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BACKGROUND: With new treatments for non-alcoholic fatty liver disease (NAFLD) on the horizon, it will be important to risk-stratify patients based on degree of fibrosis to allocate treatment to those at highest risk. No studies have examined the complication rates of liver biopsies in patients with NAFLD in the outpatient setting. METHODS: We conducted a retrospective chart review of all outpatient elective liver biopsies for NAFLD at a tertiary care centre over a 10-year period. Demographic variables and stage of fibrosis were recorded. Complications up to 1 week post-procedure were recorded. We used univariate logistic regression models to estimate the odds of major complications by fibrosis stage, age, sex, platelets, and international normalized ratio (INR). RESULTS: There were 582 biopsies reviewed in total. The mean age was 53 years. There was an even proportion of males to females. The mean fibrosis stage was 1.9; platelet count was 223.9, INR was 1, and partial thromboplastin time (PTT) was 31. Major complications occurred in 8 out of 582 biopsies (1.4%). Bleeding accounted for 6 of the major complications observed, while infection and pneumoperitoneum each occurred once. There were no statistically significant associations between age (odds ratio [OR] 0.97, 95% CI 0.92–1.03), female sex (OR 1.00, 95% CI 0.25–4.04), platelet count 1.3 (OR 0.47, 95% CI 0.057–3.85), fibrosis stage, and complication rate. CONCLUSIONS: Our results are consistent with previous studies examining complication rates in other patient populations and clinical settings and support the overall safety of liver biopsies.

BACKGROUND: While evidence has been a highlight that obesity may be associated with the increased incidence of Nonalcoholic fatty liver disease (NAFLD), these data have depended on defective measures of obesity such as body mass index (BMI), and usually have not the well-known relationship between body composition with NAFLD. METHODS: In a case-control study of people aged 20– 65 years, we directly measured body composition (using bioelectrical impedance analysis), height, weight, and waist and hip circumferences who referred to radiology clinics in Kermanshah, Iran. Dietary intake was assessed by the food frequency questionnaire (FFQ). RESULTS: Among 221 people examined, 103 cases with NAFLD and 119 as control were established. The risk of NAFLD was positively associated with higher BMI and the components of the body composition. These associations were strengthened after adjusting for potential confounders including gender, age, marital status, education, smoking, alcohol consumption, and physical activity CONCLUSION: An increasing prevalence of obesity may be associated with the increasing incidence of NAFLD as observed in many populations. We observed an increased risk of NAFLD associated with increased BMI, central adiposity, and the fat component of weight, but found no association with nonfat mass.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has become the leading cause of chronic liver disease worldwide. Type 2 diabetes (T2D) is described as one of the most significant risk factor for developing NAFLD, non-alcoholic steatohepatitis, and advanced cirrhosis. Liver biopsy cannot be used routinely to diagnose NAFLD. Therefore, it is critically urgent to develop a simple non-invasive test. AIM: This study examined fasting Acyl-Ghrelin (AG) as a non-invasive biomarker to accurately diagnose NAFLD in diabetic patients. PATIENTS AND METHODS: Sixty-one patients with T2D were divided into a test group with NAFLD, and a control group without NAFLD. Secondary causes of fatty liver, chronic viral hepatitis, and drug-induced liver damage were excluded from the study. Anthropometric measurements, lipid profile, fasting blood sugar (FBS), liver enzyme activities, and fasting AG levels were collected. Data management and analysis were performed using statistical package for social sciences version 20. RESULTS: Fasting AG level (pg/ml) in the test group (56.1 ± 10.7) was increased, but not statically significant compared with the control group (37.8 ± 9.3), p > 0.05. However, significant metabolic changes were observed in body weight, waist circumference, FBS, alanine transaminase, and aspartate transaminase between test and control groups. The mean values in the test group are 93.2 ± 14.5, 115.4 ± 7.6, 144.2 ± 25.9, 21.1 ± 5.7, and 32.3 ± 2.1. While the mean values are 87.7 ± 7.3, 95 ± 3.8, 123.7 ± 20.7, 18.6 ± 5, and 20 ± 7, respectively, in the control group. CONCLUSIONS: While elevated AG levels alone were not significant, elevated AG levels plus other parameters of liver damage and obesity were associated with the diagnosis of NAFLD. However, more studies are needed to consider elevated AG as a diagnostic marker in NAFLD patients with T2D.

The aim of this study was to investigate whether a nutritional intervention motivating increased vegetable consumption would be an effective treatment and diet therapy for patients with non-alcoholic fatty liver disease. We examined 15 patients with this disease (5 men and 10 women). During the 6-month intervention period, all participants received a small amount of vegetables twice a month as a nutritional education tool aimed at increasing vegetable consumption. They also received nutritional counseling and underwent ultrasound and blood biochemical examinations at baseline and 3 and 6 months after initiation of the intervention. Moreover, they were requested to submit dietary records for any 2 days. Green, white, and total vegetable intakes were significantly higher at 3 and 6 months than at baseline in 8 patients. These patients had significantly lower alanine amino­transferase and triglyceride concentrations than those whose vegetable intake did not increase. Additionally, green vegetable intake significantly negatively correlated with weight at 3 and 6 months (r = −0.617, p = 0.032 and r = −0.848, p = 0.008, respectively). These results suggest that our nutritional approach effectively increased vegetable consumption in at least some patients with non-alcoholic fatty liver disease, consequently improving their condition.

This study aims to systematically assess the effectiveness and safety of Huazhi Rougan granule in the treatment of non-alcoholic fatty liver.The PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), WanFang databases, VIP databases, Chinese Biomedical Literature Database (SinoMed) were searched to identify the relevant randomized controlled trials, from the establishment of the database to June 7, 2020. The Cochrane risk of bias tool for assessing risk of bias was employed to evaluate the quality of the literatures included. Meta-analyses were performed using RevMan 5.3 software.A total of 23 related literature were retrieved, 9 studies with 1,142 participants were included in the meta-analysis. The overall quality of evidence for this study is low. Meta-analysis results suggest that, Huazhi Rougan granule combined with conventional treatment was significantly superior to the silybin control group in the improvement of liver B-ultrasound, reduction of serological indexes, increase of high-density lipoprotein and total clinical effective rate, which was statistically significant. The improvement of serum lipid parameters included alanine aminotransferase (ALT): [mean deviation (MD) =-10.49, 95% confidence interval (CI): -17.09, -3.90, P0.05], aspartate transaminase (AST): (MD =-9.44, 95% CI: -14.62, -4.26, P0.05), total cholesterol (TC): (MD =-0.77, 95% CI: -0.94, -0.60, P0.05), triglyceride (TG): (MD =-0.40, 95% CI: -0.56, -0.24, P0.05). Reduce low-density lipoprotein cholesterol: (MD =-0.40, 95% CI: -0.56, -0.24, P0.05). Clinical effective rate: [risk ratio (RR) =1.25, 95% CI: 1.16, 1.36, P0.05]. Occurrence of adverse reactions: Of the 9 studies included, 5 reported adverse reactions, of which 3 reported no drug-related adverse reactions. Adverse reactions were reported in 2 cases, all of which were mild adverse reactions.The clinical efficacy of Huazhi Rougan granule combined with conventional basic therapy in the treatment of non-alcoholic fatty liver may be better than that of conventional basic therapy combined with silybin, which may improve the B-ultrasonic grading effect of the liver and reduce the serum lipid parameters of the patients. it may improve the clinical symptoms of non-alcoholic fatty liver, and the incidence of adverse reactions is low, but the number of existing clinical studies is small and the quality is low, in order to further verify the above conclusions. More high-quality clinical RCT trials need to be carried out, and internationally recognized outcome indicators should be selected and uniformly included in the scoring criteria.

