30Dec 2017

BIOCHEMICAL AND HEMATOLOGICAL PROFILE OF FATTY LIVER PATIENTS FROM WESTERN NEPAL.

  • Department of Internal Medicine, Fishtail Hospital and Research Centre.
  • Department of Laboratory, Fishtail Hospital and Research Centre.
  • Department of Biochemistry, Gandaki Medical College and Teaching Hospital.
  • Department of Clinical Laboratory Science, College of Applied Medical Sciences, Al Jouf University, Saudi Arabia.
Crossref Cited-by Linking logo

  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Background: Fatty liver disease may be the most common liver disease in the world. There are limited studies on biochemical and histological features of fatty liver disease. Different laboratory tests are extremely useful in achieving a better understanding of diseases, and thereby, allow making decision for better management. The examination of different biochemical parameters usually provides excellent clues to the cause of the disease. The rationale of the present study was to demonstrate the changes in biochemical and hematological changes in fatty liver patients compared with control groups. Methods: About 49 patients with fatty liver and 27 healthy control groups from the outpatient clinics of the Internal Medicine Department, Fishtail Hospital and Research Centre Pokhara, Nepal during the period of April 2017 to September 2017 were enrolled in the study. An overnight fasting, blood samples were taken from the patients to analyze the lipid profile, liver function tests, renal function tests FBS, HbA1c and hematological tests Hemoglobin (Hb), WBC and Platelet counts. The anthropometric parameters: waist and hip circumferences were measured, and body mass index (BMI) and waist/hip ratio (WHR), hypertension were calculated and hepatosteatosis through abdominal ultrasonography. Results: With the increased level of triglyceride, total cholesterol, LDL-C had a significantly increasing trend (P<0.05); whereas HDL went down with significant differences between two groups. The levels of alanine aminotransferase (ALT). aspartate transaminase (AST), alkaline phosphatase (ALP) and GGT were noticed significantly difference in the cases as compared to those in the controls(P<0.05). Other biochemical and hematological parameters also noticed significant difference. Conclusions: Most of the patients of fatty liver disease were asymptomatic. The study revealed that fatty liver patients have dyslipidaemia, abnormal liver function tests, FBS, HbA1c and hematological parameters were significantly different than the control group and required special attention. It?s early detection will help in modifying the disease course and delaying further complications.

