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Non-alcoholic fatty liver disease (NAFLD) is an emerging public health problem globally. NAFLD is one of the most common liver diseases worldwide and is the most common cause of abnormal liver enzymes in many developed countries. NAFLD is estimated to afflict approximately 1 billion individuals worldwide. An estimated 20-30 % of general population is afflicted from it globally. In India NAFLD could be a silent epidemic with its prevalence ranging from 9-32%. Studies have shown, strong association of NAFLD with major Non Communicable diseases (NCD) like Diabetes, Obesity, CVD, Chronic Kidney diseases, Cancers, etc. Perceiving the threat of NAFLD and the central role of hepatic accumulation of fat in the pathogenesis of other NCD, the Government of India (GoI) has taken steps to include NAFLD in the public health agenda. It has included it in the national NCD programme, i.e., National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2021. India has become the first country in the world to start a national programme for preventive efforts for NAFLD. The present review describes public health relevance of NAFLD and the process of integration of Non Alcoholic Fatty Liver Diseases (NAFLD) into NPCDCS programme in India.
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Objective To analysis the risk factors for elevated ALT level in patients with Non-alcoholic fatty liver diseases (NAFLD).Method Fifty-six (male 25,female 31) NAFLD patients with elevated ALT and 153 NAFLD patients (male 64,female 89) with normal ALT and 160 (male 80,female 80) health subjects were selected.ALT was detected by rate assay,total cholesterol (TC),triglycerides (TG),low-density lipoprotein cholesterols (LDL-C),high-density cholesterol (HDL-C) and uric acid (UA) were detected by enzymatic method.Free fatty acid (FFA) was detected by immunoturbidimetry assay.Spearman correlation was used to analysis the relation between ALT and TC,TG,LDL-C,HDL-C,UA and FFA.Logistic regression was used to analyses the risk factor for elevated ALT level.Results TC,TG,LDL-C,UA and FFA levels were significantly higher in NAFLD group (including normal ALT group and elevated ALT group) than those in health group no matter male and female,HDL-C was significantly lower in these two groups when compared to control group,but binary logistic regression and spearman analysis showed that only UA and FFA were the risk factors for elevated ALT level and significantly positively correlated with ALT level,abnormal UA and FFA for male were associated with 3.96-fold(95CI％ =1.40～ 11.22,P=0.010) and 3.27-fold (95 ％ CI =1.14 ～ 9.40,P =0.028) of increased risk of elevated ALT level respectinely,correlation coefficient were 0.40(P=0.000),0.29(P=0.006),Meanwhile Exp(B) of elevated ALT level for female with abnormal UA,FFA were 4.49 (95CI％=1.79～11.28,P=0.001) and 3.17 (95CI％ =1.25～8.04,P=0.015),correlation coefficient were 0.34 (P =0.000),0.27 (P =0.003).Conclusion Elevated ALT level was not associated with dyslipidemias,but related to UA and FFA.They can be used as candidate markers for predicting severity of liver damage.
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Objective To investigate the association between gallstone and non-alcoholic fatty liver disease (NAFLD)in middle-aged and elderly Chinese. Methods A cross-sectional study was conducted in 8934 Chinese adults from Jiading District, Shanghai. Questionnaire interview, anthropometric measurements, biochemical evaluation, and abdominal ultrasonography were performed in all the participants. Results Compared with participants without gallstone,individuals with gallstone had significantly higher prevalence of NAFLD(28.8% and 42.9%,respectively;P<0.01). Using participants without gallstone as the reference,participants with gallstone were associated with an increased risk of NAFLD after adjustment for multiple covariatesodds ratios(OR)and 95% confidence interval(CI)was 1.39(1.45-1.69). In addition,compared with participants without cholecystectomy, participants with cholecystectomy were associated with an increased risk of NAFLD(OR=1. 44, 95% CI 1. 04-1.99). Conclusion The presence of gallstone and cholecystectomy were positively associated with NAFLD in middle-aged and elderly Chinese.
