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P841 AWARENESS AND OPINION OF NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) PATIENTS ABOUT OBESITY AND ITS CONSEQUENCES
POSTERS P840 ALTERATION IN LIPID METABOLISM AFTER AN ORAL FAT LOAD IN PATIENTS WITH NAFLD L. Mezzabotta1 , E. Vanni1 , C. Rosso1 , M. Gaggini2 , R. Gambino1 , E. Buzzigoli2 , C. Saponaro2 , D. Ciociaro2 , M.L. Abate1 , F. Saba1 , F. Salomone3 , G.P. Caviglia1 , S. Carenzi1 , A. Smedile1 , M. Rizzetto1 , M. Cassader1 , A. Gastaldelli2 , E. Bugianesi1 . 1 Medical Sciences, University of Turin, Turin, 2 Cardiometabolic Risk Unit, Institute of Clinical Physiology – CNR, Pisa, 3 U.O.C. of Gastroenterology, Azienda Sanitaria Provinciale di Catania, Catania, Italy E-mail: [email protected] Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is associated with insulin resistance (IR) and impairment in whole body lipid metabolism leading to hepatic fat accumulation and fibrosis. We investigated the effect of a lipid load on lipolysis and hepatic glucose metabolism in non-diabetic/non-dyslipidaemic NAFLD patients. Methods: [2 H5 ]glycerol and[2 H2 ]glucose kinetics, plasma levels of glucose/insulin, lipid profile, endogenous glucose production (EGP) and lipolysis (Glycerol_Ra) were determined in 20 patients with biopsy proven NAFLD and 9 controls during an oral fat load (200 ml dairy cream and an egg yolk). Peripheral/hepatic/adipose tissue-IR indices were derived from plasma glucose/insulin, EGP and lipolysis. Subcutaneous, visceral and hepatic fat were assessed by NMR. Results: During fasting, EGP and lipolysis were similar in NAFLD patients and in CT (8.9±1.2 vs 8.7±0.9umol/kg min and 2.4±0.9 vs 2.1±0.6umol/kg min) although indices of IR were higher in NAFLD patients (HOMA2.3±0.9 vs 1.3±0.4, Hep-IR 92±34 vs 52±18, AdipoIR 21±10 vs 11±5 all p < 0.03). After lipid load, the triglycerides (TG) increase in NAFLD was 2-folds than CT (iAUC-TG p < 0.03) while FFA concentration increased similarly. Lipolysis was suppressed in CT but was unchanged in NAFLD, suggesting a remarkable Adipo-IR at low insulin levels, that was directly related to NAS score and degree of fibrosis (p < 0.01 for both). Adipo-IR was increased proportionally to fat accumulation in subcutaneous, visceral and hepatic fat (r2 = 0.163, p < 0.01; r2 = 0.321, p < 0.001; r2 = 0.24, p < 0.001,respectively). Conclusions: The metabolic handling of an oral fat load is impaired in subjects with NAFLD independent of pre-existing diabetes or dyslipidemia and can contribute to the progression of liver damage. Funded by FP7/2007–2013 under grant agreement no. HEALTH-F2– 2009–241762 for the project FLIP and byPRIN-2009ARYX4T. P841 AWARENESS AND OPINION OF NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) PATIENTS ABOUT OBESITY AND ITS CONSEQUENCES S.P. Singh1 , B. Misra1 , D. Misra1 , G.K. Pati1 , A. Singh1 , S.K. Kar1 , M.K. Panigrahi1 , C. Meher2 , O. Agrawal2 . 1 Department of Gastroenterology, S.C.B. Medical College, 2 Department of Radiology, Beam Diagnostics, Cuttack, India E-mail: [email protected] Background and Aims: The prevalence of nonalcoholic fatty liver disease [NAFLD] is rising globally. The aim of this study is to know the opinion of NAFLD patients regarding NAFLD and obesity and its consequences. Methods: This prospective study was conducted in 326 incidentally detected NAFLD patients using a face-to-face questionnaire. Results: Of 326 patients, 68 (20.86%) had normal weight (BMI < 23); 258 (79.14%) were either overweight or obese (BMI > 23). 23.93% didn’t have knowledge about harmful effects of obesity. About half didn’t know that consumption of fast food and prepacked meals promoted obesity. Two thirds (64.42%) had not been advised by their doctors to reduce weight. Besides, 38.76% (100/258) of the obese presumed that they had normal body S352
