• 한국산학기술학회논문지
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• 제10권6호
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• pp.1414-1423
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• 2009

본 연구는 복부초음파검사를 통하여 얻은 건강진단 결과로부터 지방간 유소견자의 비율을 파악하고, 비만, 간기능 및 고지혈증 지표들과 지방간과의 관련성을 검토할 목적으로 실시하였다. 연구대상은 2006년 7월부터 2007년 6월까지의 기간에 D시의 한 대학병원 건강검진센터에서 종합건강검진을 받았던 30세 이상 남성 772명이었으며, 연구결과, 조사대상자의 지방간 유소견율은 25.5%이었으며, 비만지표(체중, BMI, 체지방율, 허리둘레와 엉덩이둘레 비, 허리둘레와 신장 비), 간기능지표(AST, ALT, GGT) 및 고지혈증지표(TG, TC, HDL-C)들과 유의한 관련성을 갖고 있음을 알 수 있으며, 이는 연령과는 독립적으로 그 관련성이 있는 것으로 나타났다.

• 한방비만학회지
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• 제22권2호
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• pp.158-166
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• 2022

Objectives: The purpose of this meta-analysis was to evaluate the effects of berberine on non-alcoholic fatty liver disease (NAFLD) through a systematic review and meta-analysis. Methods: We searched seven electronic databases for studies through October 2022. All randomized controlled trials (RTCs) of berberine were included. Data extraction and risk of bias assessments were performed by two independent reviewers. The RevMan 5.4.1 program was used for meta-analysis. Results: A total of 279 relevant studies were identified, and 6 eligible RCTs were included to study the efficacy berberine on NAFLD. The six selected trials are studies on the effect between berberine and conventional treatment combined treatment versus conventional treatment. Liver function tests, blood lipid levels, and blood glucose levels were assessed. Combination treatment with berberine, ursodeoxycholate acid, metformin, and monascus purpureus showed statistically significant improvements in liver function levels, blood lipid levels, and blood glucose levels compared to conventional treatment alone. However, there was no significant efficacy of berberine combination dietary, exercise than control group on NAFLD. The meta-analysis results of examining 4 RCTs comparing the therapeutic efficacy of berberine showed statistically significant improvement in the liver function test, blood lipids levels, blood glucose levels. Conclusions: This study suggests that berberine has positive efficacy on blood lipids, blood glucose liver function, fatty liver condition of NAFLD. However, the level of evidence is low because of small effect size,so further investigation is needed.

• 대한방사선기술학회지:방사선기술과학
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• 제35권1호
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• pp.17-23
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• 2012

비알코올성 지방간 질환(NAFLD)은 알코올을 과도하게 섭취하지 않고도 간세포 내에 지방이 축적되어 있는 상태이며, 이는 비만과 밀접한 관련이 있다고 연구되어 지고 있다. 이 연구의 목표는 NAFLD의 위험인자를 파악하여 예방하거나 위험요인을 관리하는데 있다. 이 연구는 2011년 5월 1일부터 10월 31일까지 6개월 동안 진행되었고, 복부초음파 검사를 시행한 83명 중 연구 실험에 적합한 11명을 특별히 심사해서 선정하였다. 연구결과는 다음과 같이 나타났는데 첫째, 체중과 체질량지수에 있어 유의한 감소경향을 나타냈고, 둘째, 초음파 진단 상 지방간 심화정도의 변화에서 유의한 감소경향을 나타났으며, 셋째, 칼로리에 상관없이 꾸준한 운동을 하면 지방간 심화정도가 감소경향을 나타냈다. 따라서, 이 연구에서는 장기적인 운동 프로그램을 적용할 경우에는 지방간 치료에 긍정적인 효과를 나타낼 수 있을 것으로 추론해 본다.

• 한방비만학회지
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• 제7권2호
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• pp.85-94
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• 2007

Objectives The purpose of this study was to investigate the clinical effect of oriental medical obesity therapy on obese patient with non-alcoholic fatty liver disease. We supposed to treat patient 21 years old that had non-alcoholic fatty liver with oriental medical obesity therapy. Methods The patient was treated from the 19th of July to the 22th of August for obesity treatment. And the patient had intensive care through admission treatment from the 19th of July to the 30th of July. Herbal medicine, low calorie and low cholesterol diet, electrolipolysis, auricular acupuncture, aerobic exercise was done during the treatment period. Results His body weight decreased from 107.10㎏ to 98.85㎏. The BMI decreased from 36.2㎏/$m^2$ to 34.5㎏/$m^2$. Abdominal visceral fat tissue decreased from 190.80$cm^2$ to 145.05$cm^2$. AST was decreased from 113 to 45. ALT was decreased from 145 to 40. r-GT was decreased from 123 to 51. Oriental obesity therapy could be effective to treat obese patient with non-alcoholic fatty liver disease. Conclusions The obese patient with non-alcoholic fatty liver disease had improved liver function after oriental obesity treatment.

• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.747-761
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• 1994

Workers' periodic health examination is the main tools used to manage the health problems of most workers in Korea. The most common health problem found in workers' periodic health examination is liver disorder. Liver disorder is also one of the most common health problems in general population and one of the leading causes of mortality in adult population. Regulation proposed by government (No. 207, Ministry of Labor, 1992) defines the criteria for selection of workers with the liver dysfunction for further evaluative examination and the examination items used for diagnosis of the workers with liver dysfunction. This study was designed to evaluate the proficiency of each examination items presently defined in Regulation and propose the optimal examination items for detection of the liver disorders found by workers' periodic health examination. Study subjects are 186 workers with abnormal liver function tests in screening examination of workers' periodic health examination. Questionnaire survey including past history of liver disorder, drinking history, height and weight was done. Physical examination by physician, routine test items defined by Regulation (SGOT, SGPT, $\gamma$-GTP, protein, albumin, total and direct bilirubin, alkaline phosphatase, $\alpha$-feto protein, HBsAg and anti-HBs), anti-HCV antibody test and liver ultrasonography were done. Results are as follows; 1. Result of evaluative examination utilizing only the items defined in Regulation was; There were 75 workers with suspected live. disorder(40.3%), 63 with no liver dysfunction (33.9%), 13 with suspected hepatitis B(7.0%), 10 workers with hepatitis B(5.4%), 10 workers with hepatitis B carrier state(5.4%), 10 with alcoholic liver disorders(5.4%), 5 with fatty liver(2.7%). When alternative diagnostic criteria applying additional examination items (drinking history, body mass index, anti-HCV antibody and ultrasonography) diagnosability of liver disorder was increased. When all four items were included, final results were; 23 workers (17.8%) with hepatitis B (10 carriers, 13 suspects and 10 hepatitis B), 10 (5.4%) with hepatitis C(4 carriers, 5 suspects and 1 hepatitis C), 13(7.0%) with alcoholic liver disorder, 45(24.2%) with fatty liver (40 suspects, 5 fatty liver), 410%) with suspected liver disorders and 44 (23.7%) with normal liver. 2. Of examination items defined by Regulation, only SGOT, SGPT, $\gamma$-GTP and HBsAg were significantly different in abnormal rate and mean value, and all other laboratory findings did not showed significant difference between two groups. Drinking history, body mass index and anti-HCV antibody test which are the items that authors included in this study, also showed significant difference between two groups. Utilization of body mass index (BMI) for abnormal liver function group in diagnosis of fatty liver had high specificity (97.6%) but sensitivity (22.3%) was low. Therefore we suggest that SGOT, SGPT, $\gamma$-GTP, HBsAg, alcohol drinking history, BMI and anti-HCV Ab were useful for diagnosis of liver disorders among worker's periodic health examination.

• Journal of Preventive Medicine and Public Health
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• 제24권2호
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• pp.195-210
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• 1991

Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following ; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are $40{\sim}50's$ in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows ; If the odds ratio of below 29 year of age is 1.0 then that of $30{\sim}39$ is 1.74 (p=0.33), $40{\sim}49$ is 2.47 (p=0.10), $50{\sim}59$ is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of $0{\sim}9$ is 5.08 (p<0.01), $10{\sim}19$ is 12.37 (p<0.01), $20{\sim}29$ is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of $100{\sim}120$ is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below $29{\mu}/1{\gamma}-GT$ is 1.0 then that of $30{\sim}s59$ is 2.11 (p<0.01), $60{\sim}90$ is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then $150{\sim}199$ is 1.49 (p=0.05), $200{\sim}250$ is 1.09 (P=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and nm triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제6권2호
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• pp.174-182
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• 2003

