Navegando por Palavras-chave "Non-alcoholic fatty liver disease"
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- ItemSomente MetadadadosAssociation of nonalcoholic fatty Liver disease with cardiovascular risk factors in obese adolescents: the role of interdisciplinary therapy(Elsevier B.V., 2014-06-01) Sanches, Priscila de Lima [UNIFESP]; Piano, Aline de [UNIFESP]; Campos, Raquel Munhoz da Silveira [UNIFESP]; Carnier, June [UNIFESP]; Mello, Marco Tulio de [UNIFESP]; Elias, Natalia; Fonseca, Francisco Antonio Helfenstein [UNIFESP]; Masquio, Deborah Cristina Landi [UNIFESP]; Silva, Patricia Leao da; Corgosinho, Flavia Campos [UNIFESP]; Tock, Lian; Oyama, Lila Missae [UNIFESP]; Tufik, Sergio [UNIFESP]; Dâmaso, Ana Raimunda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Assoc Fund Incent Res; Weight Sci; Universidade Federal de Goiás (UFG)BACKGROUND: Obesity is associated with several cardiovascular risk factors, including nonalcoholic fatty liver disease (NAFLD). These risk factors can induce changes in the arteries such as an increase in the carotid intima-media thickness (cIMT), which contributes to the early development of atherosclerosis.OBJECTIVE: To determine whether NAFLD is associated with an atherogenic lipid profile, inflammatory markers, or cIMT in obese adolescents and to compare the effects of therapeutic lifestyle changes in NAFLD and non-NAFLD groups.METHODS: A total of 79 obese adolescents were divided into two groups: 33 NAFLD and 46 non-NAFLD. They were submitted to an interdisciplinary therapy involving diet exercise and psychological support during the course of 1 year. the cIMT and estimates of fat mass (liver, intra-abdominal, and subcutaneous) were determined ultrasonographically. Body composition, glucose, lipid profile, and adipokines were analyzed before and after the therapy.RESULTS: At baseline, only in the NAFLD group was the homeostasis model assessment of insulin resistance positively correlated with cIMT and triglyceride/high-density lipoprotein cholesterol ratio. Therapy was associated with an increase in adiponectin concentrations and reduced visceral fat, cIMT, leptin, and plasminogen activator inhibitor-1 concentrations, as well as the ratios of total cholesterol/high-density lipoprotein cholesterol and triglycerides/high-density lipoprotein cholesterol in both groups. Only in the non-NAFLD group did therapy result in a reduction in the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and increased high-density lipoprotein cholesterol concentration.CONCLUSIONS: in obese adolescents, NAFLD is associated with cardiovascular risk factors and inflammatory markers of atherosclerosis that were positively correlated with cIMT only in the NAFLD group. Nevertheless, the strength of the present study is that the interdisciplinary therapy effectively improved cIMT and other proinflammatory adipokines in both groups. (C) 2014 National Lipid Association. All rights reserved.
- ItemAcesso aberto (Open Access)Consumo alimentar dos portadores de doença hepática gordurosa não alcoólica: comparação entre a presença e ausência de síndrome metabólica e a gravidade da doença(Universidade Federal de São Paulo (UNIFESP), 2011-05-25) Crispim, Fany Govetri Sena [UNIFESP]; Parise, Edison Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: To evaluate the dietary intake of subjects with nonalcoholic fatty liver disease (NAFLD) and compare with recommended dietary intake, presence and absence of metabolic syndrome (MS) and disease severity (presence and absence of nonalcoholic steatohepatitis). Methods: We first evaluated 158 patients with a diagnosis of NAFLD by clinical examination, histological analysis, anthropometry (weight, height, BMI, waist circumference) and dietary intake (3 days food record) with analysis of protein, carbohydrates and lipids, including saturated fatty acids (SFA), monounsaturated (MUFA), polyunsaturated (PUFA) and cholesterol, micronutrients (vitamins A, C and E) and total dietary fiber. Of these, 59 presented dietary changes as a result of previous nutritional instruction and were excluded from the analysis. Results: Among the remaining 99 patients, when compared to the recommended dietary intake, we observed a higher intake of cholesterol and saturated fatty acids in 59,5% and 87,8%, respectively, in addition to deficient ingestion of mono- and polyunsaturated fatty acids, fibers, and vitamin E in 98,9 %, 76,7%, 64,6% and 68,6% of these patients, respectively. These findings agree with previous studies involving this population. No significant differences in diet were observed when these patients were divided according to the presence or absence of metabolic syndrome and nonalcoholic steatohepatitis (NASH). Conclusions: In this study, we observed that individuals with NAFLD presented inadequate intake of MUFA, PUFA, vitamin E and fiber and excessive consumption of SFA and cholesterol. However, no significant differences were found in diet of these patients when divided according to presence or absence of MS and NASH.
