Objective To systematically review the effect of intermittent fasting on non-alcoholic fatty liver disease (NAFLD). Methods The PubMed, EMbase, Web of Science, Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect studies on the effect of intermittent fasting on NAFLD from inception to October 1, 2022. Two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. R software was then used for meta-analysis. Results A total of 7 studies were included. The results of meta-analysis showed that intermittent fasting could reduce liver fibrosis (MD=?0.93, 95%CI 1.67 to 0.19, P<0.05), the levels of glutamic oxaloacetic transaminase (MD=?8.96, 95%CI ?11.83 to ?6.10, P<0.05), glutamyl transpeptidase (MD=?7.86, 95%CI ?12.00 to ?3.73, P<0.05), and inflammatory molecules (MD=?2.03, 95%CI ?3.69 to ?0.36, P<0.05). In addition, it reduced dietary (total energy) intake (MD=?255.99, 95%CI ?333.15 to ?178.82, P<0.05), body weight (MD=?2.42, 95%CI ?3.81 to ?1.02, P<0.05), BMI (MD=?0.52, 95%CI ?0.92 to ?0.13, P<0.05) and fat mass (MD=?2.37, 95%CI ?4.17 to ?0.57, P<0.05). Conclusion Current research evidence shows that intermittent fasting can improve NAFLD and help patients lose weight. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo expounded the relationship between phenylalanine, tyrosine and their metabolites and non-alcoholic fatty liver disease (NAFLD). MethodThe literatures related to NAFLD in recent years were reviewed and analyzed. ResultThe levels of phenylalanine, tyrosine and their metabolites had changed significantly in the occurrence and development of NAFLD, and could lead to the progress of NAFLD by affecting the related pathways of lipid metabolism. ConclusionPhenylalanine, tyrosine and their related metabolites are associated with NAFLD, but the specific pathogenesis is still unclear.
Objective To explore the relationship between different diagnostic criteria (ATPIII2002, IDF2005 and CDS2007 criteria) for metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD). Methods A total of 666 elderly males admitted to West China Hospital for routine physical examination were involved in this study in May, 2010. The diagnostic agreement rates of different criteria were compared, along with the relationship between different diagnostic criteria for MS and NALFD. Results The diagnostic agreement of CDS2007 criteria with either IDF2005 or ATPIII2002 criteria was good. However, the agreement of ATPIII2002 with IDF2005 was compromised. The prevalence of NAFLD in MS group was significantly higher than that of non-MS group (Plt;0.01). On the basis of CDS2007 criteria, there was significant correlation between NAFLD and MS (Plt;0.000). Conclusion There is a close relation between NAFLD and all three diagnostic criteria of MS. NAFLD is one of the most important risk factors of MS. The diagnostic agreement of CDS2007 criteria with the other two is good, and there is significant correlation between NAFLD and criteria CDS2007 of MS. CDS2007 is found to be of high accuracy and applicability in the diagnosis of MS in Chinese population including the elderly.
ObjectiveTo investigate the diagnostic value of spectral saturation inversion recovery, gradient-echo chemical shift MRI， and proton magnetic resonance spectroscopy in quantifying hepatic fat content. MethodsConventional T1-weighted and T2-weighted scanning (without fat saturation and with fat saturation)， gradient-echo T1W in-phase （IP） and opposedphase （OP） images and 1H-MRS were performed in 31 healthy volunteers and 22 patients who were candidates for liver surgery. Signal intensities of T1WI amp; T1WIFS (SInonfat1, SIfat1), T2WI amp; T2WI-FS (SInonfat2, SIfat2), and IP amp; OP (SIin, SIout) were measured respectively, the relative signal intensity one (RSI1), relative signal intensity two (RSI2)， and fat index (FI) were calculated. Peak values and the area under peak of 1H-MRS were measured, and the relative lipid content of liver cells (RLC ) were calculated. Twenty-two patients accepted liver resection and histological examination after MRI scanning, the proportion of fatty degenerative cells were calculated by image analysis software. Results①Hepatic steatosis group showed higher average values of RSI1, FI， and RLC to non-hepatic steatosis group (Plt;0.05), while there was no significant difference in RSI2 between two groups (Pgt;0.05). ②There was a statistical significant difference in RLC among different histopathological grades of hepatic steatosis, and RLC increased in parallel with histopathological grade (Plt;0.05).There was no significant difference in RSI2, RSI1, and FI among different histopathological grades, although the latter two had a tendency of increasing concomitant with histopathological grade (Pgt;0.05). ③The values of FI and RLC were positively correlated with the PFDC （r=0468, P=0.027； r＝0771， Plt;0.000 1）, while they were not in RSI1 and RSI2 (r=0.411, P=0.057； r=0.191, P=0.392). ConclusionsSPIR, Gradient-echo chemical shift MRI and 1H-MRS can help to differentiate patients with hepatic steatosis from normal persons, the latter also can help to classify hepatic steatosis. In quantifying hepatic fat content, 1H-MRS is superior to gradient-echo chemical shift MRI, while SPIR’s role is limited.