weight in comparison to lean NAFLD (46/68) [38.76% versus 67.65%; p < 0.0002]. 61.24% of patients who considered themselves obese attributed it to inactivity, overeating, familial and combined causes in 55.06%, 28.48%, 3.8% and 12.03% cases respectively. One third of obese NAFLD [50/158 (31.65%)] didn’t have guilt of being overweight and 9.49% (15/158) didn’t want to lose weight. Conclusions: Despite high prevalence of NAFLD, awareness among NAFLD patients regarding obesity is grossly inadequate. A third of NAFLD patients are ignorant about harmful effects of obesity. Two fifths of obese NAFLD felt that they were non-obese. Two thirds of NAFLD patients were neither educated by their physicians about effects of obesity nor advised to shed weight. There is a gross lack of awareness regarding NAFLD and obesity in patients and physicians. P842 A STUDY OF RISK FACTORS ASSOCIATED WITH NONALCOHOLIC FATTY LIVER DISEASE [NAFLD] IN INDIANS S.P. Singh1 , D. Misra1 , A. Singh1 , B. Misra1 , G.K. Pati1 , M.K. Panigrahi1 , S.K. Kar1 , C. Meher2 , O. Agrawal2 . 1 Department of Gastroenterology, S.C.B. Medical College, 2 Department of Radiology, Beam Diagnostics, Cuttack, India E-mail: [email protected] Background and Aims: To study the risk factors associated with NAFLD in Indians. Methods: 464 consecutive NAFLD patients and 181 controls were subjected to detailed questionnaire regarding risk factors, anthropometric measurements and biochemical assays including blood sugars, LFT, lipid profile and HOMA. Comparison of different variables was made between the NAFLD patients and controls by using SPSS 17. Results: NAFLD patients had higher BMI [26.25±3.80 vs 21.46±3.08 kg/m2 ], waist-hip ratio [0.96± .12 vs 0.90± .08] and waist-height ratio [0.57± .09 vs 0.50± .06] compared to controls. Fasting blood sugar [101.88±31.57 vs 90.87±10.74 mg/dl] and triglyceride level [196.16±102.66 vs 133.20±58.37 mg/dl] were significantly higher in NAFLD group. HOMA-IR was also higher in NAFLD group [2.53±2.57 vs 1.16± .58]. Majority (90.2%) of NAFLD patients were sedentary. Family history of metabolic syndrome was present in 31.2% NAFLD patients compared to 7% controls [p < 0.0001]. Dietary risk factors associated with NAFLD were nonvegetarian diet [35% vs 23%; p = 0.002], fried food [35% vs 9%; p < 0.0001], spicy foods [51% vs 15%; p < 0.001] and tea [55% vs 39%; p < 0.001]. Diabetes and hypertension were commoner in NAFLD. Snoring (57% vs 47%) and sleep apnea syndrome [17% vs 4.4%] were commoner in NAFLD. Conclusions: The risk factors associated with NAFLD in Indians are sedentary lifestyle, family history of metabolic syndrome, consumption of meat/fish, spicy foods, fried foods and tea. Other risk factors associated with NAFLD included snoring and metabolic syndrome. P843 ALTERATION IN GLUCOSE METABOLISM AFTER AN ORAL GLUCOSE LOAD AND RELATIONSHIP WITH LIVER DAMAGE IN PATIENTS WITH NAFLD E. Vanni1 , L. Mezzabotta1 , C. Rosso1 , M. Gaggini2 , R. Gambino1 , F. Salomone3 , E. Buzzigoli2 , C. Saponaro2 , F. Saba1 , D. Ciociaro2 , G.P. Caviglia1 , M.L. Abate1 , S. Carenzi1 , A. Smedile1 , M. Rizzetto1 , M. Cassader1 , A. Gastaldelli2 , E. Bugianesi1 . 1 Medical Sciences, University of Turin, Turin, 2 Cardiometabolic Risk Unit, Institute of Clinical Physiology – CNR, Pisa, 3 U.O.C. of Gastroenterology, Azienda Sanitaria Provinciale di Catania, Catania, Italy E-mail: [email protected] Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is associated with insulin resistance (IR) for different substrates and
