ObjectiveTo expounded the relationship between phenylalanine, tyrosine and their metabolites and non-alcoholic fatty liver disease (NAFLD). MethodThe literatures related to NAFLD in recent years were reviewed and analyzed. ResultThe levels of phenylalanine, tyrosine and their metabolites had changed significantly in the occurrence and development of NAFLD, and could lead to the progress of NAFLD by affecting the related pathways of lipid metabolism. ConclusionPhenylalanine, tyrosine and their related metabolites are associated with NAFLD, but the specific pathogenesis is still unclear.
Objective To investigate the diagnostic value of proton magnetic resonance spectroscopy （1 H-MRS） on the quantification of hepatic steatosis at 3.0 T MR united.Methods Twenty-two patients who were candidated for liver surgery (living liver transplantation donor candidates, lobectomy or segmental resection for focal liver diseases, etc.) were enrolled in this study. 1 H-MRS was conducted with point resolved selective spectroscopy （PRESS） sequence, using SAGE software packages. The values of water peak (PW), lipid peak (PL) were measured, the area under water peak (AW) and lipid peak (AL), and then the relative lipid content of liver cells (RLC1, RLC2) was calculated. All subjects underwent surgical resection of liver shortly after MR scanning, fresh frozen specimens were obtained for Sudan Ⅲ staining, and staging was conducted.Results In all 22 patients, 7 patients without fatty liver, 11 patients with mild fatty liver, 4 patients with moderate or severe fatty liver. Intercomparison between different histopathological grades showed following findings: the values of PL, AL, RLC1 and RLC2 had statistical significance (Plt;0.05). The values of PL， AL， RLC1 and RLC2 were positively correlated with the proportion of fatty degenerative cells (PFDC), Plt;0.05, and the highest correlation factor was 0.771 (RLC1 to the PFDC).Conclusion 1 H-MRS can accurately quantify liver fat content and reflect the severity of hepatic steatosis. It has the potential to replace invasive liver biopsy.
Objective To evaluate the value of medical imaging technology in qualitative and quantitative diagnosis of liver steatosis. Methods To describe the current status and advancement s of medical imaging technology such as sonography , CT and MRI in qualitative and quantitative diagnosis of liver steatosis , and to cont rast their advantages and shortages. Results Sonography could be used as the primary screening and evaluate measures in qualitative and quantitative diagnosis of liver steatosis , and CT was more reliable in quantitative diagnosis , MRI had significant improving with its high sensitivity and specificity. Conclusion Medical imaging technology has significant clinical value in qualitative and quantitative diagnosis of liver steatosis , especially with the help of functional MR imaging techniques such as spect roscopy and chemical shif t Gradient-Echo technic.
ObjectiveTo investigate the value of proton magnetic resonance spectroscopy (1H-MRS), gradient dual-echo, and triple-echo sequences in the quantitative evaluation of treatment effect of fatty liver at 3.0T MR.MethodsThirty patients with fatty liver diagnosed by CT or ultrasound who admitted in Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital between August 2017 and May 2018, were enrolled and undergone gradient dual-echo, triple-echo, and 1H-MRS examination before and 3 months after treatment. The fat index (FI) and relative lipid content (RLC) were measured. Fatty liver index (FLI) was calculated from blood biochemical indicators, waist circumference, and BMI at the same time. With the reference standard of FLI, the results before and after treatment measured from MRI were analyzed.ResultsThere were significantly differences of FLI, FIdual, FItriple, and RLC before and after treatment (t=5.281, P<0.001; Z=–3.651, P<0.001; Z=–3.630, P<0.001; Z=–4.762, P<0.001), all indexes decreased after treatment. FIdual and FItriple were positively correlated with FLI before (rs=0.413, P=0.023; rs=0.396, P=0.030) and after treatment (rs=0.395, P=0.031; rs=0.519, P=0.003), the highest correlation factor was FItriple to FLI after treatment. There were no significant correlation between RLC and FLI before and after treatment (P>0.05).ConclusionsIt is feasible to quantitatively evaluate the treatment effect of fatty liver by using 1H-MRS, gradient dual-echo, and triple-echo sequences. Gradient triple-echo sequences has better accuracy, which is technically easy to implement and more suitable for clinical development.
