- Email: [email protected]
1323 HYPOLIPIDEMIC THERAPY VS DIET IN HYPERCHOLESTEROLEMIC PATIENTS AFFECTED BY NONALCOHOLIC STEATOHEPATITIS (NASH)
POSTERS hepatologists’ understanding of this disease. This has implications for targeting “at-risk” populations and appropriate referral of patients to hepatology clinics. 1322 Withdrawn 1323 HYPOLIPIDEMIC THERAPY VS DIET IN HYPERCHOLESTEROLEMIC PATIENTS AFFECTED BY NONALCOHOLIC STEATOHEPATITIS (NASH) D. Donnini, A. Carnelutti, G. Nadalutti, L. De Luca, D. Cappello, F. Cugini, S. Parlamento, A. Dibenedetto, D. De Silvestri, L. Sechi, G. Soardo. Liver Unit, Department of Experimental Pathology and Clinical Medicine, University of Udine, Udine, Italy E-mail: [email protected] Background: Nonalcoholic steatohepatitis (NASH) is a serious disorder, likely to progress to liver cirrhosis. NASH patients affected by dyslipidemia have an increased risk of cardiovascular disease. Aims: The aim of the study was to evaluate the effects of hypolipidemic therapy (Rosuvastatin) vs hypolipidemic diet on lipid profiles and liver parameters in a group of NASH patients. Methods: This prospective study included 65 adult patients (35 men, 30 women) with a mean age of 50±8 years and mean BMI of 28±3.5. The patients had no history of diabetes, alcohol or drug abuse. Serological markers of viral hepatitis and autoimmune disease were negative. All the patients were moderately hyperlipidemic with total cholesterol mean of 235±15 mg/dl. Liver biopsy was performed before therapy to confirm the diagnosis of NASH. We randomly assigned 35 patients (19 men and 16 women) to follow a hypolipidemic diet for 3 months, while the remaining 30 patients (16 men and 14 women) received Rosuvastatin 5 mg/die for 3 months. BMI, waist circumference, glycaemia, serum of alanin-aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), alkaline phosphatase (AP), total cholesterol, L.DL cholesterol, HDL cholesterol, triglycerides, homeostatic model assessment (HOMA) for insulin resistance, homocysteine levels were determined at the beginning and the end of treatment. Results: The patients on diet decreased significantly their weight, BMI, AST, ALT, GGT and insulin resistance, but their lipid profiles were unaltered. The group under Rosuvastatin, instead, did not improve the liver parameters or insulin resistance, however the plasmatic concentration of cholesterol and triglycerides decreased. Conclusion: The use of Rosuvastatin improved the lipidemic profile whilst diet ameliorated the liver parameters and insulin resistance. The association of both treatements(diet and hypolipidemic therapy) might be instrumental to prevent the development of liver cirrhosis and cardiovascular diseases in patients with NASH combined with hyperlipidaemia. 1324 FAT DISTRIBUTION, LIPIDS AND INFLAMMATORY ACTIVITY CORRELATE WITH LIPID INFILTRATION OF THE LIVER IN OBESE/OVERWEIGHT CHILDREN A. Wierzbicka-Rucinska1 , P. Socha2 , S. Chelstowska3 , D. Lebensztejn4 , E. Jurkiewicz3 , W. Janczyk5 , A. Niemirska6 , M. Litwin6 . 1 Dept. of Biochemistry and Experimental Medicine, 2 4Dept. of Gastroenterology, Hepatology and Immunology, 3 Dept. of Radiology, The Children’s Memorial Health Institute, Warszawa, 4 IIIrd Dept. of Pediatrics, Medical University of Bialystok, Bialystok, 5 Dept. of Gastroenterology, Hepatology and Immunology, 6 Dept. of Nephrology and Kidney Transplantation, The Children’s Memorial Health Institute, Warszawa, Poland E-mail: [email protected] MR spectroscopy is regarded as the most sensitive method to assess lipid infiltration in the liver. Most of the pediatric studies
