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PubMed2005

Plasma adiponectin in nonalcoholic fatty liver is related to hepatic insulin resistance and hepatic fat content, not to liver disease severity.

Plasma levels of adiponectin are decreased in patients with nonalcoholic fatty liver disease (NAFLD), but the relationship among plasma adiponectin, insulin sensitivity, and histological features is unclear. In 174 NAFLD patients and 42 controls, we examined plasma adiponectin concentrations in relation to 1) lipid profile, indices of insulin resistance, and features of the metabolic syndrome (n = 174); 2) hepatic insulin resistance (clamp technique with tracer infusion) (10 patients); and 3) histological features at liver biopsy (n = 116). When the data from all subjects were combined, plasma adiponectin levels were positively associated with increased age, female gender, and plasma high-density lipoprotein levels, and negatively associated with waist circumference, body mass index, triglycerides, indices of insulin resistance, and aminotransferase levels, and also predicted the presence of the metabolic syndrome. In step-wise regression, increased age, female gender, waist circumference, triglyceride levels, and homeostasis model assessment independently associated with adiponectin (adjusted R(2), 0.329). In NAFLD, adiponectin was only associated with increased age, female gender, and triglycerides (adjusted R(2), 0.245). When the measured histological parameters were included in the model, plasma adiponectin levels were also inversely proportional to the percentage of hepatic fat content (adjusted R(2), 0.221), whereas necroinflammation and fibrosis did not fit in the model. Adiponectin was negatively correlated with insulin-suppressed endogenous glucose production during the clamp (P = 0.011). The results demonstrate that decreased levels of circulating adiponectin in NAFLD are related to hepatic insulin sensitivity and to the amount of hepatic fat content. Hypoadiponectinemia in NAFLD is part of a metabolic disturbance characterized by ectopic fat accumulation in the central compartment.

Adiponectin↗
PubMed2005

The state of insulin resistance in patients with nonalcoholic fatty liver and the intervention with Gankangyin.

OBJECTIVE: To explore the correlation of nonalcoholic fatty liver (NAFL) with insulin resistance and the intervention of it by Gankangyin(GKY). METHODS: Ninety-six patients with NAFL were randomly assigned into the treated group and the control group. They were treated with GKY and Silymarin for 3 months respectively. Oral glucose tolerance test (OGTT) and insulin release test (IRT) were conducted and insulin sensitivity indexes were determined before and after treatment. And 32 healthy nonalcoholic persons were enrolled and used as the healthy control group. RESULTS: Before treatment, the levels of blood glucose and insulin at different time points in OGTT test, and the insulin resistance index (IRI) were significantly higher (P < 0.05 or P < 0.01) while insulin sensitivity index (ISI) and insulin active index (IAI) were lower (P < 0.05 or P < 0.01) in the NAFL patients than those in the healthy persons. After treatment, the above-mentioned raised criteria were significantly lowered (P < 0.05, P < 0.01) and the lowered criteria were significantly increased (P < 0.01) in the treated group, while in the control group all the criteria were insignificantly changed (P > 0.05). CONCLUSION: Evident insulin resistance exists in NAFL patients. GKY could increase the insulin sensitivity, thus improving the state of insulin resistance in NAFL patients.

Adipose Tissue↗
PubMed2005

Viral and host causes of fatty liver in chronic hepatitis B.

