• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.185-192
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• 2007

Purpose: This study was conducted to evaluate the role of adiponectin, leptin, and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) in obese children, and to elucidatethe relationship between these adipokines and insulin resistance. Methods: A total of 61 obese children (M : F=42 : 19, mean age 11.2${\pm}$1.3 years) admitted to our facility between March 2004 and June 2005 were included in this study. Patients were divided into three groups based on their NAFLD status obese children without fatty liver (N=23); obese children with simple steatosis (N=20); and obese children with non-alcoholic steatohepatitis (NASH) (N=18). The serum levels of adiponectin, leptin, and TNF-${\alpha}$ were measured, and insulin resistance determined by homeostasis model assessment (HOMA-IR) was calculated to estimate insulin resistance. In addition, the VSR (visceralsubcutaneous fat ratio) was estimated using abdominal computed tomography. Results: There was no difference in serum TNF-${\alpha}$ and leptin levels observed between the 3 groups (22.13${\pm}$6.37 vs. 21.35${\pm}$6.95 vs. 25.17${\pm}$9.30; p=0.342 & 20.29${\pm}$8.57 vs. 16.42${\pm}$6.85 vs. 20.10${\pm}$7.86; p=0.330). However, the serum adiponectin level was significantly lower in children with non-alcoholic steatohepatitis (NASH) than in the other two groups (6.08${\pm}$1.38 in children without steatosis vs. 5.69${\pm}$0.79 in simple steatosis vs. 4.93${\pm}$1.75 in NASH; p=0.026). In addition, the VSR was significantly increased in the NASH group (0.31${\pm}$0.08 vs. 0.32${\pm}$0.11 vs. 0.47${\pm}$0.14; p=0.001), and HOMA-IR revealed a significant difference among the three groups (4.77${\pm}$3.67 vs. 6.89${\pm}$7.05 vs. 10.42${\pm}$6.73; p=0.000). However, there was no significant correlation observed between the adiponectin levels and the HOMA-IR or the VSR (r=-0.117; p=0.450 & r=-0.106; p=0.499). Conclusion: Insulin resistance may affect the development of hepatic steatosis and steatohepatitis in children, and the results of this study suggest that, of several adipokines evaluated, adiponectin is important in the progression of steatosis to steatohepatitis in obese children.

• The Monthly Diabetes
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• s.257
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• pp.34-35
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• 2011

당뇨병과 간은 상관관계가 없는 것 같지만 그동안 당뇨병과 간에 대한 연구가 여러 차례 진행돼 왔다. 우리나라에서 2001년 연구한 바에 따르면 제 2형 당뇨병에서 C형 간염의 발생률이 높은 것으로 나타났다. 뿐만 아니라 당뇨병환자에서 비알콜성 지방간이 흔하게 관찰되는 것으로 보고되고 있다. 반면 간 질환자에서 당뇨병 발생빈도가 10~30%로 매우 높게 나타나 당뇨병과 간이 밀접한 연관성이 있음을 짐직할 수 있다.

• The Journal of the Korean life insurance medical association
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• v.25
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• pp.103-118
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• 2006

근래에 한국의 생명보험 시장에는 주요 질병의 보장을 위한 상품들이 연일 쏟아져 나오고 있다. 그러나 이와 함께 증가될 수 있는 리스크에 대한 대비는 상대적으로 부족한 실정이다. 특히 간질환에 의한 급부발생이 타질환에 비하여 현격하게 높은 국내 실정에 맞게 언더라이팅 초점이 맞추어져야 할 필요가 있다. 간질환 유발인자로 대표적인 것은 B형 간염이지만, 과다한 알코올 섭취에 의한 간질환 역시 매해 빠른 속도로 증가하는 추세이다. 따라서 본 논문에서는 알코올에 의한 질환의 종류와 이와 관련된 보험금 청구 통계, 그리고 음주로 인한 교통사고의 폐해에 대해 살펴보고, 알코올 남용자를 사전에 판별할 방법을 찾아보고자 한다. 일반적으로 알려져 있는 알코올 관련 질환으로는 지방간, 알코올성 간염, 알코올성 간경변이 있으며, 이로 인한 급부발생율은 급격히 증가하고 있다. 음주로 인한 폐해는 단순히 간질환에 그치지 않고 있으며, 교통사고의 상당수가 음주와 관련이 되어있다. 이러한 리스크에 대해 국내의 상당수 보험사들은 혈액검사를 통하여 간기능에 대한 기준을 설정하여 언더라이팅을 하고 있다. 현재 주로 시행되고 있는 간기능 검사들에 대한 정확도에 대해서는 논란이 있을 수 있다. 따라서 보다 정밀한 검사법들에 대한 연구가 필요할 것이다. 외국의 경우, 보험을 가입하고자 하는 보험 대상자들은 직업이나 흡연, 위험 취미뿐만 아니라 알코올과 관련된 일정한 양식의 질문표에 대하여 성실하게 고지하도록 하고 있다. 국내에도 알코올과 관련된 자세한 고지항목을 첨부하여, 일정 기준에 미치지 못하는 가입자에 대하여 표준미달체로 분류하여 보다 정밀한 검진을 통해 세밀한 언더라이팅이 이루어져야 하겠다. 이와 아울러, 알코올로 인한 사회적 폐해의 심각성에 대한 인식 확대를 위한 각 보험사 및 유관기관의 노력이 전개된다면, 음주에 대한 진사 절차가 수월해질 것으로 기대된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.51-57
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• 2010

