Genetic polymorphism in cluster of differentiation 14 (CD14) gene C(-159) t is associated with...
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of Pre and post liver biopsy was the limitation. A large con- trol trial needs to validate. Corresponding Author. Patrick Basu. E-mail: [email protected] ANALYSIS OF RISK FACTORS FOR FIBROSIS IN BIOPSY PROVEN NAFLD Kaumudee Pattnaik, 1 Pallavi Bhuyan, 1 Sitaram Mahapatra, 1 Bijay Mishra, 2 Sanjib Kar, 2 S. P. Singh 2 1 Department of Pathology, SCB Medical College, Cuttack, India, 2 Department of Gastroenterology, SCB Medical College, Cuttack, India Background: Nonalcoholic fatty liver disease (NAFLD) is fast becoming one of the top concerns for clinicians due to the obesity epidemic and it's potential to progress to chronic liver disease which has significant impact on liver-related morbidity and mortality. Advanced fibrosis that accompanies NAFLD leads to the development of Cir- rhosis and hepatocellular carcinoma. Objectives: There is a need to identify patients who are likely to have fibrosis. Methods: Two hundred and sixteen cases were selected for liver biopsies taking into account the clinical parameters and or Ultrasonography findings of fatty liver. Formalin fixed paraffin embedded tissue sections were stained with Haema- toxylin and Eosin, Reticulin and Masson's Trichrome. Histo- pathologic scoring was done as per Brunt et al scoring system. Result: Out of 216 biopsy proven NAFLD patients, 183 were male and 33 female. On histopathological study, fibrosis was found in 48.216 (22%) cases. On evaluation of metabolic profile, two third (59%) were obese (BMI > 23), 75% had transaminitis, 93% had dyslipidemia, 23% were diabetic and 20% were hypertensive. Inspite of these metabolic derangements, only 36% had moderate fatty change on ultrasonography and rests were mild. Metabolic syndrome was present in only 45% of patients. Conclusion: At present, liver biopsy is the only diagnostic method to detect progression to fibrosis stage in NAFLD cases. Early detection of fibrosis can reverse the pathoge- netic mechanism with prompt institution of therapy. Fac- tors associated with fibrosis in our study were higher age i.e, age >40 years, female gender, high BMI >23 and moder- ate fatty change on ultrasonography. Corresponding Author. Kaumudee Pattnaik. E-mail: [email protected] PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) WITH AND WITHOUT METABOLIC SYNDROME HAVE SIMILAR INCREASE IN BODY FAT Swastik Agrawal, Ajay Duseja, Radha K. Dhiman, Yogesh K. Chawla Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Background and Objectives: Obesity predisposes to both nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS). However, body fat content has not been characterized in Indian patients with NAFLD and MS. Methods: Thirty consecutive patients (M:F 19:11, mean age 39 years) of NAFLD over a period of 1 year were evaluated for the presence of metabolic syndrome (using modified ATP III criteria) and body fat (using bioelectrical impedance analysis). Comparison of body fat was made between obese (BMI$25 Kg/m 2 ) and non-obese patients and between pa- tients with and without MS using independent sample t- test or Mann-Whitney U test as appropriate. A P value of <0.05 was considered significant. Results: Twenty four (80%) of patients were obese with a mean body mass index (BMI) of 29 4 Kg/m 2 . MS was present in 20 (67%) of patients. As expected, total body fat mass, percentage of body fat and increase in body fat mass and fat percentage from the predicted values were sig- nificantly higher in obese than in non-obese patients (29 9 vs. 17 3 Kg, 37 9 vs. 25 5%, 9 7 vs. 0 2 Kg and 7 5 vs. 3 5%, P values 0.005, 0.007, 0.050 and <0.001 respectively). However, there was no difference in BMI, total body fat mass, percentage of body fat or increase in body fat mass and fat percentage from the predicted values between patients with and without MS (29 4 vs. 28 5 Kg/m 2 , 27 9 vs. 25 9 Kg, 35 9 vs. 33 11%, 8 8 vs. 6 8 Kg and 6 5 vs. 6 6%, P values 0.429, 0.559, 0.502, 0.448 and 0.880 respectively). Conclusions: Body fat content is significantly higher in obese in comparison to non-obese patients with NAFLD. There is no difference in body fat content between patients with and without MS, suggesting that body fat content is equally increased in these two groups of patients with NAFLD. Corresponding Author. Ajay Duseja. E-mail: [email protected] GENETIC POLYMORPHISM IN CLUSTER OF DIFFERENTIATION 14 (CD14) GENE C(-159) T IS ASSOCIATED WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) Shweta Kapil, 1 Ajay Duseja, 1 Pallab Ray, 2 Ashim Das, 3 Anuradha Chakraborti, 4 Radha K Dhiman, 1 Yogesh K Chawla 1 1 Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India, 2 Department of Microbiology, Postgraduate Institute of Medical Education and JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY Journal of Clinical and Experimental Hepatology | March 2013 | Vol. 3 | No. 1S | S24–S32 S27 Non-alcoholic Fatty Liver Disease
Transcript of Genetic polymorphism in cluster of differentiation 14 (CD14) gene C(-159) t is associated with...
JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY
Non-a
lcoholic
Fatty
Live
rDisea
se
of Pre and post liver biopsy was the limitation. A large con-trol trial needs to validate.
Corresponding Author. Patrick Basu.E-mail: [email protected]
ANALYSIS OF RISK FACTORS FOR FIBROSISIN BIOPSY PROVEN NAFLD
Kaumudee Pattnaik,1 Pallavi Bhuyan,1
Sitaram Mahapatra,1 Bijay Mishra,2 Sanjib Kar,2
S. P. Singh2
1Department of Pathology, SCB Medical College, Cuttack, India,2Department of Gastroenterology, SCB Medical College, Cuttack, India
Background: Nonalcoholic fatty liver disease (NAFLD) isfast becoming one of the top concerns for clinicians due tothe obesity epidemic and it's potential to progress tochronic liver disease which has significant impact onliver-related morbidity and mortality. Advanced fibrosisthat accompanies NAFLD leads to the development of Cir-rhosis and hepatocellular carcinoma.Objectives: There is a need to identify patients who arelikely to have fibrosis.Methods: Two hundred and sixteen cases were selected forliver biopsies taking into account the clinical parametersandorUltrasonographyfindingsof fatty liver. Formalinfixedparaffin embedded tissue sections were stained with Haema-toxylin andEosin, Reticulin andMasson's Trichrome.Histo-pathologic scoringwasdone asperBrunt et al scoringsystem.Result: Out of 216 biopsy proven NAFLD patients, 183were male and 33 female. On histopathological study,fibrosis was found in 48.216 (22%) cases. On evaluationof metabolic profile, two third (59%) were obese (BMI >23), 75% had transaminitis, 93% had dyslipidemia, 23%were diabetic and 20% were hypertensive. Inspite of thesemetabolic derangements, only 36% had moderate fattychange on ultrasonography and rests were mild. Metabolicsyndrome was present in only 45% of patients.Conclusion: At present, liver biopsy is the only diagnosticmethod to detect progression to fibrosis stage in NAFLDcases. Early detection of fibrosis can reverse the pathoge-netic mechanism with prompt institution of therapy. Fac-tors associated with fibrosis in our study were higher agei.e, age >40 years, female gender, high BMI >23 and moder-ate fatty change on ultrasonography.