AIM: To investigate the viral and host causes of fatty liver in chronic hepatitis B patients and the role of fat deposits in liver damage. METHODS: A total of 164 patients (113 males and 51 females, average age 35+/-11.3 years, and range 10-62 years) with previously untreated chronic hepatitis B were included in the study. The patients were divided into two groups depending on the result of liver biopsy: group without steatosis (100 patients with <5% hepatosteatosis) and group with steatosis (64 patients with >5% hepatosteatosis). The groups were compared in terms of gender, body mass index (BMI), liver enzymes (ALT, AST, ALP, GGT), cholesterol, triglyceride, HBeAg, viral load, and histological findings. In the group with steatosis, the patients were subdivided depending on the degree of steatosis into mild group (45 patients with 5-24% steatosis), and severe group (19 patients with >25% steatosis). RESULTS: In the group of chronic hepatitis B with steatosis, the mean age, BMI, cholesterol, and triglyceride levels were significantly higher than those in the group without steatosis (P<0.05). Steatosis was found in 53 (46.9%) of male patients and 11 (22%) of female patients (P<0.05). No significant difference was found in the positivity of ALT, AST, ALP, GGT, HBeAg, viral load, histological activity index (HAI) and stage between the two groups (P>0.05). In the group with severe steatosis, the BMI was significantly higher than that in the group with mild steatosis (P<0.05). No significant difference was found in the other parameters between the groups (P>0.05). CONCLUSION: Steatosis in chronic hepatitis B appears to be a result of metabolic factors of the host rather than the effect of viruses. Steatosis is unrelated to the HAI and degree of fibrosis, which are considered as the histological indicators of liver damage.

Adult↗
PubMed1990

Stress modulates cholesterol-induced changes in plasma and liver fatty acid composition in rats fed n-6 fatty acid-rich oils.

The effects of dietary cholesterol (CH) and isolation stress on fatty acid compositions of plasma and liver cholesteryl ester and phospholipids were compared in growing rats fed an 18:2n-6 or an 18:3n-6 enriched semisynthetic diet for 2 weeks. Stress, CH-feeding, and dietary fats had no significant effects on plasma CH level, but CH-feeding alone elevated the liver CH concentrations. CH-feeding also modulated the liver polyunsaturated fatty acid compositions, i.e., increasing 18:2n-6 levels, and reducing 20:4n-6 levels, indicating an inhibition of the enzymes, delta-6 and delta-5-desaturases. The extent of these changes was less in rats fed 18:3n-6 than in those fed 18:2n-6. Stress, which alone had no significant effects on plasma and liver fatty acid compositions, attenuated the CH-induced changes of fatty acid levels.

Animals↗
PubMed2026

A Dynamic Nomogram to Predict Metabolic Dysfunction-Associated Fatty Liver Disease in Patients with Metabolic Syndrome.

BACKGROUND: Metabolic syndrome (MetS) involves multiple metabolic disorders. This study aimed to identify high-risk populations for metabolic dysfunction-associated fatty liver disease (MAFLD) in patients with MetS and to establish a dynamic predictive nomogram. METHODS: A total of 627 patients with MetS from six regions in Zhejiang Province were enrolled and categorized into MAFLD and non-MAFLD groups, then randomly assigned to training and validation sets at a ratio of 7:3. Independent predictors of MAFLD were identified using least absolute shrinkage and selection operator regression and multivariable logistic regression analyses. These predictors were then used to construct a dynamic nomogram. RESULTS: A total of 627 patients with MetS were included in the final analysis, of whom 77.0% (483/627) were diagnosed with MAFLD. Multivariable logistic regression analysis identified body mass index (BMI), waist circumference (WC), total cholesterol (TC), alanine aminotransferase (ALT), MetS-defined dysglycemia, and education level as independent risk factors for MAFLD. MetS-defined dysglycemia showed the highest odds ratio (OR) for MAFLD development [OR = 1.87, 95% confidence interval (CI): 1.07-3.29]. Although the number of MetS components and the metabolic syndrome score were significantly associated with MAFLD in univariate analysis, they were not independently associated with MAFLD in the multivariate model. A dynamic nomogram for predicting MAFLD risk in patients with MetS was developed and internally validated. The area under the receiver operating characteristic curve was 0.834 (95% CI: 0.787-0.880) in the training set and 0.839 (95% CI: 0.771-0.899) in the validation set, indicating strong predictive performance. Bootstrap internal validation demonstrated good agreement between predicted and observed outcomes in calibration curves. Decision curve analysis further indicated favorable clinical applicability of the nomogram. CONCLUSION: BMI, WC, TC, ALT, MetS-defined dysglycemia, and education level are independent risk factors for MAFLD. A dynamic nomogram for predicting MAFLD risk in patients with MetS was successfully developed and validated.

Humans↗
PubMed1992

[Acute fatty liver of pregnancy--differential diagnosis and supportive therapy].

