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Hepatic fibrosis, measured by fibroscan in a group of patients with obesity

Abstract

Introduction.Hepatic steatosis is a reversible condition caused by accumulation of triglycerides in liver cells. Non-alcoholic fatty liver disease (NAFLD) can progress to advanced liver disease: fibrosis, cirrhosis, liver failure, cancer, and finally can lead to death; therefore NAFLD contributes significantly to morbidity and mortality of hepatic cause. Materials and methods: The study was conducted on a group of 88 patients with Body Mass Index (BMI) ≥ 30kg/m², they were excluded patients with known diabetes. Results, Discussion: The statistical analysis showed that in more than half of subjects elastometry values were higher than those considered normal, obesity is a risk factor for NAFLD that progresses in hepatic fibrosis. Conclusions: Liver fibrosis is present in high percentage in patients with obesity (52% of subjects) and it was positively correlated with age, arterial stiffness and fasting glucose.

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Polyphenols treatment in patients with nonalcoholic fatty liver disease

Introduction In the last few decades, the term nonalcoholic fatty liver disease (NAFLD) has been evoked increasingly in research frameworks and in clinical practice. It defines the presence of significant fat accumulation in the liver (> 5% of hepatocytes), in the absence of alcohol abuse and any other cause of liver diseases.[ 1 ] The term NAFLD includes different clinical entities, and in particular, the fat accumulation in liver, also known as simple fatty liver and nonalcoholic steatohepatitis (NASH); it is characterized by steatosis along with

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Effect of weight reduction on histological activity and fibrosis of lean nonalcoholic steatohepatitis patient

Introduction Non-alcoholic fatty liver disease (NAFLD), the most prevalent chronic liver disorder worldwide, is a clinico-histopathological entity ranging from simple fat accumulation (steatosis) to non-alcoholic steatohepatitis (NASH). [ 1 , 2 ] NASH is diagnosed by the joint presence of steatosis and inflammation along with hepatocyte injury (evident as hepatocyte ballooning). [ 3 ] It is estimated that NASH occurs in 20% of patients with NAFLD, whereas in Bangladesh, it shows a higher proportion (42.4%). [ 4 , 5 ] Due to its progressive nature

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Effect of pentoxifylline on histological activity and fibrosis of nonalcoholic steatohepatitis patients: A one year randomized control trial

Introduction Non-alcoholic fatty liver disease (NAFLD) is a condition pathologically linked to the metabolic syndrome by the intervention of insulin resistance (IR), characterized by hepatic steatosis in the absence of significant alcohol use, hepatotoxic medications or other known liver diseases.[ 1 ] Globally, the prevalence of NAFLD is 25.24%.[ 2 ] In the Asia-Pacific region, the prevalence of NAFLD has increased remarkably over the years affecting up to 30% of the general population.[ 3 ] In case of NAFLD, Bangladeshi ethnicity is an independent risk

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The pathogenesis of non-alcoholic fatty liver disease is closely related to the metabolic syndrome components

, atherosclerosis, and aspects of insulin action. Diabetes Care 28: 2312-2319, 2005. 18. Targher G, Bertolini L, Scala L et al . Nonalcoholic hepatic steatosis and its relation to increased plasma biomarkers of inflammation and endothelial dysfunction in nondiabetic men. Role of visceral adipose tissue. Diabet Med 22: 1354-1358, 2005. 19. Savage DB, Petersen KF, Shulman GI . Disordered lipid metabolism and the pathogenesis of insulin resistance. Physiol Rev 87: 507-520, 2007. 20. Cnop M, Landchild MJ, Vidal J et al. The

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Metabolic disorders and cardiovascular risk enhanced by nonalcoholic fatty liver disease in patients with metabolic syndrom

References 1. Angulo P . Nonalcoholic Fatty Liver Disease. The New England Journal of Medicine Vol. 346, No. 16: 1221-1231, 2002. 2. Festi D, Colecchia A, Sacco T, Bondi M, Roda E and Marchesini G. Hepatic steatosis in obese patients: clinical aspects and prognostic significance. Obesity reviews 5: 27-42, 2004. 3. Farrell GC, Larter CZ. Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology 43(2 Suppl 1): S99-S112, 2006. 4. Szczepaniak LS, Nurenberg P, Leonard D

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Unusual presentation of nonalcoholic steatohepatitis-related cirrhosis in a patient with celiac disease and microscopic colitis

Abstract

Nonalcoholic steatohepatitis (NASH) is defined as the presence of hepatic steatosis and inflammation with hepatocyte injury (ballooning) with or without fibrosis. NASH is often a “silent” liver disease. Estimated prevalence of NASH ranges from 3% to 5% in different studies. The prevalence of NASH-related cirrhosis in the general population is not known. Herein, we report a case of a young female presented with NASH-related cirrhosis in the setting of poorly controlled celiac disease (CD) and microscopic colitis. A variety of liver abnormalities have been observed in patients with CD, but this unique constellation of the gut and liver pathologies has not been reported previously.