Purpose: It has been reported that children with hypopituitarism have features of metabolic syndrome, including obesity, impaired glucose tolerance, and dyslipidemia. The aim of this study was to investigate the clinical features and liver histology of pediatric non-alcoholic fatty liver disease (NAFLD) associated with hypopituitarism. Methods: We reviewed the clinical data of 11 children diagnosed with NAFLD among patients with hypopituitarism. Results: The mean age at the time of diagnosis of hypopituitarism was 10.4${\pm}$3.2 years, and the mean age at the time of diagnosis of NAFLD was 13.1${\pm}$2.7 years. A craniopharyngioma was the most common cause of pituitary dysfunction. At the time of diagnosis of NAFLD, 9 patients (82%) had a body mass index greater than the 85th percentile, 5 patients (45%) had elevated fasting blood glucose levels, and 9 patients (82%) had hypertriglyceridemia. The mean height SD score was significantly lower at the time of diagnosis of NAFLD than at the time of diagnosis of hypopituitarism. Of the six patients who were biopsied, one had cirrhosis, two had non-alcoholic steatohepatitis (NASH) with bridging fibrosis, two had NASH with mild portal fibrosis, and one had simple steatosis. Conclusion: Children with hypopituitarism are at risk of short stature, obesity, dyslipidemia, and NAFLD. The early diagnosis of NAFLD is important in children with hypopituitarism because advanced fibrosis is common.

• Journal of Korean Biological Nursing Science
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• v.15 no.2
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• pp.43-53
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• 2013

Purpose: This study was intended to analyze the types and measurement parameters of non-pharmacological interventional studies for nonalcoholic fatty liver disease (NAFLD). Methods: NAFLD related literatures were systematically reviewed. The existing literatures were searched electronically using the data base of PubMed, a Medline data base of the National Library of Medicine with the key words of nonalcoholic fatty liver disease, NAFLD, nonalcoholic steatohepatitis, and NASH. The criteria for inclusion in this review were 1) non-pharmacological intervention, 2) human, 3) English. Finally, 20 articles were included in the review. Results: The major findings of this study were as follows: 1) the types of non-pharmacological intervention were exercise (35%), caloric restriction (30%), and lifestyle modification with combination both of exercise and caloric restriction (35%), 2) Almost all studies adopted various measurement parameters derived from pathophysiological mechanism-based biomarkers such as anthropometric indices, biochemical parameters, body fat mass, and liver biopsy results. Conclusion: Non-pharmacological interventions have been reported to be effective to improve NAFLD status, and many objective biomarkers confirmed supported these findings. Therefore, the development of nursing interventions for NAFLD subjects is needed and the consideration of using mechanism-based biomarkers is suggested to verify nursing outcomes objectively.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.943-952
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• 2022

As a test for diagnosing fatty liver, recently, ultrasound and blood exam are being performed simultaneously. In particular, in the case of high-sensitivity C-reactive protein in blood exam, it is used as an index indicating the level of inflammation in various parts of the body as well as cardiovascular diseases. Thus, this study was conducted to analyze the association between metabolic syndrome components, liver function, and high-sensitivity C-reactive protein levels according to the degree of nonalcoholic fatty liver, and use it as a clinical indicator for fatty liver diagnosis. Metabolic syndrome components, liver function and high-sensitivity C-reactive protein blood test values analyzed from 1,139 men and women over 20 years of age with nonalcoholic fatty liver in abdominal ultrasonography from March 2021 to August 2021 at the Korea Association of Health Promotion, Gwangju-Jeonnam Branch. Analyzed for all men and women, the blood test values for subjects with mild fatty liver were AST 30 U/L, ALT 32.1 U/L, γ-GTP 41.2 IU/L, and hs-CRP 0.14 mg/dL. These values were lower than the blood test values of subjects with moderate fatty liver (AST 38 U/L, ALT 47.6 U/L, γ-GTP 54.9 IU/L, hs-CRP 0.22 mg/dL) and was statistically significant (p<0.001). In this case of high-sensitivity C-reactive protein test, it is statistically significant, showing higher values in Subjects with moderate fatty liver than Subjects with mild fatty liver. thus, it is considered that hs-CRP can be used as clinical data for the prevention and management of fatty liver.

