scholarly journals Pediatric Fatty Liver and Obesity: Not Always Justa Matter of Non-Alcoholic Fatty Liver Disease

Children ◽  
2018 ◽  
Vol 5 (12) ◽  
pp. 169
Author(s):  
Renata Alfani ◽  
Edoardo Vassallo ◽  
Anna De Anseris ◽  
Lucia Nazzaro ◽  
Ida D'Acunzo ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Large Scale ◽  
Correct Diagnosis ◽  
Diagnostic Algorithm ◽  
Liver Imaging ◽  
Dietary Counseling ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Obesity-related non-alcoholic fatty liver disease (NAFLD) represents the most common cause of pediatric liver disease due to overweight/obesity large-scale epidemics. In clinical practice, diagnosis is usually based on clinical features, blood tests, and liver imaging. Here, we underline the need to make a correct differential diagnosis for a number of genetic, metabolic, gastrointestinal, nutritional, endocrine, muscular, and systemic disorders, and for iatrogenic/viral/autoimmune hepatitis as well. This is all the more important for patients who are not in the NAFLD classical age range and for those for whom a satisfactory response of liver test abnormalities to weight loss after dietary counseling and physical activity measures cannot be obtained or verified due to poor compliance. A correct diagnosis may be life-saving, as some of these conditions which appear similar to NAFLD have a specific therapy. In this study, the characteristics of the main conditions which require consideration are summarized, and a practical diagnostic algorithm is discussed.

scholarly journals Ultrasound steatometry in patients with non-alcoholic fatty liver disease: pilot results

2019 ◽  
Vol 10 (1) ◽  
pp. 23-29
Author(s):  
Darya Yu. Venidiktova ◽  
Alexey V. Borsukov ◽  
Anna V. Alipenkova ◽  
Alina V. Eremkina ◽  
Anton O. Tagil ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Diagnostic Algorithm ◽  
Information Value ◽  
Ultrasound Measurement ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Alcoholic Fatty Liver Disease

Objective. To evaluate the effectiveness of the ultrasound steatometry technique in patients with non-alcoholic fatty liver disease. Materials and methods. 68 patients aged 19–62 years (median age 40.5 years) were examined, 30 men (44.1%) and 38 women (55.9%), who underwent a single diagnostic algorithm of 7 (8) stages: questioning, clinical examination, noninvasive bioimpedance, biochemical blood test, liver ultrasound in B-mode, determination of hepatorenal index, ultrasound steatometry, liver biopsy. Results. In 4 patients (5.88%), a remote clinical picture of the metabolic syndrome, fatty liver infiltration was diagnosed. Signs of steatohepatitis were present in 19 (27.9%) patients, signs of cirrhosis — in 2 (2.9%). The sensitivity and specificity were 60.3% and 72.6%, respectively, for the B-mode, 44.3% and 51.9%, respectively, for the ultrasound measurement of the hepatorenal index, 90.6% and 92.2%, respectively, for ultrasonic steatometry. Conclusion. Ultrasound steatometry is an informative method for screening of patients with non-alcoholic fatty liver disease. Correlation (r) of the ultrasound diagnosis of steatosis with biopsy at the stage S0 corresponds to 0.81, at the stage S1 — to 0.68, at the stage S2 — to 0.74, at the stage S3 — to 0.88, that indicates a high information value of this method.

scholarly journals Non-alcoholic fatty liver disease: current aspects of diagnosis in real clinical practice

2021 ◽  
Vol 2 (4) ◽  
pp. 40-50
Author(s):  
Dmitry I. Trukhan ◽  
Keyword(s):  
Clinical Practice ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Metabolic Diseases ◽  
Diagnostic Algorithm ◽  
Malignant Neoplasms ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease ◽  
Real Clinical Practice

In the diagnosis and subsequent supervision of patients with non-alcoholic fatty liver disease (NAFLD) and obesity in real clinical practice, the role and importance of the doctor of first contact (therapist and general practitioner) increases. Non-alcoholic fatty liver disease is currently considered as the hepatic component of metabolic syndrome. A diagnostic algorithm for NAFLD at the stage of primary health care is presented. The most difficult question at 2–4 levels of the diagnostic algorithm is the differential diagnosis between NAFLD and alcoholic liver disease. During a pandemic of a novel coronavirus infection (COVID-19), patients with NAFLD or NASH, as a rule, have concomitant metabolic diseases such as diabetes mellitus, arterial hypertension and obesity, and also have to take a large number of potentially hepatotoxic drugs, it is advisable to classify them as elevated risk of infection with SARS-CoV-2, and the severe course of this infection. This allows us to consider NAFLD as dangerous in terms of the severe course of COVID-19, as viral hepatitis, autoimmune hepatitis and liver fibrosis / cirrhosis. It is known that NAFLD is an independent predictor of not only high cardiovascular risks, but also hepatocellular carcinoma and malignant neoplasms of various localization, as well as a number of other comorbid conditions. The review concludes with a clinical observation illustrating the difficulty of early diagnosis of intrahepatic cholangiocarcinoma in a patient with NAFLD and other metabolic risk factors.

