January 2013, Volume 16, No.2 Abstracts

 Updates on Non-alcoholic Fatty Liver Disease

ZHENG Sheng, TANG Ying-mei.Department of Gastroenterology, the Third Peoples Hospital of Yunnan, Kunming 650011, China

Abstract Recent studies have shown that the prevalence of non-alcoholic fatty liver diseaseNAFLD 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 liverDiagnosisTherapyReview

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 diseaseNAFLDin 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 NAFLDNAFLD 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 (P0.05),whereas the body mass indexBMI, systolic blood pressure, diastolic blood pressure, fasting plasma glucose (FBG) and triglycerides showed significant differencesP0.01.The prevalences of obesity/overweight, hypertension, hypertriglyceridemia,and hyperglycemia were also significantly different between these two groupsP0.01.Non-conditional logistic stepwise regression analysis showed that BMIOR=1.449, 95%CI1.237, 1.697, P=0.000, FBGOR= 2.188, 95%CI1.353, 3.537, P=0.001.and triglycerideOR=2.213, 95%CI1.353, 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 liverRisk factorsAgedMen

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 acidUAlevels in predicting the non-alcoholic fatty liverNAFLDin type 2 diabetes mellitusT2DMpatients.

Methods Using the research data chicTR-TNC-11001489from 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 groupgroup A(≤216 μmol/L, n=738, group B216 μmol/L, n=749, group C263 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 indexBMI, triglyceridesTG, high density lipoprotein cholesterolHDL-C, low density lipoprotein cholesterolLDL-C, total cholesterol TC, and fasting plasma glucoseFPGwere 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 females33.3%, 159/477)(χ2=5.34, P0.05.The incidence of NAFLD was 22.5%166/738in group A, 28.8% 216/749in group B, 29.5% 213/722in group C, and 35.0%255/728in group D(χ2=28.15, P0.01.The horizontal comparisons of gender, age, average WC, BMI and TG, HDL-C, LDL-C, TC, and FPG among these four groups showed significant differenceP0.01.Taking A as reference group, univariate Logistic regression analysis showed that, the odds ratioORof NAFLD was 1.3795%CI1.11, 1.77, P=0.005, 1.4495%CI1.14, 1.83, P=0.002, and 1.8695%CI1.48, 2.34, P=0.000 in groups B, C, and D.After the introduction of gener and age, the OR of NAFLD was 1.4595%CI1.15, 1.84, P=0.002, 1.5295%CI1.20, 1.93, P=0.001, and 2.0395%CI1.60, 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 1.3695%CI1.06, 1.74, P=0.016, 1.3795%CI1.07, 1.74, P=0.012, and 1.6895%CI1.31, 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 2Non-alcoholic fatty liverUric acidMetabolic syndrome XBody 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 levelχ2=10.317, P0.01.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 diseaseDiabetes mellitus, type 2Non-alcoholic fatty liverUltrasonography

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 diseaseNAFLD.

Methods Ninety NAFLD patients who were treated in our hospital from January 2011 to February 2012 were selected as subjects and divided into mildn=30, moderaten=30, and severen=30groupsAnd 30 healthy people who were received physical examination at the same time were chosen as control group. The peak and mean portal vein velocityPPVV and MPVV, hepatic artery resistance indexHARI, 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,P0.01in each group.The PPVV was21.8±2.6cm/s, 19.6±2.4cm/s, 17.6±2.2cm/s, and15.8±2.1cm/s in the control, mild, moderate, and severe groups, with significant differenceF=36.82, P0.05.The MPVV was20.4±1.5cm/s, 16.6±2.4cm/s, 16.2±2.9cm/s, and13.7±0.7cm/s, respectively, with significant differenceF=54.28, P0.05.The HARI was0.79±0.03), 0.77±0.04, 0.73±0.03,and0.71±0.04, respectively, with significant differenceF=32.00, P0.05.

Conclusion Coler Doppler ultrasonography is a simple and cost-effective approach to detect the change of hemodynamics in NAFLD patients.

Key words Ultrasonography, color DopplerNon-alcoholic fatty liverHemodynamicsDiagnosis

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.Peoples 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 groupsP0.05.After treatment, the blood control rate was 91.8% 202/220 in the early morning group and 91.5%206/225in 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 (P0.05).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


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