Non-alcoholic fatty liver disease. Some diagnostic considerations

Authors

  • Marila Suárez González Hospital “Daniel Codorniú Pruna”, Placetas, Villa Clara
  • Victor Manuel López Mejia Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Jesus Manuel Eirin Rey Hospital “Daniel Codorniú Pruna”, Placetas, Villa Clara
  • Esther Lidia González González Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Yosvany Medina Garrido Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Sarah Esther Díaz Oliva Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Keywords:

non-alcoholic fatty liver disease, diagnosis

Abstract

Introduction: non-alcoholic fatty liver is the third cause of chronic liver disease in the world and is associated with obesity, diabetes mellitus type 2 and hyperlipidemia, among others. Objective: to describe some clinical, biochemical, echographic and histological aspects in a group of patients with liver disease by non-alcoholic fat deposition. Method: a descriptive cross-sectional study was carried out from September 2014 to February 2016, the sample was 41 patients who underwent an analytical evaluation and the histological and hepatic ultrasound findings were compared. Results: the sex most affected was female (33, 80,5%); the most altered biochemical parameters were alaninoaminotransferase (34, 82,9%) and glycemia (33, 80,5%); 20 of 26 patients older than 45 years presented steatohepatitis with fibrosis and 22 of the total severe steatosis according to ultrasonography (53,6%). Conclusions: female gender and age over 45 years predominated, the alaninoaminotransferase and the glycemia were the biochemical parameters that showed the highest elevation, the most relevant ultrasonographic finding was the severe hepatic steatosis and the existence of steatohepatitis with fibrosis prevailed since the anatomopathological point of view.

Downloads

Download data is not yet available.

Author Biographies

Marila Suárez González, Hospital “Daniel Codorniú Pruna”, Placetas, Villa Clara

Especialista de I Grado en Medicina General Integral y en Gastroenterología. Profesora Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Victor Manuel López Mejia, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de I Grado en Medicina General Integral. Residente de Gastroenterología.

Jesus Manuel Eirin Rey, Hospital “Daniel Codorniú Pruna”, Placetas, Villa Clara

Especialista de I Grado en Medicina General Integral y en Cardiología. Profesor Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Esther Lidia González González, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de I Grado en Medicina General Integral y en Gastroenterología. Profesora Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Yosvany Medina Garrido, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de I Grado en Medicina General Integral. Especialista de II Grado en Gastroenterología. Profesor Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Sarah Esther Díaz Oliva, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de I Grado en Gastroenterología. Profesora Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

References

1. Ascha MS, Hanouneh IA, López R, Tamimi TA, Feldstein AF, Zein NN. The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis. Hepatology [Internet]. 2010 [citado 17 Mar 2016];51(6):1972-8. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/20209604

2. Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology [Internet]. 2010 [citado 17 Mar 2016];51(1):121-9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/19827166

3. Pérez Lorenzo M, Duarte Castillo N, Montero González T, Franco Estrada S, Winograd Lay R, Brizuela Quintanilla RA. Prevalencia del hígado graso no alcohólico en muestras de biopsias hepáticas. Rev Cubana Med Milit [Internet]. 2006 [citado 17 Mar 2016];35(4):[aprox. 7 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572006000400006&lng=es&nrm=iso&tlng=es

4. Ratziu V, Charlotte F, Bernhardt C, Giral P, Halbron M, Lenaour G, et al. Long-term efficacy of rosiglitazone in nonalcoholic steatohepatitis: results of the fatty liver improvement by rosiglitazone therapy (FLIRT 2) extension trial. Hepatology [Internet]. 2010 [citado 17 Mar 2016];51(2):445-453. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/19877169

5. Valenzuela C, Aguirre C, Castillo V, Ronco AM, Llanos M. Participación del sistema endocanabinoide en el desarrollo de obesidad. Rev Méd Chile [Internet]. 2010 [citado 17 Mar 2016];138(5):621-629. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000500014&lng=en&nrm=iso&tlng=en

6. Graham ES, Angel CE, Schwarcz LE, Dunbar PR, Glass M. Detailed characterisation of CB2 receptor protein expression in peripheral blood immune cells from healthy human volunteers using flow cytometry. Int J Immunopathol Pharmacol [Internet]. 2010 [citado 17 Mar 2016];23(1):25-34. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/20377992

7. Méndez-Sánchez N, González V, King-Martínez AC, Sánchez H, Uribe M. Plasma leptin and the cholesterol saturation of bile are correlated in obese women after weight loss. J Nutr [Internet]. 2002 [citado 7 May 2016];132(8):2195-8. Disponible en: http://jn.nutrition.org/content/132/8/2195.full.pdf

