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Abstract Non alcoholic fatty liver is defined as accumulation of fat, largely triglycerides, exceeding 5% of the liver weight or visualization of more than 5% of hepatocytes containing fatty droplets on light microscopy. It is due to failure of normal hepatic fat metabolism either due to defect within the hepatocyte or to delivery of excess fat, fatty acid or carbohydrates beyond the secretory capacity of lipid of the liver cell. Non alcoholic fatty liver diseases (NAFLD) represents a spectrum of several clinicopathological lesions ranging from simple steatosis to cirrhosis including steatosis alone or steatohepatitis . In the general population, the estimated prevalence ranges from 7%-35. Nonalcoholic steatohepatitis (NASH)–associated cirrhosis accounts for approximately of 13% of all cases of hepatocellular carcinoma. Well-known risk factors are central obesity, hyperglycemia, type2 diabetes, arterial hypertension, and hypertriglyceridemia. Affected patients are generally asymptomatic, patients with benign steatosis and non-alcoholic steatohepatitis are typically asymptomatic, the most common symptoms reconstitutional and nonspecific like fatigue . weakness and malaise Right upper quadrant pain Summary and Conclusion 134 or fullness is a less frequent complaint may come to medical attention because of elevated transaminase levels, increased alkaline phosphatase levels, hepatomegaly, or some combination therefor, NAFLD remains a diagnosis of exclusion, made by eliminating other liver diseases. Therapeutic interventions are limited in NAFLD. Therapy has focused on modification of risk factors, weight loss and pharmacological therapy including insulin sensitizing agents, antioxidants as vitamin E, lipid lowering agents, silymarine, ursodeoxycholic acid. Glycated haemoglobin is a form of haemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by haemoglobin’s exposure to plasma glucose. Normal levels of glucose produce a normal amount of glycated haemoglobin. As the average amount of plasma glucose increases, the fraction of glycated haemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous two to three months prior to the measurement. Nondiabetic HbAlc values vary markedly between subjects. It may be within normal non diabetic range, may be low if associated with advanced liver diseases or may be Summary and Conclusion 135 high in insulin resistance (IR) as apart of the metabolic syndrome in NAFLD patients. A case – control study performed to characterize the relation between glycated haemoglobin and nonalcoholic fatty liver disease. Comparison between cases and controls in different variables done and there was only significant correlation between fatty liver and BMI and between fatty liver and GGT (Table 11). The high level of liver enzymes ”SGOT, SGPT & GGT” was higher in study group than in control group (Figures 24-29) but this was not statistically significant except with GGT (Table 11). The high level of cholesterol in the study group was 33.3% in comparison to 10% high level in control group (Figures 30-31) but it was not significant statistically with (P value 0.057). This may be due to small sample size of the study population. Correlation between HbA1c and (liver enzymes, total cholesterol, fasting blood glucose and BMI) and all studied variables are not statistically significant (Figures 32-42). Lastly in the present study we found that there is no association between glycated haemoglobin HbA1c and the presence or absence of fatty liver in non diabetic individuals (Table 11). |