scholarly journals Hepatic Unsaturated Fatty Acids Are Linked to Lower Degree of Fibrosis in Non-alcoholic Fatty Liver Disease

2022 ◽  
Vol 8 ◽  
Author(s):  
Michael Fridén ◽  
Fredrik Rosqvist ◽  
Håkan Ahlström ◽  
Heiko G. Niessen ◽  
Christian Schultheis ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Large Scale ◽  
Unsaturated Fatty Acids ◽  
Vaccenic Acid ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Background: The hepatic lipidome of patients with early stages of non-alcoholic fatty liver disease (NAFLD) has been fairly well-explored. However, studies on more progressive forms of NAFLD, i.e., liver fibrosis, are limited.Materials and methods: Liver fatty acids were determined in cholesteryl esters (CE), phospholipids (PL), and triacylglycerols (TAG) by gas chromatography. Cross-sectional associations between fatty acids and biopsy-proven NAFLD fibrosis (n = 60) were assessed using multivariable logistic regression models. Stages of fibrosis were dichotomized into none-mild (F0–1) or significant fibrosis (F2–4). Models were adjusted for body-mass index (BMI), age and patatin-like phospholipase domain-containing protein 3 (PNPLA3 rs738409) (I148M) genotype. A secondary analysis examined whether associations from the primary analysis could be confirmed in the corresponding plasma lipid fractions.Results: PL behenic acid (22:0) was directly associated [OR (95% CI): 1.86 (1.00, 3.45)] whereas PL docosahexaenoic acid (22:6n-3) [OR (95% CI): 0.45 (0.23, 0.89)], TAG oleic acid (18:1n-9) [OR (95% CI): 0.52 (0.28, 0.95)] and 18:1n-9 and vaccenic acid (18:1n-7) (18:1) [OR (95% CI): 0.52 (0.28, 0.96)] were inversely associated with liver fibrosis. In plasma, TAG 18:1n-9 [OR (95% CI): 0.55 (0.31, 0.99)], TAG 18:1 [OR (95% CI): 0.54 (0.30, 0.97)] and PL 22:0 [OR (95% CI): 0.46 (0.25, 0.86)] were inversely associated with liver fibrosis.Conclusion: Higher TAG 18:1n-9 levels were linked to lower fibrosis in both liver and plasma, possibly reflecting an altered fatty acid metabolism. Whether PL 22:6n-3 has a protective role, together with a potentially adverse effect of hepatic 22:0, on liver fibrosis warrants large-scale studies.

Association between consumption frequency of honey and non-alcoholic fatty liver disease: results from a cross-sectional analysis based on the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study

2020 ◽  
pp. 1-9 ◽  
Author(s):  
Shunming Zhang ◽  
Xiaohui Wu ◽  
Shanshan Bian ◽  
Qing Zhang ◽  
Li Liu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Large Scale ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Consumption Frequency ◽  
Alcoholic Fatty Liver Disease

Abstract Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. Recent evidence has suggested the protective effects of honey consumption against the metabolic syndrome, but the association between honey intake and NAFLD is still unclear. We investigated how the consumption frequency of honey was associated with NAFLD in the general population. This was a cross-sectional study of 21 979 adults aged 20–90 years. NAFLD was diagnosed based on the ultrasound-diagnosed fatty liver without significant alcohol intake and other liver diseases. Diet information, including consumption frequency of honey, was assessed by a validated 100-item FFQ. OR with 95 % CI were calculated by the binary logistic regression model, adjusting for confounding factors identified by the directed acyclic graph. Overall, 6513 adults (29·6 %) had NAFLD. Compared with participants consuming ≤1 time/week of honey, the multivariable OR of NAFLD were 0·86 (95 % CI 0·77, 0·97) for 2–6 times/week and 1·10 (95 % CI 0·95, 1·27) for ≥1 times/d (Pfor trend = 0·90). The results were generally similar in subgroups of BMI at a cut-point of 24·0 kg/m2 (Pfor interaction = 0·10). In this large-scale study, consuming honey 2–6 times/week was inversely associated with NAFLD, whereas consuming honey ≥1 times/d had no association with NAFLD. These results need replication in other large-scale prospective studies.

scholarly journals The association between adiponectin level and non alcoholic fatty liver disease (NAFLD) in obese adolescents

