• Clinical and Molecular Hepatology
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• v.24 no.4
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• pp.392-401
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• 2018

Background/Aims: Leptin is associated with metabolic disorders, which predispose one to non-alcoholic fatty liver disease (NAFLD). The role of leptin in NAFLD pathogenesis is not fully understood. We aim to investigate the association between serum leptin level and severity of NAFLD using U.S. nationally representative data. Methods: Data were obtained from the United States Third National Health and Nutrition Examination Survey. NAFLD was defined by ultrasound detection and severity of hepatic steatosis in the absence of other liver diseases. The severity of hepatic fibrosis was determined by NAFLD fibrosis score (NFS). We used multivariate survey-weighted generalized logistic regression to evaluate the association between leptin level and the degree of NAFLD. We also performed subgroup analyses by body mass index (lean vs. classic NAFLD). Results: Among 4,571 people, 1,610 (35%) had NAFLD. By ultrasound findings, there were 621 people with mild, 664 with moderate, and 325 with severe steatosis. There were 885 people with low NFS (<-1.455, no significant fibrosis), 596 with intermediate NFS, and 129 with high NFS (>0.676, advanced fibrosis). Leptin levels for normal, mild, moderate and severe steatosis were $10.7{\pm}0.3ng/mL$, $12.1{\pm}0.7ng/mL$, $15.6{\pm}0.8ng/mL$, $16{\pm}1.0ng/mL$, respectively (trend P-value<0.001). Leptin levels for low, intermediate, and high NFS were $11.8{\pm}0.5ng/mL$, $15.6{\pm}0.8ng/mL$, $28.5{\pm}3.5ng/mL$, respectively (trend P-value<0.001). This association remained significant even after adjusting for known demographic and metabolic risk factors. In the subgroup analysis, this association was only prominent in classic NAFLD, but not in lean NAFLD. Conclusions: Serum leptin level is associated with the severity of NAFLD, especially in classic NAFLD patients.

• The Journal of Internal Korean Medicine
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• v.33 no.4
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• pp.533-542
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• 2012

Objectives : We try to compared the efficacy of six herbal medicines, Rhizoma Alismatis (RA), Fructus Crataegi (FC), Fructus Lycii (FL), Radix Curcumae (RC), Radix Salviae Miltiorrhizae (RSM), and Herba Artemisiae Scopariae (HAS), constituting KHchunggan-tang which was previously proven to be hepatoprotective on non-alcoholic fatty liver disease with combined properties of cellular steatosis, ROS production, and cytoprotection. Methods : HepG2 cells were pretreated with aqueous extracts of the six herb medicines at concentrations of 1, 10, 50 and 100 ${\mu}g/ml$ each, and treated with 0.5 mM palmitate consecutively. After 21 hrs, cell viability was assessed using MTT assay, and the percentage of cells with sub-G1 DNA content was measured using fluorescence-activated cell sorting after propidium iodide staining. Results : The first three extracts, RA, FC, and FL restored cell viability reduced by palmitate in MTT assay, and RA, FC, FL and RC inhibited palmitate-induced apoptosis in sub-G1 analysis. FL showed relatively weak potential only at tested maximal dose, and RA showed the greatest higher efficacy on this experimental cellular model of nonalcoholic fatty liver disease. Conclusions : According to this comparative experiment, Rhizoma Alismatis seems to have the most powerful potential among the six herbs constituting KHchunggan-tang, and consecutive further study seems to be required for more standardized and effective clinical application of KHchunggan-tang for treatment of non-alcoholic fatty liver disease.

• The Journal of Internal Korean Medicine
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• v.35 no.2
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• pp.175-183
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• 2014

Objectives : We tried to uncover the anti-lipogenic effect and underlying mechanism of Laminaria japonica on an experimental cellular model of non-alcoholic fatty liver disease. Methods : Ethanol extract of Laminaria japonica (LJ) was prepared. Intracellular lipid content of palmitate-treated HepG2 cells was evaluated with or without LJ treatment. We measured the effects of LJ on liver X receptor ${\alpha}$ ($LXR{\alpha}$) and sterol regulatory element-binding transcription factor-1c (SREBP-1c) expression, transcription level of lipogenic genes, including acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), stearoyl-CoA desaturase-1 (SCD-1), and nuclear factor erythroid 2-related factor 2 (Nrf2) activation in HepG2 cells. Results : LJ markedly attenuated palmitate-induced intracellular lipid accumulation in HepG2 cells. LJ suppressed $LXR{\alpha}$-dependent SREBP-1c activation, and SREBP-1c mediated induction of ACC, FAS, and SCD-1. Furthermore, LJ activated Nrf2, which plays an important cytoprotective role in non-alcoholic fatty liver disease. Conclusions : Our study suggests that LJ has the potential to alleviate hepatic lipid accumulation, and this effect was mediated by inhibiting the $LXR{\alpha}$-SREBP-1c pathway that leads to hepatic steatosis. In addition, the anti-lipogenic potential may, at least in part, be associated with activation of Nrf2.