  1. Mirza MS. Obesity, Visceral Fat, and NAFLD: Querying the Role of Adipokines in the Progression of Nonalcoholic Fatty Liver Disease. ISRN Gastroenterol 2011; 2011: 592404
  2. Chitturi S, Farrell GC. 2001. Etiopathogenesis of nonalcoholic steatohepatitis. Semin Liver Dis 21:27?41.
  3. Rolo AP, Teodoro JS, Palmeira CM. Role of oxidative stress in the pathogenesis of nonalcoholic steatohepatitis. Free Radic Biol Med 2012 Jan 1;52(1):59-69.
  4. Fraser A, Harris R, Sattar N, Ebrahim S, Davey Smith G, Lawlor DA. Alanine aminotransferase, gamma-glutamyltransferase, and incident diabetes: the British Women's Heart and Health Study and meta-analysis. Diabetes Care 2009 Apr;32(4):741-750.
  5. Chitturi S, Farrell GC, George J. Non alcoholic steatohepatitis in the asian pacific region: future shock? J Gastroenterol Hepatol. 2004; 19: 368 ?74.
  6. Maharjan P, Khanal PR, Parajuli NP, Joshi G, Parajuli H, Khanal S, Bhatta B, Pandeya DR. Biochemical changes in Non-alcoholic fatty liver disease (NAFLD): A study in Nepalese Population. ACCLM 2016; 2(2):15-20.
  7. Alcolado R, Arthur MJ, Iredale JP.Pathogenesis of liver fibrosis. Clin Sci (Lond). 1997; 92: 103- 12.
  8. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011; 34:274?85.
  9. Milić S, Stimac D. Nonalcoholic fatty liver disease/steatohepatitis: epidemiology, pathogenesis, clinical presentation and treatment. Dig Dis. 2012; 30:158?62.
  10. Marceau P, Biron S, Hould FS, Marceau S, Simard S, Thung SN, Kral JG. Liver pathology and the metabolic syndrome X in severe obesity. J Clin Endocrinol Metab 1999; 84: 1513-1517.
  11. Pagano G, Pacini G, Musso G, Gambino R, Mecca F, Depetris N, Cassader M, David E, Cavallo-Perin P, Rizzetto M. Nonalcoholic steatohepatitis, insulin resistance and metabolic syndrome: further evidence for an etiologic association. Hepatology 2002;35:367-372.
  12. Marchesini G, Forlani G. NASH: from liver diseases to metabolic disorders and back to clinical hepatology. Hepatology 2002;35:497-49.
  13. Angelico F, Del Ben M, Conti R, Francioso S, Feole K, Maccioni D, Antonini TM, Alessandri C. Non-alcoholic fatty liver syndrome: a hepatic consequence of common metabolic diseases. J Gastroenterol Hepatol 2003;18:588-594
  14. Jamali R, Pourshams A, Amini S, Deyhim MR, Rezvan H, Male?kzadeh R. The upper normal limit of serum alanine amino?transferase in Golestan Province, northeast Iran. Arch Iran Med. 2008;11(6):602?7.
  15. Rocha R, Cotrim HP, Carvalho FM, Siqueira AC, Braga H, Freitas LA. Body mass index and waist circumference in non-alcoholic fatty liver disease. J Hum Nutr Diet. 2005;18(5):365?70.
  16. LaBrecque DR, Abbas Z, Anania F, Ferenci P, Khan AG, et al. World Gastroenterology Organisation global guidelines: Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. J Clin Gastroenterol 2014;48:467‑
  17. Ahmed MH, Byrne CD. Non-alcoholic steatohepatitis. In: Byrne CD, Wild S, ed. Metabolic Syndrome. Chichester, England: Wiley & Sons; 2005:279-303.
  18. Bajaj S, Nigam P, Luthra A, Pandey RM, Kondal D, Bhatt SP, Wasir JS,Misra A. A case-control study on insulin resistance, metabolic covariates & prediction score in non-alcoholic fatty liver disease. Indian J Med Res 2009;129:285-292.
  19. Rakesh Gaharwar, Sushma Trikha, Shubha Laxmi Margekar, Om Prakash Jatav,P Deepak Ganga. Study of Clinical Profile of Patients of Non Alcoholic Fatty Liver Disease and its Association with Metabolic Syndrome. Journal of the association of physicians of india .2015;63:12-16.
  20. Fassio E, Alvarez E, Dominguez N, Landeira G, Longo C. Natural history of nonalcoholic steatohepatitis: a longitudinal study of repeat liver biopsies. 2004;40(4):820?6.
  21. Kral JG, Schaffner F, Pierson RN Jr, Wang J: Body fat topography as an independent predictor of fatty liver. Metabolism, 1993; 42: 548?51
  22. Marchesini G, Bugianesi E, Folari G, Correlli F, and Lenzi M. (2003): Nonalcoholic fatty liver, Steatohepatitis, and the metabolic syndrome. Hepatology (Baltimore, MD).37(4):917-923
  23. Chiang PH, Chang TY, Chen JD. Synergistic effect of fatty liver and smoking on metabolic syndrome.?World J Gastroenterol.?2009;15:5334?9.
  24. Hamaguchi M, Kojima T, Itoh Y et al: The severity of ultrasonographic finding in nonalcoholilic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation. Am J Gastroenterol, 2007; 102: 2708?15
  25. Clark JM. The epidemiology of nonalcoholic fatty liver disease in adults. J Clin Gastroenterol. 2006; 40:5-10.
  26. Leite NC, Salles GF, Araujo AL, et al. Prevalence and associated factors of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus. Liver Int. 2009; 29(1):113-119.
  27. Lizardi-Cervera J, Laparra DI, Ch?vez-Tapia NC, et al. Prevalence of NAFLD and metabolic syndrome in asym-tomatics subjects. Rev Gastroenterol Mex. 2006; 71(4):453-459.
  28. Jin H, Gu Z, Yu C, Li Y. Association of non-alcoholic fatty liver disease with type 2 diabetes: clinical features and independent risk factors in diabetic fatty liver patients. Hepatobiliary Pancreat Dis Int. 2005; 4: 389?392.
  29. Toledo FG, Sniderman AD, Kelley DE. Influence of hepatic steatosis (fatty liver) on severity and composition of dyslipidemia in type 2 diabetes. Diabetes Care. 2006; 29: 1845?1850.
  30. Park SE, Yang HR, Chang JY, et al.: Correlation of body mass index, body fat distribution, aminotranferases and computed romography in obese children with fatty liver. Korean J Pediatr, 2005, 48: 276?283.
  31. Hanley AJ, Williams K, Festa A, Wagenknecht LE, D?Agostino RB Jr,Kempf J, Zinman B, Haffner SM, insulin resistance atherosclerosis study. Elevations in markers of liver injury and risk of type 2 diabetes:the insulin resistance atherosclerosis study. Diabetes. 2004;53:2623?2632.
  32. Shaheen AA, Myers RP. Diagnostic accuracy of the Aspartate aminotransferase to platelet ration index for the prediction of hepatitis C related fibrosis: a systematic review. Hepatalogy 2007;46:912-21.
  33. Suzuki A, Angulo P, Lymp J, Li D, Satomura S, Lindor K. Hyaluronic acid, an accurate serum marker for severe hepatic fibrosis in patients with non-alcoholic fatty liver disease.?Liver Int.?2005;25:779?786.
  34. Kaneda H, Hashimoto E, Yatsuji S, Tokushige K, Shiratori K. Hyaluronic acid levels can predict severe fibrosis and platelet counts can predict cirrhosis in patients with nonalcoholic fatty liver disease.?J Gastroenterol Hepatol.?2006;21:1459?1465.
  35. Eheim A, Medrikova D, Herzig S. Immune cells and metabolic dysfunction. Semin Immunopathol 2014; 36: 13-25
  36. Jiang Y, Zeng J, Chen B. Hemoglobin combined with triglyceride and ferritin in predicting non-alcoholic fatty liver.J Gastroenterol Hepatol 2014; 29: 1508-1514
  37. Mawatari H, Yoneda M, Kirikoshi H, Maeda S, Nakajima A, Saito S. Thrombocytopenia is more severe in patients with chronic hepatitis C than in patients with nonalcoholic fatty liver disease.?J Gastroenterol.?2012;47:606?607.

[Basant Kumar Tamrakar, Amar Nagila, Ezeldine K. Abdalhabib and Dipendra Raj Pandeya. (2017); BIOCHEMICAL AND HEMATOLOGICAL PROFILE OF FATTY LIVER PATIENTS FROM WESTERN NEPAL. Int. J. of Adv. Res. 5 (Dec). 1797-1804] (ISSN 2320-5407). www.journalijar.com

Basant Kumar Tamrakar
Chief consultant physician

DOI:

Article DOI: 10.21474/IJAR01/6149      
DOI URL: https://dx.doi.org/10.21474/IJAR01/6149

Download Full Paper

Download PDF No. of Downloads: 35 | No. of Views: 165