Corresponding Author. Kaumudee Pattnaik.E-mail: [email protected]
PATIENTS WITH NONALCOHOLIC FATTYLIVER DISEASE (NAFLD) WITH ANDWITHOUT METABOLIC SYNDROME HAVESIMILAR INCREASE IN BODY FAT
Journal of Clinical and Experimental Hepatology | March 2013 | Vol. 3 | No
Swastik Agrawal, Ajay Duseja, Radha K. Dhiman,Yogesh K. Chawla
Department of Hepatology, Postgraduate Institute of Medical Educationand Research, Chandigarh, India
Background and Objectives:Obesity predisposes to bothnonalcoholic fatty liver disease (NAFLD) and metabolicsyndrome (MS). However, body fat content has not beencharacterized in Indian patients with NAFLD and MS.Methods:Thirty consecutive patients (M:F 19:11,mean age39 years) of NAFLD over a period of 1 year were evaluatedfor the presence of metabolic syndrome (using modifiedATP III criteria) and body fat (using bioelectrical impedanceanalysis). Comparison of body fat was made between obese(BMI$25 Kg/m2) and non-obese patients and between pa-tients with and without MS using independent sample t-test or Mann-Whitney U test as appropriate. A P value of<0.05 was considered significant.Results: Twenty four (80%) of patients were obese witha mean body mass index (BMI) of 29� 4 Kg/m2. MS waspresent in 20 (67%) of patients. As expected, total bodyfat mass, percentage of body fat and increase in body fatmass and fat percentage from the predicted values were sig-nificantly higher in obese than in non-obese patients(29�9 vs. 17�3 Kg, 37�9 vs. 25�5%, 9�7 vs. 0�2 Kgand 7�5 vs. 3�5%, P values 0.005, 0.007, 0.050 and<0.001 respectively). However, there was no difference inBMI, total body fat mass, percentage of body fat or increasein body fat mass and fat percentage from the predictedvalues between patients with and without MS (29�4 vs.28�5 Kg/m2, 27�9 vs. 25�9 Kg, 35�9 vs. 33�11%, 8�8vs. 6�8 Kg and 6�5 vs. 6�6%, P values 0.429, 0.559,0.502, 0.448 and 0.880 respectively).Conclusions: Body fat content is significantly higher inobese in comparison to non-obese patients with NAFLD.There is no difference in body fat content between patientswith and without MS, suggesting that body fat content isequally increased in these two groups of patients withNAFLD.
Corresponding Author. Ajay Duseja.E-mail: [email protected]
GENETIC POLYMORPHISM IN CLUSTER OFDIFFERENTIATION 14 (CD14) GENE C(-159)T IS ASSOCIATED WITH NONALCOHOLICFATTY LIVER DISEASE (NAFLD)
Shweta Kapil,1 Ajay Duseja,1 Pallab Ray,2 Ashim Das,3
Anuradha Chakraborti,4 Radha K Dhiman,1
Yogesh K Chawla1
1Department of Hepatology, Postgraduate Institute of MedicalEducation and Research, Chandigarh, India, 2Department ofMicrobiology, Postgraduate Institute of Medical Education and
. 1S | S24–S32 S27
ABSTRACTS 21ST ANNUAL CONFERENCE—2013
Non-a
lcoholic
Fatty
LiverDisea
se
Research, Chandigarh, India, 3Department of Histopathology,Postgraduate Institute of Medical Education and Research, Chandigarh,India, 4Department of Experimental Medicine & BiotechnologyPostgraduate Institute of Medical Education and Research, Chandigarh,India
Introduction: Nonalcoholic Fatty Liver Disease (NAFLD)is a multifactorial disease. Genetic factors including poly-morphisms of Toll like receptor (TLR) and its co-receptorCD14 (Cluster of differentiation 14) may be involved in thepathogenesis of NAFLD.Aim: To study the role of genetic variants of CD14 gene [C(-159) T and C (-550) T] in the pathogenesis of NAFLD.Methodology: In a prospective study, 130 patients withNAFLD (M:F =78:52, mean age 38.47�10.6 years) and 50age and gender matched healthy volunteers(HVs)(M:F=38:12,mean age 36.56� 4.2) were included in thestudy. Genotyping of C(-159)T and C(-55)T polymorphismin the promoter region of CD14 gene was done using poly-merase chain reaction (PCR) and restriction fragmentlength polymorphism (RFLP). Results were confirmed byDNA sequencing. Recessive and dominant models were ap-plied to determine the association of these polymorphismswith the recessive and dominant allele.Results: Among C(-550)T polymorphism, CC genotype wasequally common genotype amongst patients with NAFLDand HVs (77/130 [59.2%] vs.34/50 [68%] OR 0.68, 95% CI =0.34-1.36, P=0.27). On applying recessive model (TT vs.CC+TC), [TT, 16(7.44%) vs.CC+TC,199(92.56%),OR=1.6,95%CI=0.53-5.07, P =0.37] and dominant model (TT+TC vs.CC)[TT+TC, 61 (28.37% vs. CC,154 (71.63%) OR=1.49, 95%CI=0.82-2.72, P =0.18] we did not find any association ofC(-550)T polymorphism with NAFLD. In case of C(-159)Tpolymorphism TT genotype was higher among patientswith NAFLD than HVs [59/130(45.38%)vs.10/50(20%) OR3.32, 95% CI = 1.53-7.20, P =0.001]. On applying recessivemodel [TT vs. CC+TC], C (-159) T polymorphism was foundto be associated with NAFLD [TT, 118(56.46%) vs. CC+TC,91(43.54%) OR=3.24, 95%CI=1.8-5.8, P =.0001]. Howeverwhen we applied dominant model (TT+ TCvs.CC) [TT+TC,169(80.86%), CC, 40 (19.14%), OR=1.69, 95% CI=0.9-3.14,P =0.09] we did not find any association of C (-159) T poly-morphism with NAFLD.Conclusion: C (-159) T polymorphism of TLR co-receptorCD14 is associated with NAFLD.