2020 ◽  
Vol 7 (2) ◽  
pp. 384-387
Author(s):  
Maria Mexitalia ◽  
Suci Romadhona
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Adiponectin Level ◽  
Liver Imaging ◽  
Alcoholic Fatty Liver ◽  
Obese Adolescents ◽  
Obese Subjects ◽  
Alcoholic Fatty Liver Disease

Background: Non alcoholic fatty liver disease  (NAFLD) has been associated with cytokines and inflammatory mediators. Adiponectin has insulin sensitizing effects and has correlation with severity of NAFLD disease. However, the study about the relationship between adiponectin level and NAFLD is lacking. The objective of the study was to determine the association between adiponectin level and NAFLD in obese adolescents through the role of insulin resistance. Methods: This was a cross-sectional study, that was done in August 2007.  The inclusion criteria were obese adolescents aged 11-14 years, and normal weight adolescent as control group. Adiponectin was assessed by using ELISA, insulin resistance was obtained by Homeostasis Model Assessment Insulin Resistance (HOMA-IR). NAFLD was confirmed by abdominal ultrasound, which represented by fatty liver imaging. The comparison of adiponectin level and HOMA-IR among 3 groups were analyzed by Kruskal Wallis test, meanwhile the correlation between adiponectin level and some variables were analyzed by spearman correlation. Result: There were 73 subjects, consisted of 37 obese and 36 non obese. Among obese subjects, 54.1% got NAFLD. All of our obese subjects were insulin resistance, the HOMA-IR level of obese non NAFLD was 6.1 and obese with NAFLD was 6.8. The adiponectin levels in normal children was (5.1mg / ml), obese non NAFLD  (4.1mg / ml) and obese with NAFLD (4.0 mg / ml) (p <0.001). There were no association between adiponectin level and other variables. Conclusion: There were significant differences of adiponectin levels and insulin resistance measured by HOMA-IR between normal and obese subjects, but no significant differences between the obese groups with or without NAFLD. Keywords: NAFLD, adiponectin, HOMA-IR, obesity, adolescent.  

scholarly journals Non-alcoholic fatty liver disease associated with obesity: features ursodeoxycholic acid

2019 ◽  
pp. 86-94
Author(s):  
D. I. Trukhan ◽  
O. A. Bilevich
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Ursodeoxycholic Acid ◽  
Fatty Liver Disease ◽  
Diagnostic Algorithm ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Treatment And Prevention ◽  
First Contact ◽  
Alcoholic Fatty Liver Disease

The diagnosis and management of patients with obesity and nonalcoholic fatty liver disease (NAFLD) is now the role and importance of the first contact a doctor (therapist and general practitioner). The article discusses the diagnostic algorithm of obesity, based on the classification AAСE / ACE (2014), and the possibility of ursodeoxycholic acid as part of treatment and prevention recommendations in patients with NAFLD associated with obesity.

Vitamin D levels are not associated with non-alcoholic fatty liver disease severity in a Brazilian population

2020 ◽  
pp. 1-8
Author(s):  
Jeniffer Danielle M. Dutra ◽  
Quelson Coelho Lisboa ◽  
Silvia Marinho Ferolla ◽  
Carolina Martinelli M. L. Carvalho ◽  
Camila Costa M. Mendes ◽  
...  
Keyword(s):  
Vitamin D ◽  
Liver Disease ◽  
Fatty Liver ◽  
Disease Severity ◽  
Fatty Liver Disease ◽  
Hypovitaminosis D ◽  
Alcoholic Fatty Liver ◽  
Vitamin D Levels ◽  
The Mean ◽  
Alcoholic Fatty Liver Disease

Abstract. Some epidemiological evidence suggests an inverse correlation between non-alcoholic fatty liver disease (NAFLD) frequency and vitamin D levels. Likewise, a beneficial effect of vitamin D on diabetes mellitus (DM) and insulin resistance has been observed, but this is an unsolved issue. Thus, we aimed to investigate the prevalence of hypovitaminosis D in a NAFLD Brazilian population and its association with disease severity and presence of comorbidities. In a cross-sectional study, the clinical, biochemical and histological parameters of 139 NAFLD patients were evaluated according to two different cut-off points of serum 25-hydroxyvitamin D levels (20 ng/mL and 30 ng/mL). The mean age of the population was 56 ± 16 years, most patients were female (83%), 72% had hypertension, 88% dyslipidemia, 46% DM, 98% central obesity, and 82% metabolic syndrome. Serum vitamin D levels were < 30 ng/mL in 78% of the patients, and < 20 ng/mL in 35%. The mean vitamin D level was 24.3 ± 6.8 ng/mL. The comparison between the clinical, biochemical and histological characteristics of the patients according to the levels of vitamin D showed no significant difference. Most patients with NAFLD had hypovitaminosis D, but low vitamin D levels were not related to disease severity and the presence of comorbidities.

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