• Journal of the Korean Society of Food Culture
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• v.38 no.4
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• pp.270-282
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• 2023

We performed a study to examine the association between diet quality and nonalcoholic fatty liver disease (NAFLD). Our study included 3,586 women aged 40-64 years who participated in the sixth Korea National Health and Nutrition Examination Survey. The study subjects were classified into the NAFLD group (n=816) and the normal group (n=2,770) using the hepatic steatosis index. The anthropometric indices, blood profiles, and dietary intake data of the subjects were obtained. The waist circumference, body mass index, and the serum levels of triglycerides, fasting blood sugar, HbA1c, and systolic and diastolic blood pressures were higher in the NAFLD compared to the normal groups (p<0.001, respectively). The intakes of protein (g/kg body weight, p<0.001), potassium (p<0.001), and vitamin A (p=0.006) were significantly lower in the NAFLD group. It was observed that the higher the total Korean Healthy Eating Index score, the lower the risk of NAFLD. A reverse relationship was shown between the NAFLD risk and the intakes of total fruits, total vegetables, vegetables excluding Kimchi and pickled vegetables, meat, fish, eggs and beans. Therefore, it is recommended that middle-aged women in Korea increase their intakes of fruits, vegetables, and foods high in protein for the proper management of NAFLD.

• Nutrition Research and Practice
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• v.15 no.4
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• pp.431-443
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• 2021

BACKGROUND/OBJECTIVES: Nobiletin (NOB), a citrus flavonoid, is reported to have beneficial effects on cardiovascular and metabolic health. However, there is limited research investigating the effect of long-term supplementation with low-dose NOB on high-cholesterol diet (HCD)-induced hypercholesterolemia and non-obese nonalcoholic fatty liver disease (NAFLD). Therefore, we investigated the influence of NOB on hypercholesterolemia and NAFLD in HCD-fed mice. SUBJECTS/METHODS: C57BL/6J mice were fed a normal diet (ND) or HCD (35 kcal% fat, 1.25% cholesterol, 0.5% cholic acid) with or without NOB (0.02%) for 20 weeks. RESULTS: HCD feeding markedly reduced the final body weight compared to ND feeding, with no apparent energy intake differences. NOB supplementation suppressed HCD-induced weight loss without altering energy intake. Moreover, NOB significantly decreased the total cholesterol (TC) levels and the low-density lipoprotein (LDL)/very-LDL-cholesterol to TC ratio, and increased the high-density lipoprotein-cholesterol/TC ratio in plasma, compared to those for HCD feeding alone. The plasma levels of inflammatory and atherosclerosis markers (C-reactive protein, oxidized LDL, interleukin [IL]-1β, IL-6, and plasminogen activator inhibitor-1) were significantly lower, whereas those of anti-atherogenic adiponectin and paraoxonase were higher in the NOB-supplemented group than in the HCD control group. Furthermore, NOB significantly decreased liver weight, hepatic cholesterol and triglyceride contents, and lipid droplet accumulation by inhibiting messenger RNA expression of hepatic genes and activity levels of cholesterol synthesis-, esterification-, and fatty acid synthesis-associated enzymes, concomitantly enhancing fatty acid oxidation-related gene expression and enzyme activities. Dietary NOB supplementation may protect against hypercholesterolemia and NAFLD via regulation of hepatic lipid metabolism in HCD-fed mice; these effects are associated with the amelioration of inflammation and reductions in the levels of atherosclerosis-associated cardiovascular markers. CONCLUSIONS: The present study suggests that NOB may serve as a potential therapeutic agent for the treatment of HCD-induced hypercholesterolemia and NAFLD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.1
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• pp.54-64
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• 2021

Purpose: Nonalcoholic fatty liver disease (NAFLD) is the most frequent cause of chronic liver diseases in both adults and children with obesity. The aim of this study was to compare the changes in liver enzymes and metabolic profile in adolescents with fatty liver following selected school-based exercise (SBE) and high-intensity interval training (HIIT) interventions. Methods: In a semi-experimental study, 34 obese male adolescents with clinically defined NAFLD were divided into the HIIT (n=11, age=12.81±1.02 years, body mass index [BMI]=26.68±2.32 kg/㎡), selected SBE (n=11, age=13.39±0.95 years, BMI=26.47±1.74 kg/㎡), and control (n=12, age=13.14±1.49 years, BMI=26.45±2.21 kg/㎡) groups. The ultrasonography NAFLD grade, peak oxygen uptake (VO2peak), lipid profile, insulin resistance, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels of the participants were measured before and after the exercise interventions. Results: The BMI, waist-to-hip ratio, and body fat percentage of the participants decreased, and a significant increase in VO2peak was observed after the intervention; however, the HIIT group showed a significant improvement compared with the SBE group (p<0.01). Significant reductions were observed in the levels of insulin resistance, triglyceride, total cholesterol, ALT, and AST in both groups, although high-density lipoprotein levels decreased only in the HIIT group (p<0.01). Further, a significant reduction in low-density lipoprotein level was observed in the training groups (p<0.01), but this decrease was not significant compared with the control group (p>0.01). Conclusion: HIIT and SBE are equally effective in improving health parameters in obese children and adolescents.

