• 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.

• Journal of Sasang Constitutional Medicine
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• v.27 no.1
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• pp.82-109
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• 2015

Objectives This research was proposed to present Clinical Practice Guideline (CPG) for Prevention of Sasangin disease pattern of Sasang Constitutional Medicine (SCM) and diseases closely related with Sasang constitution. Each CPG was developed by the national-wide experts committee consisting of SCM professors. Methods At first, we searched the literatures related to SCM such as "Dongeuisusebowon", Textbook of SCM and Clinical Guidebook of SCM. Also we searched the articles related to the studies about risk factors for Sasangin disease pattern of both at home and abroad. Finally, we selected leading risk factors of Sasangin disease pattern and developed CPG for prevention of Sasangin disease pattern of SCM. And then, we searched the literatures related SCM such as "Dongeuisusebowon" and the articles on the correlation between disease and Sasang constitution using case-control studies, observational studies or cross sectional studies of both at home and abroad. Next, we selected diseases closely related with Sasang constitution on the basis of articles including prevalence rate and odds ratio between disease and Sasang constitution and finally developed CPG for these diseases. Results and Conclusions We categorized risk factors of Sasang disease pattern into 2 types: non-modifiable and potentially modifiable. 3 items (age, sex and genetic factors) were classified as non-modifiable risk factors of Sasang disease pattern. 6 items (original symptom, stress, diet and nutrition, physical activity, alcohol and drug misuse) were classified as less well-documented or potentially modifiable risk factors of Sasangin disease pattern. We found out Sasang constitution is more likely to develop some diseases. It was proven that Sasang constitution increase the risk of hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. And there is high probability of Sasang constitution being potential risk factor for obesity, hyperlipidemia, allergy and cancer. Also, we found out Taeeumin is independent risk factor for hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. Therefore we recommend that Taeeumin need to prevent these disease by regular checkups and aggressive management.

• Journal of Life Science
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• v.22 no.9
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• pp.1261-1267
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• 2012

The aim of the present study was to investigate effects of a 12-week aerobic exercise training program and a gym-ball exercise training program on body composition, aspartate aminotransferase (AST), alanine aminotransferase (ALT), adipokines, and cardiovascular risk factors in obese children with nonalcoholic fatty liver disease. The subjects were separated into two groups, an aerobic exercise group (n=10), which practiced moderate aerobic exercise training for 12 weeks, and a gym-ball exercise group (n=13), which practiced resistance exercise training for 12 weeks. The results of the analyses are as follows: Weight, body mass index, and body fat were significantly lower (p<0.01, respectively), whereas the $VO_2$ max was higher in both groups (p<0.01). Fasting glucose, insulin and HOMA-IR levels were significantly decreased in the gym-ball exercise group (p<0.05), whereas adiponectin, AST, and ALT levels were significantly increased (p<0.05, p<0.001, p<0.001, respectively) in both groups after the 12-week exercise training program. In addition, our results showed that HOMA-IR, insulin, and concentrations of C-reactive protein (CRP) were significantly lower in both groups. They demonstrate that a 12-week program of regular aerobic exercise or gym-ball exercise yields beneficial effects such as an amelioration of cardiovascular risk factors, body indices, and liver function in obese children with nonalcoholic fatty liver disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.5
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• pp.455-469
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• 2021

