Subclinical Atherosclerosis Risk And Related Mechanisms Of Fatty Liver Disease And Its Exercise Intervention

Part Ⅰ The association between fatty liver disease and silent carotid plaque in Chinese aged population: a cross-sectional studyObjective:To investigate the association between fatty liver disease and carotid plaque in the elderly,especially those low risk populations.Methods: A total of 14396 asymptomatic participants aged 65 years and older who underwent comprehensive health check-up examination,including abdominal and carotid artery duplex ultrasonography(US)were screened.Fatty infiltration of liver was detected by abdominal ultrasonography.Carotid intima-media thickness(CIMT)as well as plaque prevalence were estimated by carotid ultrasound.A plaque was defined as a focal thickening of ≥ 1.2 mm in any of 12 carotid segments.Results: Participants with FLD have a higher prevalence of carotid plaque(22.36% vs 16.34%)than those without FLD.After adjusting for age,gender,BMI,liver and kidney function,glucose level,lipid profiles,and white blood cell count,FLD is significantly associated with carotid plaque [odd ratio(OR):1.887,95% confidence interval(CI): 1.588-2.241,P<0.0001].Moreover,the OR value persists to 1.87,2.22 and 1.95 when we exclude participants whom with elevated ALT,prior cardiovascular diseases(CVD)history,and obesity,respectively.Conclusions: Our results indicate that FLD is common in the elderly and is a key independent risk factor for the carotid plaque presence even in those relative healthy individuals.Old individuals identified with hepatic steatosis should carry out routine carotid ultrasound screening to detect carotid atherosclerosis and assess the risk of cardiovascular disease.Part Ⅱ Safety and efficacy of exercise intervention in patients with NAFLDObjective: To explore the effect and safety of exercise on patients with NAFLD.Methods: Non-alcoholic fatty liver disease patients were recruited and randomly divided into control group(NC)and exercise group(EI).According to the exercise program,the EI group was urged to complete the exercise intervention,and the FIBROUTOUCH test results were collected every other month for analysis.Result: After three months of aerobic exercise intervention,the content of liver fat in NAFLD patients in intervention group was significantly lower than that in control group,while the liver hardness did not change significantly.CONCLUSION:Exercise can reduce the accumulation of intrahepatic fat in patients with NAFLD.Part Ⅲ Insulin Sensitization in Insulin Resistance Cell Model Induced by Overexpression of A20Objective: To investigate the changes of A20 in the model of insulin resistance induced by high concentration of insulin in Hep G2 cells and the effect of overexpression of A20 protein on insulin resistance in Hep G2 cells.METHODS: Hep G2 cells were stimulated with high concentration of insulin for 24 hours.Glucose consumption was measured by GOD method.WB was used to detect the expression level of A20 protein.A stable strain overexpressing A20 was constructed on Hep G2 cells.Glucose consumption was measured by GOD method after 24 hours of stimulation with 10-6 mol/L insulin.The expression levels of A20,IRS-1,AKT,p-AKT and GLUT4 were detected by Western blotting..RESULTS: Stable insulin resistance cell model could be established by stimulating insulin with high concentration for 24 hours,and the expression of A20 protein changed with the increase of stimulation time.Overexpression of A20 can increase the sugar consumption of insulin resistant cells and stimulate the expression of insulin pathway related proteins.CONCLUSION: The insulin resistance model induced by high concentration insulin can stimulate the expression of A20 protein.Overexpression of A20 inhibits insulin resistance in Hep G2 cells.