目的 觀察羅格列酮鈉對血糖控制未達標的2型糖尿病（T2DM）合并與不合并非酒精性脂肪肝（NAFL）患者的降糖療效和安全性。 方法 2009年1月－2011年1月60例僅用磺脲類和二甲雙胍治療血糖控制未達標的T2DM患者，按合并和不合并NAFL分為觀察組和對照組各30例，兩組均在原口服降糖藥基礎上聯合加用國產羅格列酮鈉4 mg 1次/d，治療共3個月，觀察治療前后的血糖、胰島素、糖化血紅蛋白（HbA1c）、體質量指數（BMI）、血脂、肝功、血壓水平以及藥物不良反應，并比較治療后的血糖達標率。 結果 兩組患者治療后的空腹血糖（FPG）、餐后2 h血糖（2hPG）、HbA1c、空腹胰島素、甘油三酯和極低密度脂蛋白膽固醇均較治療前下降，高密度脂蛋白膽固醇較治療前升高（P＜0.05），而丙氨酸轉氨酶、總膽固醇、低密度脂蛋白膽固醇及血壓無明顯變化（P＞0.05），但觀察組治療后的FPG和2hPG均較對照組下降更明顯（P＜0.01），且血糖達標率為73.3%，顯著高于對照組的46.7%（P＜0.05），同時觀察組餐后2 h胰島素（2hINS）水平在治療前后均明顯高于對照組而且治療后有顯著下降（P＜0.01），但對照組治療后2hINS雖然也有下降但無統計學意義（P＞0.05）。觀察組治療前后BMI無明顯變化，但對照組治療后BMI有明顯的升高（P＜0.05）。結論 國產羅格列酮鈉片對血糖控制未達標的T2DM合并和不合并NAFL患者均有進一步降低血糖、HbA1c以及改善血脂的作用，但對T2DM合并NAFL的患者的降糖療效更顯著，未見加重肝功能損壞，不良反應小，可作為此類患者聯合用藥的一種選擇。
Objective To evaluate the value of medical imaging technology in qualitative and quantitative diagnosis of liver steatosis. Methods To describe the current status and advancement s of medical imaging technology such as sonography , CT and MRI in qualitative and quantitative diagnosis of liver steatosis , and to cont rast their advantages and shortages. Results Sonography could be used as the primary screening and evaluate measures in qualitative and quantitative diagnosis of liver steatosis , and CT was more reliable in quantitative diagnosis , MRI had significant improving with its high sensitivity and specificity. Conclusion Medical imaging technology has significant clinical value in qualitative and quantitative diagnosis of liver steatosis , especially with the help of functional MR imaging techniques such as spect roscopy and chemical shif t Gradient-Echo technic.