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Background: Estimation of adiponectin levels in diabetic and non-diabetic fatty liver and healthy controls. Methods: We studied 25 subjects for diabetic fatty liver, 25 subjects for non-diabetic fatty liver and 25 healthy controls. Clinical evaluation included anthropometric measurements, BMI, biochemical investigations and adiponectin estimation by ELISA. Results: There were 15 males (60%) and 10 (40%)females subjects in the DFL group, 18 males (72%) and 7 females (28%) subjects in the NDFL group and 13 males (52%) and 12 females (48%) subjects in the control group. 80% (20) of the DFL patients and 72% (18) subjects of NDFL group had BMI >25kg/m2. 80% (12 males and 8 females) of subjects in the DFL group and 68% (12 males and 5 females) had a waist circumference that indicated central obesity as per Indian cut-offs (>90 cm for females and >80 cm for males). The mean adiponectin (μg/ml) ± SD levels in DFL were 4.03 ± 0.43, NDFL was 5.01 ± 0.55 and in controls was 7.63 ± 0.66, the difference being statistically significant with P <0.001. The difference in the adiponectin levels was statistically significant between each of the three groups with P <0.001. There was no difference in serum adiponectin levels between males and females in all three groups. Conclusion: The chief conclusion of this study are that serum adiponectin levels are lower in subjects with NAFLD than those without it; adiponectin levels are inversely related to the degree of steatosis in NAFLD, with the lowest levels in more severe forms of steatosis.
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Objective:To study the effect of trigonelline on the change of indicators of serum transaminase, lipoprotein and liver lipid of model rats with non-alcoholic fatty liver diseases and on the expression level of Bcl-2 and Bax proteins.Methods:A total of 45 SD rats were randomly divided into Fthe control group, model group and trigonelline intervention group. Rats in the control group were fed with the common diet, while rats in the model group and intervention group were fed with the high fat diet. 8 weeks later, the intervention group received the intragastric administration of trigonellin e (with the dosage of 40 mg/kg/d) for 8 weeks; while control group and model group received the intragastric administration of saline with the equal dosage. Blood was taken from the abdominal aorta of rats 8 weeks later, detecting the level of a series of indicators of ALT, AST, TG, TC, HDL-C and LDL-C in the serum. After the rats were sacrificed, detect the indicators of TG, TC, SOD and MDA in the liver tissue of rats, as well as the expression of Bcl-2 and Bax in the liver tissue.Results: Results of histopathologic examination showed that the damage degree of liver for rats in the trigonellineintervention group was smaller than the one in the model group, with significantly reduced hepatic steatosis and the partially visible hepatic lobule. The levels of ALT, AST, TC and LDL-C in the serum of rats in the trigonelline group were significantly reduced, while the change in the levels of TG and HDL-C was not significantly different. The levels of TG, TC and MDA in the liver tissues were significantly decreased, while the level of SOD significantly increased; the expression of Bcl-2 protein in the liver tissues of rats in the trigonelline intervention group was significantly increased, while the expression of Bax protein significantly decreased.Conclusions: The trigonelline contributes to the therapeutic effect of non-alcoholic fatty liver diseases. It can also increase the expression of Bcl-2 protein and decrease the expression of Bax protein in the liver tissues, which can protect the liver.