A case of clinically diagnosed acute fatty liver of pregnancy (AFLP) is reported. Hypoglycemia and coagulopathy were predominant in the clinical course. Serial studies on blood chemistry, especially blood glucose and coagulation parameters, in association with virus serology and ultrasound, can rule out common causes of jaundice in pregnancy. This contributes to reliability of the clinical diagnosis of AFLP in the absence of liver biopsy, and ensures adequate management of the patient.

Acute Disease↗
PubMed1998

Control of fatty liver syndrome in a Jersey herd by a change of diet and the use of recombinant bovine somatotrophin.

A Jersey herd was investigated following a decrease in milk yields. The cattle were permanently housed and fed a complete diet in four groups on the basis of yield. They were generally healthy, but the dry cows and many of the milking cows were over fat. The plasma concentrations of beta-hydroxybutyrate and glucose were normal, but the activities of aspartate aminotransferase and glutamate dehydrogenase and the concentration of non-esterified fatty acids were high. Fatty liver syndrome was diagnosed. All the dry cows were condition scored and placed into one of three dietary groups according to their score. They were exercised in an outdoor paddock and entered the pre-calving feeding group at least two weeks before calving; 75 per cent of them achieved a condition score of less than 3, and most of them produced normal milk yields. Thirty cows which had developed signs of fatty liver syndrome were paired and one of each pair received an injection of 640 mg of recombinant bovine somatotrophin. The yield of the treated cows was significantly higher (P < 0.05) for the first two weeks after the injection. The treated cows had higher plasma concentrations of beta-hydroxybutyrate and non-esterified fatty acids and lower plasma urea concentrations seven days after the injection. No other biochemical parameters were affected.

3-Hydroxybutyric Acid↗
PubMed1980

Study of the protective effect of an anabolic steroid, 19-nortestosterone phenylpropionate (19-NTPP) on the fatty liver induced by high doses of rifampicin in the rat.

The purpose of this work was to study if the steatogenic effect on the liver of Rifampicin, which is an inhibitor of the RNA polymerases DNA dependent in bacteria, can be prevented by an anabolic steroid: 19 nortestosterone phenylproprionate (19-NTPP) which probably stimulates the RNA polymerase activity in eukariotic cells. 19-NTPP (25 mg/kg/24 h, i.p.) was administered to male and both intact and ovariectomized female rats for 8 days prior to the administration of Rifampicin (400 mg/kg/24 h for 8 days). In male rats, 19-NTPP does not prevent the Rifampicin-induced fatty liver. On the contrary, in female rats, 19-NTPP exerts a partial protective effect in intact as well as in ovariectomized animals. These results show that the protective effect of 19-NTPP against Rifampicin fatty liver is less complete and little specific, comparated to the protective effect obtained against another steatogenic compound in female rats: alpha-Amanitin, which is a potent inhibitor of RNA polymerase II in eukariotic cells. In conclusion, the inhibitor effect of Rifampicin on the hepatic apolipoprotein biosynthesis appears as less specific and more intricate than the comparable effect of alpha-Amanitin.

Anabolic Agents↗
PubMed1992

Enhanced induction of hepatic lipid peroxidation by ferric nitrilotriacetate in chickens susceptible to fatty liver rupture.

1. Two strains of single comb White Leghorn birds, one susceptible to fatty liver rupture (UCD-003) and a normal commercial strain, were injected with iron nitrilotriacetate and the extent of hepatic lipid peroxidation that occurred was estimated by measuring concentrations of malondialdehyde (MDA). 2. Higher concentrations of MDA were found in the livers of the UCD-003 strain than in the normal birds after injection of iron nitrilotriacetate. No differences were found in the activities of glutathione peroxidase, superoxide dismutase and catalase in the livers of untreated birds of either strain. 3. The degree of unsaturation of the fats in the livers of the two strains was similar. However, the UCD-003 birds had a significantly higher content of liver fat than the normal birds. The increased concentrations of liver fat could account for the increased lipid peroxidation in the UCD-003 birds. 4. The increased incidence of liver haemorrhage that occurs in the UCD-003 birds may be caused by the increased susceptibility of these birds to hepatic lipid peroxidation.

