Background: Nonalcoholic fatty liver disease has become a worldwide challenge. Liver biopsy remains the single most reliable approach to determine the severity of this disease. As patients with nonalcoholic fatty liver disease require close follow-up, performing this invasive method repeatedly seems impractical; therefore, designing a noninvasive system to follow up patients has become a common interest. Objectives: We intended to investigate the association between platelet counts of patients with nonalcoholic fatty liver disease and the severity of their disease based on serum levels of liver enzymes and grade of fatty liver on ultrasonography. Patients and Methods: One thousand, three hundred and five patients with nonalcoholic fatty liver disease were included in this descriptive study. Serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and platelet counts of patients were measured. The grade of fatty liver was determined by abdominal ultrasonography. Results: Of our study population, 54.3% (n = 708) were women. Patients with mild fatty liver on ultrasonography had lower platelet counts than those with moderate and severe fatty liver. However, no cutoff value of platelet count could reliably distinguish different grades of fatty liver. We found no significant association between platelet counts and serum levels of AST, ALT or ALP. However, we showed that male patients with abnormal levels of ALT had higher platelet counts. Conclusions: Platelet count in nonalcoholic fatty liver disease can serve as a clue to the severity of disease, but it cannot be considered as a sole test to follow up patients.

/pdf/association-between-platelet-count-as-a-noninvasive-marker-2gfp19ouol.pdf

Association Between Platelet Count as a Noninvasive Marker and Ultrasonographic Grading in Patients With Nonalcoholic Fatty Liver Disease

Background: Non-alcoholic fatty liver disease (NAFLD) is characterized by macro vesicular steatosis in the absence of alcohol. Patients with (NAFLD)need extensive education and support in their treatment. Our aim was to investigate the effect of telenursing on liver enzymes (ALT and AST) in patients with NAFLD. Methods: Our study is a randomized controlled clinical trial. In this study, 60 patients were enrolled from patients who referred to subspecialty gastrointestinal clinics affiliated to Shiraz University of Medical Sciences. Specialists confirmed their diseases by ultrasound and laboratory test. Simple randomization, based on random number table, was used to randomize the participants into intervention (N=30) and control (N=30) groups. Patients in both groups received dietary advice from a nutritionist and were trained to perform physical activities. Telephone intervention in the intervention group lasted for 12 weeks, in order to see the effect of follow up on the recommended diet and physical activities given by the specialist, while; the control group subjects were only followed up as usual by their physician. Results: The result of an independent t-test showed that the mean difference of liver Enzymes between the two groups was statistically significant (P<0.001). The difference of AST and ALT in the intervention and control groups was 18.03 , -1.27 and 40.70, 1.52, respectively. Conclusion: We found out that; telenursing could have a positive effect on reduction of liver enzymes (ALT, AST) in patients with NAFLD. Trial Registration Number: IRCT2015040411691N5

http://ijcbnm.sums.ac.ir/article_40749_bd8a52ed0e16047ced4765ce0c8e26cd.pdf

The Effect of Follow up (Telenursing) on Liver Enzymes in Patients with Nonalcoholic Fatty Liver Disease: A Randomized Controlled Clinical Trial.

Background and Objective: Obesity in childhood increases the risk of fatty liver disease. With respect to the increased prevalence of obesity in Iran and the world, this study aimed to investigate the relationship between fatty liver and obesity in 6 -18 year-old children. Methods: In this case-control study, 25 overweight children and 24 obese children, who had inclusion criteria, were selected by convenience sampling method. Then 27 children and teenagers with normal weight and the same sex and age were selected as the control group. Weight and height of the participants were measured and recorded, liver enzymes ALT and AST were performed for them. Data was analyzed in SPSS software using chi-square test, one-way ANOVA, Tukey range follow-up, and logistic regression. The significant level was set at p<0.05. Results: The results showed that the relative frequency of occurrence of fatty liver increased significantly along with increasing body mass index (p<0.001). There was a significant relationship between sex, body mass index, and the prevalence of fatty liver in the participants. However, no significant relationship was found between fatty liver disease and AST and ALT (p>0.05). Conclusion: There was a strong relationship between NAFLD and the abnormal body mass in children. It will be very useful if obese children to screen for susceptible to NAFLD.

