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Query: UMLS:C0015695 (
fatty liver
)
13,941
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The influence of moderate obesity on the liver was assessed in 4613 male company employees including 534 moderately obese subjects (30-50 percent
overweight
). Serum levels of transaminases and gammaglutamyl transferase activities were significantly higher in moderately obese male non-drinkers than in non-obese non-drinkers. Twenty-four percent of male non-drinkers with moderate obesity had abnormal levels of sGPT and 47 percent of moderately obese male non-drinkers had significant
hepatic steatosis
as assessed by computed tomography. Although most previous studies on this subject were concerned with morbid obesity accompanying only those of more than 50 percent
overweight
or those who required surgery, the results of this study clearly indicate that moderately obese subjects also have frequent liver dysfunction.
...
PMID:Liver function in moderate obesity--study in 534 moderately obese subjects among 4613 male company employees. 287 56
The features on computed tomographic (CT) scans of nonalcoholic
fatty liver
were investigated in 24 patients with nonalcoholic
fatty liver
related to
overweight
. CT examinations were performed before and after 3 months of a low-calorie diet. The reversibility of fatty infiltration during diet therapy could be monitored by changes in appearance on repeated CT scans.
Hepatic steatosis
improved, as assessed from increases in attenuation values on CT scans after 3 months of the diet, and the improvement was accompanied by a decrease in the elevated serum glutamic-pyruvic transaminase activity. Hepatic fatty infiltration in these patients was not always uniform, and attenuation values in the right lobe of the liver were significantly lower than those in the left lobe. After the 3-month diet therapy, the mean liver volume was significantly reduced, while the spleen volume was unchanged. Two sequential CT examinations, performed before and after diet therapy, may be useful for evaluating obese patients with elevated serum transaminase activity.
...
PMID:Obesity-related nonalcoholic fatty liver: CT features and follow-up studies after low-calorie diet. 380 3
We report on clinical, nutritional, and hepatic histological findings in 50 non-selected obese subjects (mean
overweight
+74%; range +21-138%). The pathogenesis of the liver damage was assessed with the help of multidimensional analysis of a number of clinical variables. According to the severity of the hepatic lesions, the patients have been ranged in five groups: O (normal liver) 10%; I (
fatty liver
) 48%; II (fatty hepatitis) 26%; III (fatty fibrosis) 8%; IV (fatty cirrhosis) 8%. The more severe changes (groups III and IV) were constantly associated with excessive alcohol intake. The multidimensional analysis was unable to find a relationship between obesity and the development of fibrosis and cirrhosis whereas it showed that: (a) there was a highly significant correlation between the daily ethanol intake and the degree of
overweight
, (b) severe fatty metamorphosis was significantly associated with the degree of
overweight
, the existence of diabetes mellitus, and the amount of alcohol and fat intake, (c) nutritional factors, in particular deficient protein intake, have only an accessory effect in the development of mild inflammation and fibrosis, (d) the consumption of potentially hepatotoxic drugs, very high in the obese (about five drugs per day) could have a role in the development of cirrhosis. In conclusion in our study, there was no evidence that obesity per se could result in severe liver damage.
...
PMID:Liver in obesity. 396 30
Blood glucose, serum insulin, C-peptide, free fatty acids and growth hormone were evaluated in 45 patients with histologically established
hepatic steatosis
after an oral glucose load (100 g). Glucose tolerance was impaired in 59 per cent of the patients. Significantly increased levels were found for blood glucose (fasting and after 60 and 120 min), insulin (after 60, 120 and 180 min), C-peptide (fasting and after 60, 120 and 180 min), and free fatty acids (fasting and after 60 and 120 min). Human growth hormone levels were not altered. After glucose administration the C-peptide/insulin ratio was significantly reduced in
hepatic steatosis
compared to controls. In patients with
hepatic steatosis
there were no differences between subjects with normal body weight or
overweight
nor between stadium I and stadium II ('alcoholic
hepatic steatosis
') concerning glucose, insulin, C-peptide, HGH and FFA levels in blood. We conclude, that
hepatic steatosis
is associated with relative insulin resistance to which elevated FFA may contribute. In addition, the decreased C-peptide/insulin ratios suggest an impaired hepatic insulin degradation as it was already described for more serious liver diseases.
