• Journal of Nutrition and Health
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• 제55권6호
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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.

• 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.

• Journal of Nutrition and Health
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• 제56권2호
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• pp.123-139
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• 2023

구기엽 추출물 (LLE)과 클로로필을 제거한 구기엽 추출물 (LLE(Ch^-))이 MCD diet로 비알코올성 지방간을 유도한 C57BL/6 mouse와 팔미트산으로 지방 축적을 유도한 HepG2 세포에서 지방축적의 억제에 미치는 영향을 검토하였다. 대조군 대비 LLE(Ch^-)는 혈장 TG 농도와 혈장 AST와 ALT의 활성을 유의하게 감소시켰으며 LLE군에서는 혈장 ALT 활성이 유의하게 감소하였다. 두 군 모두 간조직의 TG와 cholesterol 함량을 유의하게 낮추었으며 간조직의 병리학적 변화 결과에서 LLE군에 비해 LLE(Ch^-)군에서 지방축적의 억제효과가 더 크게 나타났다. 팔미트산 0.5 mM을 처리한 HepG2 세포에서 LLE와 LLE(Ch^-)가 1,000 ㎍/mL 농도까지 독성이 없었으며 대조군에 비하여 각각 200 ㎍/mL과 500 ㎍/mL 농도부터 세포 내 지방 축적량을 유의하게 감소시켰고 pAMPK와 pACC 발현이 농도 의존적으로 증가하였으며 FAS발현은 농도 의존적으로 억제되었다. 결과적으로 구기엽 100% 에탄올 추출물들은 간조직의 지방 축적을 억제할 수 있으며 그 효과는 클로로필 제거 구기엽의 활성이 좀 더 큰 것으로 나타났다. 따라서 이 두 소재 모두 항 지방간 효능이 있는 것으로 판단되며 기능성 소재로서의 개발 가능성을 확인하였다.

• Korean Journal of Radiology
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• 제22권1호
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• pp.155-158
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• 2021

• 한방비만학회지
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• 제9권1호
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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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• 제18권3호
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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.

• 한국식품영양과학회지
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• 제46권2호
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• pp.169-176
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• 2017

본 연구에서는 쓴메밀 새싹 추출물(TBS)을 대상으로 histone acetyltransferase(HAT) 활성 저해능을 평가하고 oleic acid와 palmitic acid(OPA)를 이용하여 HepG2 세포에서 비알코올성 지방간을 유도하여 그 효과를 검토하였다. HeLa 세포의 nuclear extract(NE)를 HAT의 source로 하여 in vitro에서 TBS에 의한 HAT 활성 저해능을 평가한 결과 추출물의 처리에 의하여 HAT 활성이 억제됨을 관찰할 수 있었다. 또한, 대표적인 HAT 단백질인 p300과 CBP를 이용하여 동일한 방식으로 HAT 억제능을 평가한 결과 TBS 처리에 의하여 두 단백질 모두 활성이 감소하였으며, 특히 TBS는 p300의 활성을 특이적으로 저해함을 확인할 수 있었다. 그뿐만 아니라 HepG2 세포에 $400{\mu}M$의 oleic acid 및 $100{\mu}M$의 palmitic acid와 함께 $200{\mu}g/mL$, $500{\mu}g/mL$의 TBS를 처리한 후 NE를 이용하여 세포 내 HAT 활성을 측정한 결과 역시 추출물 처리에 의하여 세포 내 HAT 활성이 저해되어 있음이 관찰되었다. TBS에 의한 HAT 활성의 억제는 세포 내 다양한 단백질들의 아세틸화 저해와 지질축적에 의하여 아세틸화 변형을 일으키는 것으로 알려진 histone H3K9, H4K8의 아세틸화 및 H3K36의 아세틸화를 감소시켰으며, 세포 내 지질합성과 관련된 대표적 유전자인 SREBP1c, ACLY, FAS의 전사 활성 역시 저해함을 관찰하였다. 이와 같은 변화를 통하여 OPA에 의하여 HepG2 세포 내에 축적되었던 지질은 TBS의 처리에 의하여 효과적으로 감소하였으며 이때 처리된 OPA와 소재에 의한 세포 내 독성은 관찰되지 않았다. 그러므로 이러한 결과는 TBS에 의한 HAT 활성의 저해가 히스톤 단백질의 아세틸활 변형을 억제하고 이를 통하여 지방 합성 관련 유전자들의 전사 활성을 감소시켜 결과적으로 세포 내 지질축적을 방지하는 것으로 생각되며, TBS은 비알코올성 지방간질환의 예방에 좋은 천연물 소재로 활용될 수 있을 것이라 여겨진다.

• 대한한방내과학회지
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• 제40권1호
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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.

• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.412-421
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• 2021

Objectives: Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent metabolic disease. Muscle is known to influence NAFLD development. Therefore, this study aimed to determine the relationships among low muscle mass, NAFLD, and hepatic fibrosis using various definitions of low muscle mass and NAFLD diagnostic methods, including magnetic resonance imaging-based proton density fat fraction (MRI-PDFF). Methods: This cross-sectional study included 320 participants (107 males, 213 females) from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population cohort. Muscle mass was assessed using whole-body dual-energy X-ray absorptiometry and adjusted for the height squared, body weight, and body mass index (BMI). NAFLD was diagnosed using ultrasonography (US), MRI-PDFF, and the comprehensive NAFLD score (CNS). Hepatic fibrosis was assessed using magnetic resonance elastography. Multivariable logistic and linear regression analyses were performed to determine the aforementioned associations. Results: According to US, 183 participants (57.2%) had NAFLD. Muscle mass adjusted for body weight was associated with NAFLD diagnosed using US (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.70 to 5.31), MRI-PDFF (OR, 2.00; 95% CI, 1.13 to 3.53), and CNS (OR, 3.39; 95% CI, 1.73 to 6.65) and hepatic fibrosis (males: β=-0.070, p<0.01; females: β=-0.037, p<0.04). Muscle mass adjusted for BMI was associated with NAFLD diagnosed by US (OR, 1.71; 95% CI, 1.02 to 2.86) and CNS (OR, 1.95; 95% CI, 1.04 to 3.65), whereas muscle mass adjusted for height was not associated with NAFLD. Conclusions: Low muscle mass was associated with NAFLD and liver fibrosis; therefore, maintaining sufficient muscle mass is important to prevent NAFLD. A prospective study and additional consideration of muscle quality are needed to strengthen the findings regarding this association.

• 대한한의학회지
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• 제41권4호
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• pp.64-71
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• 2020

Objectives: This study was done to look into whether Nrf2 take some role in the anti-lipogenic effect of kaurenoic acid in a nonalcoholic fatty liver disease (NAFLD) cellular model. Materials and Methods: We measured the effect of kaurenoic acid on intracellular steatosis and Nrf2 activation. Next, the effect of kaurenoic acid on SREBP-1c and some lipogenic genes in palmitate treated HepG2 cells with or without Nrf2 silencing. Results: The increased SREBP-1c expression was significantly decreased by concomitant kaurenoic acid treatment in non-targeting negative control siRNA transfected HepG2 cells. However, kaurenoic acid did not significantly inhibited increased SREBP-1c level in Nrf2 specific siRNA transfected HepG2 cells Conclusions: Kaurenoic acid has a potential to activate Nrf2, which may suppress SREBP-1c mediated intracellular steatosis in HepG2 cells.