirmed the changes induced by high fat diet and the preventive effect of green tea extract.ConclusionPreventive effect of green tea on fatty liver disease in the rats fed with high fat diet is related to its antioxidant properties.Keywords: High fat fed diet, Green tea, Antioxidants, Hepatic steatosis
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