Purpose: The rs641738 C>T in membrane-bound O-acyltransferase domain-containing protein 7 (MBOAT7) is implicated, along with the rs738409 C>G polymorphism in patatin-like phospholipase domain-containing protein 3 (PNPLA3), in nonalcoholic fatty liver disease (NAFLD). The association of these polymorphisms and NAFLD are investigated in Hispanic children with obesity. Methods: Obese children with and without NAFLD were enrolled at a pediatric tertiary care health system and genotyped for MBOAT7 rs641738 C>T and PNPLA3 rs738409 C>G. NAFLD was characterized by the ultrasonographic presence of hepatic steatosis along with persistently elevated liver enzymes. Genetic variants and demographic and biochemical data were analyzed for the effects on NAFLD. Results: Among 126 enrolled subjects, 84 in the case group had NAFLD and 42 in the control group did not. The two groups had similar demographic distribution. NAFLD was associated with abnormal liver enzymes and elevated triglycerides and cholesterol (p<0.05). Children with NAFLD had higher percentage of PNPLA3 GG genotype at 70.2% versus 31.0% in non-NAFLD, and lower MBOAT7 TT genotype at 4.8% versus 16.7% in non-NAFLD (p<0.05). PNPLA3 rs738409 C>G had an additive effect in NAFLD; however, MBOAT7 rs641738 C>T had no effects alone or synergistically with PNPLA3 polymorphism. NAFLD risk increased 3.7-fold in subjects carrying PNPLA3 GG genotype and decreased in MBOAT7 TT genotype. Conclusion: In Hispanic children with obesity, PNPLA3 rs738409 C>G polymorphism increased the risk for NAFLD. The role of MBOAT7 rs641738 variant in NAFLD is less evident.

• Molecules and Cells
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• v.44 no.2
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• pp.116-125
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• 2021

Cardiovascular diseases (CVDs) are the most common cause of death in patients with nonalcoholic fatty liver disease (NAFLD) and dyslipidemia is considered at least partially responsible for the increased CVD risk in NAFLD patients. The aim of the present study is to understand how hepatic de novo lipogenesis influences hepatic cholesterol content as well as its effects on the plasma lipid levels. Hepatic lipogenesis was induced in mice by feeding a fat-free/high-sucrose (FF/HS) diet and the metabolic pathways associated with cholesterol were then analyzed. Both liver triglyceride and cholesterol contents were significantly increased in mice fed an FF/HS diet. Activation of fatty acid synthesis driven by the activation of sterol regulatory element binding protein (SREBP)-1c resulted in the increased liver triglycerides. The augmented cholesterol content in the liver could not be explained by an increased cholesterol synthesis, which was decreased by the FF/HS diet. HMG-CoA reductase protein level was decreased in mice fed an FF/HS diet. We found that the liver retained more cholesterol through a reduced excretion of bile acids, a reduced fecal cholesterol excretion, and an increased cholesterol uptake from plasma lipoproteins. Very low-density lipoproteintriglyceride and -cholesterol secretion were increased in mice fed an FF/HS diet, which led to hypertriglyceridemia and hypercholesterolemia in Ldlr-/- mice, a model that exhibits a more human like lipoprotein profile. These findings suggest that dietary cholesterol intake and cholesterol synthesis rates cannot only explain the hypercholesterolemia associated with NAFLD, and that the control of fatty acid synthesis should be considered for the management of dyslipidemia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.204-209
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• 2008

Non-alcoholic fatty liver disease (NAFLD) is typically associated with obesity and insulin resistance. Non-alcoholic steatohepatitis (NASH) is a more serious form of NAFLD. Although fibrosis is common in pediatric NASH, cirrhosis has been rarely reported. Patients with hypothalamic or pituitary dysfunction are at risk for obesity and insulin resistance with subsequent development of NAFLD. We report a case of NAFLD progressing to cirrhosis in an obese 16 year-old boy with hypopituitarism.

• Korean Journal of Radiology
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• v.23 no.1
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• pp.13-29
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• 2022

Nonalcoholic fatty liver disease, characterized by excessive accumulation of fat in the liver, is the most common chronic liver disease worldwide. The current standard for the detection of hepatic steatosis is liver biopsy; however, it is limited by invasiveness and sampling errors. Accordingly, MR spectroscopy and proton density fat fraction obtained with MRI have been accepted as non-invasive modalities for quantifying hepatic steatosis. Recently, various quantitative ultrasonography techniques have been developed and validated for the quantification of hepatic steatosis. These techniques measure various acoustic parameters, including attenuation coefficient, backscatter coefficient and speckle statistics, speed of sound, and shear wave elastography metrics. In this article, we introduce several representative quantitative ultrasonography techniques and their diagnostic value for the detection of hepatic steatosis.

