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Can Non-alcoholic Fatty Liver Disease (NAFLD) and Alcoholic Liver Disease (ALD) Co-Exist?
Abstracts
Can Non-alcoholic Fatty Liver Disease (NAFLD) and Alcoholic Liver Disease (ALD) Co-Exist? S Kapil, M Mehta, A Duseja, RK Dhiman, YK Chawla Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh Introduction: Presence of co-factors increases the risk of developing significant liver disease in patients consuming alcohol in unsafe limits. The aim of the study was to assess the prevalence of metabolic risk factors of NAFLD (metabolic syndrome) in patients with alcoholic liver disease (ALD). Methodology: Twenty-two patients with ALD-cirrhosis (all males, mean age 51.8 ± 9.4 years) were evaluated prospectively for the prevalence of metabolic syndrome (MS). The diagnosis of ALD-cirrhosis was based on the history of alcohol intake, serum biochemistry, imaging and gastroscopy. Patients with positive viral markers (HBsAg, anti-HCV) and hepatocellular carcinoma were excluded. Adult treatment panel III criteria with modified abnormal waist as per the Asia Pacific criteria were used to define MS. Anthropometric measurements were done when the patients were free of ascites and pedal edema. Results: Mean body weight, body mass index (BMI) and waist were 72.8 ± 11 Kg, 24.8 ± 3.6 Kg/m2 and 92.7 ± 7.5 cm, respectively. Seven patients (31.8%) were overweight, 9 (40.9%) had obesity and 12 (54.5%) patients were centrally obese. Six (27.3%) patients had diabetes mellitus, 7 (31.8%) had hypertension and abnormal HDL and triglycerides were present in 11 (50%) and 5 (22.7%) patients, respectively. Atleast one component of MS was seen in all (100%) patients, 2 components in 12 (54.5%) and full-blown MS (≥ 3 components) was present in 6 (27.2%) patients. Conclusion: High prevalence of metabolic risk factors suggests the contribution of NAFLD in causing significant liver disease in patients with alcoholic liver disease. Conflict of Interest: None
Oral Plenary Session Subcutaneous Adipose Tissue is an Important Determinant of Histological Severity in Patients with Non-alcoholic Fatty Liver Disease (NAFLD) NS Choudhary, A Duseja, N Kalra, A Das, RK Dhiman, YK Chawla Departments of Hepatology, Radiodiagnosis and Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Background: There is sparse literature on the association of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with metabolic syndrome and liver histology in patients with nonalcoholic fatty liver disease (NAFLD). Objective: To study the correlation of VAT and SAT with metabolic syndrome (MS) and liver histology in patients with NAFLD. Methods: A single slice CT scan at the level of L4–L5 vertebrae was done to assess the abdominal VAT and SAT volumes (VATV, SATV). Adult treatment panel III criteria with modified abnormal waist as per the Asia Pacific criteria were used to define MS. Histological grading was done according to the NAFLD activity score (NAS). Results: Twenty-one patients with NAFLD [13 males and 8 females, mean age of 38.62 (11.38) years] were included prospectively. Even though overweight/obese patients had severe liver disease (higher NAS score), there was no difference in the volume of VAT adjusted for body mass index (BMI) between 6 (28.5%) lean patients (BMI) < 23 Kg/m2 and 15 (71.5%) overweight/obese patients with NAFLD. Seventeen (80.9%) patients had at least one component of MS and 5 patients (23.8%) had full blown MS. Presence of MS or insulin resistance had no significant correlation with the histological severity. There was no difference in the VATV/BMI, but SATV/BMI and TATV/ BMI were higher in the NASH and borderline NASH group than the no-NASH group. Both SAT and VAT adjusted for BMI correlated with hepatic steatosis but only SAT adjusted for BMI correlated with homeostasis model assessment for insulin resistance (HOMA-IR), number of components of MS and NAFLD activity score on histology. Conclusion: Both VAT and SAT are related to the degree of hepatic steatosis, but only SAT is related to the NAFLD activity score in patients with NAFLD. Conflict of Interest: None
