• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.5
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• pp.443-454
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• 2021

Purpose: Due to the increasing prevalence of obesity worldwide, non-alcoholic fatty liver disease (NAFLD) has reached epidemic dimensions over time. NAFLD is the most common cause of childhood chronic liver disease. There is a relationship between NAFLD and oxidative stress. This study aims to investigate the changes in thiol/disulfide homeostasis parameters to determine the oxidant/antioxidant balance in obese rats with diet-induced NAFLD and healthy rats. Methods: Twelve Wistar albino rats were used in this study. Experimentally produced NAFLD obese rats (n=6) and healthy rats were compared. Experimental NAFLD model was created with a special fatty liver diet (Altromin^® C1063, Fatty Liver Diet, Exclusivet, Lage, Germany). The biochemical and histopathological features of the groups, as well as serum thiol/disulfide homeostasis parameters, were analyzed and compared. Results: In the experimentally induced NAFLD rat model, they gained more weight than the control group. Steatosis (at least grade 2) occurred in all rats fed with special fatty liver diet for 12 weeks. Histopathologically, no high-grade inflammation was observed in rats with experimental NAFLD after feeding a diet for 12 weeks. Results revealed that aspartate transaminase and alanine transaminase levels were high, albumin levels were low, oxidant stress parameters increased, and antioxidant thiol groups decreased. Conclusion: Experimental NAFLD is characterized by increased oxidant stress accompanying fatty tissue in the liver. Analysis of thiol/disulfide homeostasis parameters in NAFLD can be used in further studies to develop effective treatment options.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.184-190
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• 2022

Objectives: This study aims to report the clinical efficacy of Korean medical treatment of a patient with nonalcoholic fatty liver disease accompanied by obesity and dyslipidemia. Methods: A 52-year-old man with nonalcoholic fatty liver disease, obesity, and dyslipidemia was treated with Saenggangunbi-tang extract from November 3, 2021 to January 8, 2022. During the treatment period, the patient also undertook exercise and maintained a hypocaloric diet to reduce body weight. Changes were observed in the patient's symptoms, laboratory findings, such as liver enzymes and lipid profiles, and bioelectrical impedance analyzer results. Results: After taking Saenggangunbi-tang extract for approximately two months, with concomitant adjustments to exercise and diet, the serum levels of liver enzymes and triglyceride were decreased and the patient's body weight, body mass index, hepatic steatosis index, and visceral fat area were also reduced. In addition, symptoms including fatigue and dyspepsia improved. Conclusion: This study suggests that Saenggangunbi-tang extract with exercise and a regulated diet could be a helpful treatment strategy for managing nonalcoholic fatty liver disease with metabolic disorders.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.2
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• pp.74-78
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• 2012

With a markedly increased prevalence of obesity, non-alcoholic fatty liver disease (NAFLD) now becomes the most common cause of chronic liver disease in both adults and children. The etiology and pathogenesis of NAFLD are multifactorial and remain incompletely understood. According to the "two-hit" theory, inflammatory cytokines and adipokines are activated by oxidative stress and they are involved in insulin resistance, necroinflammatory steatohepatitis and fibrosis. This review discusses the latest updates on the role of some of important inflammatory adipokines and cytokines in the pathogenesis of NAFLD with an emphasis on their potential therapeutic implications.

• Biomolecules & Therapeutics
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• v.21 no.4
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• pp.264-269
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• 2013

Silymarin has been introduced fairly recently as a hepatoprotective agent. But its mechanisms of action still have not been well established. The aim of this study was to make alcoholic fatty liver model of rats in a short time and investigate silymarin's protective effects and possible mechanisms on alcoholic fatty liver for rats. The model of rat's alcoholic fatty liver was induced by intragastric infusion of ethanol and high-fat diet for six weeks. Histopathological changes were assessed by hematoxylin and eosin staining (HE). The activities of alanine transarninase (ALT) and aspartate aminotransferase (AST), the levels of total bilirubin (TBIL), total cholesterol (TC) and triglyceride (TG) in serum were detected with routine laboratory methods using an autoanalyzer. The activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx) and the level of malondialdehyde (MDA) in liver homogenates were measured by spectrophotometry. The TG content in liver tissue was determined by spectrophotometry. The expression of nuclear factor-${\kappa}B$ (NF-${\kappa}B$), intercellular adhesion molecule-1 (ICAM-1) and interleukin-6 (IL-6) in the liver were analyzed by immunohistochemistry. Silymarin effectively protected liver from alcohol-induced injury as evidenced by improving histological damage situation, reducing ALT and AST activities and TBIL level in serum, increasing SOD and GPx activities and decreasing MDA content in liver homogenates and reducing TG content in liver tissue. Additionally, silymarin markedly downregulated the expression of NF-${\kappa}B$ p65, ICAM-1 and IL-6 in liver tissue. In conclusion, Silymarin could protect against the liver injury caused by ethanol administration. The effect may be related to alleviating lipid peroxidation and inhibiting the expression of NF-${\kappa}B$.

