Hepatic lipase activity is increased in non-alcoholic fatty liver disease beyond insulin resistance.

BACKGROUND AND OBJECTIVE: Hepatic lipase is a lipolytic enzyme mostly synthesized and localized at the surface of liver sinusoidal capillaries, which hydrolyses triglycerides and phospholipids of intermediate density, large low density (LDL) and high density lipoproteins. Hepatic lipase activity is increased in insulin resistant states. Non-alcoholic fatty liver disease (NAFLD) is characterized by insulin resistance. However, at present, no data are available regarding the behaviour of hepatic lipase with regard to the degree of hepatic steatosis. Our aim was to evaluate hepatic lipase activity in NAFLD patients and its relationship to the severity of hepatic steatosis. DESIGN AND PATIENTS: We studied 48 patients with NAFLD (diagnosed by ultrasonography and confirmed by liver biopsy) and 30 controls. Steatosis was semi-quantitatively assessed and considered as mild or grade 1, moderate or grade 2 and severe or grade 3. MEASUREMENTS: hepatic lipase activity, lipid and lipoprotein profile (including intermediate density lipoproteins and dense LDL), adiponectin, insulin, glucose and high sensitivity C-reactive protein were measured. Homeostasis model assessment for insulin resistance (HOMA) index was calculated. RESULTS: Patients with hepatic steatosis presented with higher hepatic lipase activity, HOMA and dense LDL and lower levels of adiponectin, high density lipoproteins, cholesterol and apoA-I. Hepatic lipase activity positively correlated significantly with the severity of hepatic steatosis. Hepatic lipase correlated with a more atherogenic profile and persisted higher in patients even after corrected for age, gender, body mass index, HOMA and adiponectin. CONCLUSION: The higher hepatic lipase activity in NAFLD patients contributes to a more atherogenic profile linked to increased cardiovascular risk, beyond the insulin resistance and the reduction in adiponectin.

[Predictive factors in the treatment of esophageal achalasia]. / Factores Predictivos en el Tratamiento de la Acalasia del Esófago.

With aim of determining if there are predictive factors in the treatment of achalasia of the esophagus, we analyzed in a group of 119 patients variables such as age, gender, X-Rays, Chagas' disease serology and esophageal manometry before and after treatment. The only significant factor was the LES pressure post-treatment but, since the sampling was heterogeneous, and the differences where the same between bad and good results, we believe it has no predictive value in the treatment of achalasia of the esophagus.

Factores predictivos en el tratamiento de la acalasia del esofago / Predictive factors in the treatment of esophageal achalasia

Con el fin de determinar si existen factores predictivos que permitan aventurar el resultado del tratamiento de la acalasia del esófago, analizamos una serie de variables tales como edad, sexo, grado radiológico de la enfermedad, serología para enfermedad de Chagas y manometría del esófago antes y después del tratamiento. Si bien hallamos diferencias significativas entre los valores de presión del EEI pre y post-tratamiento, no hay diferencia entre los grupos que obtienen buenos o malos resultados en la manometría post-tratamiento. Por lo que ninguno de los parámetros evaluados tiene valor predictivo

Factores Predictivos en el Tratamiento de la Acalasia del Esófago. / [Predictive factors in the treatment of esophageal achalasia]

With aim of determining if there are predictive factors in the treatment of achalasia of the esophagus, we analyzed in a group of 119 patients variables such as age, gender, X-Rays, Chagas disease serology and esophageal manometry before and after treatment. The only significant factor was the LES pressure post-treatment but, since the sampling was heterogeneous, and the differences where the same between bad and good results, we believe it has no predictive value in the treatment of achalasia of the esophagus.

Factores predictivos en el tratamiento de la acalasia del esofago / Predictive factors in the treatment of esophageal achalasia

Con el fin de determinar si existen factores predictivos que permitan aventurar el resultado del tratamiento de la acalasia del esófago, analizamos una serie de variables tales como edad, sexo, grado radiológico de la enfermedad, serología para enfermedad de Chagas y manometría del esófago antes y después del tratamiento. Si bien hallamos diferencias significativas entre los valores de presión del EEI pre y post-tratamiento, no hay diferencia entre los grupos que obtienen buenos o malos resultados en la manometría post-tratamiento. Por lo que ninguno de los parámetros evaluados tiene valor predictivo (AU)