• 생명과학회지
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• 제33권12호
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• pp.967-977
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• 2023

Rubus crataegifolius (RC)는 장미과에 속하는 전통적인 아시아 약용 식물이다. RC 열매는 항산화 작용을 통해 성인병을 예방하는 것으로 알려져 있다. 본 연구에서는 RC 열매 추출물(RCex)이 비만과 비알코올성 지방간 질환(NAFLD)에 미치는 영향을 동물 모델을 통해 평가하였다. 28마리의 수컷 C57BL/6J 마우스에 8주간 비만을 유도한 후, 추출물을 8주간 경구 투여하였다. 그룹 1은 일반 대조군으로 표준사료를 섭취하였다. 그룹 2는 HFD 대조군으로, 그룹 3에는 심바스타틴(6.5 mg/kg/일)을, 그룹 4에는 RCex (200 mg/kg)을 투여하였다. RCex투여는 실험 마우스의 체중, 지방 조직, 간 무게를 감소시켰으며, 또한 지질 대사(ALT, AST, TC, TG, LDL, HDL)를 포함한 생화학적 바이오마커를 개선하였다. AMPK의 활성화는 지방생성 유전자(LXR, SREBP-1c, FAS, ACC1)의 발현을 감소시켰으며, RCex에 의한 CPT 활성 증진 효과를 검증하였다. RCex는 또한 에너지 소비 및 신진대사와 관련된 호르몬(adiponectin 및 leptin)의 혈장 수준에도 영향을 미쳤다. 또한, RCex가 HFD로 유도된 비만 mice의 포도당 불내성을 개선했음을 확인 하였다. RCex는 AMPK의 인산화를 통해 지방산 산화 및 지방산 합성을 조절함으로써 항비만 및 항NAFLD 효과를 가짐을 처음으로 입증하였다. 이는 R. crataegifolius가 비만 및 관련 NAFLD 예방에 좋은 보충제가 될 수 있음을 시사한다.

• 한국콘텐츠학회논문지
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• 제11권10호
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• pp.342-348
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• 2011

생체 간이식 공여자를 대상으로 시행되는 간생검 조직소견의 지방변성 정도와 복부초음파검사 결과를 분석하여, 지방간 질환의 진단에 있어서 초음파검사의 타당성을 알아보고자 하였다. 총 지방 함유량 10% 기준으로 범주화 하여 10% 이하를 음성, 10% 이상을 양성으로 하였을 때 초음파검사의 민감도는 64.6%이었고, 특이도는 68% 이었으며, 양성 예측도와 음성 예측도는 각각 76.8%, 54% 이었다. 초음파검사 결과 정상과 경증을 음성으로, 중등도를 양성으로 조작하였을 때 초음파검사의 민감도는 26.8% 이었고, 특이도는 100% 이었으며, 양성 예측도와 음성 예측도는 각각 100%, 45.5% 이었다. 총 지방 함유량 10% 이상을 상태변수(State variable)로 ROC curve 분석을 시행 하였을 때. 간/신장 명도비의 곡선하면적(Area under curve, AUC)은 0.859로 지방간을 예측하는데 좋은 지표로 나타났으며, 95% 신뢰구간(CI: 0.795~0.922)이 통계적으로 유의한 값을 보였다(p<0.001). 지방간진단에 있어서 복부초음파검사는 간생검 병리학적 결과를 예측하는데 높은 타당도를 보였다.

• 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.

• BMB Reports
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• 제49권3호
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• pp.139-148
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• 2016

In the past decade, the incidence of type 2 diabetes (T2D) has rapidly increased, along with the associated cardiovascular complications. Therefore, understanding the pathophysiology underlying T2D, the associated complications and the impact of therapeutics on the T2D development has critical importance for current and future therapeutics. The prevailing feature of T2D is hyperglycemia due to excessive hepatic glucose production, insulin resistance, and insufficient secretion of insulin by the pancreas. These contribute to increased fatty acid influx into the liver and muscle causing accumulation of lipid metabolites. These lipid metabolites cause dyslipidemia and non-alcoholic fatty liver disease, which ultimately contributes to the increased cardiovascular risk in T2D. Therefore, understanding the mechanisms of hepatic insulin resistance and the specific role of liver lipids is critical in selecting and designing the most effective therapeutics for T2D and the associated co-morbidities, including dyslipidemia and cardiovascular disease. Herein, we review the effects and molecular mechanisms of conventional anti-hyperglycemic and lipid-lowering drugs on glucose and lipid metabolism.

