الفهرس 
NON ALCOHOLIC FATTY LIVER DISEASEOnly 14 pages are availabe for public view
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Abstract
SUMMARY
N
onalcoholic fatty liver disease (NAFLD) has a prevalence of 25% worldwide and is described as the leading cause of chronic liver disease. Liver disease was found to be the third leading cause of death among persons with NAFLD. Its prevalence is increasing in conjunction with metabolic syndrome due to engaged risk factors, which include abdominal obesity, type 2 diabetes, dyslipidemia (high triglycerides and/or low high-density-lipoproteins), age, male sex, and alcohol consumption.
Although ultrasound and magnetic resonance are helpful for the diagnosis of NAFLD, liver biopsy is still the gold standard. New insights and diagnostic improvements in NAFLD such as transient elastography and FibroScan are exciting alternatives. However, we targeted focusing on noninvasive, cheap, and useful biomarkers in clinical practice. In this way, the role of circulating biomarkers related to endothelial dysfunction and the severity of underlying liver disease need to be investigated.
NAFLD is also an ongoing inflammatory condition, we hypothesized that plasma PTX3 levels increase in patients with NAFLD and aimed to investigate the potential relationship of plasma PTX3 levels with the degree of liver damage of NAFLD patients to see if there is any clinical role of PTX3 (and its stimulant TNF-a) in the diagnosis and staging of NAFLD/NASH patients
This study was conducted at Ain Shams University hospitals t to investigate the clinical usefulness of plasma Pentraxin3 (PTX3) levels versus fibroscan to predict NASH and the potential relationship of its levels with the degree of liver damage in NAFLD /NASH Egyptian patients.
We included a total of 80 subjects who were divided into two groups; group 1 included 60 patients with NAFLD, and group 2 included 20 healthy controls.The group of NAFLD was divided into 2 subgroups:
NASH group(30 patients)
Non NASH (30 patients)
After a written consent all subjects were subjected to complete history taking, thorough physical examination and waist circumference. Additionally, laboratory investigations were ordered for all participants including CBC, liver function tests, fasting blood sugar, plasma insulin level, HOMA IR, lipid profile along with serum PX3 level. FIB-4 and APRI scores were calculated for all of them. Pelviabdominal ultrasound was done for all subjects included in the study and fibroscan liver elasticity was done for all patients of NAFLD.
Our study showed the following findings:
The mean age of the included subjects was 41.9 years in the NAFLD group and 27.8 years in the control group, with highly significant difference between the two groups (p <0.001) while no statistically significant difference found between both groups regarding sex with (p-value = 0.242)
Also we found that there was statistically significant increase in the percentage of patients with DM and obesity in NAFLD group than control group with p-value 0.023 and <0.001; respectively, while no significant difference between NASH and non NASH (subgroups of NAFLD) regarding demographic data (age & sex) and risk factors (DM & obesity).Our findings showed a highly significant difference in waist circumference in cases against controls (p < 0.001).
Our findings showed highly significant elevation of fasting blood sugar, insulin &HOMA -IR in cases of NAFLD compared to controls (p < 0.001) in the 3 parameters.
Our study showed a highly significant elevation of serum total cholesterol, LDL & triglycrides levels in cases against controls (p = 0.001),while there was a highly significant decrease of HDL in the NAFLD patients compared to controls.
Our findings showed highly significant elevation of both liver transaminases (ALT and AST) in cases compared to controls (p < 0.001).
In the current study, APRI score &FIB-4 score of the studied patients (60 NAFLD) were.89 and 1.73 respectively.
Also in this study, the fibroscsn stages results were
F0: 23patients, F1: 11 patients,F2-3: 12 patients,
F3-4: 10 patients & F4: 4 patients.
In this study, our important parameter plasma PTX3 was found to be higher in patients with NASH (4.97 ng/ml) than in those with a more benign form of NAFLD, namely non-NASH(2.21ng/ml).
Also, higher plasma PTX3 levels were associated with a higher fibrosis grade, although the correlation between plasma PTX3 levels and fibrosis grade was weak.