الفهرس 
Platelet activationOnly 14 pages are availabe for public view
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Abstract
Non-alcoholic fatty liver disease (NAFLD) refers to a group of conditions where there is accumulation of excess fat in the liver of people who drink little or no alcohol.NAFLD is considered the hepatic manifestation of metabolic syndrome.The prevalence of NAFLD in the developed countries ranges from 20 to 30%. The prevalence of steatosis in subjects with a BMI35 kg/m2 raised to 85-90%. In Egypt, its prevalence in the morbidly obese population has been estimated as 22% for male and 48% for female.Platelet has been known as an implicating factor in the pathophysiology of atherosclerotic disease. Larger platelets are more hemostatically active, so the mean platelet volume (MPV) is known as to reflect the state of thrombogenesis.Patients with NAFLD were more likely to have CAD compared to patients without NAFLD, independent of obesity and other risk factors. The MPV was found to be higher in patient with diagnosed AMI than in non-AMI populations. Elevated MPV was associated with increased mortality following a
myocardial infarction.
A limitation of MPV is that the MPV cut-off point that is most useful for
predicting cardiovascular events in clinical practice remains unknown. Another
important consideration is the variability in the timing and methods of blood sample preparation, which may have had a significant impact on the
measurement of MPV. The aim of the present work is to study the mean platelet volume in patients with non-alcoholic fatty liver disease.This study was conducted on one hundred and sixteen subjects (liver
transplantation donors) classified according to the results of liver biopsy into
three groups: Control group (n = 52), Group I (n = 43) (Subjects with simple
steatosis) G II (n = 21) (Subjects with non-alcoholic steatohepatitis).
All the patients subjected to:
1- Through history taking .
2- Complete physical examination was done with particular emphasis on
anthropometric measurements and stressing on the absence of exclusion criteria.
3. Routine and specific investigations as:
Complete blood count, KFTs(Serum urea and Serum creatinine), Fasting
blood glucose and 2 hour postprandial blood glucose, Lipid profile (Total
cholesterol , Triglycerides , HDL-cholesterol and LDL-cholesterol),
LFTs(Alanine transaminase , Aspartate transaminase , serum albumin, PT%,
total and direct bilirubin)
5. Radiological study (Abdominal ultrasonography ) .
6. Liver biopsy.
Results of this study revealed that:
• There was no significant difference between the three studied groups
regarding demographic data (age and sex).
• The mean value of BMI was significantly higher in group II than
group I than controls. Also there was strong +ve correlation between
MPV and both BMI in group I and II.
• The mean value of waist circumference in male was significantly higher in group II than group I than controls, while in female it was significantly higher in group I and II than control but there was no significant difference between group I and II.• Also there was strong +ve correlation between MPV and waist
circumference in female of group I and male of group II.
• Hematological profile: no significant difference between the three
groups regarding hemoglobin level or WBCs count but the mean value
of platelet count was significantly lower in group I than controls ,
also it was significantly lower in group II than controls but there was
no significant difference between group II and group I.
• The mean value of fasting blood sugar was significantly higher in
group I and group II than in control group , but there was no
significant difference between group I and group II, also the MPV is
in significant +ve correlation with fasting blood sugar in group I and
II., which mean that MPV increase with increase fasting blood glucose
level.
• No significant difference regarding 2 hour post-prandial blood glucose
between the three studied groups.
• Comparison between the three studied groups was statically nonsignificant
as regards to total cholesterol and LDL-c.
• The mean value of triglyceride was significantly higher in group II
than group I than controls also there was significant +ve correlation
between MPV and TG in group I and II.
• The mean value of HDL-c was significantly lower in group II than
group I than controls, also there was significant -ve correlation
between MPV and HDL-c in group I and II which mean that MPV increase with decrease HDL-c level. • No significant difference between the studied groups regarding liver function tests.• Regarding KFTs in the form of blood urea and creatinine there was no
significant difference between the studied groups.Ultrasonographic data: the prevalence of bright liver by
ultrasonography was significantly higher in group II than group I than
controls which means that liver ultrasonography has a good
correlation with histological findings of NAFLD.
• The mean value of MPV was significantly higher in group I than
controls, and significantly higher in group II than controls, but there
was no significant difference between group II and group I.
• Also there was significant difference regarding MPV according to the
degree of steatosis, this was obvious when group I was subdivided
into two groups; group of mild steatosis and group of moderate
steatosis and the mean value of MPV was significantly higher in
moderate steatosis than in mild steatosis .• The mean value of mean platelet volume among patient with bright liver is significantly higher than those with normal liver by ultrasound.