Animals↗
PubMed2004

Soy protein affects serum insulin and hepatic SREBP-1 mRNA and reduces fatty liver in rats.

The consumption of soy protein was shown to reduce blood lipids in humans and other animal species. Furthermore, it was shown that the ingestion of soy protein maintains normal insulinemia. Thus, the purpose of the present study was to determine whether soy protein affects the synthesis of lipids in the liver through sterol-regulatory element binding protein-1 (SREBP-1) due to modulation of insulin levels. We first conducted a short-term study in which rats were fed a diet containing 18 g/100 g soy protein or casein for 10 d. Rats fed soy protein had significantly lower serum insulin concentrations than rats fed casein, and this response was accompanied by an elevation in hepatic SREBP-1 mRNA that was 53% lower than that in rats fed casein at d 10. The increase in SREBP-1 mRNA occurred 30 min after consumption of the casein mean, and increased steadily for the next 2 h. We then conducted a second study to assess the long-term effect of soy protein consumption for 150 d on hepatic SREBP-1 expression. Long-term consumption of soy protein maintained normal insulin concentrations compared with rats fed casein, which were hyperinsulinemic. Thus, rats fed the soy protein diet had significantly lower expression of SREBP-1 mRNA than rats fed the casein diet. Soy protein intake also reduced the expression of fatty acid synthase (FAS) and malic enzyme, leading to low hepatic lipid depots of triglycerides and cholesterol, whereas rats fed the casein diet developed fatty liver. These data suggest that soy protein regulates SREBP-1 expression by modulating serum insulin concentration, thus preventing the development of fatty liver.

Animals↗
PubMed2000

IL-18 and IL-12 induce intestinal inflammation and fatty liver in mice in an IFN-gamma dependent manner.

BACKGROUND: In murine models of inflammatory bowel disease, colonic inflammation is considered to be caused by an aberrant Th1-type immune response. AIM: To investigate if systemic administration of interleukin (IL)-12 and IL-18 to wild-type BALB/c mice induces liver injury and intestinal inflammation, and if pathological changes are observed, what cytokines are involved. METHODS: Mice (BALB/c-wild-type (wt), MRL-lpr/lpr, BALB/c-interferon gamma knock out (IFN-gamma KO), C57BL/6-inducible nitric oxide synthase (iNOS) KO, and BALB/c tumour necrosis factor alpha (TNF-alpha) KO) were injected intraperitoneally each day with IL-12 (20 ng/g/mouse) and/or IL-18 (200 ng/g/mouse). RESULTS: Administration of IL-12 and IL-18 to BALB/c-wt mice induced prominent intestinal mucosal inflammation and fatty liver, leading to piloerection, bloody diarrhoea, and weight loss. IL-12 and IL-18 induced striking elevations in serum levels of IFN-gamma that caused NO production, although increased NO had no exacerbating effect on mice. Moreover, iNOS KO mice, or MRL lpr/lpr mice lacking functional Fas were equally susceptible to IL-12 and IL-18. Administration of IL-12 and IL-18 did not induce TNF-alpha production in wild-type mice, and the same treatment to TNF-alpha KO mice induced intestinal mucosal inflammation. Furthermore, they had diffuse and dense infiltration of small fat droplets in their hepatocytes associated with an increase in serum levels of liver enzymes. In contrast, the same treatment in IFN-gamma KO BALB/c mice and iNOS KO mice did not induce these changes. CONCLUSIONS: Our study strongly indicates that IL-18 together with IL-12 induces intestinal mucosal inflammation in an IFN-gamma dependent but TNF-alpha, NO, and Fas ligand independent manner, and fatty liver is dependent on IFN-gamma and NO.

Animals↗
PubMed2006

Chemoprevention of spontaneous development of hepatocellular carcinomas in fatty liver Shionogi mice by a cyclooxygenase-2 inhibitor.