investigating fatty liver disease were based on ultrasonography but the precision of assessment of fat deposition in the liver was poor. The aim of the study was to investigate the relationship between amount of liver fat with various risk factors including fat distribution, lipid disturbances and markers of inflammatory activity. Methods: We investigated 29 overweight/obese children aged 14.8±1.6 y. In 19 pts fatty liver was an isolated finding and in 9 pts was accompanied by arterial hypertension. All children underwent detailed investigation which included risk factors associated with a metabolic syndrome. In all children MR spectroscopy to assess lipid deposition in the liver as well as MR spectroscopy of the lumbar region to assess subcutaneous and visceral adipose tissue was performed. Results: The patients presented with normal or moderate abnormalities of the parameters studied: ALT 37.9±12.7 U/L, AST 29.5±11.0 U/L, TCH 188±36.0 mg/dl; TG 101.8±31.6 mg/dl; decreased HDL-C 41±10.6 mg/dl; Apo AI 1.18±0.36 g/l; adiponectin 13.8±12.6 mg/ml; leptin 30.6±24.0 mg/ml. There was a wide range of fat content in the liver detected by MR spectroscopy (mean 159.2 cm2 ; max-min: 6.33–824.7 cm2 ) as well as visceral adipose tissue (28.5 cm2 ; 4.23–61.3 cm2 ) and subcutaneous fat (331.3 cm2 ; 75.9–811.7 cm2 ). Total liver fat content significantly correlated with visceral adipose tissue (r = 0.527), intraperitoneal visceral fat (r = 0.43), subcutaneous fat tissue (r = 0.4) and serum concentrations of hsCRP (r = 0.51) (all p < 0.05). Liver fat content correlated negatively with serum concentration of adiponectin (r = −0.59) and apolipoprotein AI (r = −0.62) (all p < 0.05). Conclusions: Subcutaneous and visceral fat is associated with the degree of lipid infiltrations in the liver as well as indicators of metabolic syndrome; HDL-C, apoA1, hsCRP and adiponectin. Pts with isolated fatty liver disease had greater amount of fat in the liver in comparison with pts with fatty liver disease accompanied by arterial hypertension. 1325 NON-ALCOHOLIC FATTY LIVER DISEASE AND CORRELATION OF SERUM ALANIN AMINOTRANSFERASE (ALT) LEVEL WITH HISTOPATHOLOGIC FINDINGS S. Khosravi1 , S.M. Alavian2 , Nasser Ebrahimi Daryani1 , A. Zare1 , S.-M. Fereshtehnejad1 , S. Taba Taba Vakili3 , Narges Ebrahimi Daryani1 , S. Abdollahzade1 . 1 Tehran University of Medical Sciences, 2 Baghiatallah University, 3 Gastroenterology Department, Shahid Beheshti Medical University, Tehran, Iran E-mail: [email protected] Background and Aim: To characterize the histopathologic specifications of Non-Alcoholic Fatty. Liver Disease (NAFLD), in patients with little or no history of alcohol consumption based on the level of serum alanin aminotranferase (ALT). Methods: In a cross-sectional study, biopsy proven NAFLD patients from two gastroenterology clinics were assessed. Patients’ histopathologic, demographic, and laboratory data were retrospectively collected. We defined two groups according to the ALT level (cut-point of 35 U/l), and a quantitative pathologic grading of all biopsy specimens was calculated based on Brunt Scoring Values. Results: Data from 147 NAFLD patients including 127 males (86.4%) and 20 females (13.6%) with the mean age of 41.36 years (SD=11.18) was analyzed. Considering ALT level, mean quantitative grade of hepatosteatosis was 1.50 (SD=0.67) and 1.74 (SD=0.73), p = 0.136 and advanced fibrosis (consisted of grades III and cirrhosis) 4.5% (1/22) and 5.6% (7/125), p = 0.327 were not significantly different. Conclusion: These findings reflect ALT’s little contribution to predict NAFLD severity. Thus, considering ALT levels as an indicator of disease severity may result in false direction of physicians and patients.
