Metabolik Sendromlu Olmayan Hastalarda Non-Alkolik Yağlı Karaciğer Hastalığı

Yıl 2021, Cilt: 5 Sayı: 2, 143 - 149, 29.05.2021

Vahide Betül Canıtez İbrahim Güney , Edip Erkuş

https://doi.org/10.29058/mjwbs.811398

Öz

Objective: Non-alcoholic fatty liver disease (NAFLD) is the most common type of chronic liver diseases and it is the hepatic evidence of metabolic syndrome (MtS). But patients with NAFLD have not always MtS, and all patients with MtS have not always NAFLD. In our study, we aimed to investigate the factors related to NAFLD in patients with non-MetS.
Materials And Methods: Our study was made at least 400 volunteers from 10 randomly selected Family Health Centers (FHCs) in our city center. Complete blood counts, biochemical tests and hepatobiliary ultrasonography (hUSG) were performed from the individuals. Body mass index (BMI), homeostasis Model Assessment of insulin Resistance (HOMA-IR), fibrosis-4 (FIB-4) and BARD scores were calculated.
Results: The prevalence of fatty liver was detected as 33.8% with hUSG. The frequencies of stage 1, 2 and 3 fatty liver were found to be 71.6%, 25.4% and 3.0%, respectively, in those with fatty liver (n=67). In univariate analysis; there were statistically significant differences between those with and without fatty liver individuals for the parameters of age, BMI, waist circumference, diastolic blood pressure, hemoglobin, AST/ALT ratio, ALT, GGT and triglyceride levels. In multivariate logistic regression analysis, BMI (OR: 1,311, p <0.001), hemoglobin (OR: 1,311, p = 0.005), DBP (OR: 1.046, p = 0.044) were shown to be independently associated factors for fatty liver.
Conclusion: The frequency of non-alcoholic fatty liver disease is also common in patients with non-MtS. BMI, hemoglobin and DBP are independently associated parameters for NAFLD in those with non-MtS.

Anahtar Kelimeler

Non-alcoholic fatty liver disease, metabolic syndrome, hemoglobin level, obesity

Destekleyen Kurum

yok

Proje Numarası

Çalışma 21.02.2018 tarih ve 2018/71 sayılı yerel etik kurul tarafından onaylandı.

Teşekkür

.

Non-Alcoholic Fatty Liver Disease in Patients with Non-Metabolic Syndrome

Öz

Amaç: Non-alkolik yağlı karaciğer hastalığı (NAFLD) en yaygın kronik karaciğer hastalığı türüdür ve metabolik sendromun (MtS) hepatik kanıtıdır. Ancak NAYKH'li hastalar her zaman MtS'ye sahip değildir ve MtS'li tüm hastalar her zaman NAYKH 'ye sahip değildir. Çalışmamızda MetS olmayan hastalarda NAYKH ile ilişkili faktörleri araştırmayı amaçladık.

Gereç Ve Yöntemler: Çalışmamız şehir merkezimizde rastgele seçilen 10 Aile Sağlığı Merkezi'nden (ASM) en az 400 gönüllü ile yapılmıştır. Bireylerden tam kan sayımı, biyokimyasal testler ve hepatobiliyer ultrasonografi (hUSG) yapıldı. Vücut kitle indeksi (BMI), homeostaz Modeli İnsülin Direnci Değerlendirmesi (HOMA-IR), fibrozis-4 (FIB-4) ve BARD skorları hesaplandı.

Bulgular: Çalışmada karaciğer yağlanması prevalansı hUSG ile 33,8 % olarak tespit edildi. Karaciğer yağlanması olanlarda (n = 67) evre 1, 2 ve 3 yağlı karaciğer sıklığı sırasıyla 71,6 %, 25,4 % ve 3,0 % olarak bulundu. Tek değişkenli analizde; yağlı karaciğeri olan ve olmayan bireyler arasında yaş, vücut kitle indeksi, bel çevresi, diyastolik kan basıncı, hemoglobin, AST / ALT oranı, ALT, GGT ve trigliserit düzeyleri parametreleri açısından istatistiksel olarak anlamlı farklılıklar vardı. Çok değişkenli lojistik regresyon analizinde, BMI (OR: 1,311, p <0,001), hemoglobin (OR: 1,311, p = 0,005), DBP (OR: 1,046, p = 0,044) yağlı karaciğer için bağımsız ilişkili faktörler olarak gösterilmiştir.

