Navegando por Palavras-chave "Non-alcoholic steatohepatitis"
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- ItemSomente MetadadadosEffect of 6-month nutritional intervention on non-alcoholic fatty liver disease(Elsevier B.V., 2010-11-01) Elias, Maria Cristina [UNIFESP]; Parise, Edison Roberto [UNIFESP]; Carvalho, Luciana de [UNIFESP]; Szejnfeld, Denis [UNIFESP]; Netto, Joao Prola [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: We evaluated the effect of diet therapy as exclusive treatment on insulin resistance, biochemical parameters of metabolic syndrome, and degree of hepatic steatosis in patients with non-alcoholic fatty liver disease.Methods: Thirty-one patients with non-alcoholic fatty liver disease received a diet with a reduction of 500 to 1000 cal/d, containing 15% protein, 55% carbohydrates, and 30% fat, for 6 mo. At entry and 6 mo after dietary instructions, degrees of hepatic steatosis and visceral obesity were assessed by computed tomography: serum aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, glucose, triacylglycerols, and high-density lipoprotein cholesterol were measured by automated methods. Body mass index, waist circumference, waist-to-hip ratio, and food intake (7-d diary) were also evaluated. At the end of follow-up, the patients were classified as adherent or non-adherent to treatment according to a weight loss of more or less than 5% of initial body weight, respectively.Results: Seventeen patients were classified as adherent (group 1) and 14 as non-adherent (group 2). Group 2 only presented a significant reduction in body mass index and waist circumference. in contrast, in group 1, in addition to significant improvement of all anthropometric parameters, a significant reduction was observed in alanine aminotransferase and gamma-glutamyl transferase levels, homeostasis model assessment for insulin resistance, visceral fat and tomographic liver density, together with an increase in serum high-density lipoprotein cholesterol levels. These patients presented a significant decrease in total energy intake and in total and saturated fats.Conclusion: Nutritional intervention as exclusive treatment, with a loss of at least 5% of initial weight, is effective in the treatment of non-alcoholic fatty liver disease. (C) 2010 Elsevier Inc. All rights reserved.
- ItemAcesso aberto (Open Access)Plasmatic higher levels of homocysteine in Non-alcoholic fatty liver disease (NAFLD)(Biomed Central Ltd, 2013-04-02) Carvalho, Sylene Coutinho Rampche de; Muniz, Maria Tereza Cartaxo; Siqueira, Maria Deozete Vieira; Siqueira, Erika Rabelo Forte; Gomes, Adriana Vieira; Silva, Karina Alves; Bezerra, Lais Carvalho Luma; D'Almeida, Vania [UNIFESP]; Oliveira, Claudia Pinto Marques Souza de; Pereira, Leila Maria M. Beltrao; Univ Pernambuco; Liver Inst Pernambuco; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Inst Figado PernambucoBackground: Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease, which includes a spectrum of hepatic pathology such as simple steatosis, steatohepatitis, fibrosis and cirrhosis. the increased serum levels of homocysteine (Hcy) may be associated with hepatic fat accumulation. Genetic mutations in the folate route may only mildly impair Hcy metabolism. the aim of this study was to investigate the relation between liver steatosis with plasma homocysteine level and MTHFR C677T and A1298C polymorphisms in Brazilian patients with NAFLD.Methods: Thirty-five patients diagnosed with NAFLD by liver biopsy and forty-five healthy controls neither age nor sex matched were genotyped for C677T and A1298C MTHFR polymorphisms using PCR-RFLP and PCR-ASA, respectively, and Hcy was determined by HPLC. All patients were negative for markers of Wilson's, hemochromatosis and autoimmune diseases. Their daily alcohol intake was less than 100 g/week. A set of metabolic and serum lipid markers were also measured at the time of liver biopsies.Results: the plasma Hcy level was higher in NAFLD patients compared to the control group (p = 0.0341). No statistical difference for genotypes 677C/T (p = 0.110) and 1298A/C (p = 0.343) in patients with NAFLD and control subjects was observed. the genotypes distribution was in Hardy-Weinberg equilibrium (677C/T p = 0.694 and 1298 A/C p = 0.188). the group of patients and controls showed a statistically significant difference (p < 0.001) for BMI and HOMA_IR, similarly to HDL cholesterol levels (p < 0,006), AST, ALT, gamma GT, AP and triglycerides levels (p < 0.001). A negative correlation was observed between levels of vitamin B12 and Hcy concentration (p = 0.005).Conclusion: Our results indicate that plasma Hcy was higher in NAFLD than controls. the MTHFR C677T and A1298C polymorphisms did not differ significantly between groups, despite the 677TT homozygous frequency was higher in patients (17.14%) than in controls (677TT = 4.44%) (p > 0.05). the suggested genetic susceptibility to the MTHFR C677T and A1298C should be confirmed in large population based studies.
- ItemAcesso aberto (Open Access)Serum laminin, type IV collagen and hyaluronan as fibrosis markers in non-alcoholic fatty liver disease(Associação Brasileira de Divulgação Científica, 2005-05-01) Santos, V.n. dos [UNIFESP]; Leite-Mór, Marilisa Moraes Barros [UNIFESP]; Kondo, Mario [UNIFESP]; Martins, J.r. [UNIFESP]; Nader, Helena Bonciani [UNIFESP]; Lanzoni, Valeria Pereira [UNIFESP]; Parise, Edison Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Hepatic fibrosis in patients with non-alcoholic fatty liver disease is associated with progression of the disease. In the present study, we analyzed the discriminative ability of serum laminin, type IV collagen and hyaluronan levels to predict the presence of fibrosis in these patients. In this preliminary report, we studied 30 overweight patients divided into two groups according to the absence (group I, N = 19) or presence (group II, N = 11) of fibrosis in a liver biopsy. Triglycerides, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltranspeptidade, hyaluronan (noncompetitive fluoroassay), type IV collagen, and laminin (ELISA) were determined. Group II presented significantly higher mean laminin, hyaluronan, type IV collagen, and aspartate aminotransferase values, which were due to the correlation between these parameters and the stage of fibrosis in the biopsy (Spearman's correlation coefficient, rS = 0.65, 0.62, 0.53, and 0.49, respectively). Analysis of the ROC curve showed that laminin values >282 ng/ml were those with the best diagnostic performance, with 87% accuracy. Association of laminin with type IV collagen showed improvement in the positive predictive value (100%), but with reduction in diagnostic sensitivity (64%). When compared with the criteria of Ratziu et al. [Gastroenterology (2000) 118: 1117-1123] for the diagnosis of septal fibrosis, laminin values presented a better diagnostic accuracy (83 vs 70%). Determination of extracellular matrix components in serum, especially of laminin, may identify patients with non-alcoholic fatty liver disease and fibrosis and these components may be used as indicators for liver biopsy in these patients.