Comparison of lipid profile in different grades of non-alcoholic fatty liver disease diagnosed on ultrasound

Objective:To detect and compare serum lipid abnormalities in patients diagnosed with different grades of non-alcoholic fatly liver on ultrasonography.Methods:A total of 70 cases which included 30 males and 40 females,diagnosed as nonalcoholic fatty liver disease(NAFLD)on ultrasound were investigated with serum lipid profile.Then a comparison of lipid abnormalities between different grades of fatty liver diagnosed on ultrasound was done.P value was calculated by using analysis of variance lest(ANOVA)and P value<0.05 was considered as statistically significant.Results:Out of 70 cases which were diagnosed as NAFLD on ultrasonography,gradeⅠNAFLD cases were 47.15%,gradeⅡwere 42.85%and gradeⅢwere 10%.The mean age of the patients was49.14 years.Male to female ratio was 3:4.Serum triglycerides,total cholesterol,LDL and VLDL levels were raised in 67.14%,45.71%34.28%,25.71%of cases respectively.Low serum HDL levels were seen in 62.85%of patients.On statistical analysis we found increasing grades of NAFLD were significantly associated with increasing values of total cholesterol(P value-0.001),LDL(P value-0.000)and VLDL(P value-0.003)and decreasing HDL(P value-0.000).Conclusion:Most of the patients of NAFLD in India is asymptomatic,non-diabetic and non-hypertensive.Though liver biopsy is the gold standard melhod for diagnosis of NAFLD,Ultrasonography which is non-invasive,simple tool,can be used for the early detection of NAFLD in asymptomatic patients.

Protective Effects and Action Mechanism of Total Flavonoids of POLYGONI PERFOLIATI HERBA on Rats with Nonalcoholic Steatohepatitis

[Objectives]To study the protective effects and mechanism of POLYGONI PERFOLIATI HERBA on rats with nonalcoholic steatohepatitis( NASH). [Methods] Sixty rats were randomly divided into normal group,model group,metformin group( 0. 5 mg/kg),and high dose,medium dose,and low dose groups of total flavonoids of POLYGONI PERFOLIATI HERBA( 600,300,150 mg/kg). The standard feed was given to the normal group,and the model group and the total flavonoids groups were fed with high-fat diet for 13 weeks to establish the NASH rat model. At the 8 th week,the metformin group and the POLYGONI PERFOLIATI HERBA total flavonoids groups were given with the corresponding drug treatment for 6 weeks,blood was taken from the eyeball to collect liver tissue. Biochemical method was used to determine ALT,AST,TC,TG,HDL-c,LDL-c,SOD,MDA,GSH-Px activity or content in serum and HOMA-IR,and ELISA was used to measure the TNF-α,IL-1β and IL-6 content in liver tissue; Western blotting was used to detect the expression levels of AMPK,p-AMPK and ACC in liver tissue. [Results] Total flavonoids of POLYGONI PERFOLIATI HERBA could significantly decrease the activity or content of ALT,AST and MDA in serum of NASH rats( P < 0. 05,P < 0. 01),and enhance the activity of SOD and GSH-Px( P < 0. 05,P < 0. 01),reduce serum TC,TG,LDL-c levels and insulin resistance index,increase HDL-c levels( P < 0. 05,P < 0. 01); down-regulate liver IL-1β,IL-6,TNF-α,ACC levels and up-regulate p-AMPK expression( P < 0. 05,P < 0. 01). [Conclusions]The total flavonoids of POLYGONI PERFOLIATI HERBA have a good protective effect on NASH rats,and its mechanism may be related to the functions of regulating the lipid metabolism,alleviating insulin resistance,inhibiting oxidative stress,inhibiting inflammatory reaction and regulating AMPK and ACC protein expression.

Nonalcoholic steatohepatitis critically rewires the ischemia/ reperfusion-induced dysregulation of cardiolipins and sphingolipids in mice