• 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.

• Journal of Digital Convergence
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• v.17 no.8
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• pp.283-291
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• 2019

The aim of investigated the role of FABP5 in the hepatic lipogenesis and lipid metabolisms. Mice were overexpressed and silenced liver FABP5 using virus particles. Mice were fed a Western-type diet or regular chow for 1week and then sacrificed mouse after 24hr fasted. Liver homogenates were used for protein analysis by Western blot and mRNA levels by RT-PCR. Hepatic and serum lipids were analysed by thin-layer chromatography. Mice fed a Western-type or high saturated fat diet revealed large increases in FABP5 expression. However, FABP5 mRNA levels were drastically reduced under fasted. Hepatic TG was significantly increased FABP5-OEAV mice, but a significantly decreased hepatic free cholesterol under fed. The discovered a substantial decrease in hepatic TG mass with FABP5 silencing. In these data, presented evidence for an important role of FABP5 in hepatic lipogenesis and hepatic TG storage. FABP5 may also be a potential target in the treatment of NAFLD, metabolic syndrome, and obesity. Furthermore, studies to which transcription factors are involved in FABP5 expression and regulation.

• Journal of Life Science
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• v.29 no.10
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• pp.1144-1151
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• 2019

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease associated with various metabolic syndromes, such as obesity, dyslipidemia, hypertension, and diabetes. Cudrania tricuspidata is a medicinal plant distributed widely in Asia and has been used in clinical practice to treat various diseases. The aim of this study is to determine the lipid-lowering effects of C. tricuspidata fruit extract (CTE) using a cell model induced by free fatty acids (FFAs). HepG2 cells were exposed to 1mM FFAs (palmitic acid:oleic acid = 2:1) for 24 hr to simulate the conditions of NAFLD in vitro. CTE attenuated the increases of lipid accumulation, intracellular triglyceride, and cholesterol content and inhibited 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase) activity in the HepG2 cells in a dose-dependent manner. Also, CTE inhibited the protein expression of lipogenesis-related genes, such as sterol regulatory element-binding protein-1/-2 (SREBP-1/-2), fatty acid synthase (FAS), and stearoyl CoA desaturase-1 (SCD-1) in FFAs-induced lipid accumulation in HepG2 cells. In addition, CTE-induced adenosine monophosphate-activated protein kinase (AMPK) phosphorylation in HepG2 cells. These results suggest that CTE attenuates hepatic lipid accumulation by inhibiting lipogenesis through the modulation of the AMPK signaling pathway on FFAs-induced lipogenesis in HepG2 cells and may potentially prevent NAFLD.

• Journal of Nutrition and Health
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• v.46 no.4
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• pp.307-314
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• 2013

Resveratrol (RSV) exerts several beneficial effects on metabolism and metaflammation-related diseases, including diabetes and non-alcoholic fatty liver disease (NAFLD). The purpose of this study is to investigate whether RSV affects pathophysiology of diabetes and NAFLD as well as hepatic autophagy in a rodent model of diet induced obesity (DIO). DIO was induced in a subset of C57BL/6J mice fed a high fat (HF, 45% kcal fat) diet. After six weeks of HF diet treatment, RSV (8 mg/kg/day) was administered via an osmotic pump for a period of four weeks. Therefore, the experimental groups were as follows: 1) lean control (CON), 2) HF diet-induced obese control (HF), and 3) HF_RSV. Body weight and food intake were monitored daily. Fasting glucose, insulin, and adiponectin in serum and lipid profiles in serum and liver were analyzed. In addition, the autophagic process was investigated using transmission electron microscopy (TEM). Body weight and food intake were not affected by RSV treatment. Impaired glucose control accompanied by DIO was recovered with RSV as shown by lower levels of fasting serum glucose and insulin when compared with HF obese controls. In addition, RSV treatment resulted in increased levels of serum adiponectin, however, indices of lipid profile in serum and livers were reduced. Results of TEM analysis showed that a HF diet induced excessive autophagy with the presence of double-membrane autophagosomes, which was ameliorated by RSV. The regulatory effect of RSV on autophagy was confirmed by the altered LC3-II formation, which increased with a HF diet and was decreased by RSV treatment. These results suggest that RSV treatment improves glucose control and lipid profile and these beneficial effects may be mediated by an altered autophagic process.