Corresponding Author. Ajay Duseja.E-mail: [email protected]
LIVER DISEASE STRUCTURE EXPLORED INRUSSIAN FEDRATION NATIONAL – WIDEDIREG-L-01903 STUDY FOR NON ALCOHOLICFATTY LIVER DISEASE SCREENING
Elena Zyatenkova, Vladimir Ivashkin, Oxana Drapkina
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I.M. Sechenov First Moscow State Medical University.V.H,VasilenkoClinic of Propedeutics, Gastroenterology, and Hepatology, Russia
Background and Aims: To assess liver disease nosologicstructure in patients enrolled into the national popula-tion-based DIREG-L-01903 study for non-alcoholic fattyliver disease (NAFLD) screening.Methods: In total of 30,787 primary care patients (56% fe-males, mean age 47.8�16 yrs) were enrolled into open mul-ticenter national-wide prospective study. Careful clinicalexamination, serum biochemistry (including ALT, AST,g-GT, lipid spectrum and hepatitis screening) and abdom-inal ultrasound diagnostics with precise liver, spleen andpancreas assessment and waist circumstence were per-formed in 30,754 patients.Results: NAFLD was found in 8215 (27&)of included pa-tients. Within group with confirmed NAFLD liver steatosiswas diagnosed in 80.3%, steatohepatitisin 16.8 %, and cir-rhosis in 2.9% of patients. AST was increased $ 1.5 N in2816 (9.2%), ALT was increased $ 1.5 N in 3144 (10.2%)of patients. In total, liver ultrasound examination revealedliver enlargement in 16.3%, portal hypertension in 0.5 %,signs of liver steatosis in 24.2 %, signs of liver fibrosis in2.3%, signs of liver cirrhosis in 0.8% of total patients.
Corresponding Author. Elena Zyatenkova.E-mail: [email protected]
THE ROLE OF CORRECTION OFDISBACTERIOSIS IN TREATMENT OFATHEROGENIC DISLIPOPROTEINEMIA INPATIENTS WITH NONALCOHOLIC FATTYLIVER DISEASE
Elizaveta Cherkashova, Larisa Zvenigorodskaja,Tamara Nilova
Central Scientific Research Institute of Gastroenterology, Moscow,Russia
Background and Aims: Nonalcoholic fatty liver disease(NAFLD) is one of the important factors of cardiovascularrisk. However the diagnosis of NAFLD is frequently late.The aim of the study was to devise noninvasive methodto diagnose NAFLD.Methods: One hundred and eight patients were examinedin the age of 35-70 years. All patients before and after treat-ment were examined by several points: biochemical bloodanalysis (lipids, parameters of liver function), endotoxinand nitric oxide in blood, analysis of short chain fat acids(SFA) in feces Liber biopsy was also performed for all thepatients. We also made biopsy of liver. Patients have beendivided into 2 groups depending on activity of hepatitis:1)steatosis 2)steatohepatitis, and into 3 groups accordingto the therapy: 1)statin 10mg; 2)probiotic; 3)probiotic incombination with statin.
© 2013, INASL