• Journal of Yeungnam Medical Science
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• v.36 no.2
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• pp.67-77
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• 2019

The paradigm of chronic liver diseases has been shifting. Although hepatitis B and C viral infections are still the main causes of liver cirrhosis and hepatocellular carcinoma (HCC), the introduction of effective antiviral drugs may control or cure them in the near future. In contrast, the burden of nonalcoholic fatty liver disease (NAFLD) has been increasing for decades, and 25 to 30% of the general population in Korea is estimated to have NAFLD. Over 10% of NAFLD patients may have nonalcoholic steatohepatitis (NASH), a severe form of NAFLD. NASH can progress to cirrhosis and HCC. NASH is currently the second leading cause to be placed on the liver transplantation list in the United States. NAFLD is associated with obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome. The pathophysiology is complex and associated with lipotoxicity, inflammatory cytokines, apoptosis, and insulin resistance. The only proven effective treatment is weight reduction by diet and exercise. However, this may not be effective for advanced fibrosis or cirrhosis. Therefore, effective drugs are urgently needed for treating these conditions. Unfortunately, no drugs have been approved for the treatment of NASH. Many pharmaceutical companies are trying to develop new drugs for the treatment of NASH. Some of them are in phase 2 or 3 clinical trials. Here, pharmacologic therapies in clinical trials, as well as the basic principles of drug therapy, will be reviewed, focusing on pathophysiology.

• Preventive Nutrition and Food Science
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• v.21 no.1
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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.

• The Korea Journal of Herbology
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• v.29 no.2
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• pp.47-54
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• 2014

Objectives : This study was undertaken to verify the effect of Gangjihwan(Di-fatty, DF) composed with Pakistani Ephedra Herba on nonalcoholic fatty liver disease(NAFLD) using high fat diet-fed male mice. Method : Eight-week old C57BL/6N mice were used for all experiments. Standard chow diet-fed mice were used as normal group and high fat diet-fed NAFLD mice were randomly divided into 5 groups: control, atorvastatin, DF(1), DF(2) and DF(3). After 8 weeks, mice were treated with water, atorvastatin(10mg/kg) and DF(40, 80, 160mg/kg) for 8 weeks. And we investigated body weight gain, plasma lipid and glucose metabolism, histological analysis for liver on the mice. Results : Compared with controls, DF-treated mice had very significantly lower body weight gain and lower visceral adipose tissue weight, the magnitudes of which were prominent in DF(3). Consistent with their effects on body weight gain, DF-treated mice had lower blood total cholesterol and triglyceride level compared with controls. Consistent with their effects on body weight gain and blood plasma lipid level, DF-treated mice had lower liver weight and hepatic lipid accumulation of DF-treated groups was significantly decreased than control group. Also Blood plasma AST, ALT and ${\gamma}$-GT concentration were not changed by DF, and these results may indicate DF do not show any toxic effects. Conclusions : These results suggest that DF effectively improves NAFLD. DF reduces liver weight and prevents lipid accumulation of hepatocyte by reducing body weight gain and modulating blood plasma lipid metabolism levels.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.5
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• pp.470-478
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• 2019

Purpose: The incidence of non-alcoholic fatty liver disease (NAFLD) in children is gradually increasing. The aim of this study was to investigate the use of serum adiponectin and soluble adiponectin receptor 2 (soluble Adipo R2) levels for the diagnosis of fatty liver disease in obese and overweight children. Methods: The study included 51 obese and overweight children between the ages of 6 and 18 years diagnosed with NAFLD using ultrasonography and 20 children without fatty liver disease. Patients whose alanine transaminase level was two times higher than normal (${\geq}80U/L$) were included in the non-alcoholic steatohepatitis (NASH) group. Results: NASH was observed in 11 (21.6%) of the patients with NAFLD. The incidence of obesity was higher in patients with NASH (80% and 45%, p=0.021). While the adiponectin levels were similar in patients with NAFLD and those without, they were below the normal level in the whole study group. Adiponectin and soluble Adipo R2 levels of patients with NASH were lower than those in patients without NASH; however, this difference was not statistically significant (p=0.064 and p=0.463). Soluble Adipo R2 levels in obese patients with NAFLD were higher than those in obese children without NAFLD (p<0.001). Conclusion: Soluble adiponectin receptor 2 level is a noninvasive marker that can be used for the diagnosis of NAFLD in obese children.