Yu Xia, Yanxia Zhang, Huiyun Wang Department of Health Comprehensive Geriatrics, Yidu Central Hospital of Weifang, Weifang, Shandong, People’s Republic of ChinaCorrespondence: Yu XiaDepartment of Health Comprehensive Geriatrics, Yidu Central Hospital of Weifang, No. 4138, Linglongshan Road, Weifang, Shandong, 262500, People’s Republic of ChinaTel +86-536-3279993Email xiayuvsrain@163.comPurpose: Non-alcoholic fatty liver disease (NAFLD) is a disease associated with genetic-environmental-metabolic stress, which severely damages the liver function of patients. This study aimed to explore the significance and probable functions of HCG18 in NAFLD.Patients and Methods: The expression of HCG18 and miR-197-3p was tested by qRT-PCR. The clinical signification of HCG18 was provided by the ROC curve and Pearson correlation. The corresponding mechanism was punctuated by the luciferase reporter assay and HFD-managed mice.Results: HCG18 expression was higher in the patients with NAFLD than in controls and in individuals with HOMA-IR score ≥ 2.5 than those with HOMA-IR score < 2.5. HCG18 expression in NAFLD patients was related to BMI, HOMA-IR, ALT, FBG, TC, and TG. HCG18 showed satisfactory predictive accuracy in differentiating NAFLD patients and patients with HOMA-IR ≥ 2.5. Besides, HCG18 had protective impacts on blood glucose and fat deposition but not on body weight. MiR-197-3p is a direct gene of HCG18, and a reverse correlation was found between miR-197-3p and HCG18. Furthermore, miR-197-3p regulated the influence of HCG18 on insulin resistance and lipid accumulation.Conclusion: Increased levels of HCG18 might be an alternate indicator for NAFLD patients. The HCG18-miR-197-3p axis exerted effects on the progression of fat sedimentation and glucose disorder in NAFLD.Keywords: HCG18 miR-197-3p, diagnosis, insulin resistance, lipid accumulation

Soybean has become an important world commodity because of its low price, good nutritional value and recognized functional health benefits in recent years. β-conglycinin is one of the major storage proteins in soybean. It has captured a growing interest recently because of its allergenicity and potential health benefits, which continues to drive the research and commercial development of β-conglycinin-based food products and ingredients. In this review, the structure, the amino acid composition, extraction methods and electrophoretic pattern of β-conglycinin are briefly summarized. Studies on β-conglycinin by allergenicity, plasma lipid-controlling, obesity and nonalcoholic fatty liver disease are highlighted, critically discussing their main shortcomings and challenges and identifying the research gaps. Studies to date have demonstrated the cultivation of β-conglycinin with health benefits as functional ingredients and foodstuffs. The current research focuses on proteins, mainly challenging the mechanisms of subunit/peptide effects interaction and identifying and characterizing the hidden biological activities in the polypeptide chains. There is much scope for further exploration into various aspects of β-conglycinin, such as the selection of mutant strains and genetic engineering and prospects on targeted β-conglycinin exploitation in the nutraceutical area. In addition, the safety evaluation of β-conglycinin and its stabilized emulsions deserve more attention to food-related applications.

Purpose Non-alcoholic fatty liver disease (NAFLD) is the most common chronic hepatic disease worldwide with functional impairment of the mitochondria occurring from early stages. Technetium-99m methoxy-isobutyl-isonitrile (99mTc-MIBI) is a lipophilic agent trapped in the mitochondria. This study aims to evaluate the utility of 99mTc-MIBI heart/liver uptake ratio in screening for NAFLD during myocardial perfusion imaging (MPI). Methods 70eligible patients underwent a two-day rest/stress 99mTc-MIBI scan with a 2-minute planar image acquired in rest phase, at 30, 60 and 120 minutes post radiotracer administration. Heart/liver uptake ratio was calculated by placing identical regions of interest on the heart and liver dome. All patients underwent liver ultrasound and were allocated into groups A, having NAFLD, and B, healthy individuals without NAFLD. Results Mean count per pixel heart/liver ratios gradually increased over time in either groups; nonetheless the values were significantly higher in group A, regardless of acquisition timing; with the P-value equal to 0.007, 0.014 and 0.010 at 30, 60 and 120 minutes, respectively. Conclusions Determining 99mTc-MIBI heart/liver uptake ratio during rest phase in patients undergoing MPI may be a useful, non-invasive screening method for NAFLD; with no additional cost, radiation burden or adverse effects in these patients.

BACKGROUND Autoimmune markers including plasma cells (PC), anti-smooth-muscle antibody (ASMA), anti-nuclear antibody (ANA), and raised immunoglobulin G (IgG) are commonly observed in non-alcoholic steatohepatitis (NASH), however their clinical significance is unknown. AIM To determine if autoimmune markers in NASH patients are independently associated with poorer clinical outcomes. METHODS Consecutive patients with biopsy proven NASH from Christchurch Hospital, New Zealand and Singapore General Hospital (SGH) were included between 2005 to 2016 in a prospective multi-centre cohort study. Patients with other causes of chronic liver disease were excluded. IgG > 14 g/L or globulin fraction > 50%, ANA ≥ 1:40, SMA ≥ 1:40 were considered positive. Multivariate analysis was performed to assess which markers were independently associated with mortality and hepatic decompensation. RESULTS Total 261 patients were included of which 201 were from SGH. The median age was 53 and 51.9% were male. Advanced fibrosis was present in 31.4% at diagnosis. PC, ASMA, ANA and raised IgG were observed in 13.1%, 4.9%, 27.8% and 30.1% of patients respectively. After multivariate analysis, elevated IgG [Hazard Ratio (HR) 6.79, 95%CI: 2.93-17.15] and fibrosis stage (HR 1.37, 95%CI: 1.03-1.87) were found to be independently associated with increased risk of liver decompensation. Age (HR 1.06, 95%CI: 1.02-1.10) and elevated IgG (HR 3.79, 95%CI: 1.90-7.68) were independent factors associated with higher mortality risk. CONCLUSION Elevated IgG, rather than ANA, ASMA or plasma cells, is independently associated with increased risk of hepatic decompensation and mortality in NASH. It could hence be important for prognostication.

