الفهرس 
NON-ALCOHOLIC FATTY LIVEROnly 14 pages are availabe for public view
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Abstract
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AFLD is the result of hepatic fat accumulation in patients without a history of excessive alcohol consumption, predisposing medications or other defined liver disorders.
NAFLD is strongly associated with obesity, insulin resistance, hypertension and dyslipidaemia and is now regarded as the liver manifestation of the metabolic syndrome.
Elevation of serum uric acid (SUA) significantly increased the risk of NAFLD where generation of uric acid, which is catalyzed by xanthine oxidoreductase, is accompanied by generation of reactive oxygen species which might act as the‘‘second hit’’ that induces NAFLD development.
The aim of the study is to assess the impact of hypouricemic therapy by allopurinol on improving the hepatological condition of NAFLD patients with hyperuricemia.
The following objectives are considered:1- Evaluating the effect of treating hyperuricemia on NAFLD patients’ hepatological condition assessed sonographically and biochemically.
2- Evaluating the effect of treating hyperuricemia in NAFLD on hepatic apoptosis, as assessed by cytokeratin-18 and adiponectin.
46 non-alcoholic fatty liver patients who were suffering from hyperuricemia fulfilled the criteria and were enrolled in the study, along the study 31 patients only completed the study till the end where 14 patients were lost due to non compliance and one patient due to hypersensitivity to allopurinol. These patients were divided into two groups;
group A: Placebo group who received starch based placebo for 3 months and group B: Treatment group who received allopurinol (100 initially which was increased to 300 mg if needed) until normalization of uric acid, both groups received antilipidemic drugs according to their lipid profile abnormality.
Patients with the following conditions were included in the study
1- Adult male or female patients aged between 25 and 65 years old.
2- Elevated serum uric acid (> 7 mg/dL in men, and > 6 mg/dL in women).
3- Dyslipidemic.
4- Treatment free (from statins, fenofibrates, liver support and allopurinol) for the past 3 months prior starting the therapeutic regimen.
Patients with the following conditions were excluded from the study
1- Viral hepatitis (B or C)
2- Alcohol consumption more than 40 g per week for the past 12 months, and life-time cumulative consumption more than 100 kg.
3- Diabetes Mellitus, hypertension.
4- Autoimmune liver disease
5- Malignancy of any nature.
6- Any systemic failure ( cardiovascular, renal or respiratory)
7- Patients with major psychiatric illness.
8- Pregnant or lactating women.