Non-alcoholic Fatty Liver Disease And Metabolic Syndrome

Non-alcoholic fatty liver disease is agradually-recognized pathosymptom, including NAFLD, NASH, HC (hepatic cirrhosis). It may even evol to liver cancer. MS (metabolic syndrome) is a kind of danger-agent-collection for cardiovascular disease. Tough differented diagnostic criteria for MS, it is fundamentalcompri-sed of obesity, hypertention, hyperlipemia and hyperglycaemia. Glycolipid metabolic disturbance is basical pathological changes and IR (insulin resistance) is core and foundation of MS. Recently a lot of literature report that NAFLD is accompanied with element of MS .American has regarded NAFLD for a component of MS and founded IR to run through all along it. Liver is a important organ for energy metabolism, the mechanism of liver adipose degeneration, turnover of fatty liver and an effect to glycolipid metabolic disturbance have evoked widespread interest in the world. The research can clarify the relation between fatty liver and insulin resistance and also generate influence for therapy and preservation of MS, DM, NAFLD.Object: To explore the possible relation between NAFLD and metabolic syndrome and study the effects of non-alcoholic fatty liver disease (NAFLD) on the incidence of metabolic abnormalities and multiple metabolic disorders, to acknowledge clinical significance ofnon-alcoholic fatty liver disease .Design and Methods: Part 1: 110 subjects without a history of known diabetes participated in this study. All the participants had no history of excessive drinking (alcohol intake less than 40g per day for male and 20g per day for female) and infection of hepatitis B or hepatitis C. An ultrasonograghy was performed to detect whether there was excessive fat deposition in liver. Based on the liver ultrasonograph results, participants were divided into two groups: NAFLD group(n=110) and non-fatty liver group (control group) (n=55), Data of participant's age, gender, height, weight, body mass index and blood pressure were recorded. Data of fasting serum glucose, lipid profile, and hepatic function test (ALT, AST, ALP, Y-GT) were also collected. Diagnosis criteria of metabolic syndrome (MS) Chinese Diabetes Society suggestion for MS in 2004 (CDS) were applied to analyze the prevalence of metabolic syndrome in patients with NAFLD. First, we contrast above-mentioned all the index level between NAFLD group and control group. Second, we contrast accompaniment ratio of MS and all element of MS between NAFLD group and control group. Third, according to concomitance MS or not, the NAFLD group participants were divided into two groups, then contrast all the above-mentioned index between two groups. Part 2: Collecting 70 subjects with follow-up data, We divided all participants into two groups: NAFLD group (n=30) and control group (n=40). Recorded participant's age, gender, height, weight, bodymass index, blood pressure, fasting serum glucose, lipid profile, AST, ALT, ALP, GGT, and contrast in interclass as a basical level. Then on the basis of the follow-up results, we contrast index above-mentioned, MS and element of MS among all the groups.Results: part1: The average age of NAFLD group was 50.73±12.18yr, which was a little bit higher than that of control group (p=0.041). Sex distribution between the two goups, however, had no significant difference (p=0.625). According to the metabolic syndrome CDS criteria, the prevanlence of metabolic syndrome in NAFLD was higher than that in control group (CDS: 34.7%vs 3.5%, 'p=0.000). Compared with the control group, patients in NAFLD group were older, had larger BMI (p=0.000) and hypercholesterolemia, hypertriglyceridemia and low HDL, and higher hepatic function test (AST, ALT, ALP, r-GT). To contrast the control group, the component of metabolic syndrome (hypertriglyceridemia, blood glucoseabnormalities) were higher in NAFLD than that in control.On the basis of the Chinese Diabetes Society Suggestion for MS in 2004(CDS), the patients of NAFLD was divided two groups.We could see the number of man accompanied MS in NAFLD was higher than woman , however, age distributions between the two groups,had no significant difference. Compared with the without-MS NAFLD group,the patients with MS in NAFLD group had larger BMI, hypertention, hypercholesterolemia, hypertriglyceridemia, ALT, AST. Part2: At the end of follow-up, the incidence rates of obesity(76.5%Vs19.2%), hypertention (72.5%Vs51.1%) hypertrigly- ceridemia (52.5%Vs 23.5%), hypercholestemia(28.5% Vs 20.3%), impaired fasting glucose (29.0% Vs14.6%), diabetes mellitus(17.2% Vs5.7%)and multiple metabolic disorders in fatty liver group were significantly higher than those in control group. The overall 70 participants were regrouping according to obesity (or) fatty liver at the based line.the incidence rates of hypertension, hypertriglyceridemia, hypercholestemia, impaired fasting glucose, diabetes mellitus, and multiple metabolic disorders in group of fatty liver alone were significantly higher than the group of neither fatty liver nor obesity, but were not different from the group of obesity alone and the group of both fatty liver and obesity.Conclusion: The prevalence of impaired glucose regulation, metabolic syndrome and its component were higher in NAFLD than that in control. NAFLD might promote the developmentof hypertension, hyperlipidemia, impaired fasting glucose, diabetes mellitus, and multiple metabolic disorders, independent of obesity.