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Diabetes Mellitus, Obesity and Underlying Non Alcoholic Fatty Liver Disease - Independent Risk Factors for Hepatocellular Carcinoma

Abstract

Background and Aims. Hepatocellular carcinoma (HCC) is one of the most common malignancies. Obesity, together with the underlying liver steatosis, has received increased attention as a risk factor for HCC. Diabetes Mellitus (DM) is also reported to be associated with HCC. We aimed to estimate the risk of HCC in obese and diabetic patients. Material and method. We prospectively analyzed 414 obese and diabetic patients, over a period of 5 years. We evaluated all patients using screening methods such as abdominal ultrasound and serum alpha-fetoprotein every 6 month, in order to detect HCC occurrence. Kaplan-Meier analysis estimated the cumulative incidence of HCC. Univariate and multivariate Cox regression analysis assessed the association between HCC and obesity. Results. Median follow-up was 4.3 years. 11 from 77 cirrhotic obese patients, and 18 from 150 non-cirrhotic obese patients developed HCC (p=ns). 7 from 51 patients with DM and cirrhosis, and 14 from 136 non-cirrhotic patients with DM developed HCC (p=ns). The cumulative incidence of HCC was 2.8%, respectively 2.6%, in cirrhotic patients with obesity or DM, compared with 2.2%, respectively 2.0%, in non-cirrhotic patients with obesity or DM (p=ns). Conclusion. Obesity and DM, along with nonalcoholic fatty liver disease (NAFLD), seems to be independent risk factors for HCC occurrence.

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Pharmacological Approaches for Nonalcoholic Fatty Liver Disease

Abstract

Background and aims: Nonalcoholic fatty liver disease (NAFDL) is a multifactorial condition with a wide spectrum of histological severities, from asymptomatic hepatic steatosis to nonalcoholic steatohepatitis (NASH) with or without fibrosis. NAFLD is highly common and potentially serious in children and adolescents and affects approximately one third of the general population. It is closely associated with obesity, insulin resistance and dyslipidemia. NASH is a histological diagnosis and has a great significance because it can progress to cirrhosis, liver failure, and hepatocellular carcinoma (HCC), and is associated with both increased cardiovascular and liver related mortality. The purpose of this review is to summarize the evidence for current potential therapies of NAFLD.

Material and Methods: We searched MEDLINE from 2010 to the present to identify the pharmacological approaches for NAFLD.

Results and conclusions: NAFLD may be a new risk factor for extrahepatic diseases such as cardiovascular disease (CVD), chronic kidney disease (CKD), colorectal cancer, type 2 diabetes mellitus (T2DM) and osteoporosis. Currently there is no specific targeted treatment for NAFLD/NASH.

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Type 2 Diabetes and Hashimoto Thyroiditis-Possible Associations and Clinical Correlations - Preliminary Results

Abstract

Background and aims: The primary objective is to evaluate the possible relationship between Type 2 Diabetes (T2DM) and Hashimoto Thyroiditis (HT), since the only correlation described until now is between Type 1 Diabetes and HT based on the autoimmune mechanism. The secondary end-point is to evaluate if there is a correlation between the characteristics of Type 2 Diabetes and autoimmune thyroiditis and if the metabolic component may be a factor of association.

Material and method: We designed a retrospective, observational research, enrolling patients from “Sanamed” Hospital from Bucharest. Between 2016 and 2017 in our clinic a number of 150 patients were enrolled, in the following groups: 50 only with T2DM, 50 only with HT and 50 with both T2DM and HT.

Results: The main observations of the study were the following: the prevalence of obesity was higher in patients with T2DM (p<0.001) than in the group with HT (p<0.001); Dyslipidemia was higher in the HT group (p<0.001) than in the group of T2DM (p<0.001); Ischemic cardiac disease was more frequent in the HT group (p<0.001) than in the Diabetes group (p<0.001); in the group that had both T2DM and HT, the HbA1c was correlated with pre-existing Thyroid pathology (p<0.001), also Dyslipidemia was associated with hepatic steatosis (p<0.001).

Conclusions: After assessing all the parameters we have reached the conclusion that there is an association between the characteristics of T2DM and HT, as well as an interaction between these two diseases, considering their metabolic component.

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