목 적: 지방간은 여러 비만 합병증 중의 하나로 최근 소아 비만이 늘어나면서 그 유병률이 증가하고 있다. 소아에서 지방간은 대부분 양성 경과를 보이지만 일부에서는 지방 섬유화와 지방 간경변으로 진행된 사례도 보고되고 있어서 지방간의 조기 진단과 관리의 필요성이 증가하고 있다. 저자들은 비만아에서 간 효소치의 상승으로 지방간의 동반 유무 및 그 정도를 예측할 수 있는지 알아보고, 비만아에서 지방간을 예측할 수 있는 다른 예측인자에 대해 알아보고자 하였다. 방 법: 2002년 3월부터 2003년 7월까지 예수병원 소아과 비만 클리닉에 내원한 4세부터 16세사이의 환아 중 비만도가 20% 이상인 44례의 환아를 대상으로 하였다. 대상 환아의 비만도, 체질량지수를 측정하였고 체성분 분석, 간 효소치, 혈청 지질 검사 및 복부 초음파 검사를 시행하였다. 결 과: 1) 대상 환아의 평균 연령은 $10.3{\pm}2$세였고 남자는 29례, 여자는 15례였다. 비만도는 경도 비만은 15례(34%), 중등도 비만은 16례(36%), 고도 비만은 13례(30%)였다. 34례에서 복부 초음파를 시행하였는데 지방간이 없는 군은 15%, 경도 지방간은 29%, 중등도 지방간은 47%, 고도 지방간은 9%였다. 2) ALT치의 상승은 지방간이 동반된 비만아에서 89.7%, 지방간이 없는 비만아에서 40%였고, AST/ALT비가 1보다 작은 경우는 지방간이 동반된 비만아에서 96.6%, 지방간이 없는 비만아에서 60%로 지방간의 동반 유무에 따라 유의한 차이를 보였다(p<0.05). 3) ALT치의 상승과 AST/ALT비의 감소는 지방간의 정도와 유의한 상관관계를 보이지 않았다(p>0.05). 4) 지방간 군에서 고콜레스테롤혈증, 고중성지방 혈증이 있는 환아의 수가 비지방간 군에 비해 유의하게 높았으나(p<0.05) 나이, 비만도, 체지방률, 복부비만율, HDL 콜레스테롤, LDL 콜레스테롤과는 유의한 차이를 보이지 않았다(p>0.05). 결 론: 비만아에서 ALT치가 상승하거나 AST/ALT비가 1보다 작은 경우는 지방간의 동반을 예측하는데 유용한 것으로 나타났고 총 콜레스테롤, 중성 지방이 높은 경우 또한 지방간의 예측 인자로 나타났다. 따라서 지방간의 예측 인자가 동반된 비만아에서는 지방간이 동반되어 있을 가능성이 높으므로 비만에 대한 적극적이고 지속적인 관리가 필요할 것으로 생각된다. 그러나 ALT치의 상승과 AST/ALT비의 감소를 통해 지방간의 정도를 예측하는 것은 어려운 것으로 나타나 지방간의 진행정도를 알기 위해서는 초음파 검사 등의 추가적인 검사가 필요할 것으로 생각된다.

• 한국응용과학기술학회지
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• 제10권1호
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• pp.39-47
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• 1993

This study was performed observe the effect of vegetable oil on the liver of 0.5% cholesterol-fed rats. In this experiment, male rats of Sprague-Dawley strain were used. The rats were divided into 5groups which were fed differently either for 8 weeks: basal diet, 20% sunflower oil diet, 20% soybean oil diet, 20% rapeseed oil diet.,20% coconut oil diet. The total cholesterol, triglyceride level in the liver were showed tendency of increase with increasing of P/S ratios. Bile acid excretion in the fecal increased with increasing of P/S ratios. The value of TBA in the serum and liver were increased in proportion to the amount of polyunsaturated fatty acid. The liver fatty acid of coconut-fed group showed larger variation than fatty acid of the cocount oil. The fat chang of sunflower oil diet in the liver showed the largest change.

• Journal of Nutrition and Health
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• 제34권6호
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• pp.626-636
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• 2001

To compare the effect of three kinds of n-3 fatty acids-eicosapentaenoic acid(EPA), docosahexaenoic acid(DHA) and perilla oil (PO)-on serum and liver lipid levels and fatty acid composition of liver phospholipid(PL) at low fat level(5%, w/w), 4-weeks old Sprague-Dawley rats were fed with one of five different oil diets for 4 weeks. Beef tallow(BT) and corn oil(CO) was used as control for sturated or n-6 fatty acid respectively. Se겨m concentrations of cholesterol(TC) and phospholipid(PL) were lower in PO DHA and EPA groups than in BT and CO groups. HDL-cholesterol levels were higher in CO and PO groups than in EPA, DHA and BT groups. Liver PL concentrations were higher in DHA and EPA groups than in CO, PO and BT groups, but liver TC and heal PL and TC concentrations did not show any significant difference among groups. Hepatic fatty acid composition of phosphatidylcholine (PC) and phosphatidylethanolamine (PE), two major phospholipids in liver, reflected their dietary fatty acid composition. In PC and PE, total percentage own-6 series was higher in CO group than in any other groups, and that own-3 series was higher in DHA and PO groups than in EPA, CO and BT groups. Moreover, the ratio of 20 : 4/18 : 2 was lower in PO and DHA groups than in EPA, CO and BT groups. On the contrary, the percentage of C22 : 6 was lower in EPA, CO and BT groups than in PO and DHA groups. These results revealed that n-3 series(EPA, DHA and PO) were more effective in lowering um lipids than n-6 fatty acids or saturated fatty acid. Based on the results of fatty acid composition of hepatic phospholipid, we suggest that the dietary effect of PO and DHA on antiatherogenic characteristics seems to be similar extent. In addition, the effect of EPA might not be significantly different from that of BT or CO in the view of eicosanoids production from the precursor fatty acid. These difference of hepatic fatty acid composition might come from other characteristics of dietary oil as well as the type of unsaturation, not from the carbon chain length or the degree of unsaturation of n-3 fatty acid.