Cyclooxygenase 2 (COX-2) and retinoid X receptor alpha (RXRalpha) are suggested to have roles in carcinogenesis. COX-2 inhibitors have been reported to suppress growth of hepatocellular carcinoma (HCC) cell lines in vitro. However, little is known about the preventive effect of these drugs on spontaneous hepatocarcinogenesis in vivo. Etodolac exists in a racemic mixture containing S- and R-etodolac. S-etodolac is responsible for COX-2 inhibitory activity and R-etodolac is related to the downregulation of RXRalpha. Here, the effect of etodolac on spontaneous development of HCC in fatty liver Shionogi mice is evaluated. Etodolac was administered at a low (2 mg/kg) or high (10 mg/kg) dose three times a week for 16 months starting at the age of 3 months. The development of HCC was suppressed slightly in the high-dose group, and suppressed markedly in the low-dose group, although the development of fatty liver was not inhibited in either group. Plasma prostaglandin E2 levels were also decreased significantly in the low-dose group, consistent with the suppression of HCC. The expression of RXRalpha and proliferating cell nuclear antigen in non-tumorous liver tissues was decreased significantly in both the low-dose and high-dose groups. These findings show that etodolac treatment at an optimum dose suppresses hepatocarcinogenesis in vivo, and may be useful for preventing the development of HCC in humans.

Animals↗
PubMed1988

Acute fatty liver of pregnancy: CT evaluation. Case report.

CT scans of two patients with acute fatty liver of pregnancy were reviewed in conjunction with the clinical evolution of this uncommon and potentially fatal disorder. In each of the CT scans, liver density measurements were less than those of the spleen. While the findings are non-specific, in the proper clinical context they are highly suggestive and may be the sole method of diagnosis, as these patients often have coagulation problems which rule out liver biopsy. It is an important diagnosis, as the high maternal and fetal mortality rates appear to be considerably reduced by early foetal delivery.

Acute Disease↗
PubMed1999

Fatty liver and nonalcoholic steatohepatitis. Where do we stand and where are we going?

BACKGROUND: Fatty liver (FL) is the most common liver disease but its clinical significance remains elusive. Nonalcoholic steatohepatitis (NASH) is increasingly recognized as a cause of liver failure, sometimes recurring following transplantation. Recent data on both conditions are critically reviewed. METHODS: A Medline search of the medical literature (1990 to September 1998) and cross-references was performed. RESULTS: FL most commonly affects middle-aged men with obesity, altered glucose metabolism, hyperlipidemia, and hypertension. The link between biology of HCV, iron metabolism and FL should be addressed. Prospective studies should also quantify the rate and the factors involved in the progression of FL to NASH. The clinical spectrum of NASH is currently broader than it was initially recognized. Diagnosis of FL and NASH may involve ultrasonography, liver biopsy, and recognition of related conditions. Treatment of these conditions must be tailored according to patient's features. CONCLUSIONS: The clinical significance of FL is incompletely understood at present. The relationship, if any, of FL and the metabolic syndrome should be carefully investigated.

Fatty Liver↗
PubMed1989

Molecular cloning and sequencing of chicken liver fatty acid synthase cDNA.

The complete amino acid sequence of chicken liver fatty acid synthase [acyl-CoA:malonyl-CoA C-acyltransferase (decarboxylating, oxoacyl- and enoyl-reducing, and thioester-hydrolyzing), EC 2.3.1.85] has been determined from the corresponding cDNA sequence. A 5.3-kilobase-pair (kbp) region of cDNA coding for chicken fatty acid synthase has been cloned and sequenced that is contiguous to the 2.3-kbp region previously sequenced [Yuan, Z., Liu, W. & Hammes, G.G. (1988) Proc. Natl. Acad. Sci. USA 85, 6328-6331]. The cDNA codes for the remaining 1677 amino acids of the previously unsequenced region of the protein. The amino acid sequence contains peptides known to be associated with the NADPH binding site of the enoylreductase active center, the acetyl/malonyltransacylase active site, the "waiting" site containing cysteine, and a pyridoxal 5'-phosphate binding site. Locations of the NADPH binding site of the beta-ketoacylreductase active site and of the dehydratase active site are proposed on the basis of protein sequence homologies to catalytic sites in other enzymes. The molecular weight of the complete polypeptide chain is 267,288. A linear functional map of the chicken fatty acid synthase derived from its primary sequence is presented.

Amino Acid Sequence↗