摘要:目的：探討成都地區體檢人群中丙氨酸氨基轉移酶（ALT）升高率與其升高的相關因素,為正確分析引起ALT升高的原因提供相關依據。方法:以參與體檢的8734名體檢人群為研究對象,收集身高、體重、血壓、丙氨酸氨基轉移酶、空腹血糖、高密度脂蛋白、低密度脂蛋白、總膽固醇、甘油三酯、血清HBsAg、脂肪肝及膽石癥等相關資料進行分析。結果:在全部體檢人群中,ALT升高率為1011%,男性ALT升高率為13.70%,女性ALT升高率為6.30%,男性明顯高于女性（Plt;0001）；ALT升高組的年齡均數小于ALT正常組（Plt;0001）；在ALT升高的受檢者中,脂肪肝、高脂血癥、肥胖、糖尿病、膽囊結石、飲酒及乙肝等患病率均高于ALT正常組受檢者（Plt;005）。結論:脂肪肝、糖脂代謝紊亂及乙肝是體檢人員ALT升高的主要原因；男性和低齡也是體檢者ALT升高的危險因素。Abstract: Objective: To investigate the prevalence and relative factors of elevated serum alanine aminotransferase(ALT) levels and providescientific bases for its causes analysis in physical examination people in Chengdu. Methods: Subjects who received medical examination in physical examination center of west China hospital were screened in this study. The information of height, body weight, blood pressure, serum ALT, fasting plasma glucose, highdensity lipoprotein cholesterol, lowdensity lipoprotein cholesterol, total cholesterol, triglyceride, hepatitis B surface antigen (HBsAg) statue, fatty liver and cholelithiasis were collected and analyzed. 〖WT5”HZ〗Results:〖WT5”BZ〗 A total of 8734 cases were included in this study. The total prevalence of elevated ALT was observed in 1011%, including 137% in man and 63% in woman, and this difference between man and woman was statistic significant (P＜0001). The mean age of ALT elevated group was obvious lower than that of normal ALT group (P＜0001). Interesting, the occurrence rates of fatty liver, hyperlipidemia, obesity, diabetes,gallstones, drinking and positive hepatitis B surface antigen in ALT elevated group were all significant higher than that in normal ALT group (P＜005). Conclusion: Fatty liver, glyeolipid metabolism disorder, and hepatitis B were main reasons of elevated ALT. Male and young cases were both high risk of elevated ALT in this study.
ObjectiveTo investigate the value of proton magnetic resonance spectroscopy (1H-MRS), gradient dual-echo, and triple-echo sequences in the quantitative evaluation of treatment effect of fatty liver at 3.0T MR.MethodsThirty patients with fatty liver diagnosed by CT or ultrasound who admitted in Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital between August 2017 and May 2018, were enrolled and undergone gradient dual-echo, triple-echo, and 1H-MRS examination before and 3 months after treatment. The fat index (FI) and relative lipid content (RLC) were measured. Fatty liver index (FLI) was calculated from blood biochemical indicators, waist circumference, and BMI at the same time. With the reference standard of FLI, the results before and after treatment measured from MRI were analyzed.ResultsThere were significantly differences of FLI, FIdual, FItriple, and RLC before and after treatment (t=5.281, P<0.001; Z=–3.651, P<0.001; Z=–3.630, P<0.001; Z=–4.762, P<0.001), all indexes decreased after treatment. FIdual and FItriple were positively correlated with FLI before (rs=0.413, P=0.023; rs=0.396, P=0.030) and after treatment (rs=0.395, P=0.031; rs=0.519, P=0.003), the highest correlation factor was FItriple to FLI after treatment. There were no significant correlation between RLC and FLI before and after treatment (P>0.05).ConclusionsIt is feasible to quantitatively evaluate the treatment effect of fatty liver by using 1H-MRS, gradient dual-echo, and triple-echo sequences. Gradient triple-echo sequences has better accuracy, which is technically easy to implement and more suitable for clinical development.
摘要:目的:通過建立高脂血癥脂肪肝動物模型,探討杜仲葉醇提取物(alcohol extractive of Folium Eucommiae,AEFE)對脂肪肝的防治作用。方法:高脂飲食8周加維生素D36×105IU/kg分3d腹腔注射，建立大鼠高脂血癥脂肪肝動物模型。各給藥組從造模第3周開始分別灌胃給予洛伐他汀(4mg·kg-1·d-1)、 AEFE(70、140和420mg·kg-1·d-1),共給藥6周。各組每天灌服等量生理鹽水，灌胃容積為0.5mL/100g體重。結果:AEFE用藥6周后顯示,各劑量組血清膽固醇、甘油三酯和游離脂肪酸、谷丙轉氨酶和谷草轉氨酶均較模型組明顯降低(Plt;005),肝組織丙二醛含量降低和超氧化物歧化酶活性升高,肝脂肪變性和炎癥反應減輕,尤以中劑量組作用最明顯(Plt;001)。AEFE對肝內腫瘤壞死因子α濃度無明顯影響。結論:AEFE改善高脂性大鼠肝臟脂肪變性,此作用可能與其降血脂、抗氧化損傷有關。