Vol 1 No 1 (2018): Current Issue
Research

Hepatic and Systemic Effect of Non-Alcoholic Fatty Liver Disease Severity in Obese and Non-Obese Indian Patients

Baibaswata Nayak
Department of Gastroenterology, Pathology, NMR and Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Suraj Kumar Nongthombam
1Department of Gastroenterology, Pathology, NMR and Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Bio
Neelanjana Roy
Department of Gastroenterology, Pathology, NMR and Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Neeti Nadda
Department of Gastroenterology, Pathology, NMR and Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Anand Kumar
Department of Gastroenterology, Pathology, NMR and Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Krishnendu Mondol
Department of Gastroenterology, Pathology, NMR and Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Virendra Kumar
Department of NMR, All India Institute of Medical Sciences, New Delhi, India
Prasenjit Das
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
Perumal Vanamail
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Shalimar
Department of Gastroenterology, Pathology, NMR and Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Subrat Kumar Acharya
Department of Gastroenterology, Pathology, NMR and Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Published December 25, 2018
Keywords
  • NAFLD,
  • Obesity,
  • Insulin resistance,
  • Adipokine,
  • Cytokines,
  • Oxidative stress
  • ...More
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Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is now predominant globally due to increased sedentary lifestyle and obesity. Recently, high prevalence of NAFLD also has been documented in non-obese individuals with increased risk of cirrhosis and hepatocellular carcinoma. The systemic and hepatic manifestations of NAFLD severity in obese and non-obese Indian patients are not clear.
Methods: The clinically diagnosed NAFLD patients (n=54, non-obese and obese) were assessed for liver injury and hepatic fat content by histopathology, Fibroscan and MRS. Liver biopsy and hepatic venous sampling were performed by trans-jugular approach and mRNA expression was assessed by real-time PCR.
Result: High liver fat content (LFC, 20. 4 ± 10. 4%, 16 ± 11. 5% and 9. 34 ± 15. 4%) and increased abdominal obesity (WHR, 1. 03 ± 0. 06, 0. 97 ± 0. 05 and 0. 93 ± 0. 06) was observed in both obese and non-obese NAFLD patients as compare to disease control. Histopathological examination of liver indicated increased fibrosis (grade ≥ 1) in both obese (76%) and non-obese (64%) group. Significant increased levels of LBP, MDA and adipokines levels (p < 0. 001) were observed in hepatic and systemic circulation of obese and non-obese groups than healthy and diseased controls. A positive correlation of biomarkers for liver injury was found between hepatic and systemic circulation. Hepatic gene expression of adipokines and cytokines also corroborated this trend among groups.
Conclusion: The extent of liver injury is quite high in both non-obese and obese NAFLD patients. The drivers of injury in these patients are due to hepatic fat and SIBO induced endotoxin mediated up-regulation of proinflammatory adipocytokines and oxidant stress in liver.