...
PMID:Hyperinsulinemia in hepatic steatosis. 674 19
To test the hypothesis that
fatty liver
coexists with other metabolic abnormalities of the insulin resistance syndrome, and responds to their amelioration, we prospectively studied 48 consecutive patients with chronically elevated liver enzymes and clinical, ultrasound and histological findings consistent with fatty infiltration of the liver. Most of the patients were
overweight
or obese (64%) with increased waist circumference which closely relates to visceral fat. Only 10% of the patients had normal glucose tolerance: 44% had diabetes mellitus, 29% impaired glucose tolerance, and 17% were hyperinsulinaemic. The most common dyslipidaemia found was hypertriglyceridaemia and/or low HDL-C (86%). Dietary intervention and follow-up (median 24 months), supplemented by oral hypoglycaemic or lipid-lowering drugs as needed, resulted not only in weight loss (mean 3.7 kg), decreased fasting blood glucose (p < 0.005) and improvement in serum lipid profile (p < 0.02 for both triglycerides or HDL-C) but also in an improvement of serum liver enzymes in 96%, which became normal in more than half of the patients. Thus,
fatty liver
was strongly associated with many features of the insulin resistance syndrome, and follow-up revealed a high potential for reversibility and a benign course.
...
PMID:Fatty liver--an additional and treatable feature of the insulin resistance syndrome. 1020 58
There is no established treatment for steatohepatitis in patients who are not alcoholics. This disease is a potentially progressive liver disease associated with hepatic insulin resistance. Only a weight-reducing diet in
overweight
patients has proved effective. We treated 20 patients who had steatohepatitis but were not alcoholics with metformin (500 mg three times a day for 4 months), an agent that improves hepatic insulin sensitivity. When compared with the six individuals not complying with treatment, long-term metformin significantly reduced mean transaminase concentrations, which returned to normal in 50% of actively-treated patients. Also, insulin sensitivity improved significantly and liver volume decreased by 20%. Similar data have been reported in insulin-resistant ob/ob mice with
fatty liver
. A randomised-controlled study is needed.
...
PMID:Metformin in non-alcoholic steatohepatitis. 1183 Feb 32
Obesity is the most prevalent and serious nutritional disease among western countries and is rapidly replacing undernutrition as the most common form of malnutrition in the world. Approximately 300,000 deaths a year are currently associated with
overweight
and obesity, second only to cigarette smoking as a leading cause of preventable death in the United States. Obesity effects 9 organ systems and is a risk factor for gastroesophageal reflux disease, nonalcoholic
fatty liver
disease, cholelithiasis, and colon cancer. Evidence-based guidelines on the identification, evaluation, and treatment of
overweight
and obesity have recently been developed by the National Institutes of Health to help practitioners effectively manage their patients. The body mass index is used to classify weight status and risk of disease. Treatment for obesity includes lifestyle management, consisting of diet therapy, physical activity, and behavioral modification, and may include pharmacotherapy or surgery based on level of risk. Currently only 2 medications, sibutramine and orlistat, are approved for long-term use. An initial weight loss of 10% of body weight achieved over 6 months is a recommended target. This article reviews the evaluation and management of the adult obese patient.
...
PMID:Medical management of obesity. 1223 Mar 15
Living donor liver transplantation allows an increasing number of patients with end-stage liver disease the opportunity for effective treatment in the face of a critical shortage of cadaveric organs.