Background: Nearly 25% of adults worldwide are affected by non-alcoholic fatty liver disease (NAFLD). taged changes in the liver from steatosis progress to non-alcoholic steatohepatitis (NASH) and its complicated forms such as fibrosis, cirrhosis, and hepatocellular carcinoma. There are very few data in the literature on the development of NAFLD in conditions of high altitude. There are no data on the state of pro- and anti-inflammatory cytokines in NAFLD in high altitude conditions. Thus, simulating NAFLD on animals in artificial highlands will help find answers to these questions. Aim: to study the features of the course of non-alcoholic fatty liver disease (NAFLD) in experimental animals in artificial high-mountain conditions. Material and methods: The study was carried out on 180 male Wistar rats. 7 groups of experimental animals were formed, which were divided into control and experimental groups. The rats of the control group were on a standard diet. Non-alcoholic fatty liver disease was modeled by keeping animals on a diet (Ackermann et al., 2005) rich in fructose and fat in low and high mountain conditions (in a pressure chamber 6000 m above sea level) for 35 and 70 days. In all groups of animals, the following was determined: the concentration of total bilirubin (TB), the activity of the enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), the level of total cholesterol (TC), low-density lipoprotein cholesterol (LDL), the total protein content in plasma (TP), pro- and anti-inflammatory cytokines. Results: In animals on a diet enriched with fructose and fat, it equally led to the inhibition of the synthetic function of the liver, both in high altitude and in low altitudes. Liver enzyme levels were uncertain. AST levels were high in all major groups, with a similar upward trend at 5 and 10 weeks on the fructose-fortified diet. The greatest shift was observed on the part of ALT in animals under conditions of hypobaric hypoxia, the growth of which was statistically significantly lower than in the low- altitude groups. The opposite picture was observed in pigment metabolism. Indicators of total cholesterol and LDL increased almost twofold in the main high- altitude groups, and were significantly higher than the indicators of low- altitude animals with p

This research was aimed to estimate the course of hypertension on the background of obesity and nonalcoholic fatty liver disease according to its stages (steatosis and steatohepatitis). Ninety patients were evaluated for anthropometric, general-clinical, laboratory, instrumental and immune-enzymatic research methods. With USG, the most characteristic features of fatty liver infiltration and the criteria for the distinction of steatosis from steatohepatitis were revealed, and on the basis of them 2 groups were formed. Thus, the progression of nonalcoholic fatty liver disease to the stage of steatohepatitis was accompanied by a more pronounced increase in blood pressure larger in comparison with steatosis of mass index of myocardium and anterior-posterior size of the left atrium, indicating the progression of structural myocardial disorders. Therefore, the presence of non-alcoholic steatohepatitis in patients with hypertension can be regarded as unfavorable prognostic criteria for the development of heart failure. In the presence of steatohepatitis, more marked changes in lipidograms were noticed for Low-Density Lipoprotein and Triglyceride values and a violation of the functional state of the liver with a cytolytic syndrome on the activity of AST and ALT and the total bilirubin, which may contribute to the progression of liver damage.

Aim: To study the hepatoprotective and antioxidant activity of 50% aqueous-alcoholic leaves extract of Morinda tinctoria (Rubiaceae) against non-alcoholic fatty liver disease. Study Design: All experiments involving animals complies with the ethical standards of animal handling and approved by institutional animal ethical and welfare committee of the Institute of Pharmacy, PSIT (1273/AC/09/ CPCSEA) and plant were collected from Ranan Nagar, Madurai, Tamil Nadu, India and was authenticated by Dr. Navin K. Ambasht, Head and Associate Professor, Botany Department, Christ Church College, Kanpur, Uttar Pradesh, India. Place and Duration of Study: The study was carried out at Institute of Pharmacy, PSIT, Kanpur, Uttar Pradesh, India, during 2018-21. Methodology: The hepatoprotective potential of Morinda tinctoria leaves extract (MTLE) 150 and 300 mg/kg body weight was studied on Methionine and Choline deficient diet, High Fat Diet, Cholesterol and Cholate diet, and Streptozotocin + HFD induced non-alcoholic fatty liver disease. At the end of the treatment blood sample was collected from direct cardiac puncture and analysed for various parameter like alanine aminotransferase, aspartate transaminase, low density lipoprotein, high density lipoprotein, triglycerides, total cholesterol, free fatty acid and malondialdehyde. Results: The phytochemical investigation of extract showed presence of alkaloids, flavonoids, amino acid, saponin, tannins, phenols, carbohydrate and for the first time the present study showed that Morinda tinctoria leaves extract reduced level of alanine aminotransferase, aspartate transaminase, triglycerides, total cholesterol, low density lipoprotein, free fatty acid, malondialdehyde and enhance the level of Superoxide dismutase, High Density Lipoprotein and it also returned hepatic damage towards normal which further supports hepatoprotective and antioxidant activity of M. tinctoria. leaves extracts. Conclusions: M. tinctoria leaves extract showed maximum curation in the dose 300 mg/kg body weight against non-alcoholic fatty liver disease.

Back ground: Non-Alcoholic Fatty Liver Disease (NAFLD) is a common cause of Chronic Liver Disease (CLD) worldwide and is becoming a major public health problem. NAFLD has been recognized as a hepatic manifestation of Metabolic Syndrome (MetS) linked with Insulin Resistance (IR) and is currently considered as the hepatic component of the Metabolic Syndrome (MetS). NAFLD is strongly associated with IR and is mostly silent which is often discovered incidentally through elevated hepatic enzyme levels. The purpose of this study is to find out the association of Fasting Lipid Profile (FLP) with IR in NAFLD subjects. Materials and methods: A prospective hospital based cross sectional study was carried out in the Department Of Biochemistry, Institute of Nuclear Medicine and Allied Sciences (INMAS) and Chittagong Medical College Hospital. One hundred & fifty (150) subjects aging between 18-60 years were included in this study by non probability consecutive sampling method. Important variables in this study were Fasting Plasma Glucose (FPG) Fasting Serum Insulin (FPI) and Fasting Lipid Profile (FLP). IR was calculated by using Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index i.e. (FPI μIU x FPG mmol/L)/22.5. Results: In this study HOMA-IR was significantly higher in cases than that of controls (4.77±0.16) and showing Insulin Resistance (IR) in 90% of the cases. There was a significant association of HOMA-IR with increased serum Triglyceride (TG) in NAFLD cases. Conclusion: The findings of the current study suggest that independent variable such as increased Serum TG was associated with IR in NAFLD subjects. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 3-7

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is one of the common liver diseases worldwide that is not associated with alcohol consumption; it is a group of disorders caused by fat accumulation in the liver. AIM: The research aims to assess the levels of serum sialoprotein, sclerostin, and osteocalcin in men with NAFLD. METHODS: The current study was conducted in Basra city, Iraq in 2020, which includes 400 men with NAFLD, age ranges between (30 and 50) years, and 400 matched health men as controls, serum levels of study parameters were measured using the ELISA method. RESULTS: The results showed a significant decrease in the levels of serum osteocalcin but a non-significant difference in sclerostin and bone sialoprotein in men with NAFLD comparing with the control group, also age and disease severity factors did not show any significant effect on study parameters in the patient’s group. CONCLUSION: In conclusion, men with NAFLD may be prone to some disturbances in the bone health regardless of disease progression and age in Basrah city.

