الفهرس 
Non-alcoholic fatty liver disease (NAFLD)Only 14 pages are availabe for public view
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Abstract
Among metabolic disorders, non-alcoholic fatty liver disease (NAFLD) has gained special attention in the last decade since it represents the most common chronic liver disease worldwide with an estimated prevalence around25% in the general population and up to 80% in obese individuals. NAFLD is an established risk factor for all cause and cardiovascular mortality. However, mechanisms behind NAFLD development and progression to steatohepatitis (NASH) have not been fully unraveled.
Vasopressin (VP) is a hormone secreted by the pituitary gland in response to increased plasma osmolality, low plasma volume, and low blood pressure. Copeptin is a cleavage product of the C-terminal part of the VP precursor which correlates well with plasma VP concentrations and which is easier to measure reliably. Thus, copeptin is nowadays considered the circulating surrogate bio-marker of VP.
Beside its role in inducing reactive vasoconstriction and inhibiting diuresis and, thus, controlling blood volume, VP exerts major effects on glucose and lipid metabolism by stimulating the hepatic glycogenolysis, gluconeogenesis, and fat production and by modulating the release of insulin and glucagon from the pancreatic Langerhans’islets.
VP exerts a direct influence on the hepatic fat metabolism by stimulating the production of triglycerides in rat hepatocytes; Indeed, obese rats with water-induced reduction of circulating VP levels have significantly decreased hepatic fat content compared with control obeserats, independently from changes in body adiposity. In humans, clinical observations show a relationship between elevated plasma copeptin levels and the presence of hepatic cirrhosis, likely reflecting underlying circulatory dysfunction suggesting a role of copeptin as a prognostic marker of liver disease.
Obesity, dyslipidemia, insulin resistance, type 2 diabetes, and heart disease have thus all been shown to associate with both fatty liver disease and elevated VP (copeptin) concentration.
The study is aimed to Detect the elevation of plasma copeptin in obese patients with non alcoholic fatty liver disease in relation to general population.
This is A randomized case control cross sectional study, was carried out at internal medicine and gastroenterology department, Ain Shams University hospitals, on 100 patients above 18 years old with Hepatic Steatosis Index (HSI) and NAFLD-Liver Fat Score (LFS), over a period of 6 months.
The main results of the study revealed that:
• among the cases in group A there were 18 (36%) males and 32 (64%) females with mean age 23.22 (±3.48 SD) and range (18-29) years.
• Among the cases in group B there were 24 (48%) males, 26 (52%) females with mean age 24.66 (±3.79 SD) and range (18-30) years.
• There was no statistically significant difference between the studied groups as regard Demographic data.
• there was high statistically significant difference between the studied groups as regard anthropometrics.
• there was high statistically significant difference between the studied groups as regard Blood pressure.
• there was no statistically significant difference between the studied groups as regard CBC.
• there was high statistically significant difference between the studied groups as regard AST and ALT.
• there was high statistically significant difference between the studied groups as regard Fasting Lipid profile.
• there was high statistically significant difference between the studied groups as regard Serum creatinine.
• there was no statistically significant difference between the studied groups as regard glucose profile.
• there was statistically significant difference between the studied groups as regard Ultrasound.
• there was high statistically significant difference between the studied groups as regard Serum plasma copeptin.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.
CONCLUSION
Our study demonstrates for the first time that copeptin levels predict the presence and severity of NAFLD in obese persons. Studies with longitudinal design are warranted for exploring the possible involvement of AVP/V1aR system in the development and progression of NAFLD.
RECOMMENDATIONS
Further studies on large geographical scale and on larger sample size to emphasize our conclusion.
More patients, longer follow-up, and multicenter experience are all necessary to accurately figure out elevation of plasma copeptin in obese patients with nonalcoholic fatty liver disease in relation to general population.