• Korean Journal of Radiology
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• v.21 no.4
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• pp.413-421
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• 2020

Objective: A widely applicable, non-invasive screening method for non-alcoholic fatty liver disease (NAFLD) is needed. We aimed to develop and validate an index combining computed tomography (CT) and routine clinical data for screening for NAFLD in a large cohort of adults with pathologically proven NAFLD. Materials and Methods: This retrospective study included 2218 living liver donors who had undergone liver biopsy and CT within a span of 3 days. Donors were randomized 2:1 into development and test cohorts. CTL-S was measured by subtracting splenic attenuation from hepatic attenuation on non-enhanced CT. Multivariable logistic regression analysis of the development cohort was utilized to develop a clinical-CT index predicting pathologically proven NAFLD. The diagnostic performance was evaluated by analyzing the areas under the receiver operating characteristic curve (AUC). The cutoffs for the clinical-CT index were determined for 90% sensitivity and 90% specificity in the development cohort, and their diagnostic performance was evaluated in the test cohort. Results: The clinical-CT index included CTL-S, body mass index, and aspartate transaminase and triglyceride concentrations. In the test cohort, the clinical-CT index (AUC, 0.81) outperformed CTL-S (0.74; p < 0.001) and clinical indices (0.73-0.75; p < 0.001) in diagnosing NAFLD. A cutoff of ≥ 46 had a sensitivity of 89% and a specificity of 41%, whereas a cutoff of ≥ 56.5 had a sensitivity of 57% and a specificity of 89%. Conclusion: The clinical-CT index is more accurate than CTL-S and clinical indices alone for the diagnosis of NAFLD and may be clinically useful in screening for NAFLD.

• Journal of Nutrition and Health
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• v.55 no.6
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• pp.684-698
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• 2022

Purpose: Recent studies have reported a significant association between skeletal muscle, muscle strength and non-alcoholic fatty liver disease (NAFLD). The effect of nutrient intake on the prediction of skeletal muscle mass and strength or its suggested correlation with metabolic diseases has been primarily reported in healthy individuals. The current study explores the association between energy intake and handgrip strength (HGS) in individuals with NAFLD. Methods: Data were obtained from the Korea National Health and Nutrition Examination Surveys 2016-2018. Data from 12,469 participants were extracted and 1,293 men and 1,401 women aged 20 years and older were included in the analyses of patients with NAFLD. The presence of NAFLD was determined using the hepatic steatosis index. To estimate relative skeletal muscle strength, HGS was measured using a digital dynamometer and calculated by adjusting the body mass index of the dominant arm. Study subjects in the NAFLD and non-NAFLD groups were separately categorized according to quartiles of the calculated HGS. Results: We found that individuals with low (EQ1) energy intake had lower odds of HGS compared to subjects with high (EQ4) energy intake, irrespective of their NAFLD status (p < 0.0001). However, the HGS did not differ based on the level of protein or fat intake ratio. Additionally, the effect of energy intake on HGS was more pronounced in men than in women. Conclusion: Energy intake was associated with the risk of weak HGS in men with NAFLD. The results indicate that energy intake may be a key factor in nutrition care for NAFLD patients with low muscle function.

• The Journal of the Korea Contents Association
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• v.11 no.10
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• pp.342-348
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• 2011

The study aimed to compare the validity between the abdominal ultrasonographic(US) grading system of fatty liver and histologic grading system of fatty liver in living liver donor candidates. As the fatty liver is defined as pathologic total fat >10%, US validity was sensitivity 64.6%, specificity 68%, positive predictive value 76.8%, negative predictive value 54%. As the strict data handling on US grading normal, mild fatty liver are negative, moderate fatty liver is positive, US validity was sensitivity 26.8%, specificity 100%, positive predictive value 100%, negative predictive value 45.5%. ROC curve analysis according to different cut off value of liver-to-kidney brightness ratio was Area under ROC curve=0.859(95% CI=0.795~0.922, state variable= total fat 10%). There were statistically significant difference( p<0.001). Ultrasonography for the fatty diagnosis showed a high validity to predict the result of histology grade of fatty liver.