Journal of Hepatology 2012 vol. 56 | S389–S548
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investigating fatty liver disease were based on ultrasonography but the precision of assessment of fat deposition in the liver was poor. The aim of the study was to investigate the relationship between amount of liver fat with various risk factors including fat distribution, lipid disturbances and markers of inflammatory activity. Methods: We investigated 29 overweight/obese children aged 14.8±1.6 y. In 19 pts fatty liver was an isolated finding and in 9 pts was accompanied by arterial hypertension. All children underwent detailed investigation which included risk factors associated with a metabolic syndrome. In all children MR spectroscopy to assess lipid deposition in the liver as well as MR spectroscopy of the lumbar region to assess subcutaneous and visceral adipose tissue was performed. Results: The patients presented with normal or moderate abnormalities of the parameters studied: ALT 37.9±12.7 U/L, AST 29.5±11.0 U/L, TCH 188±36.0 mg/dl; TG 101.8±31.6 mg/dl; decreased HDL-C 41±10.6 mg/dl; Apo AI 1.18±0.36 g/l; adiponectin 13.8±12.6 mg/ml; leptin 30.6±24.0 mg/ml. There was a wide range of fat content in the liver detected by MR spectroscopy (mean 159.2 cm2 ; max-min: 6.33–824.7 cm2 ) as well as visceral adipose tissue (28.5 cm2 ; 4.23–61.3 cm2 ) and subcutaneous fat (331.3 cm2 ; 75.9–811.7 cm2 ). Total liver fat content significantly correlated with visceral adipose tissue (r = 0.527), intraperitoneal visceral fat (r = 0.43), subcutaneous fat tissue (r = 0.4) and serum concentrations of hsCRP (r = 0.51) (all p < 0.05). Liver fat content correlated negatively with serum concentration of adiponectin (r = −0.59) and apolipoprotein AI (r = −0.62) (all p < 0.05). Conclusions: Subcutaneous and visceral fat is associated with the degree of lipid infiltrations in the liver as well as indicators of metabolic syndrome; HDL-C, apoA1, hsCRP and adiponectin. Pts with isolated fatty liver disease had greater amount of fat in the liver in comparison with pts with fatty liver disease accompanied by arterial hypertension. 1325 NON-ALCOHOLIC FATTY LIVER DISEASE AND CORRELATION OF SERUM ALANIN AMINOTRANSFERASE (ALT) LEVEL WITH HISTOPATHOLOGIC FINDINGS S. Khosravi1 , S.M. Alavian2 , Nasser Ebrahimi Daryani1 , A. Zare1 , S.-M. Fereshtehnejad1 , S. Taba Taba Vakili3 , Narges Ebrahimi Daryani1 , S. Abdollahzade1 . 1 Tehran University of Medical Sciences, 2 Baghiatallah University, 3 Gastroenterology Department, Shahid Beheshti Medical University, Tehran, Iran E-mail: [email protected] Background and Aim: To characterize the histopathologic specifications of Non-Alcoholic Fatty. Liver Disease (NAFLD), in patients with little or no history of alcohol consumption based on the level of serum alanin aminotranferase (ALT). Methods: In a cross-sectional study, biopsy proven NAFLD patients from two gastroenterology clinics were assessed. Patients’ histopathologic, demographic, and laboratory data were retrospectively collected. We defined two groups according to the ALT level (cut-point of 35 U/l), and a quantitative pathologic grading of all biopsy specimens was calculated based on Brunt Scoring Values. Results: Data from 147 NAFLD patients including 127 males (86.4%) and 20 females (13.6%) with the mean age of 41.36 years (SD=11.18) was analyzed. Considering ALT level, mean quantitative grade of hepatosteatosis was 1.50 (SD=0.67) and 1.74 (SD=0.73), p = 0.136 and advanced fibrosis (consisted of grades III and cirrhosis) 4.5% (1/22) and 5.6% (7/125), p = 0.327 were not significantly different. Conclusion: These findings reflect ALT’s little contribution to predict NAFLD severity. Thus, considering ALT levels as an indicator of disease severity may result in false direction of physicians and patients.
Journal of Hepatology 2012 vol. 56 | S389–S548
S521