Non-alcoholic fatty liver disease (NAFLD) is currently considered the most common cause of liver disease. Its prevalence is increasing in parallel with the obesity and type 2 diabetes mellitus (DM2) epidemics in developed countries. Several recent studies have suggested that NAFLD may be the hepatic manifestation of a systemic inflammatory metabolic disease that also affects other organs, such as intestine, lungs, skin and vascular endothelium. It appears that local and systemic proinflammatory/anti-inflammatory cytokine imbalance, together with insulin resistance and changes in the intestinal microbiota, are pathogenic mechanisms shared by NAFLD and other comorbidities. NAFLD is more common in patients with extrahepatic diseases such as inflammatory bowel disease (IBD), obstructive syndrome apnea (OSA) and psoriasis than in the general population. Furthermore, there is evidence that this association has a negative impact on the severity of liver lesions. Specific risk characteristics for NAFLD have been identified in populations with IBD (i.e. age, obesity, DM2, previous bowel surgery, IBD evolution time, methotrexate treatment), OSA (i.e. obesity, DM2, OSA severity, increased transaminases) and psoriasis (i.e. age, metabolic factors, severe psoriasis, arthropathy, elevated transaminases, methotrexate treatment). These specific phenotypes might be used by gastroenterologists, pneumologists and dermatologists to create screening algorithms for NAFLD. Such algorithms should include non-invasive markers of fibrosis used in NAFLD to select subjects for referral to the hepatologist. Prospective, controlled studies in NAFLD patients with extrahepatic comorbidities are required to demonstrate a causal relationship and also that appropriate multidisciplinary management improves these patients’ prognosis and survival.

Inflammation is one of the primary factors associated with the causation and/or progression of several lifestyle disorders, including obesity, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). NAFLD is a spectrum of disorders, and starts with simple steatosis, progresses to non-alcoholic steatohepatitis, and then advances to fibrosis, cirrhosis and finally, hepatocellular carcinoma, due to perpetual cycles of insults caused by inflammation and other cellular stress. Emerging evidence has documented that patients with NAFLD have severe coronavirus disease 2019 (COVID-19), and patients with COVID-19 have a higher liver injury and mortality. Although the exact cause or mechanism is not known, inflammatory cytokine storm is a characteristic feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and is known to be associated with higher mortality among COVID-19 patients. Therefore, the COVID-19 pandemic seems to be a major concern in NAFLD patients, who have contracted SARS-CoV-2 infection and develop COVID-19. This is evident in patients at any stage of the NAFLD spectrum, as the inflammatory cytokine storm may cause and/or aggravate the progression or severity of NAFLD. Thus, there is a need for resolution of the inflammatory cytokine storm in these patients. A large body of evidence has demonstrated the efficacy of omega-3 long-chain polyunsaturated fatty acids (ω-3 LCPUFA) in NAFLD conditions, due to their anti-inflammatory, immunomodulatory and anti-viral properties. Therefore, intervention with ω-3 LCPUFA, an effective pharmaconutrient along with the standard treatment for COVID-19 may be useful in the management of the NAFLD spectrum in COVID-19 patients with pre-existing NAFLD conditions by resolving the inflammatory cytokine storm and thereby attenuating its progression. Although there are challenges in implementation, optimistically they can be circumvented and the pharmaconutrition strategy may be potentially helpful in tackling both the pandemics; NAFLD and COVID-19 at least in this subset of patients.

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the world. Therapeutic activity of icariin, a major bioactive component of Epimedii Herba, in NAFLD is still unknown. Herein, the C57BL/6J mice were fed with a high-fat diet for 16 weeks to establish a NAFLD model. Mice were assigned to five groups: control group, NAFLD group, and icariin treatment groups. Effects of icariin on blood indices, glucose tolerance, insulin sensitivity, histopathological morphology, cell apoptosis, lipid accumulation, and AMPK signaling were analyzed. In addition, another cohort of mice were assigned to five groups: control group, NAFLD group, dorsomorphin treatment group, icariin treatment group, and dorsomorphin + icariin treatment group. Expression of proteins in liver tissues associated with AMPK signaling, and levels of ALT and AST were evaluated. Icariin attenuated the NAFLD-induced increase of the TG, TC, LDL-C, ALT, AST levels. HDL-C levels were affected neither by NAFLD nor by icariin. Furthermore, icariin treatment (100-200 mg/kg) counteracted the NAFLD-reduced glucose tolerance and insulin sensitivity and modulated histopathological changes, cell apoptosis, and lipid accumulation in liver tissues. Additionally, icariin mitigated the NAFLD-induced up-regulation of the cleaved caspase 3/9, SREBP-1c, and DGAT-2 levels, and enhanced the expression level of CPT-1, p-ACC/ACC, AMPKα1, PGC-1α, and GLUT4. Effects of icariin on the AMPK signaling and levels of AST and ALT could be reversed by AMPK inhibitor, dorsomorphin. This paper investigates the glucose-reducing and lipid-lowering effects of icariin in NAFLD. Moreover, icariin might function through activating the AMPKα1/PGC-1α/GLTU4 pathway.

BACKGROUND: Nonalcoholic steatohepatitis (NASH) is a severe form of fatty liver disease that has been shown to be associated with chronic kidney disease (CKD). Mechanism for the association of NASH with CKD remains unclear. In this study, we examined the association between NASH severity and kidney glucose uptake and the liver-secreted signaling molecule fibroblast growth factor 21 (FGF21). METHODS: Kinetic parameters for kidney glucose transport rate (K(1)) and standardized uptake value (SUV) were determined using dynamic positron emission tomography after injection of (18)F-fluorodeoxyglucose. Liver biopsies were scored for NASH activity (inflammation and ballooning), fibrosis, and steatosis FGF21 was measured from fasting serum samples. Patients were categorized by liver biopsy and multivariate analyses were performed to evaluate the associations. RESULTS: Of 41 NASH patients 73% were females, 71% white, 51% with steatosis ≥2, 39% with NASH activity ≥4 and fibrosis ≥3. With severe NASH activity, kidney SUV significantly increased even when adjusted for underlying insulin-resistant (IR) state. Kidney K(1) decreased significantly in higher liver activity in unadjusted models but not when adjusted for IR. FGF21 decreased with severe liver activity in adjusted models (P

Introduction: The clinical spectrum of NAFLD is wide extending and ranges from NAFL to NASH, advanced fibrosis, cirrhosis, HCC. It has emerged as the most prevalent chronic liver disease worldwide in adults and children's. NAFLD is commonly linked with MS such as obesity, DM, H0TN, hypercholesterolemia. Methods: This is an observational study conducted to determine risk factor, severity and complication associated with NAFLD. Data was collected from outpatient and inpatients of gastroenterology department and also through patient or care taker interview. Result: A total of 112 cases of liver disease were observed among them 61 cases were found with NAFLD. Majority of cases were examined with Grade I fatty liver. Males were more prone to develop NAFLD and the most highest prevalence was found in the age group 51-70yrs. DM is the main RF and PHTN is the common complication observed. Beta blocker, ARB, statins, are frequently observed prescribed drugs to manage risk factors and complication. Hepatoprotective drugs like ursodeoxycholic acid, SAMe are given. Conclusion: The study concluded that the prevalence of Grade I fatty liver was high followed by CLD. Further, patients with NAFLD were predominantly middle aged men, most of whom were overweight and obese. Prevalence of NAFLD appears to be substantially higher than that predicted on basis of elevated ALT levels. Male sex, BMI, abnormal transaminase level, and MS were independently associated with ultrasonographic severe fatty change. Early detection, as well as steps to prevent the condition through lifestyle modification may halt the progression of a benign disease to advanced illness. Sedentary behavior or physical inactivity is a developing issue quietly putting individuals at elevated risk.