- ItemAcesso aberto (Open Access)Doença hepática gordurosa não alcoólica em pacientes com psoríase(Universidade Federal de São Paulo (UNIFESP), 2017-07-31) Simal, Thaiza Alonso [UNIFESP]; Silva, Ivonete Sandra de Souza e [UNIFESP]; Ferraz, Maria Lucia Cardoso Gomes [UNIFESP]; Petri, Valeria [UNIFESP]; Maria Lucia Cardoso Gomes Ferraz : http://lattes.cnpq.br/1870810357457710; Valeria Petri : http://lattes.cnpq.br/8894929595866495; http://lattes.cnpq.br/5846912595934815; http://lattes.cnpq.br/8034082225405658; Universidade Federal de São Paulo (UNIFESP)Introduction: The prevalence rates of nonalcoholic fatty liver disease is increased in psoriasis and vary depending of the region studied. The factors associated with nonalcoholic fatty liver disease in psoriasis, as well as the severity of liver disease in this population, are not fully understood. Objectives: Evaluation of the prevalence of nonalcoholic fatty liver disease in patients with psoriasis, the different degrees of liver fibrosis in patients with liver disease and the comparison of epidemiological, clinical and laboratory characteristics between psoriasis patients with and without nonalcoholic fatty liver disease. Methods: Patients with psoriasis followed up at a Dermatology Service of Unifesp between 2015 and 2016 and submitted to abdominal ultrasound were enrolled. Clinical-epidemiological and laboratory characteristics were compared between patients with and without steatosis. Liver fibrosis was evaluated by transient hepatic elastography. The results were analyzed using the chi-squared or Fisher’s exact test when appropriate, Student t-test or Mann-Whitney and logistic regression analysis. Results: One hundred and seventy-one patients with a mean age of 50 years and with a slight predominance of men (52%) were studied. The prevalence of nonalcoholic fatty liver disease was 51%. Patients with psoriasis and nonalcoholic fatty liver disease had a higher body mass index (p = 0,036), higher prevalence of metabolic syndrome (p < 0,001), more severe psoriasis area severity index (p = 0,005) and higher alanine aminotransferase serum levels (p = 0,002). Transient elastography was performed on 52 patients with nonalcoholic fatty liver disease and detected significant fibrosis in 36% of cases, including cirrhosis in 15%. Conclusion: The high prevalence of liver disease in psoriasis and its association with metabolic syndrome and severe psoriasis area severity index suggest a common physiopathogenic factor for these diseases. The presence of a significant number of patients with advanced liver disease alerts to the need for systematic evaluation of this condition among patients with psoriasis.
- 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.
- ItemSomente MetadadadosMetabolic differences between male and female adolescents with non-alcoholic fatty liver disease, as detected by ultrasound(Wiley-Blackwell, 2010-08-01) Fernandes, M. T. B. [UNIFESP]; Ferraro, A. A.; Azevedo, R. A. de [UNIFESP]; Fagundes Neto, U. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Background:Age, developmental stage and gender are risk factors for paediatric non-alcoholic fatty liver disease (NAFLD).Aims:The aim of this study was to identify differences in clinical or laboratory variables between sexes in adolescents with NAFLD.Methodology:Ninety obese adolescents including 36 males and 54 females were evaluated. Inclusion criteria for this study were a Body Mass Index above the 95th percentile, as set forth by the National Center for Health Statistics, and an age of 10-19 years. A clinical and laboratory evaluation was conducted for all adolescents.Results:The variables that were found to be predictive of NAFLD in adolescence were visceral fat, Aminotransferase, Gamma-Glutamyl Transferase, triglyderides, cholesterol and LDL-cholesterol. We also observed that cholesterol and LDL-cholesterol variables were influenced by gender, i.e. there was a significant statistical difference in the values of these variables between male and female adolescents. With regard to cholesterol serum concentrations, the risk was 6.99 times greater for females, compared with 1.2 times for males; and for LDL-cholesterol serum concentrations the risk was 8.15 times greater for females, compared with and 1.26 times for males.Conclusion:Female adolescents with NAFLD showed a significantly different metabolic behaviour than males.
- 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.