• Nutrition Research and Practice
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• v.8 no.2
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• pp.172-176
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• 2014

BACKGROUND/OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is becoming an important public health problem as metabolic syndrome and type 2 diabetes have become epidemic. In this study we investigated the protective effect of Cordyceps militaris (C. militaris) against NAFLD in an obese mouse model. MATERIALS/METHODS: Four-week-old male ob/ob mice were fed an AIN-93G diet or a diet containing 1% C. militaris water extract for 10 weeks after 1 week of adaptation. Serum glucose, insulin, free fatty acid (FFA), alanine transaminase (ALT), and proinflammatory cytokines were measured. Hepatic levels of lipids, glutathione (GSH), and lipid peroxide were determined. RESULTS: Consumption of C. militaris significantly decreased serum glucose, as well as homeostasis model assessment for insulin resistance (HOMA-IR), in ob/ob mice. In addition to lowering serum FFA levels, C. militaris also significantly decreased hepatic total lipids and triglyceride contents. Serum ALT activities and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and interleukin-6 (IL-6) levels were reduced by C. militaris. Consumption of C. militaris increased hepatic GSH and reduced lipid peroxide levels. CONCLUSIONS: These results indicate that C. militaris can exert protective effects against development of NAFLD, partly by reducing inflammatory cytokines and improving hepatic antioxidant status in ob/ob mice.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.680-719
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• 2022

Objectives: The aim of this study was to investigate the trends in research on non-alcoholic fatty liver disease (NAFLD) using Korean traditional medicine. Methods: This review included studies related to the treatment of NAFLD, irrespective of the year of publication. The search terms were "nonalcoholic fatty liver disease", "non-alcoholic fatty liver", "nonalcoholic hepatitis", "herb", "herbal medicine", "acupuncture", and "traditional medicine". The studies were analyzed according to the type of research. Results: After screening, 179 studies were selected from the 592 identified by the search. The types of studies were 151 in vivo or in vitro studies, 5 randomized controlled trials, 12 case reports, 2 unspecified clinical studies, 8 review articles, and 1 article that was difficult to classify. Conclusion: Analysis of the trends in Korean traditional medicine treatment by reviewing the studies on NAFLD revealed a focus on experimental studies rather than clinical studies. Therefore, multifaceted and well-designed studies are needed.

• The Journal of Pediatrics of Korean Medicine
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• v.34 no.4
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• pp.11-21
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• 2020

Objectives This study aimed to investigate the efficacy of Ephedra sinica (E. sinica), Panax ginseng (P. ginseng), and Alisma orientale (A. orientale) Extract (MIT) on insulin resistance induced by Non-alcoholic fatty liver disease (NAFLD). Methods C57BL /6 male mice (8-week-old, 20 g) were divided into four groups: control group (Ctrl), high-fat diet group (HFDF), high fat diet with metformin administration group (METT), and high fat diet with MIT administration group (MITT). Each 10 mice were allocated to each group (a total of 40 mice). All mice were allowed to eat fat-rich diet freely throughout the experiment. To examine the effect of MIT, we observed Cannabinoid receptor type 1 (CB1), Cannabinoid receptor type 2 (CB2), G protein-coupled receptor 55 (GPR55), and Transforming growth factor-β (TGF-β). Results In the MITT group, positive reactions of the CB1, CB2, and GPR55 were significantly was significantly suppressed compared to the HFDF group. The positive reactions of the CD36 and TGF-β in the liver tissue were significantly suppressed in MITT. Conclusions MIT has the effect of improving NAFLD induced insulin resistance through the regulation of the lipid metabolism.