• The Journal of Pediatrics of Korean Medicine
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• v.33 no.2
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• pp.12-21
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• 2019

Objectives Coptidis Rhizoma and Glycyrrhiza Uralensis are herbs that treat obesity and dampness-phlegm. The aim of this study is to investigate the efficacy of Coptidis Rhizoma and Glycyrrhiza Uralensis on lipid deposition with nonalcoholic fatty liver disease (NAFLD). Methods Male 6-week-old C57BL/6 male mice were divided into three groups: control group (Ctrl), high fat diet group (HFF), and high fat diet with Coptidis Rhizoma and Glycyrrhiza Uralensis extract administration group (CGT). Each 10 mice were allocated to each group (total of 30 mice). All mice were allowed to eat fat rich diet freely throughout the experiment. To examine the effect of Coptidis Rhizoma and Glycyrrhiza Uralensis, we observed weight changes, total cholesterol and glucose levels, lipid blot distributions, PGC-1, p-$I{\kappa}B$, and p-JNK. Results Body weights for all mice were measured and analyzed the difference between the groups. Weight gain was significantly lower in CGT group than the HFF group. Total cholesterol and glucose levels were significantly lower in CGT group. The distribution of lipid blots and positive reaction of PGC-1 were significantly lower in CGT group. The positive reaction of p-$I{\kappa}B$ in hepatic tissues was significantly lower in CGT group. The positive reaction of p-JNK in hepatic tissues was significantly lower in CGT group. Conclusions Coptidis Rhizoma and Glycyrrhiza Uralensis have the effect of improving non - alcoholic fatty liver induced insulin resistance through regulation of lipid metabolism.

• The Journal of Korean Medicine
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• v.41 no.4
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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.

• The Journal of Korean Medicine
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• v.32 no.1
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• pp.109-120
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• 2011

Objectives: The aim of this investigation was to evaluate the efficacy of KHchunggan-tang aqueous extract on the experimental nonalcoholic fatty liver disease(NAFLD) induced by palmitate. Materials and Methods: To generate a cellular model of NAFLD, we used HepG2 cells, a human hepatoma cell line, treated with 0.5 mM palmitate. By this cellular model, effects of KHchunggan-tang aqueous extract were evaluated. Intracellular lipid accumulation, free radical formation, and apoptosis were detected by Nile red staining, 2',7'-dichloroflourescin diacetate(H2DCF-DA), and 4',6-diamidino-2-phenylindole(DAPI)/propidium iodide(PI) staining, respectively. Some proteins related with NAFLD were determined by western blot. Results: Typical pathological features of NAFLD occurred in the cellular model. Palmitate increased the levels of intracellular lipid vacuoles, decreased cell viability, and increased apoptosis. Palmitate increased free radical formation and lipid peroxidation, too. However, KHchunggan-tang aqueous extract reduced palmitate-induced pathologic features, i.e. steatosis, free radical formation, and apoptosis. In addition, KHchunggan-tang aqueous extract suppressed palmitate-activated c-Jun N-terminal kinase(JNK) signaling, and SP600125, a JNK inhibitor, significantly reversed the palmitate-induced pathologic changes as KHchunggan-tang aqueous extract. It means that the signaling pathway other than JNK can be involved in the KHchunggan-tang mediated cellular protection of palmitate-treated Hep G2 cells. Conclusions: These results suggest that KHchunggan-tang aqueous extract has hepatoprotective effects on NAFLD with combined properties in cellular steatosis, ROS production, and cytoprotection, and thus may have valuable clinical applications for treatment of this chronic liver disease.