The Study Of Clinical Characteristic And Risk Factors Of Non-alcoholic Fatty Liver Disease

Objective To assess the impact of liver fat content on beta cell function andinsulin sensitivity in patients with NAFLD. To identify the characteristics and riskfactors of NAFLD will help to prevent and treat it.Participants and methods 1,All participants were diagnosed with NAFLD byabdominal ultrasonography in lst affiliated hospital of JI NAN University frommay 2006 to march 2007. 2,All participants had no history of viral hepatitis orexcessive drinking(alcohol intake less than 140g per week for male and 70g perweek for female). 3,Detail history, anthropometrical parameters (height,weight,waistline and hipline). A B-mode ultrasonic examination was performed todetermine the liver fat content and participants were divided into the following threegroups based on their liver fat content: mild fatty degeneration group, moderate fattydegeneration group,severe fatty degeneration group. 4,Control group had 114subjects who had a negative history of hypertension, hyperlipidemia and fatty liverand negative familial history of hypertension or diabetes with NGT and normal liverultrasonograph.Of 90 patients of NAFLD have taken glucose tolerance test havingplasma glucose measured 2 hours after 82.5g oral glucose load. 5,Biochemicalindices:fasting plasma glucose, triglycerides, total cholesterol, HDL-cholesterol,LDL-cholesterol, alanine aminotransferase (ALT),aspartate aminotransferase(AST),plasma insulin.Results 1,Totally 405 individuals were diagnosed with NAFLD,232 men and173 women.The age of the participants ranged from 21 to 80 while there was nosignificant difference in age and sex among all the four groups. BMI,waistline andthe ratio of waist-hip circumference among mild fatty degeneration group, moderatefatty degeneration group and severe fatty degeneration group also had statisticaldifference. 2,The fasting plasma glucose, triglycerides,total cholesterol, HDL-cholesterol, LDL-cholesterol, plasma insulin had significant differencebetween NAFLD group and control group(P＜0.05).The difference aslo wereamong NAFLD groups (P＞0.05). 3,Both HOMA-IR index and HOMA-βhaddifference among severe fatty degeneration group, moderate fatty degenerationgroup and mild fatty degeneration group(P＜0.05). 4,The number of NAFLDincreased with aging, especially in women over 50 yeas old and man over 60 yeasold. No significant differences has been detected between male and female. 5,The90 patients who taking the OGTT were divided into two groops: patients with anormal glucose tolerance formed group 1 (64 patients) and patients with impaired ordiabetic glucose tolerance formed group 2 (26 patients). Age, female sex, UA,fasting insulin, fasting plasma glucose and HOMA-IR index were statisticallysignificantly different between the group 1 and group 2. 6,NAFLD was not onlyassociated with the quantity of body fat but also with its distribution. 7,Multivariateanalysis showed that family history of DM, hyperlipidemia, obesity, aging wererisk factors of NAFLD.Conclusion 1,Obesity and hyperlipidemia are the most common characteristics ofNAFLD. 2,The degree of fatty infiltration in liver is fi'equently associated withaging, female,obesity, and hyperlipidemia. NAFLD is closely associated with MS.3,Insulin resistance was common in NAFLD. With the liver fat contentincreasing,IR aggravated and the function ofβcell deteriorated. 4,Obesity,family history of DM, hyperlipidemia, aging, DBP, UA may be the related riskfactors of NAFLD. 5,Performing OGTT in cases with NAFLD may be useful forearly screening of diabetes mellitus.