• 보건행정학회지
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• 제31권4호
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• pp.472-478
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• 2021

Background: Early identification of patients who are highly likely to develop severe illness among confirmed cases of coronavirus disease 19 (COVID-19) can be expected to lead to effective treatment. This study therefore aimed to determine whether the presence of nonalcoholic fatty liver disease (NAFLD) has an impact on the exacerbation of COVID-19 symptoms. Methods: The study used the Korean National Health Insurance claim data for treatment of COVID-19 patients in 2020. NAFLD includes nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). The outcome variables used were hospitalization and the use of medical devices. Hospitalization was defined by a length of stay exceeding one day and the use of medical devices was defined as one or more uses of a ventilator or extracorporeal membrane oxygenation. Multivariable logistic regression analysis was performed to determine if there was a difference in the hospitalization and use of medical devices of COVID-19 patients depending on the presence of NAFLD. Results: The odds ratio of hospitalization was 1.059, indicating slightly higher odds of hospitalization for patients with NAFL or NASH compared to those without the conditions, but it was not statistically significant (0.969-1.156). On the other hand, the odds ratio of use of medical devices was high at 1.667 and was statistically significant (1.111-2.501). Conclusion: The study results found NAFLD to be a risk factor that can exacerbate symptoms in COVID-19 patients. Accordingly, it is necessary to identify NAFLD patients through preemptive screening and provide them with appropriate treatments.

• 대한본초학회지
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• 제33권5호
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• pp.1-8
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• 2018

Objectives : The aim of this study is to investigate the preventive effect of Puerariae Flos ethanol extract (PE) on methionin and choline deficient (MCD)-diet-induced Nonalcoholic fatty liver disease (NAFLD) in C57BL/6J mice. Methods : In the in vivo experiments, C57BL/6J mice were divided into 4 groups; Normal group, Control group, MCD+PE 100 group, and MCD+PE 300 group. After 4 weeks, body weight, liver weight, biochemical parameters for liver function test, histological changes, reverse transcription polymerase chain reaction (RT-PCR), and Western blot were assessed. Results : Mice lost body weight with the MCD-diet and the MCD+PE 100 group and MCD+PE 300 groups lost less than the control group, though showed no statistical significance. Liver weights were decreased by the MCD diet, but MCD+PE 300 groups were increased significantly. In the liver function test, all the values were decreased with the MCD-diet, MCD+PE 100 group and MCD+PE 300 groups were increased significance. In histological findings of the livers, MCD-diet induced severe fatty accumulation in the livers, but this fatty change was reduced in the MCD+PE 100 group and MCD+PE 300 groups was inhibited respectively. In lipid accumulation factors (such as SREBP-1c, $C/EBP{\alpha}$, PPAR-${\gamma}$), MCD+PE 100 group and MCD+PE 300 groups showed inhibitory effect on liver lipogenesis by reducing associated gene expressions caused by MCD diet. Conclusions : We were able to know that Puerariae Flos ethanol extract (PE) shown hepatoprotective effects via a decrease on the hepatic lipogenesis factors in the experimental NAFLD Models.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권3호
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• pp.199-206
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• 2016

Purpose: To analyze the associations among the degrees of nonalcoholic fatty liver disease (NAFLD) by ultrasonography and metabolic syndrome, degrees of obesity in children, and degrees of parental obesity. Methods: A total of 198 children with obesity who visited a pediatric obesity clinic were prospectively enrolled in this study. The severity of NAFLD based on ultrasonography was classified into no, mild, moderate, or severe NAFLD group. The degree of obesity based on the percentage over standard weight for height per sex was classified into mild, moderate, or severe. Results: Of 132 patients evaluated for the degree of NAFLD and metabolic syndrome, the p-value of correlation between the two factors was 0.009. Therefore, metabolic syndrome might significantly affect the degree of NAFLD. Of 158 patients evaluated for the degree of NAFLD and the degree of obesity, the p-value of correlation between the two factors was 0.122. Of 154 patients evaluated for the degree of obesity and father's obesity, the p-value was 0.076. Of 159 patients evaluated for the degree of obesity and mother's obesity, the p-value was 0.000, indicating that mother's obesity could significantly affect the degree of obesity in children. Of 142 patients evaluated for the degree of obesity and metabolic syndrome, the p-value was 0.288. Conclusion: Metabolic syndrome might significantly affect the degree of nonalcoholic fatty liver in children. In addition, mother's obesity might be a significant factor that affects the degree of obesity in children.

• Clinical Nutrition Research
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• 제11권3호
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• pp.194-203
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• 2022

To investigate adipokines (vaspin, omentin-1, adiponectin and leptin) and their correlation with hepatosteatosis degree in obese/overweight (O/O) children. We analyzed adipokine levels of 81 children (49 O/O, [body mass index (BMI) > 95^th] and 32 non-obese (BMI = 5-85^th) admitted to the pediatric outpatient clinic. Serum triglyceride, glucose, low density lipoprotein-cholesterol, total cholesterol, high density lipoprotein-cholesterol, alanine aminotransferase, aspartate aminotransferase (AST), insulin, HbA1c levels and leptin, omentin-1, vaspin, adiponectin levels were studied. O/O children with hepatosteatosis were divided into grades 1, 2 and 3 according to the degree of hepatosteatosis determined by ultrasonography. While AST (p = 0.001), triglyceride (p = 0.006), BMI percentile (p = 0.000), HOMA index (p = 0.002), systolic blood pressure (p = 0.02), leptin (p = 0.001), omentin-1 (p = 0.001), adiponectin (p = 0.001) levels were higher, vaspin level was lower (p = 0.008) in the (O/O) group compared to the controls. There was a positive correlation between HDL and vaspin, and a negative correlation between HDL and omentin-1 in the O/O group. Also it was observed that as the degree of hepatosteotosis increased, leptin (p = 0.004), omentin-1 (p = 0.001) levels were increased. There was no significant change in vaspin level (p = 0.128). The high levels of omentin-1, leptin and adiponectin have an association with the development of hepatosteatosis in O/O children.