Hepatic steatosis
decreases functional graft mass and may contribute to graft dysfunction. Screening liver biopsy allows accurate quantitation of hepatic fat, but is an invasive procedure that is not universally employed in the evaluation of living donors. We studied 100 consecutive prospective right lobe living donors, all evaluated with liver biopsy, imaging studies, and various clinical parameters. The accuracy and predictive value of body mass index (BMI) and imaging were compared with biopsy in determining the amount of hepatic fat. There were no complications to biopsy, with 33% showing some degree of steatosis. BMI correlated only weakly with biopsy, with 73% of
overweight
(BMI > 25) donors having little or no hepatic fat. Imaging was only 12% sensitive to small amounts (5% to 10%) of fat, with increasing sensitivity to more severe steatosis. Imaging diagnosed steatosis in 2 donors without hepatic fat and failed to identify a candidate denied with biopsy-proven 30% steatosis. Conversely, 9% of candidates with BMIs of 25 or less had 10% or greater steatosis. Moreover, three candidates were denied surgery because biopsy detected occult liver disease. Accurate quantification of hepatic fat is not afforded by BMI and imaging studies alone. Screening liver biopsy has a low complication rate and may serve to increase donor safety. Biopsy is essential in identifying donor grafts at risk for poor recipient outcome while maximizing the donor pool.
...
PMID:One hundred consecutive hepatic biopsies in the workup of living donors for right lobe liver transplantation. 1247 50
Non-alcoholic steatohepatitis (NASH), is a critical link in the chain of metabolic
fatty liver
disorders that spans steatosis to cryptogenic cirrhosis. It is the hepatic manifestation of the insulin resistance (or metabolic) syndrome, and provides a clue to understanding fibrotic progression of other chronic liver diseases, particularly hepatitis C. Non-alcoholic steatohepatitis is often the first clinical indication of insulin resistance, with its complications of high blood pressure, coronary heart disease and type 2 diabetes. Among those with risk factors, NASH is common: present in at least 20% of obese adults or children with or without type 2 diabetes, and at least 5% of those
overweight
. With emerging urbanization, increasing affluence and behavioral changes of physical inactivity and high fat/energy-excessive diet, type 2 diabetes has become common in Asia and the western Pacific rim. The rates range from 7-40%, which in countries like Japan represents a 3-20-fold increase (depending on age) over the last 20 years. The increase is associated with central adiposity, insulin resistance,
hepatic steatosis
and NASH. After cancer, cirrhosis from NASH is now the second most common age-related cause of death in type 2 diabetes. Reversing these trends must become a public health priority; the first awakenings were evident in Taiwan at the time of this meeting. In order to stimulate clinicians to think more about the importance of metabolic liver disease for development of cirrhosis, this review will cover clinical and laboratory features, natural history and an approach to diagnosis and management of NASH. Some emerging concepts on pathogenesis will be mentioned briefly, but the emphasis will be on the potency of lifestyle adjustments (physical activity and diet) to prevent or reverse
fatty liver
disorders.
...
PMID:Non-alcoholic steatohepatitis: what is it, and why is it important in the Asia-Pacific region? 1254 95
Nonalcoholic fatty liver disease is a condition gaining increasing recognition as a cause of cirrhosis and end-stage liver disease. The condition appears identical to alcoholic liver disease histologically, yet occurs in patients with negligible alcohol intake. Nonalcoholic fatty liver disease covers a spectrum of diseases ranging from simple fatty deposition in the liver to fat and inflammation and finally to fibrosis and cirrhosis. Conditions most frequently found in association with nonalcoholic
fatty liver
disease include obesity, Type 2 diabetes, and hyperlipidemia. Although the exact etiology of nonalcoholic
fatty liver
disease is not clear, insulin resistance is thought to play an important factor. Patients typically present with asymptomatic serum aminotransferase elevations of 2-3 times normal. Symptoms may include fatigue and abdominal pain. The clinical course is difficult to predict due to a lack of research in the natural history of the disease. It is known a percentage of patients progress to end-stage liver disease and may require liver transplantation. No medical treatment has been found to be totally effective. Patients who are
overweight
or obese should be encouraged in gradual weight reduction that has been associated with improvement in liver test abnormalities.
...
PMID:Nonalcoholic Fatty liver disease. 1292 Apr 29
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