• Journal of Preventive Medicine and Public Health
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• 제30권1호
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• pp.103-128
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• 1997

The object of this study is to evaluate the possibility of chemical-induced liver disorder among workers exposed to various chemicals and to classify the the liver function abnormalities by causes and to analyse the risk factors for each liver disorders. A cross-sectional study including questionnaire survey, physical examination, laboratory tests and ultrasonography of liver was conducted on 1,126 workers, 459 workers in a coal chemical plant(company A) and 667 workers in an insulation material manufacturing factory(company B). An industrial hygienist reviewed the chemicals used in both companies and evaluated the work environments to classify the workers by chemical exposure semiquantitatively. The results are as follows: 1. Of 459 workers in company A, 83 workers(18.1%) are classified as nonexposed, group 163(35,5%) as short-term exposure group, 155(33.8%) as intermediately exposed group and 58(12.6%) as long-term exposed group bared on the mean daily exposure to hepatotoxic chemicals evaluated by an industrial hygienist. Of 667 workers in company B, 484(72.6%) workers were classified as nonexposed and 183(35.5%) as exposed group. 2. Workers with SGOT level higher than 40 IU/l were (10.0%) in company A and 77(11.5%) in company 3, and those with SGPT level higher than 35 IU/l were 118(25.7%) in company A and 198(29.7%) in company B. The differences were not significant between companies and between exposure groups(p>0.05). Workers with $\gamma-GT$ level higher than 62 IU/l were 29(6.3%) in company A and 77(11.5%) in company B (p<0.01). The difference between exposure groups was not significant(p>0.05) within companies. Workers with liver function abnormalities(defined as SGOT higher than 40 IU/l or SGPT higher than 35 IU/l) were 338(30.0%) among 1,126 workers. Of 338 workers with live. function abnormalities 139(12.3%) had fatty liver by ultrasonography, 79(7.0%) had alcoholic liver(defined as workers with liver function abnormalities with weekly alcohol consumption greater than 280 g for more than 5 years), 54(4.8%) had hepatitis B, 12(1.1%) had hepatitis C and the other 114(33.7%) was not otherwise classified. Prevalences of alcoholic liver and fatty liver were significantly lower in company A(prevalence ratio 0.24 for alcoholic liver, p<0.001, prevalence ratio 0.76 for fatty liver, p<0.05) but prevalences of liver disorders between exposure groups within companies were not significant(p>0.05). 3. Summary prevalence ratios(SPR) of live. function abnormalities, fatty live. and other liver disorders, adjusted by age and company were not significantly higher in exposed group in any chemicals(p>0.05) but in some chemicals, SPRs were significantly lower. 4. On simple analysis of risk factors for liver function abnormalities, prevalence odds ratio(POR) of those with age between 30 and 39 was 1.54(p<0.01) and those with age ever 40 was 1.51(p<0.01). POR of those with histories of liver disorders and general anesthesia was 1.77(p<0.001) and 4.02 for those with overweight and 6.23 for those with obesity, defined by body mass index(p<0.001). 5. On logistic regression analysis, risk factors of liver function abnormality were fatty liver(POR 2.92 for grade 1, 12.15 for grade 2), presence of hepatitis B surface antigen(POR 3.62) and obesity(POR 5.38 for overweight and 16.52 for obesity). Presence of hepatitis B surface antigen(POR 0.18) was the only preventive facto. of fatty live. Company(POR 0.30) and obesity(POR 2.49 for overweight, 4.52 for obesity) were related to the alcoholic live. Obesity(POR 2.94 for overweight) was the only significant risk factor of hepatitis B and there was no significant risk factor for liver function abnormality not otherwise classified. It is concluded that the evidence of liver disorder related with chemical exposure is not evident in these factories. It is also postulated that fatty liver and alcoholic liver is most common causes of liver function abnormalities among workers and effort for weight control and improvement of life style should be done.