Journal of Hepatology 2014 vol. 60 | S215–S359
weight in comparison to lean NAFLD (46/68) [38.76% versus 67.65%; p < 0.0002]. 61.24% of patients who considered themselves obese attributed it to inactivity, overeating, familial and combined causes in 55.06%, 28.48%, 3.8% and 12.03% cases respectively. One third of obese NAFLD [50/158 (31.65%)] didn’t have guilt of being overweight and 9.49% (15/158) didn’t want to lose weight. Conclusions: Despite high prevalence of NAFLD, awareness among NAFLD patients regarding obesity is grossly inadequate. A third of NAFLD patients are ignorant about harmful effects of obesity. Two fifths of obese NAFLD felt that they were non-obese. Two thirds of NAFLD patients were neither educated by their physicians about effects of obesity nor advised to shed weight. There is a gross lack of awareness regarding NAFLD and obesity in patients and physicians. P842 A STUDY OF RISK FACTORS ASSOCIATED WITH NONALCOHOLIC FATTY LIVER DISEASE [NAFLD] IN INDIANS S.P. Singh1 , D. Misra1 , A. Singh1 , B. Misra1 , G.K. Pati1 , M.K. Panigrahi1 , S.K. Kar1 , C. Meher2 , O. Agrawal2 . 1 Department of Gastroenterology, S.C.B. Medical College, 2 Department of Radiology, Beam Diagnostics, Cuttack, India E-mail: [email protected] Background and Aims: To study the risk factors associated with NAFLD in Indians. Methods: 464 consecutive NAFLD patients and 181 controls were subjected to detailed questionnaire regarding risk factors, anthropometric measurements and biochemical assays including blood sugars, LFT, lipid profile and HOMA. Comparison of different variables was made between the NAFLD patients and controls by using SPSS 17. Results: NAFLD patients had higher BMI [26.25±3.80 vs 21.46±3.08 kg/m2 ], waist-hip ratio [0.96± .12 vs 0.90± .08] and waist-height ratio [0.57± .09 vs 0.50± .06] compared to controls. Fasting blood sugar [101.88±31.57 vs 90.87±10.74 mg/dl] and triglyceride level [196.16±102.66 vs 133.20±58.37 mg/dl] were significantly higher in NAFLD group. HOMA-IR was also higher in NAFLD group [2.53±2.57 vs 1.16± .58]. Majority (90.2%) of NAFLD patients were sedentary. Family history of metabolic syndrome was present in 31.2% NAFLD patients compared to 7% controls [p < 0.0001]. Dietary risk factors associated with NAFLD were nonvegetarian diet [35% vs 23%; p = 0.002], fried food [35% vs 9%; p < 0.0001], spicy foods [51% vs 15%; p < 0.001] and tea [55% vs 39%; p < 0.001]. Diabetes and hypertension were commoner in NAFLD. Snoring (57% vs 47%) and sleep apnea syndrome [17% vs 4.4%] were commoner in NAFLD. Conclusions: The risk factors associated with NAFLD in Indians are sedentary lifestyle, family history of metabolic syndrome, consumption of meat/fish, spicy foods, fried foods and tea. Other risk factors associated with NAFLD included snoring and metabolic syndrome. P843 ALTERATION IN GLUCOSE METABOLISM AFTER AN ORAL GLUCOSE LOAD AND RELATIONSHIP WITH LIVER DAMAGE IN PATIENTS WITH NAFLD E. Vanni1 , L. Mezzabotta1 , C. Rosso1 , M. Gaggini2 , R. Gambino1 , F. Salomone3 , E. Buzzigoli2 , C. Saponaro2 , F. Saba1 , D. Ciociaro2 , G.P. Caviglia1 , M.L. Abate1 , S. Carenzi1 , A. Smedile1 , M. Rizzetto1 , M. Cassader1 , A. Gastaldelli2 , E. Bugianesi1 . 1 Medical Sciences, University of Turin, Turin, 2 Cardiometabolic Risk Unit, Institute of Clinical Physiology – CNR, Pisa, 3 U.O.C. of Gastroenterology, Azienda Sanitaria Provinciale di Catania, Catania, Italy E-mail: [email protected] Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is associated with insulin resistance (IR) for different substrates and
Journal of Hepatology 2014 vol. 60 | S215–S359