• Journal of Korea Association of Health Promotion
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• v.4 no.1
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• pp.95-103
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• 2006

Purpose: With remarkable increase in the prevalence of childhood obesity, nonalcoholic fatty liver disease increased, The aim of this study is to evaluate the prevalence of the increase liver enzymes, lipid levels and fasting blood glucose level in normal and obese children. Methods: A total of 2206 elementary students were grouped according to obesity index; normal group and obesity group(mild, moderate, severe). Aspartate aminotransferase(AST, SGOT) and alanine aminotrausferase(ALT, SGPT) were measured with tota1 cholesterol, triglyceride and fasting blood glucose. Results: Compared with the 2.7% of ALT > 50 IU/L in normal group, obese groups showed significantly higher prevalence; 6.7% in mild obesity group, 11.8% in moderate group and 15.0% in severe group. The prevalence of hypertriglyceremia was 12,4% in normal weight group, which is significantly lower than obesity group(mild obesity group 24.8%, moderate and severe 32.1% each). Conclusion: The prevalence of nonalcoholic fatty liver increased along with severity of obesity. Of Nutritional assessment, intervention, and preferably prevention are necessary for health promotion elementary students.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2021.04a
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• pp.5-5
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• 2021

Alcoholic and nonalcoholic steaohepatitis is a leading form of chronic liver disease with few biomakers ad treatment options currently available. a progressive disease of NAFLD may lead to fibrosis, cirrhosis, and hepatocellular carcinoma. Recently, we extracted HIMH0021, which is an active flavonoid component in the Acer tegmentosum extract, has been shown to protect against liver damage caused by hepatic dysfunction. Therefore, in this study, we aimed to investigate whether HIMH0021 could regulate steatohepatitis and liver fibrosis during alcoholic or nonalcoholic metabolic process. HIMH0021, which was isolated from the active methanol extract of A. tegmentosum, inhibited alcohol-induced steatosis and attenuated the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) during hepatocellular alcohol metabolism, both of which promote lipogenesis as well as liver inflammation. Treatment with HIMH0021 conferred protection against lipogenesis and liver injury, inhibited the expression of cytochrome P4502E1, and increased serum adiponectin levels in the mice subjected to chronic-plus-binge feeding. Furthermore, in hepatocytes, HIMH0021 activated fatty acid oxidation by activating pAMPK, which comprises pACC and CPT1a. These findings suggested that HIMH0021 could be used to target a TNFα-related pathway for treating patients with alcoholic hepatitis.

• Journal of Nutrition and Health
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• v.42 no.8
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• pp.732-739
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• 2009

Metabolic syndrome has been strongly associated with elevated alanine aminotransferase (ALT), a surrogate of nonalcoholic fatty liver disease. We investigated the relationship between metabolic syndrome and elevated ALT in the general Korean population. The study sample was comprised of 4,781 Korean adults who had participated in the 2005 Korean National Health and Nutrition Examination Survey. Metabolic syndrome was defined by National Cholesterol Education Program for Adult Treatment Panel III. Elevated ALT was defined as an enzyme activity > 40 IU/L for men, and > 31 IU/L for women. ALT was measured by enzymatic methods. Among participants, 425 (8.9%) subjects displayed elevated ALT. The odds ratios (ORs) for elevated ALT increased in subjects with obesity or one of components of metabolic syndrome such as abdominal obesity, high blood pressure, high fasting glucose, high triglyceride, and low HDL cholesterol after adjusting for age and sex. The unadjusted OR for elevated ALT increased according to the number of components of metabolic syndrome (OR = 1.5, 95% CI: 0.96-2.32 for 1 component; OR = 3.0, 95% CI: 1.98-4.61 for 2 components; OR = 6.3, 95% CI: 4.29-9.35 for ${\geq}3$ components; p for trend < 0.0001). This trend did not differ after adjustments for putative risk factors including age, sex, BMI, smoking status, and alcohol intake. Metabolic syndrome is implicated as a strong risk factor of elevated ALT in Korean adults.