الفهرس 
History and Definition of NAFLDOnly 14 pages are availabe for public view
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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
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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).