The purpose of the study was to determine the possibilities of cluster analysis as a method for assessing the severity of Non-alcoholic fatty liver disease in its comorbidity with hypertension. Materials and methods. In the study, we examined 63 patients with non-alcoholic steatohepatitis and hypertension, 62 patients with isolated non-alcoholic steatohepatitis and 20 healthy individuals as a control group. All patients underwent anthropometric examinations, including determination of waist circumference, measuring systolic and diastolic blood pressure, performing routine laboratory tests, revealing plasma levels of kallistatin, interleukin-1β and interleukin-10 by enzyme-linked immunosorbent assay. Abdominal ultrasonography was performed to determine the thickness of the right, left and caudal lobes of the liver, and 2-dimensional shear wave elastography with calculating the liver parenchyma stiffness (E, kPa) was performed to determine the fibrotic changes of the liver. Cluster analysis was performed in the program "STATISTICA 8.0." using a hierarchical method and k-means algorithm with pre-standardized data. Results and discussion. According to the results of clustering, 3 subgroups of patients with non-alcoholic fatty liver disease and hypertension were identified. Cluster 1 was characterized by low systolic and diastolic blood pressure, waist circumference, low levels of alanine aminotransferase and aspartate aminotransferase, moderate interleukin-1β levels, low activity of kallistatin and interleukin-10, ultrasound signs of hepatomegaly and increased liver parenchyma stiffness. Cluster 2 included patients with the highest systolic and diastolic blood pressure, moderate waist circumference, highest alanine aminotransferase, aspartate aminotransferase and interleukin-1β levels, low activity of kallistatin and interleukin-10, the most pronounced ultrasound hepatomegaly signs and the worst liver elastography results. Cluster 3 was characterized by moderate systolic and diastolic blood, minimum alanine aminotransferase, aspartate aminotransferase and interleukin-1β content, highest kallistatin and interleukin-10 levels, minimum thickness of liver lobes and lowest liver parenchymal stiffness. Clusters differed significantly from the control group in all parameters, and from the isolated non-alcoholic fatty liver disease group, significant differences were found in all characteristics except waist circumference and interleukin-1β levels. The clusters varied in at least 4 parameters, and the maximum dissimilarity was found between clusters 2 and 3, which differed by 9 indicators. Conclusion. Thus, the clustering of examination results of the patients with non-alcoholic fatty liver disease and hypertension showed a statistically significant distribution of groups according to the severity of liver fibrosis. The elevated systolic and diastolic blood pressure, increased alanine aminotransferase and aspartate aminotransferase, decreased activity of kallistatin and interleukin-10 and signs of hepatomegaly according to ultrasound data could be considered as markers of severe liver fibrosis. The cluster distribution of patients with non-alcoholic fatty liver disease and hypertension opens prospects for the development of new integrated methods in assessment of liver parenchyma changes severity in patients with this comorbidity

BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, affecting over 30% of the United States population. Early patient identification using a simple method is highly desirable. AIM To create machine learning models for predicting NAFLD in the general United States population. METHODS Using the NHANES 1988-1994. Thirty NAFLD-related factors were included. The dataset was divided into the training (70%) and testing (30%) datasets. Twenty-four machine learning algorithms were applied to the training dataset. The best-performing models and another interpretable model (i.e., coarse trees) were tested using the testing dataset. RESULTS There were 3235 participants (n = 3235) that met the inclusion criteria. In the training phase, the ensemble of random undersampling (RUS) boosted trees had the highest F1 (0.53). In the testing phase, we compared selective machine learning models and NAFLD indices. Based on F1, the ensemble of RUS boosted trees remained the top performer (accuracy 71.1% and F1 0.56) followed by the fatty liver index (accuracy 68.8% and F1 0.52). A simple model (coarse trees) had an accuracy of 74.9% and an F1 of 0.33. CONCLUSION Not every machine learning model is complex. Using a simpler model such as coarse trees, we can create an interpretable model for predicting NAFLD with only two predictors: fasting C-peptide and waist circumference. Although the simpler model does not have the best performance, its simplicity is useful in clinical practice.

The article considers the non-alcoholic fatty liver disease as an important medical and social problem. This problem include such questions as metabolic syndrome, essential lipoproteinemia, insulinoresistance. It is possible to consider non-alcoholic steatohepatitis as predictor of liver fibrosis and chirrosis. The questions of diagnosis and treatment are discussed.

INTRODUCTION: Non‐alcoholic fatty liver disease (NAFLD) is a growing public health issue. Non‐invasive methods to assess the fibrosis stage are limited, and biopsy remains the gold standard. The objective of our study was to assess whether the portal venous pulsatility index (VPI) can be used as a predictor of high‐risk NAFLD at a tertiary referral centre for liver transplantation. METHODS: We retrospectively reviewed patients with biopsy‐proved NAFLD who had undergone a liver ultrasound scan within 1 year of biopsy at our centre from 2011 to 2019. RESULTS: We did not find a significant correlation between the VPI and the NAFLD risk category or correlation between the VPI and degree of steatosis (P > 0.05 for both). CONCLUSION: Since VPI can be easily obtained on routine liver ultrasound and since other studies do report a positive association with significant fibrosis, more studies are needed before it can be recommended or not in risk‐stratifying NAFLD patients into high‐ vs. low‐risk NAFLD.

Background Non-alcoholic fatty liver disease (NAFLD) has high morbidity and mortality related to cardiovascular disease (CVD), but statins have been historically underutilised in these patients due to concern for hepatotoxicity. Aims To characterise trends in statin use among individuals with NAFLD and to determine predictors of statin utilisation in this population. Methods Individuals with NAFLD were identified from 2005 to 2018 continuous National Health and Nutrition Examination Survey. Trends in statin use over time were assessed, and predictors of statin under-utilisation for primary prevention were identified. The roles of a known diagnosis of liver disease and disease severity were examined. Results We included 14 113 individuals; 34.6% had NAFLD, of whom 5.4% reported a liver disease diagnosis. There was a significant increase in statin use for primary prevention between 2005 and 2018 (18.1%-25.0%; P = 0.03), but guideline-indicated use for this purpose was low (54.5% between 2005 and 2012; 48.6% between 2013 and 2018). A known NAFLD diagnosis was a negative predictor of statin use during the earlier time period but not more recently. Utilisation did not decrease with increasing liver disease severity. Conclusions In a nationally representative population with NAFLD, statin use for primary prevention has increased over time, but guideline-concordant use remains low. A known liver disease diagnosis was associated with lack of statin use in the earlier time period but not more recently, suggesting a changing perspective of underlying liver disease impacting statin utilisation. Further work to improve guideline-indicated statin use in this high-risk population is needed.

