January 2013, Volume 16, No.2 Abstracts
ZHENG Sheng, TANG Ying-mei.Department of Gastroenterology, the Third People′s Hospital of Yunnan, Kunming 650011, China
【Abstract】 Recent studies have shown that the prevalence of non-alcoholic fatty liver disease（NAFLD） has increased year by year. Liver fatty deposition plays an important role in insulin resistance and lipid metabolic disorders. The treatment of NAFLD, is followed with interest by experts at home and abroad, related researches are expanded deeply. This paper reports newest progress in NAFLD research at home and abroad, discusses its new concepts from metabolic perspective, introduces the latest achievements in diagnosis and treatment.
【Key words】 Non-alcoholic fatty liver；Diagnosis；Therapy；Review
Risk Facters of Non-alcoholic Fatty Liver Disease in Elderly Men
YOU Zhi-qing, ZHANG Shu-ping, GUO Wei, et al.Depatment of Endocrinology, the PLA Chengdu Milltary Command General Hospital, Chengdu 610083, China
【Abstract】 Objective To investigate the risk factors of non-alcoholic fatty liver disease（NAFLD）in elderly men.
Methods Among 1 043 elderly (≥60 years) men who received health check-up in our hospital from April to August 2011,242 were diagnosed with fatty liver by abdominal ultrasound,of which 164 were NAFLD（NAFLD group）.Another 72 healthy subjects were randomly selected as the control group.The clinical features and laboratory findings were compared between two groups.The potential risk factors of NAFLD were analyzed by non-conditional Logistic stepwise regression analysis.
Results The levels of total cholesterol, high-density lipoprotein,apo A1,apo B,and white blood cell were not significantly different between these two groups (P＞0.05),whereas the body mass index（BMI）, systolic blood pressure, diastolic blood pressure, fasting plasma glucose (FBG) and triglycerides showed significant differences（P＜0.01）.The prevalences of obesity/overweight, hypertension, hypertriglyceridemia,and hyperglycemia were also significantly different between these two groups（P＜0.01）.Non-conditional logistic stepwise regression analysis showed that BMI〔OR=1.449, 95%CI（1.237, 1.697）, P=0.000〕, FBG〔OR= 2.188, 95%CI（1.353, 3.537）, P=0.001〕.and triglyceride〔OR=2.213, 95%CI（1.353, 3.621）, P=0.002〕 were the risk factors of NAFLD.
Conclusion The main risk factors of NAFLD include hypertriglyceridemia, hyperglycemia and obesity/overweight.Lowering plasma lipids and plasma glucose and weight loss by adopting healthy lifestyle are critical in the prevention and treatment of NAFLD.
【Key words】 Non-alcoholic fatty liver；Risk factors；Aged；Men
Role of Serum Uric Acid Level in Predicting Non-alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus
WANG Jian-jun, ZHANG Yan-min, WU Shou-ling, et al.Department of Gastroenterology, Zhaogezhuang Hospital of Kailuan, Tangshan 063000, China
【Abstract】 Objective To investigate the role of serum uric acid（UA）levels in predicting the non-alcoholic fatty liver（NAFLD）in type 2 diabetes mellitus（T2DM）patients.
Methods Using the research data （chicTR-TNC-11001489）from Kailuan Group, we retrospctively enrollled 2 937 eligible subjects.Based on the the quantiles of the baseline UA levels, these patients were divided into 4 group：group A（≤216 μmol/L, n=738）, group B（216～ μmol/L, n=749）, group C（263～ μmol/L, n=722）, and group D（＞316 μmol/L, n=728）.The incidence of NAFLD as well as age, waist circumference （WC）, body mass index（BMI）, triglycerides（TG）, high density lipoprotein cholesterol（HDL-C）, low density lipoprotein cholesterol（LDL-C）, total cholesterol （TC）, and fasting plasma glucose（FPG）were recorded.The potential risk factors of NAFLD were analyzed using conditional Logistic regression analysis.
Results The incidence of NAFLD was 28.9%（850/2 937）, among whom males accounted for 28.1%（691/2 460）, and with statistically significant difference when compared with females（33.3%, 159/477）（χ2=5.34, P＜0.05）.The incidence of NAFLD was 22.5%（166/738）in group A, 28.8% （216/749）in group B, 29.5% （213/722）in group C, and 35.0%（255/728）in group D（χ2=28.15, P＜0.01）.The horizontal comparisons of gender, age, average WC, BMI and TG, HDL-C, LDL-C, TC, and FPG among these four groups showed significant difference（P＜0.01）.Taking A as reference group, univariate Logistic regression analysis showed that, the odds ratio（OR）of NAFLD was 1.37〔95%CI（1.11, 1.77）, P=0.005〕, 1.44〔95%CI（1.14, 1.83）, P=0.002〕, and 1.86〔95%CI（1.48, 2.34）, P=0.000〕 in groups B, C, and D.After the introduction of gener and age, the OR of NAFLD was 1.45〔95%CI（1.15, 1.84）, P=0.002〕, 1.52〔95%CI（1.20, 1.93）, P=0.001〕, and 2.03〔95%CI（1.60, 2.57）, P=0.000〕 in groups B, C, and D.After the further introduction of TG, TC, HDL-C, LDL-C, FPG, and BMI, the OR for NAFLD in groups B, C, and D were 1.36〔95%CI（1.06, 1.74）, P=0.016〕, 1.37〔95%CI（1.07, 1.74）, P=0.012〕, and 1.68〔95%CI（1.31, 2.17）, P=0.000〕.