• Preventive Nutrition and Food Science
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• 제21권1호
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• pp.14-23
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• 2016

Non-alcoholic fatty liver disease (NAFLD) is caused by fat accumulation and is associated with oxidative stress. In this study, we investigated the potential protective effect of pomegranate (Punica granatum L.) peel extract (PPE) against oxidative stress in the liver of rats with NAFLD. Sprague-Dawley rats were fed a high fat diet (HFD), 20% corn oil, or palm oil for 8 weeks in the presence or absence of PPE. The control group was fed a basal diet. The progression of NAFLD was evaluated histologically and by measuring liver enzymes (alanine transaminase and aspartate transaminase), serum lipids (triglycerides and total cholesterol), and oxidative stress markers. The HFD feeding increased the body weight and caused NAFLD, liver steatosis, hyperlipidemia, oxidative stress, and elevated liver enzymes. Administration of PPE ameliorated the hepatic morphology, reduced body weight, improved liver enzymes, and inhibited lipogenesis. Furthermore, PPE enhanced the cellular redox status in the liver tissue of rats with NAFLD. Our findings suggest that PPE could improve HFD-induced NAFLD via abolishment of hepatic oxidative damage and hyperlipidemia. PPE might be considered as a potential lead material in the treatment of NAFLD and obesity through the modulation of lipid metabolism.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제10권2호
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• pp.185-192
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• 2007

목 적: 본 연구에서는 소아 비만 환자에서 발생하는 비알코올성 지방간 질환의 발병에 TNF-${\alpha}$, adiponectin, leptin 등의 adipokine들이 미치는 영향을 알아보며, 이들 adipokine과 체지방분포 및 인슐린 저항성과의 연관성을 함께 살펴보고자 하였다. 방 법: 2004년 3월에서 2005년 6월까지 분당서울대병원 소아과에 내원한 비만한 소아 61명을 대상으로 하여 비알코올성 지방간 질환의 상태에 따라 대상 환자들을 지방간 질환이 없는 소아 비만 환자(n=23), 단순 지방간(n=20), 그리고 비알코올성 지방간염(n=18)의 세군으로 나누고, 각 환자에서 혈중 TNF-${\alpha}$, leptin, adiponectin 농도를 측정하고 인슐린 저항성의 지표로서 HOMA-IR을 계산하였으며 복부 전산화단층촬영에서 VSR (visceral-subcutaneous fat ratio)을 산출하였다. 결 과: 총 61명(남 : 여=42 : 19, 평균 연령 11.2${\pm}$1.3세)의 환아를 대상으로 지방간 질환에 따라 세 군으로 나누었을 때, 세 군 간의 성별, 연령별 차이는 없었다(p=0.422, p=0.119). 각 군의 혈중 TNF-${\alpha}$ 농도는 유의한 차이가 없었고(22.13${\pm}$6.37 vs. 21.35${\pm}$6.95 vs. 25.17${\pm}$9.30; p=0.342), leptin 농도에도 유의한 차이가 없었으나 (20.29${\pm}$8.57 vs. 16.42${\pm}$6.85 vs. 20.10${\pm}$7.86; p=0.330), adiponectin은 유의한 차이를 보여 비알코올성 지방간염에서 혈중농도가 의미 있게 감소하였다 (6.08${\pm}$1.38 vs. 5.69${\pm}$0.79 vs. 4.93${\pm}$1.75; p=0.026). 복부 전산화단층 촬영에서 산출한 VSR도 지방간염군에서 유의하게 증가된 소견을 보였다(0.31${\pm}$0.08 vs. 0.32${\pm}$0.11 vs. 0.47${\pm}$0.14; p=0.001). HOMA-IR도 세 군에서 유의한 차이를 보였다(4.77${\pm}$3.67 vs. 6.89${\pm}$7.05 vs. 10.42${\pm}$6.73; p=0.000). 그러나 adiponectin과 HOMA-IR 또는 VSR간에 유의한 상관관계는 보이지 않았다(r=-0.117; p=0.450 & r=-0.106; p=0.499). 결 론: 인슐린 저항성은 비만한 소아에서 간 내 지방 축적과 지방간염으로의 진행과정에 모두 영향을 미칠 것으로 추정되며, 비만한 소아의 지방조직에서 분비되는 adipokine 중에서 adiponectin이 단순지방간에서 지방간염으로의 이행하는 기전에 관여할 것으로 여겨진다.