Sarcopenia is the progressive loss of skeletal muscle mass and functionality that is typically associated with older age. Recent literature has noted a high prevalence of sarcopenia in patients with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). This review seeks to compile the current understanding of the pathophysiology, diagnosis, outcomes, and management of sarcopenia in the setting of NAFLD and NASH. Patients with advanced fibrosis from NASH and NASH-related cirrhosis have been found to have significantly higher risks of developing sarcopenia. Recent evidence suggests that sarcopenia does not adversely affect liver transplant waitlist survival in patients with NASH cirrhosis. One-year post-liver transplant survival was also found to not differ significantly in individuals with NASH cirrhosis and pretransplant sarcopenia when compared to those without sarcopenia. While the association between the two pathologies has been well-established, additional investigation is necessary to elucidate the outcomes and novel treatment options for patients with sarcopenia and NASH.

Introduction: Body Mass Index (BMI) is a screening tool that indicates whether a person is underweight, healthy weight or obesity. Fast foods are commercial, ready-to-eat meals with high fat, little fiber, and minimal vitamins or calcium. This study intended to identify baseline BMI and fast foods, snacks and non-alcoholic beverages intake and expenditure on those foods among school children in an urban government school. Method: A cross-sectional study was conducted among 463 students, studying in grade 8-12 of Tri-Padma Vidyashram Secondary School during 21/02/2021 – 12/04/2021. Non probability convenience sampling and self developed structured questionnaire was used to collect data. SPSS 16 was used for analysis. BMI, frequency and amount of fast foods, snacks and non-alcoholic beverages consumption and their monthly expenditure on those foods were measured using descriptive statistics. Results: The study shows that 382(82.5%) had normal BMI, 38(8.2%) overweight, 10(2.2%) obese, 28(6.0%) were in moderate malnutrition and 5(1.1%) were in severe malnutrition; therefore, the baseline BMI is ≥-2 to ≤ + 1 SD. 458(98.92%) respondents consume fast foods, snacks and non-alcoholic beverage. Instant noodles (chowmein and packaged chow-chow) are the highly consumed fast foods 412(89.95%), followed by panipuri 394(86.02%) and samosa 386(84.27%). 263(57.42%) students/participants frequently consume fast foods, snacks and non-alcoholic beverage. The mean expenditure on fast foods, snacks and non-alcoholic beverage (Mean ± SD) is Rs.2676.82 ± 1363.43. Conclusion: Majority of the respondents have normal BMI. More than half respondents frequently consume fast foods, snacks and non-alcoholic beverage and expense much money though they study in government school. Key words: Body Mass Index (BMI), Fast foods, Non-alcoholic beverages, School children, Snacks.

Liver-gut communication is vital in fatty liver diseases, and gut microbes are the key regulators in maintaining liver homeostasis. Chronic alcohol abuse and persistent overnutrition create dysbiosis in gut ecology, which can contribute to fatty liver disease. In this review, we discuss the gut microbial compositional changes that occur in alcoholic and nonalcoholic fatty liver diseases and how this gut microbial dysbiosis and its metabolic products are involved in fatty liver disease pathophysiology. We also summarize the new approaches related to gut microbes that might help in the diagnosis and treatment of fatty liver disease.

Paediatric non-alcoholic fatty liver disease is a chronic liver disease resulting from excessive fat accumulation in the liver. It is closely associated with obesity and some other risk factors. In the last few years, its prevalence in the developed world has been increasing rapidly alongside paediatric obesity. It is generally asymptomatic and is accidentally dis-covered when diagnosing other diseases or during systematic examinations. The additional presence of inflammatory signs is characteristic of non-alcoholic steatohepatitis, which may progress to cirrhosis and end-stage liver disease. The initial diagnosis is based on non-invasive methods (blood tests, ultrasound), but in some cases, the definite diagnosis is based on liver biopsy. Other causes of liver disease and hepatic steatosis must be excluded. The frequency and methods of follow-up are dependent on the presence of risk factors and the severity of the liver changes. First-line treatment is based on lifestyle changes with weight reduction, minimizing risk factors and increasing physical activity. Medical treatment or nutritional supplements are currently not prescribed due to insufficient evidence. A practical approach to a child with fatty liver disease is illustrated by a case presentation.

Metabolic side effects of atypical antipsychotics are an important cause of deterioration of cognitive function and failure of drug adherence. The antifatty effect trypsin/chymotrypsin (T/C) and their mechanisms of action remain unclear. To investigate possible therapeutic effect of T/C in rat model of chronic olanzapine (OLZ) – induced hepatic steatosis. Twenty rats were divided into two groups: control (C), given distilled water, and O, given 1 mg/kg of OLZ orally daily for 7 weeks. Then, both groups were given T/C 3 enzyme activity unit (EAU)/kg orally as an add-on treatment daily for the next 5 weeks and were named T/C or T/C+O groups. Rat performance in radial arm water maze was tested twice before and after T/C treatment. We measured liver enzymes, alpha-1 antitrypsin, albumin, total protein, direct and total bilirubin, inflammatory cytokines, and lipoprotein serum levels. Liver samples were collected for histopathology and Ki67 expression. The T/C add-on caused significant reduction in OLZ-induced elevation of alanine transaminase (ALT; P < 0.01), aspartate transaminase (AST; P < 0.001), alkaline phosphatase (ALP; P < 0.05), total cholesterol (Tc; P < 0.01), low-density lipoproteins (LDL-c; P < 0.05), steatosis score (P < 0.001), hepatocyte necrosis (P < 0.01), and significantly increased Ki67 expression (P < 0.01). The T/C add-on to OLZ provided protection against hepatic steatosis, elevated enzymes, and disturbed lipid profile and increased Ki67 without disturbing memory function.

We evaluated the effect of artichoke leaf extract (ALE) on the livers of mice with non-alcoholic fatty liver disease (NAFLD) induced by high-fat/high-fructose diet and H2O2-treated HepG2 cells, as ...

"Smart" multisensors and biosensor systems based on modern information and communication technologies make it possible to qualitatively improve the parameters of testing systems for biologically active, chemical and toxic substances and biological or biophysical objects, improve parameter control, data processing and analysis in digital agriculture, food industry, environmental monitoring and other areas of human activity. These next-generation devices combine biologically sensitive elements with converters of biophysical signals into electrical digital signals. The article reveals the basic principles of construction of biosensor devices, their practical implementation and application. The own results of development of a wireless network of "smart" multisensors and biosensor devices for express diagnostics of a condition of grape and fruit crops and control of process of production of wine are presented. In order to test the capabilities of the unit of measurement, a number of experimental works were performed. To perform such work, it was first necessary to develop a new embedded software for the microprocessor of Analog Devices ADuCM350, and the corresponding user software for the OS Windows 10. Experiments were performed using disposable sensors based on the enzyme glucose oxidase to measure the sugar content in glucose and wine solution. A review and analysis of modern biosensor devices used in the production of alcoholic and Non-Alcoholic Beverages were done. The comparative table of analyzers for different studies based on biosensors is made. Development and preparation for mass production of "smart" biosensors, biosensor devices and networks based on them is in line with global scientific and technological trends of today and, of course, the near future. Keywords: biosensors, ammetric transducers, wireless sensor network, express diagnostics of grape and berry crops.