Conclusion T2DM patients are susceptible to NAFLD, with the blood UA level as its independent risk factor.
【Key words】 Diabetes mellitus, type 2；Non-alcoholic fatty liver；Uric acid；Metabolic syndrome X；Body mass index
Prevalence and Risk Factors of Non-alcoholic Fatty Liver Disease in Coronary Heart Disease with Type 2 Diabetes Mellitus Patients
LI Qing-xiang, ZHANG Ying, ZHANG Xin-yong, et al.The 35th Wards, Anzhen Hospital, Capital Medical University & Beijing Institute of Heart,Lung and Blood Vessel Diseases, Beijing 100029, China
【Abstract】 Objective To investigate the incidence and risk factors of NAFLD in coronary artery disease with type 2 diabetes mellitus patients undergoing coronary angiogram.
Methods 280 patients with coronary artery disease in type 2 diabetes mellitus who underwent coronary angiogram were enrolled into this study.All patients had ultrasound screening for fatty liver.
Results Among 280 recruited patients,178(63.6%) had fatty liver by ultrasonography.The incidence of NAFLD increased with the severity of coronary artery lesions（χ2 trend=6.148, P=0.01）.Multi-vessel lesions in moderate to severe NAFLD was higher than the mild level（χ2=10.317, P＜0.01）.By multivariable Logistic regression analysis, multi-vessel lesions or stenosis of left main stem were risk factor in NAFLD patients with coronary heart disease in diabetes mellitus.
Conclusion In coronary artery disease patients with diabetes mellitus, multi-vessel lesions and stenosis of left main stem are the important risk factors for NAFLD occurrence.
【Key words】 Coronary disease；Diabetes mellitus, type 2；Non-alcoholic fatty liver；Ultrasonography
Doppler Ultrasound in Assessment of Hemodynamics of Patients with Non-alcoholic Fatty Liver Disease
LI Bao-qi, XU Hong-qiang, WANG Jin-ping, et al.Department of Ultrasonic, the First Affiliated Hospital of Anhui Traditional Chinese Medical College, Hefei 230031, China
【Abstract】 Objective To investigate the value of Doppler ultrasound in the assessment of the changed hemodynamics of patients with non-alcoholic fatty liver disease（NAFLD）.
Methods Ninety NAFLD patients who were treated in our hospital from January 2011 to February 2012 were selected as subjects and divided into mild（n=30）, moderate（n=30）, and severe（n=30）groups；And 30 healthy people who were received physical examination at the same time were chosen as control group. The peak and mean portal vein velocity（PPVV and MPVV）, hepatic artery resistance index（HARI）, and spectral waveform of the middle hepatic vein were measured with Doppler ultrasound.
Results The spectrum waveforms in the middle hepatic vein showed significant difference（χ2=28.342,P＜0.01）in each group.The PPVV was（21.8±2.6）cm/s, （19.6±2.4）cm/s, （17.6±2.2）cm/s, and（15.8±2.1）cm/s in the control, mild, moderate, and severe groups, with significant difference（F=36.82, P＜0.05）.The MPVV was（20.4±1.5）cm/s, （16.6±2.4）cm/s, （16.2±2.9）cm/s, and（13.7±0.7）cm/s, respectively, with significant difference（F=54.28, P＜0.05）.The HARI was（0.79±0.03）, （0.77±0.04）, （0.73±0.03）,and（0.71±0.04）, respectively, with significant difference（F=32.00, P＜0.05）.
Conclusion Coler Doppler ultrasonography is a simple and cost-effective approach to detect the change of hemodynamics in NAFLD patients.
【Key words】 Ultrasonography, color Doppler；Non-alcoholic fatty liver；Hemodynamics；Diagnosis
Effects of Compound Hypotensive Tablets Administered at Different Time Points on Pressure Rhythm and 24-hour Ambulatory Blood Pressure in Patients with Non-dipper Essential Hypertension
JING Shan,WANG Hong-yi,SUN Ning-ling,et al.People′s Hospital of Beijing University,Beijing 100044,China
【Abstract】 Objective To investigate the effects of Compound Hypotensive tablets on blood pressure rhythm and 24-hour ambulatory blood pressure in treatment of non-dipper essential hypertension.
Methods In this multicenter,open-labeled,single armed,and non-controlled study,a total of 461 eligible patients with non-dipper essential hypertension entered the final analysis.Patients were randomized to taking the Compound Hypotensive tablets in the early morning or in the evening (1 tablet per day) for 6 months.The 24-hour ambulatory blood pressure before and after treatment were measured.
Results Compared with the baseline level, the SBP and DBP blood pressure was dramatically reduced after treatment in both two groups（P＜0.05）.After treatment, the blood control rate was 91.8% （202/220） in the early morning group and 91.5%（206/225）in the evening group.Compared with pre-treatment,the 24-hour systolic/diastolic blood pressure, day systolic/diastolic blood pressure,and night systolic/diastolic blood pressure significantly decreased (P＜0.05).After treatment,the pressure rhythm was changed from non-dipper to dipper in 190 patients (104 patients from the early morning group and 86 patients from the evening group).
Conclusion Compound Hypotensive tablets can effectively lower the clinic blood pressure,ambulatory blood pressure,and night blood pressure in patients with non-dipper essential hypertension,wheter taking in the early morning or evening.In addition,it can adjust the abnormal rhythm of blood pressure.
【Key words】 Compound hypotensive tablets; Blood pressure determination; Hypertension; Non-dippers