• Journal of Life Science
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• v.30 no.5
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• pp.434-442
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• 2020

In this study, Tenebrio molitor (brown mealworm) larvae powder was fermented with Saccharomyces cerevisiae M1 (KACC 93023). The fermented and non-fermented powders were subsequently administered to rats with induced non-alcoholic fatty liver disease to compare the degree of improvement. The rats exhibited abnormal lipid metabolism due to orotic acid, and the group that were fed the fermented larvae powder showed similar weight to normal rats. AST, ALT, ALP, and LDH activities, all known indicators of liver health, and various other lipid-related indicators appeared positive, suggesting improvement. The lipid peroxide and glutathione content in the liver tissue and serum were similar to or better than those of the normal group. Finally, morphological observations of liver tissue using H&E and oil red O stainings revealed that the fermented powder group showed markedly reduced fat along with normal hepatocyte shape and arrangement. To summarize, it was confirmed that dietary brown mealworm larvae improve non-alcoholic fatty liver function, and, when fermented with yeast, most indicators showed positive improvements to almost normal levels. As such, the fermented powder can be considered to improve non-alcoholic fatty liver, suggesting that it may be used as a material for various products in the future.

• The Journal of Korean Medicine
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• v.37 no.1
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• pp.151-157
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• 2016

Objectives: The purpose of this study is to report the clinical effect of Shihosogan-tang extract on NAFLD through ultrasound. Methods: The patient was treated with Shihosogan-tang extract. We observed the changes in symptoms and ultrasound imaging on a patient with NAFLD. Results: After treatment, the symptoms of the patient with NAFLD were decreased and ultrasound imaging were improved from moderate to mild grade. Conclusion: The patient of NAFLD was improved in symptoms and ultrasound imaging.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2023.04a
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• pp.43-43
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• 2023

In this study, we investigated in vitro inhibitory activity of wild-simulated ginseng (WSG) against non-alcoholic fatty liver disease using HepG-2 cells. T0901317 treatment increased the lipid accumulation in HepG-2 cells, but WSG treatment inhibited T0901317-mediated lipid accumulation. In addition, WSG downregulated T0901317-mediated expression of SREBP-1c, ACC, FAS and SCD-1 protein. In addition, WSG increased the phosphorylation level of LKB1 and AMPK. Compound C treatment blocked WSG-mediated downregulation of SREBP-1c protein. In conclusion, WSG is considered to inhibit the accumulation of lipids and triglycerides in HepG-2 cells by inducing the activation of LKB1 and AMPK successively, thereby reducing the expression of FAS, ACC, and SCD-1 through suppression of SREBP-1c expression.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1789-1794
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• 2015

Background: Non-alcoholic fatty liver disease (NAFLD), the most common liver problem in diabetes, is a risk factor for liver cancer. Diabetes, high body mass index (BMI) and old age can all contribute to NAFLD progression. Transient elastography (TE) is used for non-invasive fibrosis assessment. Objectives: To identify the prevalence of NAFLD and significant hepatic fibrosis in diabetic patients and to assess associated factors. Materials and Methods: One hundred and forty-one diabetic and 60 normal subjects were screened. Fatty liver was diagnosed when increased hepatic echogenicity and vascular blunting were detected by ultrasonography. Liver stiffness measurement (LSM) representing hepatic fibrosis was assessed by TE. LSM ${\geq}7$ kPa was used to define significant hepatic fibrosis. Results: Four cases were excluded due to positive hepatitis B viral markers and failed TE. Diabetic patients had higher BMI, systolic blood pressure, waist circumference and fasting glucose levels than normal subjects. Fatty liver was diagnosed in 82 (60.7%) diabetic patients but in none of the normal group. BMI (OR: 1.31; 95%CI: 1.02-1.69; p=0.038) and alanine aminotransferase (ALT)(OR: 1.14; 95%CI: 1.05-1.23; p=0.002) were associated with NAFLD. Diabetic patients with NAFLD had higher LSM than those without [5.99 (2.4) vs 4.76 (2.7) kPa, p=0.005)]. Significant hepatic fibrosis was more common in diabetic patients than in normal subjects [22 (16.1%) vs 1 (1.7%), p=0.002]. Aspartate aminotransferase (AST)(OR: 1.24; 95%CI: 1.07-1.42; p=0.003) was associated with significant hepatic fibrosis. Conclusions: Sixty and sixteen percent of diabetic patients were found to have NAFLD and significant hepatic fibrosis. High BMI and ALT levels are the predictors of NAFLD, and elevated AST level is associated with significant hepatic fibrosis.