Parabolic relationship between sex-specific serum high sensitive C reactive protein and non-alcoholic fatty liver disease in Chinese adults: a large population-based study (original) (raw)
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Sultan Qaboos University Medical Journal, 2010
ObjectivesThe objective of this study was to identify the presence of non-alcoholic fatty liver disease (NAFLD) in patients with coronary artery disease (CAD).Methods149 patients were selected, who had been referred to the Institute of Cardiology, Banglore, India, between January 2007 and June 2009 and diagnosed with CAD. Four patients did not participate in the study. Venous blood samples were taken from these cases, and agematched healthy controls who came for a master health check-up (N = 100). All were subjected to routine liver function tests including serum transaminases, enzyme immunoassays for plasminogen activator inhibitor I (PAI-I), C reactive protein (CRP), and tumour necrosis factor-alpha (TNF-α). Using ultrasonography and serum alanine aminotransferase (ALT) levels, the presence of NAFLD in CAD patients was reported.ResultsCAD patients with NAFLD had significantly higher liver enzymes and marginally higher A1C levels compared to control subjects. Levels of TNF-α and PAI-I were higher in CAD patients with NAFLD compared to both female and male controls (P <0.1 and P <0.05). Levels of CRP (P <0.01 in both groups) and uric acid were increased in both group of patients (P <0.05 and P <0.01 in male and female patients, respectively). Levels of adiponectin were significantly reduced in the patients compared to the controls (P <0.05 and P <0.001) in male and female patients respectively.ConclusionThe increased serum levels of PAI-I and TNF-α reflected the proinflammatory status in these CAD patients which may be due to the presence of NAFLD. This could contribute additively to the development of cardiovascular events (CVD).
Hepatology, 2019
In spite of tremendous research advancements in nonalcoholic fatty liver disease (NAFLD), our understanding of sex-differences in NAFLD remains insufficient. This review summarizes current knowledge on sex differences in NAFLD, identifies current gaps, and discusses important considerations for future research. The prevalence and severity of NAFLD are higher in men than in women during the reproductive age. However, after menopause, NAFLD occurs at a higher rate in women suggesting that estrogen is protective. Sex differences also exist for the major risk factors of NAFLD. In general, animal models of NAFLD recapitulate sex differences observed in patients with more severe steatosis and steatohepatitis, more pro-inflammatory/pro-fibrotic cytokines, and a higher incidence of hepatic tumors in males than females. Based on computer modeling, female and male livers are metabolically distinct with unique regulators modulating sex-specific metabolic outcomes. Analysis of the literature reveals that most published clinical and epidemiological studies fail to examine sex differences appropriately. Considering the paucity of data on sex differences and the knowledge that regulators of pathways relevant to current therapeutic targets for NAFLD differ by sex, clinical trials should be designed to test drug efficacy and safety according to sex, age, reproductive stage (i.e., menopause) and synthetic hormone use.Conclusion:Sex differences do exist in the prevalence, risk factors, fibrosis, and clinical outcomes of NAFLD suggesting that, while not yet incorporated, sex will probably be considered in future practice guidelines. Adequate consideration of sex differences, sex hormones/menopause status, age, and other reproductive information in clinical investigation and gene association studies of NAFLD are needed to fill current gaps and implement precision medicine for patients with NAFLD.
Clinical Profiles of Asians with NAFLD: A Systematic Review and Meta-Analysis
Digestive Diseases, 2021
Introduction: NAFLD is increasingly prevalent in Asia, where people suffer more metabolic comorbidities at a lower body mass index (BMI), suggesting potential differences in their clinical profile. Therefore, we attempted to characterize the clinical profile of Asians with NAFLD via a meta-analytic approach. Methods: We searched PubMed, EMBASE, and Cochrane databases from January 1, 2000, to January 17, 2019. Two authors independently reviewed and selected 104 articles (2,247,754 persons) that identified NAFLD in Asians and reported relevant data, especially BMI and ALT, and excluded individuals with other liver disease and excessive alcohol consumption. Individual patient-level data were obtained from seven cohorts in Asia to complement meta-analyzed data. Results: Overall, the mean age was 52.07 (95% CI: 51.28–52.85) years, with those from Southeast Asia (42.66, 95% CI: 32.23–53.11) being significantly younger. The mean BMI was 26.2 kg/m2, higher in moderate-severe versus mild hep...
National Journal of Medical Research, 2023
Background: Non-alcoholic fatty liver disease (NAFLD) is a growing concern due to its potential to lead to liver transplants and its association with cardiovascular disease (CVD). However, the relationship between NAFLD and CVD remains debated, and non-invasive diagnostic methods for NAFLD are recommended. This study aimed to estimate the prevalence of NAFLD among patients with CAD and explore the association between CAD severity and the probability of developing NAFLD. Methodology: A cross-sectional study was conducted among CAD patients. Patients with a history of infectious liver disease, pregnant or lactating individuals, and those with excessive alcohol consumption were excluded. Coronary angiography was performed to assess CAD severity using the Gensini score. Ultrasonography and non-invasive assessments, such as the Fibrosis-4 (FIB-4) index, were used to diagnose and stage NAFLD. Result: The study included 156 CAD patients, with 79 (50.6%) being male. Out of total, 31 (19.8%) had severe, 79(50.6%) had moderate, and 46 (29.48%) had mild NAFLD. Male patients showed a significantly higher prevalence of severe NAFLD compared to females. There was no significant difference in the mean age of CAD patients across NAFLD severities. Severe NAFLD was associated with higher mean Gensini scores and FIB-4 values compared to mild to moderate NAFLD patients. A positive correlation was found between Gensini score and FIB4, suggesting that Gensini score could be an alternative to FIB4 in diagnosing NAFLD severity among CAD patients. Conclusion: The study revealed a high prevalence of NAFLD among CAD patients, with severe NAFLD being associated with higher CAD severity.
Fatty liver and chronic inflammation in Chinese adults
Diabetes Research and Clinical Practice, 2008
To investigate the significance of fatty liver as predictor of insulin resistance (IR) and chronic inflammation. This cross-sectional study included 450 adults of Han Chinese origin aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=35. Excluded were cases with hepatitis B or C, alcoholic liver disease, or currently using thiazolidinedione. The volunteers were screened for the presence of the components of metabolic syndrome (MtS). IR index was estimated by the homeostasis model assessment. The fatty liver index was evaluated by computed tomography, calculated as the liver/spleen (L/S) ratio arrived at by averaging Hounsfield values obtained for five 3-mm slices. Serum levels of adiponectin, C-reactive protein (CRP), leptin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were checked in 100 subjects with low-L/S ratio and 100 age- and sex-matched controls. Fatty liver index correlated with all MtS traits and IR index. The values of L/S ratios in subjects with 0, 1, 2, 3 and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=4 traits of MtS were 1.25+/-0.13, 1.18+/-0.16, 1.12+/-0.21, 1.05+/-0.25 and 0.92+/-0.25, respectively (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). In our stepwise regression analysis to compare the L/S ratios to the conventional traits of MtS for association with adipokine dysregulation, we found L/S ratio to be independently associated with most of them: adiponectin (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001), CRP (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001), IL-6 (p=0.005) and TNF-alpha (p=0.014). In Chinese, fatty liver index correlated well with IR index and can be a better marker of chronic inflammation than the conventional components of MtS.