The relationship between Nonalcoholic fatty liver disease and obesity in children

Introduction: One of the most common forms of chronic liver disease related to lifestyle is non-alcoholic liver disease
Objectives: The present study was conducted to compare weight and waist circumference of patients with and without non-alcoholic fatty liver disease (NAFLD) referred to hospitals affiliated to Tehran University of Medical Sciences in 2017
Patients and Methods: This case-control study was carried out on 300 outpatients and inpatients patients aged between 18 to 65 years referred to the ultrasonography section of hospitals with convenience sampling method Based on the results of ultrasonography, these subjects were divided into two groups; case (100 patients) and control group (200 subjects)
Results: The mean BMI (body mass index) and waist circumferences of patients without NAFLD were 2247 ± 197 kg/m2 and 8384 ± 868 cm, respectively, while in the patients with fatty liver the mean BMI and waist circumference were 2610 ± 221 kg/m2 and 9883 ± 728 cm, respectively (P = 0001)
Conclusion: The results of the data analysis showed that the patients with fatty liver have high levels of BMI in comparison with those who had not fatty liver Regarding the high prevalence of non-alcoholic fatty liver, lifestyle changes and the implementation of educational interventions to increase awareness are necessary

Comparison of body mass index and waist circumference of patients with and without nonalcoholic fatty liver in Tehran

Introduction: Nutrition as a modifiable risk factor that plays an important role in prevent or delay the onset of non-alcoholic fatty liver disease (NAFLD). Thus, the aim of the current study was to assess and compare physical activity, dietary fiber and sugar intake between non-alcoholic fatty liver disease and healthy individuals.Methods: The present case-control study was done on 225 cases of NFLD and 450 controls. International Physical Activity Questionnaire and Food Frequency questionnaire were used respectively to assess the physical activity level and dietary intake of individuals. Anthropometric measurements included weight, height, body mass index (BMI) and waist to hip ratio ware calculated for the subjects. All data were analysed using SPSS version 21.0. Results: the result of our study showed that the physical activity level of NAFLD patients were lower than control group (P<0.05). For the insoluble dietary fiber, we observed a significant lower consumption in the case group as compared to the control group (P<0.05). The fructose, galactose, total sugar, and glucose variables showed significant increase in the case group (P<0.05). Conclusions: Our results indicated that following unhealthy diet such as high consumption of simple carbohydrates such as glucose, fructose, and galactose might be related to NAFLD. However, consuming dietary fiber and insoluble fiber may play protective roles in NAFLD.

https://jnfh.mums.ac.ir/article_13785_badacd1fe0e5fed70c7c1f941377fdf5.pdf

Comparison of Physical Activity and Fiber and Sugar Intake in Patients with Nonalcoholic Fatty Liver Disease with Healthy Individuals

Background: Nonalcoholic fatty liver disease (NAFLD) describes a common clinicopathological
condition characterized by significant lipid deposition in the hepatocytes in patients
without history of excessive alcohol ingestion. The objective of this study was to assess the clinical
and paraclinical features and risk factors of NAFLD patients in comparison with healthy
population.
Materials and Methods: In this case-control study, 102 patients with NAFLD were compared
with 102 controls in East Azerbaijan province. The diagnosis of NAFLD was provided by liver
ultrasonography to confirm the presence of steatohepatitis. Liver function tests, lipid profile, blood
sugar, body mass index (BMI) and waist circumference were measured in all participants. The
statistical analysis was performed using chi-square, t tests and logistic regression model and
P<0.05 was considered significant.
Results: This study consists of 102 patients (56 men and 46 women) and 102 controls (43 men
and 59 women) (P=0.089). The mean ± SD of age of the patients was 42.53 10.70 years and
45.46 13.51 years for controls (P=0.069). The mean SD of BMI was 30.51 4.69 in patient
group and 26.48 4.40 in control group (P<0.0005). The 9.8 percent of patients were underweight,
41.17 percent were in normal range and 49.01 percent were obese.
The central obesity was seen in 59.8 percent of patients and 30.7 percent of controls (P<0.05).
The incidence of some characteristics in patients and controls were as follow respectively:
hypertriglyceridemia (63.7% vs. 20.2%), hypercholesterolemia (20.2% vs. 9.8%), hypertension
(47.6% vs. 10.8%), diabetes (21.4% vs 2.3%), and elevated ALT (46.6% vs 0.9%). Elevated AST
level was more common in the NAFLD group (37.9%) compared to control group (2.9%)
(P<0.0005). Hypertension, grade of BMI and hypertriglyceridemia were recognized as independent
predictors.
Conclusion: NAFLD has similar characteristics in our population compared to other parts of
the world. Hypertension high, grades of BMI and hypertriglyceridemia are suggested as useful
indicators for screening of NAFLD in our population.

m Tarzmani

Papers

Clinico- biochemical comparison of patients with Nonalcoholic fatty liver disease and healthy populace