© 2011, INASL
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Can Non-alcoholic Fatty Liver Disease (NAFLD) and Alcoholic Liver Disease (ALD) Co-Exist? S Kapil, M Mehta, A Duseja, RK Dhiman, YK Chawla Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh Introduction: Presence of co-factors increases the risk of developing significant liver disease in patients consuming alcohol in unsafe limits. The aim of the study was to assess the prevalence of metabolic risk factors of NAFLD (metabolic syndrome) in patients with alcoholic liver disease (ALD). Methodology: Twenty-two patients with ALD-cirrhosis (all males, mean age 51.8 ± 9.4 years) were evaluated prospectively for the prevalence of metabolic syndrome (MS). The diagnosis of ALD-cirrhosis was based on the history of alcohol intake, serum biochemistry, imaging and gastroscopy. Patients with positive viral markers (HBsAg, anti-HCV) and hepatocellular carcinoma were excluded. Adult treatment panel III criteria with modified abnormal waist as per the Asia Pacific criteria were used to define MS. Anthropometric measurements were done when the patients were free of ascites and pedal edema. Results: Mean body weight, body mass index (BMI) and waist were 72.8 ± 11 Kg, 24.8 ± 3.6 Kg/m2 and 92.7 ± 7.5 cm, respectively. Seven patients (31.8%) were overweight, 9 (40.9%) had obesity and 12 (54.5%) patients were centrally obese. Six (27.3%) patients had diabetes mellitus, 7 (31.8%) had hypertension and abnormal HDL and triglycerides were present in 11 (50%) and 5 (22.7%) patients, respectively. Atleast one component of MS was seen in all (100%) patients, 2 components in 12 (54.5%) and full-blown MS (≥ 3 components) was present in 6 (27.2%) patients. Conclusion: High prevalence of metabolic risk factors suggests the contribution of NAFLD in causing significant liver disease in patients with alcoholic liver disease. Conflict of Interest: None
Oral Plenary Session Subcutaneous Adipose Tissue is an Important Determinant of Histological Severity in Patients with Non-alcoholic Fatty Liver Disease (NAFLD) NS Choudhary, A Duseja, N Kalra, A Das, RK Dhiman, YK Chawla Departments of Hepatology, Radiodiagnosis and Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Background: There is sparse literature on the association of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with metabolic syndrome and liver histology in patients with nonalcoholic fatty liver disease (NAFLD). Objective: To study the correlation of VAT and SAT with metabolic syndrome (MS) and liver histology in patients with NAFLD. Methods: A single slice CT scan at the level of L4–L5 vertebrae was done to assess the abdominal VAT and SAT volumes (VATV, SATV). Adult treatment panel III criteria with modified abnormal waist as per the Asia Pacific criteria were used to define MS. Histological grading was done according to the NAFLD activity score (NAS). Results: Twenty-one patients with NAFLD [13 males and 8 females, mean age of 38.62 (11.38) years] were included prospectively. Even though overweight/obese patients had severe liver disease (higher NAS score), there was no difference in the volume of VAT adjusted for body mass index (BMI) between 6 (28.5%) lean patients (BMI) < 23 Kg/m2 and 15 (71.5%) overweight/obese patients with NAFLD. Seventeen (80.9%) patients had at least one component of MS and 5 patients (23.8%) had full blown MS. Presence of MS or insulin resistance had no significant correlation with the histological severity. There was no difference in the VATV/BMI, but SATV/BMI and TATV/ BMI were higher in the NASH and borderline NASH group than the no-NASH group. Both SAT and VAT adjusted for BMI correlated with hepatic steatosis but only SAT adjusted for BMI correlated with homeostasis model assessment for insulin resistance (HOMA-IR), number of components of MS and NAFLD activity score on histology. Conclusion: Both VAT and SAT are related to the degree of hepatic steatosis, but only SAT is related to the NAFLD activity score in patients with NAFLD. Conflict of Interest: None
© 2011, INASL
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