Background:Lipid dysregulation plays a fundamental role in nonalcoholic steatohepatitis(NASH),which is an emerging critical risk factor that aggravates hepatic ischemia/reperfusion(I/R)injury.However,the specific lipids that mediate the aggressive I/R injury in NASH livers have not yet been identified.Methods:The mouse model of hepatic I/R injury on NASH was established on C56B/6J mice by first feeding the mice with a Western-style diet to induce NASH,then the NASH mice were subjected to surgical procedures to induce hepatic I/R injury.Untargeted lipidomics were performed to determine hepatic lipids in NASH livers with I/R injury through ultra-high performance liquid chromatography coupled with mass spectrometry.The pathology associated with the dysregulated lipids was examined.Results:Lipidomics analyses identified cardiolipins(CL)and sphingolipids(SL),including ceramides(CER),glycosphingolipids,sphingosines,and sphingomyelins,as the most relevant lipid classes that characterized the lipid dysregulation in NASH livers with I/R injury.CER were increased in normal livers with I/R injury,and the I/R-induced increase of CER was further augmented in NASH livers.Metabolic pathway analysis revealed that the enzymes involved in the synthesis and degradation of CER were highly upregulated in NASH livers with I/R injury,including serine palmitoyltransferase 3(Sptlc3),ceramide synthase 2(Cers2),neutral sphingomyelinase 2(Smpd3),and glucosylceramidase beta 2(Gba2)that produced CER,and alkaline ceramidase 2(Acer2),alkaline ceramidase 3(Acer3),sphingosine kinase 1(Sphk1),sphingosine-1-phosphate lyase(Sgpl1),and sphingosine-1-phosphate phosphatase 1(Sgpp1)that catalyzed the degradation of CER.CL were not affected by I/R challenge in normal livers,but CL was dramatically reduced in NASH livers with I/R injury.Consistently,metabolic pathway analyses revealed that the enzymes catalyzing the generation of CL were downregulated in NASH-I/R injury,including cardiolipin synthase(Crls1)and tafazzin(Taz).Notably,the I/R-induced oxidative stress and cell death were found to be aggravated in NASH livers,which were possibly mediated by the reduction of CL and accumulation of CER.Conclusions:The I/R-induced dysregulation of CL and SL were critically rewired by NASH,which might potentially mediate the aggressive I/R injury in NASH livers.

疏肝降脂汤治疗非酒精性脂肪性肝炎的临床疗效观察

目的:研究疏肝降脂汤治疗非酒精性脂肪性肝炎的临床疗效。方法:将80例非酒精性脂肪性肝炎患者随机分两组,治疗组40例服用疏肝降脂汤,对照组40例服用易善复胶囊。两组疗程均为3个月,观察两组患者的临床疗效及治疗前后肝功能指标、血脂、肝脏B超的变化,同时观察并记录所有患者的不良反应,评价治疗药物的安全性。结果:治疗组总有效率为87.5%,对照组总有效率为65%(P<0.05)。治疗后,两组患者的ALT、AST、TC、TG、γ-谷氨酰转移酶(γ-GT)水平均显著降低(P<0.05),治疗组和对照组相比,治疗组在降低肝功能血清酶学指标上优于对照组(P<0.05);治疗后两组患者的肝脏B超病情分级均明显改善(P<0.05)。且治疗组改善较对照组更加明显(P<0.05)。服药过程中两组患者均未见不良反应发生。结论:疏肝降脂汤具有改善肝功能、降低血脂的疗效,而且能显著改善患者临床症状。

复方甘正对非酒精性脂肪肝的治疗作用

[目的]观察复方甘正对高脂饮食诱导的大鼠非酒精性脂肪肝(NASH)的治疗作用。[方法]将30只SD大鼠随机分为3组:正常组、模型组和复方甘正治疗组。测定各组空腹血清丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、总胆固醇(TC)、三酰甘油(TG)及肝匀浆TG、TC的水平,同时检测肝匀浆丙二醛(MDA)水平及超氧化物歧化酶(SOD)活性。[结果]模型组体重(493.20±19.55)g比正常组(371.60±31.69)g显著增高(P<0.01),治疗组(421.80±15.51)g较模型组显著降低(P<0.05)。模型组肝指数(3.33±0.74)比正常组(2.89±0.14)显著增高,治疗组(2.97±0.10)较模型组显著降低(均P<0.05);正常组肝细胞无脂肪变性,模型组普遍发生脂肪变性,治疗组肝脂肪变性程度较模型组显著减轻,正常组无炎性细胞浸润,模型组肝小叶内出现汇管区炎症,炎症活动度明显高于正常组,治疗组较模型组明显减低(均P<0.01);模型组血清ALT、AST及TC较正常组均显著升高,治疗组较模型组显著下降,但仍高于正常组(P<0.01,<0.05)。模型组血清TG水平与正常组接近,治疗组与模型组比较下降不明显;模型组肝匀浆TG、MDA水平高于正常组,SOD活性低于正常组;治疗组TG、MDA较模型组显著下降(均P<0.01),TG已降至正常水平。治疗组SOD活性较模型组明显增加,但低于正常组(均P<0.01),3组间TC水平比较差异无统计学意义。[结论]复方甘正具有显著的抗炎、抗脂质过氧化和清除氧自由基的作用。