8. Louvet A, Teixeira-Clerc F, Chobert MN, Deveaux V, Pavoine C, Zimmer A, et al. Cannabinoid CB2 receptors protects against alcoholic liver disease by regulating Kupffer cell polarization in mice. Hepatology [Internet]. 2011 [citado 17 Mar 2016];54(4):1217-26. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/21735467

9. Callén L, Moreno E, Barroso-Chinea P, Moreno-Delgado D, Cortés A, Mallol J, et al. Cannabinoid receptors CB1 and CB2 form functional heteromers in brain. J Biol Chem [Internet]. 2012 [citado 17 Mar 2016];287(25):20851-65. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22532560

10. Liangpunsakul S, Chalasani N. What should we recommend to our patients with NAFLD regarding alcohol use? Am J Gastroenterol [Internet]. 2012 [citado 17 Mar 2016];107(7):976-978. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22764020

11. Crespo García J, Arias Loste MT. Esteatohepatitis no alcohólica [Internet]. En: Farreras Valenti P, Rozman C. Farreras-Rozman Medicina Interna. España: Elsevier; 2012. p. 335-340 [citado 17 Mar 2016]. Disponible en: https://www.clinicalkey.es/#!/content/book/3-s2.0-B9788490229965000405

12. Tam J, Cinar R, Liu J, Godlewski G, Wesley D, Jourdan T, et al. Peripheral cannabinoid-1 receptor inverse agonism reduces obesity by reversing leptin resistance. Cell Metab [Internet]. 2012 [citado 17 Mar 2016];16(2):167-79. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22841573

13. Fabbrini E, Sullivan S, Klein S. Obesity and nonalcoholic fatty liver disease: biochemical, metabolic, and clinical implications. Hepatology [Internet]. 2010 [citado 17 Mar 2016];51(2):679-89.Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/20041406

14. Rakoski MO, Singal AG, Rogers MA, Conjeevaram H. Meta-analysis: insulin sensitizers for the treatment of non-alcoholic steatohepatitis. Aliment Pharmacol Ther [Internet]. 2012 [citado 17 Mar 2016];32(10):1211-21. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/20955440

15. Yilmaz Y. NAFLD in the absence of metabolic syndrome: different epidemiology, pathogenetic mechanisms, risk factors for disease progression? Semin Liver Dis [Internet]. 2014 [citado 17 Mar 2016];32(1):14-21. Disponible en: https://www.researchgate.net/publication/221896525_NAFLD_in_the_Absence_of_Metabolic_Syndrome_Different_Epidemiology_Pathogenetic_Mechanisms_Risk_Factors_for_Disease_Progression

16. Liechti F, Dufour JF. Treatment of NASH with ursodeoxycholic acid: cons. Clin Res Hepatol Gastroenterol [Internet]. 2012 [citado 17 Mar 2016];36 Suppl 1:S46-52. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23141894

17. Ratziu V. Treatment of NASH with ursodeoxycholic acid: pro. Clin Res Hepatol Gastroenterol [Internet]. 2012 [citado 17 Mar 2016];36 Suppl 1:S41-5. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23141893

18. Caporaso N, Morisco F, Camera S, Graziani G, Donnarumma L, Ritieni A. Dietary approach in the prevention and treatment of NAFLD. Front Biosci (Landmark Ed) [Internet]. 2014 [citado 17 Mar 2016];17:2259-68. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22652776

19. Di Rosa M, Malaguarnera L. Genetic variants in candidate genes influencing NAFLD progression. J Mol Med (Berl) [Internet]. 2012 [citado 17 Mar 2016];90(2):105-118. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/21894552

20. Kim MS, Kung S, Grewal T, Roufogalis BD. Methodologies for investigating natural medicines for the treatment of nonalcoholic fatty liver disease (NAFLD). Curr Pharm Biotechnol [Internet]. 2012 [citado 17 Mar 2016];13(2):278-291. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/21470125

Downloads

How to Cite

1.
Suárez González M, López Mejia VM, Eirin Rey JM, González González EL, Medina Garrido Y, Díaz Oliva SE. Non-alcoholic fatty liver disease. Some diagnostic considerations. Acta Méd Centro [Internet]. 2017 Apr. 3 [cited 2025 Jul. 1];11(2):10-8. Available from: https://revactamedicacentro.sld.cu/index.php/amc/article/view/811

Issue

Vol. 11 No. 2 (2017): April-June

Section

Original Articles

License

Authors who have publications with this journal agree to the following terms:

  1. Authors will retain their copyright and assign to the journal the right of first publication of their work, which will simultaneously be subject to a Creative Commons License / Attribution-Noncommercial 4.0 International (CC BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
  2. Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g., depositing it in an institutional repository or publishing it in a monographic volume) as long as the initial publication in this journal is indicated.
  3. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which can produce interesting exchanges and increase citations of the published work. (See The effect of open access).