• Journal of Nutrition and Health
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• v.56 no.2
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• pp.123-139
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• 2023

Purpose: This study was conducted to establish whether an ethanol extract of Lycium barbarum leaves (LLE) and an ethanol extract of Lycium barbarum leaves from which chlorophyll has been removed, denoted as LLE(Ch^-), have a protective effect against hepatic fat accumulation. Methods: The inhibitory effects of LLE and LLE(Ch^-) on liver fat accumulation were examined in C57BL/6 mice with non-alcoholic fatty liver disease (NAFLD) induced by an methionine and choline deficient diet and in HepG2 cells with palmitic acid-induced fat accumulation. Results: The plasma triglyceride, aspartate aminotransferase, and alanine aminotransferase levels were lower in the LLE(Ch^-) group, whereas the plasma ALT activity decreased significantly in the LLE group. In both the LLE and the LLE(Ch^-) groups, the triglyceride and cholesterol contents in the hepatic tissue were significantly reduced. A greater inhibitory effect on tissue fat accumulation was observed in the LLE(Ch^-) group than in the LLE group. In HepG2 cells, LLE and LLE(Ch^-) were non-toxic up to a concentration of 1,000 ㎍/mL. Compared to the control group, intracellular fat accumulation in the LLE and LLE(Ch^-) groups were significantly reduced at concentrations of 200 ㎍/mL and 500 ㎍/mL, respectively. The expression of phosphorylated adenosine monophosphate-activated protein kinase and phosphorylated acetyl-CoA carboxylase in both LLE groups increased at the concentrations of 100 ㎍/mL and 500 ㎍/mL. The fatty acid synthase expression was suppressed in a concentration-dependent manner at 10 ㎍/mL. Conclusion: The examined two ethanol extracts of LLE inhibit hepatic fat accumulation in NAFLD. This effect was more pronounced in the LLE(Ch^-) group. Therefore, these 2 extracts have an anti-steatosis effect and can be used for NAFLD treatment.

• Korean Journal of Radiology
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• v.22 no.1
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• pp.155-158
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• 2021

• Journal of Korean Medicine for Obesity Research
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• v.9 no.1
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• pp.79-86
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• 2009

Objectives The purpose of this study was to investigate the clinical effect of oriental obesity therapy on obese patient with non-alcoholic fatty liver disease(NAFLD). Methods The patient was treated from November 17, 2008 to May 15, 2009 for obesity treatment. And the patient had intensive care through admission treatment from November 17, 2008 to November 29, 2008. Electrolipolysis, auricular acupuncture, herbal medicine, low calorie diet and aerobic exercise were done during the treatment period. Results His body Weight decreased from 102.8kg to 82.7kg. The BMI decreased from 35.2kg/m$^2$ to 28.9kg/m$^2$. NAFLD effectively improved on sonography form grade II${\sim}$III to grade I${\sim}$II after oriental obesity therapy, AST decreased from 65 to 19. ALT decreased from 152 to 18. Oriental obesity therapy could be effective to treat obese patient with NAFLD. Conclusions The obese patient with NAFLD improved on sonography by oriental obesity therapy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.168-174
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• 2015

Purpose: Recent studies have suggested that decreased serum potassium level may contribute to various metabolic disorders in adult patients including nonalcoholic fatty liver disease (NAFLD). We aimed to study the correlation between serum potassium levels and the histologic severity of NAFLD in children. Methods: Pediatric patients with biopsy-proven NAFLD were included in this study. Demographic, clinical, and histopathological data were obtained. Multivariable logistic regression analysis was used to assess whether potassium levels are associated with the presence of nonalcoholic steatohepatitis (NASH) or fibrosis after adjusting for possible confounders. A p-value <0.05 was considered statistically significant. Results: Among 125 biopsies, 49.6% (62) had evidence of NASH while 66.4% (83) had some degree of fibrosis (stage 1-3). Mean serum potassium was significantly lower in NASH group as compared to non-NASH group ($4.4{\pm}0.42mmoL/L$ vs. $4.8{\pm}0.21$, p<0.001). Higher potassium level had negative correlation with presence of steatosis, ballooning, lobular inflammation, fibrosis and NAFLD activity score (p<0.05). On multivariable analysis and after adjusting for the metabolic syndrome and insulin resistance, higher potassium level was significantly associated with lower likelihood of having a histological diagnosis of NASH on biopsy (odds ratio [OR], 0.12; 95% confidence interval [95% CI], 0.05-0.28; p<0.001). Similarly, the likelihood of having fibrosis decreases by 76% for every 0.5 mmoL/L increase in potassium (OR, 0.24; 95% CI, 0.11-0.54; p<0.001). Conclusion: Our study shows an inverse relationship between serum potassium levels and the presence of aggressive disease (NASH and fibrosis) in children with NAFLD.

