الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Nonalcoholic fatty liver disease (NAFLD) and non alcoholic steatohepatitis (NASH) are highly prevalent diseases, and it is estimated that a quarter of the adult population currently has NAFLD. Furthermore, 20% to 30% of patients with NAFLD will develop fibrosing steatohepatitis that may progress to cirrhosis, end stage liver disease, and hepatocellular carcinoma Aim of the work: To find a causal relationship or an association between the fatty liver and atherosclerotic heart disease depending on clinical and laboratory bases. Method: The present study included 100 subjects selected from attendants of Out and/or Inpatients Medical Clinics, Mansoura University Hospitals (MUH) during the period between August 2003 to October 2005. Subjects were divided into 4 groups according to the presence or absence of fatty liver and atherosclerotic heart disease or their risk factors matched for each other regarding sex and age. Group I : 25 patients with fatty liver disease. Group II : 25 patients with atherosclerotic coronary heart disease. Group III : 25 patients with risk factors for both atherosclerotic heart disease and fatty liver (obesity, hypertension, type 2 diabetes etc). Group IV : 25 healthy control group. Results: Mean age was 47 years; it was relatively high in group II with ischemic heart disease when compared to group I with NAFLD and group III with risk factors respectively. There was no significant sex difference among all groups but male sex was predominated in group I with NAFLD. Age, BMI and WHR (truncal obesity) were important typical clinical parameters that were significantly correlated with the laboratory parameters of that continuous spectrum of clinical disorders i.e. overt NAFLD, overt atherosclerotic coronary heart disease and their preclinical predictors. Conclusions: Hepatomegally (clinically or by abdominal ultrasonography) rather than the mere presence of hepatic steatosis (liver biopsy) was significantly correlated with the metabolic abnormalities associated with NAFLD. That is the more the liver is overloaded with fat the more severe is the metabolic abnormalities present. Myocardial ischemia (ECG & EchoDoppler study) was significantly correlated with the same metabolic abnormalities associated with NAFLD and to a lesser degree in patients with risk factors. |