• The Journal of Internal Korean Medicine
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• v.35 no.2
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• pp.184-194
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• 2014

Objectives : This study was designed to investigate the effect on lipoapoptosis of Alisma orientale extract against free fatty acid-induced cellular injury. Methods : HepG2 cells were used in an vitro model. HepG2 cells were treated with free fatty acids to generate a cellular model of nonalcoholic fatty liver disease (NAFLD). Using this cellular model, the anti-apoptotic effect and reducing steatosis of Alisma orientale extract against free fatty acid-induced cellular injury was evaluated by measuring steatosis and apoptosis. Results : Alisma orientale extract significantly attenuated free fatty acid-induced intracellular steatosis. Alisma orientale extract inhibited free fatty acid-mediated activation of pJNK, PUMA, BAX, caspase-3, and -9, and apoptotic kinases that are correlated with NAFLD. Alisma orientale extract also promoted Bcl-2, a anti-apoptotic protein. Conclusions : From the above, the Alisma orientale extract decreased the hepatocyte steatosis and showed the hepatocelluar protective effect by the regulation of apoptosis-related protein. It proposes the possibility of Alisma orientale extract to the treatment of nonalcoholic fatty liver disease in clinics.

• Journal of Korean Biological Nursing Science
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• v.15 no.2
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• pp.43-53
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• 2013

Purpose: This study was intended to analyze the types and measurement parameters of non-pharmacological interventional studies for nonalcoholic fatty liver disease (NAFLD). Methods: NAFLD related literatures were systematically reviewed. The existing literatures were searched electronically using the data base of PubMed, a Medline data base of the National Library of Medicine with the key words of nonalcoholic fatty liver disease, NAFLD, nonalcoholic steatohepatitis, and NASH. The criteria for inclusion in this review were 1) non-pharmacological intervention, 2) human, 3) English. Finally, 20 articles were included in the review. Results: The major findings of this study were as follows: 1) the types of non-pharmacological intervention were exercise (35%), caloric restriction (30%), and lifestyle modification with combination both of exercise and caloric restriction (35%), 2) Almost all studies adopted various measurement parameters derived from pathophysiological mechanism-based biomarkers such as anthropometric indices, biochemical parameters, body fat mass, and liver biopsy results. Conclusion: Non-pharmacological interventions have been reported to be effective to improve NAFLD status, and many objective biomarkers confirmed supported these findings. Therefore, the development of nursing interventions for NAFLD subjects is needed and the consideration of using mechanism-based biomarkers is suggested to verify nursing outcomes objectively.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.2
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• pp.187-196
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• 2021

Purpose: The rising prevalence of childhood obesity in the past decades has caused non-alcoholic fatty liver disease (NAFLD) to become the most common cause of pediatric chronic liver disease worldwide. This study was aimed at determining the effect of vitamin D (Vit D) on ultrasonography and laboratory indices of NAFLD and some blood biochemical indicators in children. Methods: In this interventional study liver ultrasonography was performed in 200 children with overweight and obesity. A 108 had fatty liver among which 101 were randomly divided into two groups of study (n=51) and control (n=50). The study group was treated with Vit D, 50000 U once a week whereas the control group received placebo with the same dose and package, both for 12 weeks. At the end of the intervention lab tests and ultrasound study was performed once again to evaluate the response to treatment. Results: It was found out that Vit D supplementation improved the fatty liver grade in the study group. The mean changes in hemoglobin (Hb), uric acid, highdensity lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), insulin, albumin and alanine aminotransferase (ALT) was significantly higher in the study group compared to controls (p<0.05). After the intervention and means adjustment, a significant difference was obtained in HDL-C, insulin, LDL-C and homeostasis model assessment of insulin resistance (HOMA-IR) between the two groups. Conclusion: Vit D supplementation in addition to improving the fatty liver grade in ultrasonography and increasing the blood Vit D level, increases the HDL and Hb level besides decreasing uric acid, LDL, HOMA-IR, insulin and ALT levels.