Aim. Assessment of the morphological changes of the liver on the model of non-alcoholic steatosis in laboratory animals and hemostasis parameters in animals and patients with steatosis. Materials and methods. The experimental part of the study was conducted on 18 white rats divided into 2 groups: control (intact animals) and “Steatosis” (animals with liver steatosis modeled in laboratory conditions). The clinical part was performed on 52 patients with non-alcoholic fatty liver disease (the clinical form is non-alcoholic liver steatosis), with an average age of 43.0 ± 11.1 years and a body mass index of 37.2 ± 2.6. The control group consisted of 20 practically healthy individuals. At the end of the experiment, on the 30th day, the animals were removed from the experiment, direct blood sampling was performed from the right atrium, the liver mass and mass coefficient were determined, and a histological examination of the liver was performed. Laboratory tests included the determination of the following indicators of hemostasis in blood plasma: activity of the von Willebrand factor, platelet aggregation with ADP, collagen and ristocetin; prothrombin time, Quick prothrombin, international normalized ratio, thrombin time, activated partial thromboplastin time (APTT), fibrinogen and Hageman-dependent fibrinolysis. Results. In the experiment, the mass coefficient of the liver was significantly higher in the “Steatosis” group compared to the control group (3.75 (3.38-3.99) and 3.5 (3.3-3.6), respectively) (p = 0.009). Structural reorganization of the liver confirms the development of steatosis in animals. In animals with steatosis, a change in indicators reflecting the activity of the plasma link according to the external mechanism of coagulation was found: an elongation of the prothrombin time (p = 0.034), a decrease in the prothrombin index according to Quick (p = 0.018), an increase in INR (p = 0.027). APTT and thrombin time in animals with steatosis are higher than in the control, but these changes are not statistically significant (p = 0.181 and p = 0.364, respectively). The concentration of fibrinogen, Hageman-dependent fibrinolysis, platelet aggregation with ADP and the activity of the von Willebrand factor did not have statistically significant differences when comparing the two groups. In patients with steatosis, the number of platelets did not significantly differ from the control (p = 0.082). However, there was a decrease in aggregation with collagen (p = 0.002) and with ADP (p = 0.02). Platelet aggregation with ristocetin and the activity of the von Willebrand factor was higher than in the control (p = 0.001 and p = 0.01, respectively). In patients with steatosis, there was an extension of the APTT and an increase in the concentration of fibrinogen in comparison with the control, but these indicators did not go beyond the reference values of the set. The thrombin time was significantly prolonged in patients with steatosis in comparison with practically healthy individuals (p < 0.001). Conclusion. Non-alcoholic fatty liver disease is accompanied by a violation of the functioning of both vascular-platelet and coagulation hemostasis. There is a violation of the aggregation properties of platelets, signs of endothelial damage, hepatic coagulopathy.

The non-alcoholic fatty liver disease (NAFLD) is the predominant etiological factor for liver disease. There is a risk of the development of hepatocellular carcinoma (HCC) in patients suffering from NAFLD. Non-alcoholic steatohepatitis (NASH) is one of the risk factors for the development of HCC. The aim is to discuss an association of NAFLD and HCC in the adult population. HCC is one of the debilitating complications of NAFLD/NASH and obesity is a causative factor for NAFLD/NASH. Various clinical data suggest that obesity appears to be a causative factor in the progression of NAFLD/NASH to HCC. We searched data from the PubMed/Medline and Google Scholar databases including various studies and review articles. Significantly, an increased number of HCC patients with cryptogenic liver disease had well-differentiated tumors than in HCC patients with chronic viral hepatitis and alcoholism. HCC is one of the debilitating complications of NAFLD/NASH and obesity is a causative factor for NAFLD/NASH. Various preclinical and clinical data suggest that obesity appears to be an important causative factor in the progression of NAFLD/NASH to HCC.

Annotation. Today it is important to study the clinical and prognostic role of neurohumoral disorders in patients with stable forms of chronic coronary syndrome (CCS) and concomitant liver pathology. The aim of the study: to investigate the levels of markers of insulin, adipokine balance, systemic inflammation and endothelial dysfunction and their predictor value for the presence of non-alcoholic fatty liver disease (NAFLD) in patients with CCS. The prospective monocenter double open study in parallel groups involved 120 patients with CCS: stable angina pectoris II-III functional class aged 60.0 (55.0; 64.0) years, of whom 67 (55%) men and 53 (45 %) women. The control selected group included 30 healthy individuals aged 59.0 (58.0; 66.0) years, including 14 (46%) men and 16 (54%) women. Determination of the serum concentration of biomarkers (adiponectin, resistin, insulin, asymmetric dimethylarginine (ADMA), C-reactive protein) was performed using enzyme-linked immunosorbent assay. Statistical data processing was performed using the license program package “Statistica 13.0” (StatSoftInc, USA, № JPZ8041382130ARCN10-J). The hypothesis about the normality of the distribution of the studied indicators was tested using the Shapiro-Wilk test. Quantitative traits were presented as M ± m or Me (Q25; Q75), depending on the type of distribution. Significance of differences was assessed using Student's t-test (for normal distribution) or Mann-Whitney U-test for independent samples (for distribution other than normal). In order to establish the threshold values of biomarkers for predicting the presence of NAFLD ROC analysis was used. It was found that in patients with CCS with concomitant NAFLD, compared with patients with CCS without liver pathology, there is a significant (p

Non-alcoholic Fatty Liver Disease (NAFLD) is one of the diseases that have evolved lately into a major challenge for gastroenterologists. Although, the term NAFLD has not been familiar to the medical world since long, other conditions resembling the presentation of NAFLD have been there since primitive times. It is a reversible condition of the liver, wherein large vacuoles of triglyceride fat accumulates in liver cells via the process of steatosis, despite any evidence of excessive alcohol consumption. In the developed countries NAFLD is reported to be the most common liver disorder, with a worldwide prevalence of 6–35%, in India its prevalence has been increasing gradually. Unani physicians have described liver as one of the principal organs of the body. It is the primary source of natural faculties, where the functions of digestion, concoction, absorption and excretion are performed, normally temperament of liver is hot and moist which can get converted to cold due to mutable dietary habits, consumption of fatty and cold food in abundance etc. In Unani System of Medicine, NAFLD has not been described as such, but it can be studied under Su’-i-Mizāj Kabid Bārid due to correlation of most of the symptoms. Its management mainly consists of elimination of morbid matter which is accumulated in the liver and correction of Su’-i-Mizāj Kabid Bārid by using drugs having opposite temperament (Ilaj bil zid).