Sonuç: Non-alkolik yağlı karaciğer hastalığı sıklığı, MtS olmayan hastalarda da yaygındır. BMI, hemoglobin ve DBP, MtS olmayanlarda NAFLD için bağımsız olarak ilişkili parametrelerdir.

Anahtar Kelimeler

Non-alkolik yağlı karaciğer hastalığı, metabolik sendrom, hemoglobin düzeyi, obezite

Proje Numarası

Çalışma 21.02.2018 tarih ve 2018/71 sayılı yerel etik kurul tarafından onaylandı.

Kaynakça

• 1. Preiss D, Sattar N. Non-alcoholic fatty liver disease: an overview of prevalence, diagnosis, pathogenesis and treatment considerations. Clin Sci (Lond) 2008;115:141-50.
• 2. Shukla V., et al. A Study of Endothelial Dysfunction in Patients of Non-Alcoholic Fatty Liver Disease. J Assoc Physicians India, 2017. 65(9): p. 18-22.
• 3. Miyaoka Y., et al., A novel hamster nonalcoholic steatohepatitis model induced by a high-fat and high-cholesterol diet. Exp Anim, 2018. 67(2): p. 239-247.
• 4. Neuschwander-Tetri, B.A., Non-alcoholic fatty liver disease. BMC Med, 2017. 15(1): p. 45.
• 5. Streba L.A., et al. Nonalcoholic fatty liver disease, metabolic risk factors, and hepatocellular carcinoma: an open question. World J Gastroenterol, 2015. 21(14): p. 4103-10.
• 6. Vanni E, et al. From the metabolic syndrome to NAFLD or vice versa? Dig Liver Dis 2010;42:320-30.
• 7. Green RM. NASH-hepatic metabolism and not simply the metabolic syndrome. Hepatology 2003;38:14-7.
• 8. Matthews D.R., et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 1985. 28(7): 412-9.
• 9. Sterling R.K., et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology, 2006. 43(6): p. 1317-25.
• 10. Harrison S.A., et al. Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease. Gut, 2008. 57(10): p. 1441-7.
• 11. Grundy S.M., et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 2005. 112(17): p. 2735-52.
• 12. Salva-Pastor N, et al. The diagnostic and initial approach of the patient with non-alcoholic fatty liver disease: role of the primary care provider. Gasroenterol Hepatol Bed Bench 2019; 12(4):267-77.
• 13. Monn KW, et al. The prevalence of metabolic syndrome in patients with nonalcoholic fatty liver disease. Korean J Hepatol 2004;10;197-206.
• 14. Kang H, et al. Metabolic syndrome is associated with greater histologic severity, higher carbohydrate, and lower fat diet in patients with NAFLD. Am J Gastroenterol 2006; 101:2247-53.
• 15. Younossi Z, et al. Nonalcoholic fatty liver disease in patients with type 2 diabetes. Clin Gastroenterol Hepatol. 2004;2(3):262-65.
• 16. Amarapurkar D, et al. Prevalence of nonalcoholic fatty liver disease: population based study. Ann Hepatol. 2007;6:161-63.
• 17. Yang S, et al. Nonalcoholic fatty liver disease is an early predictor of metabolic diseases in a metabolically healthy population. Plos One 2019;November 4:1-15.
• 18. Makker J, et al. Preclinical cardiac disease in nonalcoholic fatty liver disease with and wtihout metabolic syndrome. Am J Cardiovasc Dis 2019;9(5):65-77.
• 19. Yilmaz Y, et al. Characterization of nonalcoholic fatty liver disease unrelated to the metabolic syndrome. Eur j Clin Invest 2012;42 (4):411-18.
• 20. Marchesini G, et al. Nonalcoholic fatty liver disease, steatohepatitis, and the metabolic syndrome. Hepatology 2003;37:917-23.
• 21. Trak-Smayra V, et al. Serum proteomic profiling of obese patients: correlation with liver pathology and evoluation after bariatric surgery. Gut 2009;58:825-32.
• 22. Xu L, et al. Haemoglobin and non-alcoholic fatty liver disease: further evidence from a population-based study. Gut 2009;58:1706-7.
• 23. Brunt EM, Tiniakos DG. Histopathology of nonalcoholic fatty liver disease. World J Gastroenterol 2010 Nov 14;16(42):