• Herbal Formula Science
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• v.28 no.2
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• pp.189-198
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• 2020

Objectives : This study investigated the liver-protective effects of MJY2018, a Herbal formula, against alcoholic fatty liver disease and anti-oxidative effects. Methods : Its effects were investigated in an alcoholic fatty liver disease model in male C57BL/6 mice, which were fed Lieber-DeCarli liquid diet containing ethanol. MJY2018 (100 and 200 mg/kg bw/day) or silymarin (50 mg/kg bw/day) were orally administered daily in the alcoholic fatty liver disease mice for 16 days. Results : The results indicate that MJY2018 promotes hepatoprotection by significantly reducing aspartate transaminase (AST) and alanine transaminase (ALT) levels as indicators of liver damage in the serum. Furthermore, MJY2018 reduced accumulation of triglyceride and total cholesterol, increased levels of superoxide dismutase (SOD) and glutathione (GSH) in the livers of the alcoholic fatty liver disease mice model. Additionally, it improved the serum alcohol dehydrogenase (ADH) activity. Conclusions : These results indicate that MJY2018 were effective in improving and protecting oxidative stress and alcoholic liver disease.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.13-20
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• 2005

Purpose : Obesity is, along with metabolic syndrome, closely related with nonalcoholic fatty liver disease. This study tried to evaluate the prevalence of nonalcoholic liver disease in obese children and verify the factors associated with the disease. Methods : Two hundred and seventy nine children who showed a body mass index of 95 percentile over the baseline in health examinations of surrounding schools were evaluated. Questionnaires, body measurements, blood examinations, and ultrasonographic measurements of abdominal fat were examined. Results : Out of 279 children enrolled for the study, 27 children were found to possess nonalcoholic liver disease(9.7%). Among those found to be positive for nonalcoholic liver disease, it's prevalence increased to 15.2%(22 out of 144 children) among children with severe obesity. Factors known to be involved with metabolic syndrome, namely waist/hip circumference ratio and thickness of abdominal fat, were found to be closely related to nonalcoholic fatty liver as well. Conclusion : The prevalence of nonalcoholic fatty liver in obese children was 9.7%, with higher incidence observable in severer obesity. Factors responsible for metabolic syndrome were closely associated with nonalcoholic fatty liver disease, and the level of insulin resistance, which is an useful index in both diseases, can be utilized in evaluation of the effect of treatment and control of risk factors.

• YAKHAK HOEJI
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• v.49 no.4
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• pp.306-311
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• 2005

Semisulospira libertine (SL) has been used as a folk medicine for quenching a thirst, hepatic fever and inflammation in oriental countries. Although SL has been anecdotally ascertained to ameliorate the hepatic diseases, there are no sufficient experimental evidences. The purpose of this study was to examine the effect of Bitam-S, in which SL is a main component, on non-alcoholic fatty liver disease manifested in C57BL/6J ob/ob mice. At 6 week old, the ob/ob mice were randomly divided into four groups; control and three treatment groups. The control mice was to receive a regular diet, and the treatment groups were fed a regular diet with either 250mg/kg, 500mg/kg of Bitam-S (BS250 and BS500) or 300mg/kg of metformin (MT300) for a 8-week period. Bitam-S exerted beneficial effects on lipid homeostasis in ob/ob mice that are not necessarily due to its ability to decrease food intake but its specific effects on hepatic lipogenesis related genes (SREBP1a, FAS and SCD-1). The combined effects of Bitam-S to reduce body weight and lipogenic gene expressions, and reduce the deposition of triglyceride in the liver are indicative of a marked improvement in obesity-related non-alcoholic fatty liver disease. Taken together, Bitam-S has potential as a treatment agent for non-alcoholic fatty liver disease and deserves clinical trial in the near future.