В последнее время неалкогольная жировая болезнь печени является одним из самых распространенных заболеваний печени среди взрослых и все чаще диагностируется у детей и подростков. Это обусловливает значительный интерес к поиску новых звеньев этиопатогенеза болезни. С разработкой и применением современных методов исследования кишечной микробиоты был достигнут значительный прогресс в понимании ее влияния на здоровье человека. В обзоре литературы представлены современные данные, которые демонстрируют роль кишечной микробиоты в формировании и развитии неалкогольной жировой болезни печени у детей.

Objective — to study the features of endotoxinemia and its relationship with changes in the intestinal microbial spectrum in obese patients with non-alcoholic fatty liver disease (NAFLD). Materials and methods. 84 patients with obesity and NAFLD were examined. The control group consisted of 20 apparently healthy individuals. The concentration of endotoxin (ET) in the blood serum was determined using the LAL Chromogenic Endpoint Assay kit manufactured by Hycult Biotech (Netherlands), relative quantitative composition of the microbiota at the level of basic phylotypes — by real-time polymerase chain reaction (CFX96Touch (Bio-Rad, USA)) using universal primers for the 16SpPHK gene and taxon-specific primers), quantitative composition of microbiota — using test of the «Colonoflor-16» system (Alfalab, RF) by real-time polymerase chain reaction.Results. Among patients with comorbidity of obesity and NAFLD, there were 40.48 % of males and 59.52 % of females, whose mean age was 53.72 ± 4.61 years. The ET level in the examined patients with comorbidity of obesity and NAFLC was significantly (p < 0.001) higher (1.01 ET/ml) than in the control group (0.60 ET/ml), was significantly (p < 0,05) is higher in women than in men (1.06 and 0.92 UE/ml, respectively) and increased with increasing age of patients (r = 0.30, p < 0.05). The ET level correlated with the relative content of Firmicutes (r = 0.39, p < 0.05) and their ratio in Bacteroidetes (r = 0.29, p < 0.05) and the level of Bifidobacterium spp. (r = 0 .37, p < 0 .05) a nd h ad a n i nverse r elationship w ith t he r elative c ontent o f B acteroidetes ( r = – 0.42, p < 0.01), including Bacteroides fragilis group (r = – 0.43, p < 0.01), Escherichia coli (r = – 0.41, p < 0.01) and total bacterial mass (r = – 0.39, p < 0.05). In the intestinal microbiota of the examined patients, a decrease in the representatives of the Lactobacillus spp. and Bifidobacterium spp. in 84.5 % and 30.9 % of patients, respectively, as well as Bacteroides thetaiotaomicron (88.0 %), Akkermansia muciniphila (79.8 %) and Faecalibacteriumprausnitzii (33.3 %). Whereas the number of gram-negative bacteria increased primarily due to Enterobacter spp, Citrobacter spp (45.2 %), Escherichia coli (19 %), Bacteroides fragilis group (29.8 %). It should be noted that the decrease in the level of A. muciniphila was often accompanied by an increase in the content of enterobacteria, while the excess content of B. fragilis group was accompanied by an increase above the upper limit of E. coli and the presence of anaerobic imbalance in the microbiota. In turn, increasing the number of Enterobacter spp. / Citrobacter spp. It was often accompanied by an increase in the content of E. coli and representatives of the B. fragilis group, against the background of a reduced number of A. muciniphila. Conclusions. The above indicates the presence of metabolic endotoxinemia in patients with comorbidity of obesity and NAFLD against the background of a decrease in the number of gram-positive anaerobic Lactobacillus spp. i Bifidobacterium spp. and bacteria involved in providing the intestinal barrier function (Bacteroides Thetaiotaomicron, Akkermansia muciniphila, Faecalibacterium prausnitzii), which creates conditions for an increased amount of ET into the blood and is especially important against the background of an increase in the content of gram-negative bacteria (representatives of gammaproteobacteria and bacteria of the Bacteroides fragilis), which are the source of ET.

Актуальність. Неалкогольна жирова хвороба печінки (НАЖХП) є самостійною нозологічною одиницею, характеризується накопиченням жиру в гепатоцитах, не пов’язаним зі зловживанням алкоголем, і включає широкий спектр порушень — від жирової дистрофії печінки, неалкогольного стеатогепатиту до фіброзу з можливим переходом у цироз печінки. З огляду на поширеність цієї патології, погіршення якості життя хворих, збільшення смертності від ускладнень зростає інтерес до розробки методів для точної й своєчасної оцінки фіброзу. Мета: порівняльна характеристика результатів транзієнтної еластометрії (FibroScan) і неінвазивних лабораторних індексів у визначенні фіброзної трансформації печінки у хворих із неалкогольною жировою хворобою печінки. Матеріали та методи. У дослідження включені пацієнти з НАЖХП, які проходили обстеження й лікування у відділенні захворювань печінки та підшлункової залози ДУ «Інститут гастроентерології НАМН України». Обстежені 42 пацієнти з НАЖХП, серед яких 18 (45 %) чоловіків і 24 (55 %) жінки. Усім пацієнтам було виконано розрахунок неінвазивних маркерів фіброзу печінки: APRI, FIB-4, співвідношення аланінамінотрансферази/аспартатамінотрансферази, проведено вимірювання жорсткості печінки за допомогою апарату FibroScan. Результати нашої роботи узгоджуються з більшістю досліджень, згідно з якими найбільш ефективним з малоінвазивних індексів є APRI. Висновки. Поєднання транзієнтної еластометрії (FibroScan) з індексом APRI може забезпечити більш ефективний підхід до діагностики фіброзу печінки у хворих з НАЖХП. Background. Non-alcoholic fatty liver disease (NAFLD), an independent nosological entity, is characterized by fat accumulation in hepatocytes not associated with alcohol abuse, and includes a wide spectrum of disorders: from fatty liver, non-alcoholic steatohepatitis to fibrosis with possible outcome in liver cirrhosis. Given the prevalence of this disease, the deterioration of the quality of life of patients, increased mortality from complications, there is a growing interest in developing techniques for accurate and timely assessment of fibrosis. Objective: comparative characteristics of the results of transient elastometry (FibroScan) and non-invasive laboratory indices in the determination of fibrotic transformation of the liver in patients with non-alcoholic fatty liver disease. Materials and methods. The study included patients with NAFLD, who underwent diagnostics and treatment in the department of liver and pancreas of the SI “Institute of Gastroenterology of the NAMS of Ukraine”. Results. We have examined 42 patients with NAFLD, among which 18 (45 %) men and 24 (55 %) women. All patients underwent calculation of non-invasive markers of liver fibrosis: aspartate aminotransferase to platelet ratio index (APRI), fibrosis-4 index, aspartate aminotransferase/alanine aminotransferase ratio, the measurement of liver stiffness using the FibroScan apparatus. Conclusions. Our results are consistent with most studies indicating that the most effective non-invasive index is APRI. The combination of transient elastography (FibroScan) and the APRI may provide a more effective approach to the diagnosis of liver fibrosis in patients with NAFLD.