• Clinical Nutrition Research
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• v.11 no.1
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• pp.42-49
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• 2022

Data on the association between dietary red meat intake and non-alcoholic fatty liver disease (NAFLD) are limited. We designed this case-control study to determine the association between red and processed meat consumption and risk of NAFLD in Iranian adults. A total of 999 eligible subjects, including 196 NAFLD patients and 803 non-NAFLD controls were recruited from hepatology clinics in Tehran, Iran. A reliable and validated food frequency questionnaire was used to evaluate the red and processed meat intakes. The analyzes performed showed that in an age- and gender-adjusted model, patients with the highest quartile of red meat intake had an approximately three-fold higher risk of NAFLD than those with the lowest quartile of intake (odds ratio [OR], 3.42; 95% confidence interval [CI], 2.16-5.43; p value < 0.001). Moreover, patients in the highest quartile of processed meat intake had a 3.28 times higher risk of NAFLD, compared to the lowest quartile(OR, 3.28; 95% CI, 1.97-5.46; p value < 0.001).Both these associations remained significant by implementing additional adjustments for body mass index, energy intake, dietary factors, diabetes, smoking, and physical activity (OR, 3.65; 95% CI, 1.85-7.18; p value < 0.001 and OR, 3.25; 95% CI, 1.57-6.73; p value = 0.002, respectively).Our findings indicate that both red and processed meat intakes are related to the increased odds of NAFLD; however, prospective studies are needed to confirm these results.

• Journal of the Korean Society of Food Science and Nutrition
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• v.46 no.2
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• pp.169-176
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• 2017

Non-alcoholic fatty liver disease (NAFLD) is caused by chronic lipid accumulation due to dysregulation of lipid metabolism in the liver, and it is associated with various human diseases such as obesity, dyslipidemia, hypertension, and diabetes. Histone acetylation is a representative epigenetic mechanism regulated by histone acetyltransferases (HATs) and deacetylases. We observed that tartary buckwheat sprout (TBS) suppressed lipid accumulation in HepG2 cells through its anti-HAT activity. We showed that TBS was a novel HAT inhibitor with specificity for the major HAT enzyme p300. Importantly, TBS reduced acetylation of total and histone proteins, H3K9, H3K36, and H4K8, resulting in decreased transcriptional activities of sterol regulatory element-binding protein 1c, ATP citrate lyase, and fatty acid synthase. These results suggest that TBS inhibits the NAFLD transcription-modulating activity of lipogenesis-related genes through modification of histone acetylation.

• The Journal of Internal Korean Medicine
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• v.40 no.1
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• pp.13-37
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• 2019

Objectives: The purpose of this study was to assess the effects of Korean medicine for non-alcoholic fatty liver disease (NAFLD). We analyzed the result of randomized controlled trials (RCTs) that applied Korean medicine to NAFLD patients through meta analysis and systematic review. Methods: The key question was to the effects of Korean medicine for NAFLD patients according to the PICO-SD (participants, intervention, comparison, outcome, study design) and we included only RCTs. We searched 10 databases including NDSL, KMBASE, KISS, KISTI, KoreaMed, Koreantk, OASIS, Cochrane, Pubmed, EMBASE without a language restriction. We assessed risk of bias by Cochrane group's Risk of Bias tool. Results: The finally selected 12 RCTs were analyzed. Total number of participants was 1189 (male 719, female 470) as 684 and 505 in the oriental medicine group (i.e. herbal drugs, acupuncture, acupoint embedding therapy) and control group (conventional drugs, placebo), respectively. The meta analysis results of examining 7 RCTs comparing the therapeutic efficacy of herbal medicine with that of Western medicine showed statistically significant (p<0.05) differences in the efficacy evaluation, liver function test results, blood lipids, and TNF-${\alpha}$. Furthermore, the meta analysis results of investigating 3 RCTs comparing the therapeutic efficacy of herbal medicine with that of a placebo showed statistically significant (p<0.05) differences in the liver function test results, blood lipids, and waist circumference. Conclusions: The research showed that Korean medicine for NAFLD can be effective treatment. But more studies are required to enhance the level of evidence and we should report on safety.