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OBJECTIVE@#To study the effect of trigonelline on the change of indicators of serum transaminase, lipoprotein and liver lipid of model rats with non-alcoholic fatty liver diseases and on the expression level of Bcl-2 and Bax proteins.@*METHODS@#A total of 45 SD rats were randomly divided into the control group, model group and trigonelline intervention group. Rats in the control group were fed with the common diet, while rats in the model group and intervention group were fed with the high fat diet. 8 weeks later, the intervention group received the intragastric administration of trigonellin e (with the dosage of 40 mg/kg/d) for 8 weeks; while control group and model group received the intragastric administration of saline with the equal dosage. Blood was taken from the abdominal aorta of rats 8 weeks later, detecting the level of a series of indicators of ALT, AST, TG, TC, HDL-C and LDL-C in the serum. After the rats were sacrificed, detect the indicators of TG, TC, SOD and MDA in the liver tissue of rats, as well as the expression of Bcl-2 and Bax in the liver tissue.@*RESULTS@#Results of histopathologic examination showed that the damage degree of liver for rats in the trigonelline intervention group was smaller than the one in the model group, with significantly reduced hepatic steatosis and the partially visible hepatic lobule. The levels of ALT, AST, TC and LDL-C in the serum of rats in the trigonelline group were significantly reduced, while the change in the levels of TG and HDL-C was not significantly different. The levels of TG, TC and MDA in the liver tissues were significantly decreased, while the level of SOD significantly increased; the expression of Bcl-2 protein in the liver tissues of rats in the trigonelline intervention group was significantly increased, while the expression of Bax protein significantly decreased.@*CONCLUSIONS@#The trigonelline contributes to the therapeutic effect of non-alcoholic fatty liver diseases. It can also increase the expression of Bcl-2 protein and decrease the expression of Bax protein in the liver tissues, which can protect the liver.
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Objective: To study the effect of trigonelline on the change of indicators of serum transaminase, lipoprotein and liver lipid of model rats with non-alcoholic fatty liver diseases and on the expression level of Bcl-2 and Bax proteins. Methods: A total of 45 SD rats were randomly divided into the control group, model group and trigonelline intervention group. Rats in the control group were fed with the common diet, while rats in the model group and intervention group were fed with the high fat diet. 8 weeks later, the intervention group received the intragastric administration of trigonellin e (with the dosage of 40 mg/kg/d) for 8 weeks; while control group and model group received the intragastric administration of saline with the equal dosage. Blood was taken from the abdominal aorta of rats 8 weeks later, detecting the level of a series of indicators of ALT, AST, TG, TC, HDL-C and LDL-C in the serum. After the rats were sacrificed, detect the indicators of TG, TC, SOD and MDA in the liver tissue of rats, as well as the expression of Bcl-2 and Bax in the liver tissue. Results: Results of histopathologic examination showed that the damage degree of liver for rats in the trigonelline intervention group was smaller than the one in the model group, with significantly reduced hepatic steatosis and the partially visible hepatic lobule. The levels of ALT, AST, TC and LDL-C in the serum of rats in the trigonelline group were significantly reduced, while the change in the levels of TG and HDL-C was not significantly different. The levels of TG, TC and MDA in the liver tissues were significantly decreased, while the level of SOD significantly increased; the expression of Bcl-2 protein in the liver tissues of rats in the trigonelline intervention group was significantly increased, while the expression of Bax protein significantly decreased. Conclusions: The trigonelline contributes to the therapeutic effect of non-alcoholic fatty liver diseases. It can also increase the expression of Bcl-2 protein and decrease the expression of Bax protein in the liver tissues, which can protect the liver.
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Objective To evaluate the effect of Pingganjian Decoction (Decoction for liver diseases) on the non-alcoholic fatty liver diseases (NAFLD).Methods Totally 105 NAFLD patients were randomized into a treatment group (54 cases) and a control group (51 cases).The former was treated with Pingganjian Decoction while the latter treated with Fufang Yiganling Tablets and Zhibituo Tablets for 3 months.Changes in the symptoms scores,body mass index (BMI),waist-hip ratio (WHR),CT ratio of liver-spleen,homeostasis model assessment insulin resistance (HOMA-IR),liver functions,uric acid and blood-fat before and after treatment were observed.Results After treatment,in the treatment group,the symptom score was significantly decreased,CT ratio of liver-spleen was significantly increased,and the level of HOMA-IR was decreased.Compared with those of the control group,the difference was significant (P