Objective To explore the relationship between different diagnostic criteria (ATPIII2002, IDF2005 and CDS2007 criteria) for metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD). Methods A total of 666 elderly males admitted to West China Hospital for routine physical examination were involved in this study in May, 2010. The diagnostic agreement rates of different criteria were compared, along with the relationship between different diagnostic criteria for MS and NALFD. Results The diagnostic agreement of CDS2007 criteria with either IDF2005 or ATPIII2002 criteria was good. However, the agreement of ATPIII2002 with IDF2005 was compromised. The prevalence of NAFLD in MS group was significantly higher than that of non-MS group (Plt;0.01). On the basis of CDS2007 criteria, there was significant correlation between NAFLD and MS (Plt;0.000). Conclusion There is a close relation between NAFLD and all three diagnostic criteria of MS. NAFLD is one of the most important risk factors of MS. The diagnostic agreement of CDS2007 criteria with the other two is good, and there is significant correlation between NAFLD and criteria CDS2007 of MS. CDS2007 is found to be of high accuracy and applicability in the diagnosis of MS in Chinese population including the elderly.
摘要:目的：探討成都地區體檢人群中丙氨酸氨基轉移酶（ALT）升高率與其升高的相關因素,為正確分析引起ALT升高的原因提供相關依據。方法:以參與體檢的8734名體檢人群為研究對象,收集身高、體重、血壓、丙氨酸氨基轉移酶、空腹血糖、高密度脂蛋白、低密度脂蛋白、總膽固醇、甘油三酯、血清HBsAg、脂肪肝及膽石癥等相關資料進行分析。結果:在全部體檢人群中,ALT升高率為1011%,男性ALT升高率為13.70%,女性ALT升高率為6.30%,男性明顯高于女性（Plt;0001）；ALT升高組的年齡均數小于ALT正常組（Plt;0001）；在ALT升高的受檢者中,脂肪肝、高脂血癥、肥胖、糖尿病、膽囊結石、飲酒及乙肝等患病率均高于ALT正常組受檢者（Plt;005）。結論:脂肪肝、糖脂代謝紊亂及乙肝是體檢人員ALT升高的主要原因；男性和低齡也是體檢者ALT升高的危險因素。Abstract: Objective: To investigate the prevalence and relative factors of elevated serum alanine aminotransferase(ALT) levels and providescientific bases for its causes analysis in physical examination people in Chengdu. Methods: Subjects who received medical examination in physical examination center of west China hospital were screened in this study. The information of height, body weight, blood pressure, serum ALT, fasting plasma glucose, highdensity lipoprotein cholesterol, lowdensity lipoprotein cholesterol, total cholesterol, triglyceride, hepatitis B surface antigen (HBsAg) statue, fatty liver and cholelithiasis were collected and analyzed. 〖WT5”HZ〗Results:〖WT5”BZ〗 A total of 8734 cases were included in this study. The total prevalence of elevated ALT was observed in 1011%, including 137% in man and 63% in woman, and this difference between man and woman was statistic significant (P＜0001). The mean age of ALT elevated group was obvious lower than that of normal ALT group (P＜0001). Interesting, the occurrence rates of fatty liver, hyperlipidemia, obesity, diabetes,gallstones, drinking and positive hepatitis B surface antigen in ALT elevated group were all significant higher than that in normal ALT group (P＜005). Conclusion: Fatty liver, glyeolipid metabolism disorder, and hepatitis B were main reasons of elevated ALT. Male and young cases were both high risk of elevated ALT in this study.
ObjectiveTo summarize the mechanism of endoplasmic reticulum stress (ERS) in liver diseases. MethodWe sorted out and summarized the studies related to ERS and liver diseases in recent years. ResultsEndoplasmic reticulum plays important roles in protein folding, calcium ion storage, and lipid synthesis in cells. ERS will be induced when the number of misfolded/unfolded proteins in the endoplasmic reticulum increases or the calcium ion homeostasis is unbalanced. The endoplasmic reticulum regulates the unfolded protein response through three transmembrane receptor proteins to initiate corresponding pathways for restoring endoplasmic reticulum homeostasis. Prolonged stress can lead to metabolic disorders. Mild ERS can promote the progression of hepatocellular carcinoma, and continuous ERS will induce cell apoptosis and play an anti-tumor effect; ERS can promote lipid accumulation in non-alcoholic fatty liver disease and aggravate the progression of the disease; in hepatic ischemia reperfusion injury, ERS activation will aggravate liver damage. Meanwhile, ERS activation plays an important pathogenic role in the pathogenesis of drug-induced liver injury. ConclusionERS plays a crucial regulatory role in the occurrence and development of liver-related diseases, providing a theoretical basis and new approach for targeted ERS therapy in liver diseases.
