Evaluation of plasma adiponectin level in patients with nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease is an increasingly recognized condition that may progress to end stage liver disease; the aim was to study the level of plasma adiponectin in patients with nonalcoholic fatty liver with DM, and chronic hepatitis C in comparison with a control group. The study was conducted on 60 individuals, 37 males and 23 females, their age ranged from 26 to74 Ys, they were categorized into 3 groups: G 1: 20 apparently healthy individual serving as a control group, G2: 20 patients with type 2 DM and fatty liver, G 3: 20 patients with chronic hepatitis C and fatty liver. All cases underwent full clinical examination and laboratory investigaions, including [CBC], [ESR], liver and kidney- function tests ,fasting and 2hours PP blood glucose, lipograms, Polymerase chain reaction [PCR] for HCV-RNA in addition to abdominal ultrasonography and estimation of serum adiponectin level by ELISA technique. A significantly decreased plasma adiponectin levels were found in patients with fatty liver disease when compared to the control group. In addition, plasma adiponectin in group 2 [DM] show significant positive correlation with fasting blood glucose level [r =-52, p<0.05]. However plasma adiponectin levels, were significantly lower in group 3 [HCV] than in the other groups. A significant lower adiponectin levels was observed in male in all groups, further more plasma adiponectin in group 3 [HCV] show significant spositive correlation with blood urea [r =0.48, p <0.05] and HDL level [r =0.49, p <0.05]. Plasma adiponectin level is decreased in patients with NAFLD with type2 DM and chronic HCV and may suggest fat accumulation in the liver

comparative study of different procedures for the diagnosis of tuberculous ascites

To determine the diagnostic features of tuberculous peritonitis that distinguish it from other causes of ascites, 50 ascitic patients were examined prospectively. The biochemical, bacteriological and immunological properties of ascitic fluid from 11 patients with tuberculosis, 24 patients with hepatic cirrhosis and 15 patients with malignant ascites were compared. High values of adenosine deaminase activity [ADA] and gamma interferon [IFN - gamma] were detected in ascitic fluid of tuberculous patients. The sensitivity, tests of IFN. gamma ADA and PCR in the diagnosis of tuberculous ascites were 90.9%, 81.8%, and 36.3%, respectively while the specificity tests of all were 100%. A significant positive correlation was present between ADA activity and IFN - gamma level in ascitic fluid. The same correlation was detected between ADA activity and total protein concentration. However IFN - gamma was considered superior to ADA in diagnosis of tuberculous peritonitis in cases with decreased ascitic fluid total protein. Laparoscopic peritoneal biopsies in the seven tuberculous patients, revealed histopathologic granuloma and gave positive culture for T.B. It is concluded that, increased ascitic IFN - gamma and ADA arc useful, rapid non invasive screening tests in diagnosis of tuberculous peritonitis, whereas PCR has a limited utility. The best confirmation is by laparoscopic peritoneal biopsy followed by histopathologic and culture studies