Nonalcoholic steatohepatities in type 2 diabetes mellitus

The present study was conducted on 22 females with type 2 diabetes mellitus and hepatomegaly in whom ultrasonography showed bright hepatomegaly, in addition to 20 healthy controls of comparable age and sex. Patients with evidence of hepatitis C, B, metabolic liver disease or autoimmune hepatitis were excluded. None of the patients and controls was alcohol drinker. In all patients and controls, fasting and two-hour postprandial plasma glucose, HbA1c, bilirubin, aspartate aminotransferase [AST], alanine aminotransferase [ALT], alkaline phosphatase, cholesterol and triglyceride were done. Liver biopsy using Baxter cut needle [G14] was done in patients only. It can be concluded that nonalcoholic steatohepatitis [macrovesicular steatosis and lobular inflammation alone] occurs in 31.8% of patients with hepatic steatosis in type 2 diabetes mellitus. Hepatocyte necrosis and progression to hepatic fibrosis may occur in some cases. Progression to fibrosis may occur in patients with inadequate glycemic control

Growth hormone and insulin like growth factor-1 in patients with heart failure due to dilated cardiomyopathy

The aim of this study was to evaluate the level of growth hormone [GH] and insulin like growth factor-1 [IGF-1] in patients with heart failure due to idiopathic dilated cardiomyopathy to find out if the development or progression of heart failure is associated with a derangement of GH and IGF-1. The study was conducted on 30 patients with congestive heart failure due to dilated cardiomyopathy and 7 normal healthy subjects as a control group. The results revealed a significant increase in the serum levels of GH and a significant low serum IGF-1 and albumin in the patients as compared with the control group. Then, the patients were classified according to the NYHA functional classes into four classes [I, II, III and IV]. Sixteen patients were found in functional class IV. There were no differences in the results of this class and the whole patients group, suggesting that class IV represented the whole patient group studied. The study concluded that the serum levels of GH were increased and the serum levels of IGF-1 were diminished in patients with heart failure due to dilated cardiomyopathy. These abnormalities in GH and IGF-1 may have many etiological factors. Abnormalities of GH/IGF-1 axis might have a role either in the development or the progression of heart failure in dilated cardiomyopathy