الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 242 |  |  |
| | | from | 242 | | |
Abstract
Nowadays, MAFLD is regarded as the most prevalent hepatic disorder. According to estimates, it affects 20%–30% of the general population and up to 70%–90% of obese or diabetic people.
Recently, The fatty liver disease has been recognized to be associated with multiple hepatic and systemic extrahepatic diseases and malignancies.
The current prospective, analytic, hospital based study, was carried out at the Internal Medicine Department, Minia University Hospital and hepatology hospital in collaboration with clinical pathology department, and radiology department Minia University Hospital, from January 2021 to December 2022.
The aim of the study was to detect the level of LAL, neuronal regeneration related protein, and the polymorphism of cholesterol ester transfer protein gene in MAFLD.
It was conducted on a group of patients with MAFLD disease who were selected from those consecutively attended to Internal Medicine clinic, and hepatology clinic Minia University Hospital.
Our study included 80 MAFLD patients, this group of patients was classified into 4 groups (25 obese diabetics, 15 lean diabetics, 20 obese non diabetics, 20 lean non diabetics), compared to another group including 20 normal control.
All included patients and controls were subjected to:
I- Full cinical history
II-Thourough clinical examination and calculation of anthrobometric measurements:
• Body mass index (BMI).
• Waist circumference
• Hip circumference
• Waist hip ratio.
III-Laboratory assessment :
A-Routine investigation:
• Complete blood count (C.B.C).
• Complete liver function tests (ALT, AST, GGT, PC, PT, INR, albumin , alk. Phosphatase, total and direct bilirubin).
• Lipid profile, (cholesterol, LDL, HDL, TG).
• Fasting blood sugar.
• Fasting insulin level .
• Calculation of HOMA-IR.
• Serum ferritin.
• Serum ceruloplasmin.
• Anti nuclear anti body.
• Blood urea, serum creatinine.
• Thyroid function (TSH, FT3, FT4) for exclusion of hypothyroidism.
• HBs Ag, HCV Ab.
B-Specific investigation:
• Lysosomal acid lipase by ELISA .
• Neuronal regeneration related protein by ELISA.
• Fibroblast growth factor 21.
• Cholesterol ester transfer protein gene polymorphism study by PCR.
VI-Methods of diagnosis:
1-Imaging:
• Abdominal ultrasound.
• MRI studies to detect grade of staetosis.
• Shear wave elastography to detect grade of fibrosis.
2- Scores calculation:
Scores for steatosis:
• Hepatic staetosis index
• Fatty liver index.
• Scores for fibrosis:
• Fib 4.
• Fib 6.
• NAFLD fibrosis score.
Results:
This study has reported the following data:
The study population is age and sex matched. Our MAFLD patients presented significant higher frequency of systolic (SBP) and diastolic (DBP) blood pressure; and diabetes mellitus than the normal controls, (P<0.001).
There was high frequency of type II diabetes in patients than controls.
There was significant difference in anthropometric measures between patients and controls.
At the same time, MAFLD patients have significantly higher values of ALT AST, Alk pho, and GGT than controls, (P<0.001).
Also, there was significant increase in TLC (P<0.001) and platelets (P=0.006) in our MAFLD patients than controls that indicating persistent chronic inflammatory state.
There was significant increase in TSH in MAFLD patients when compared to controls (P<0.001).
At the same time, MAFLD patients have significantly higher values of cholesterol, triglyceride, FBG, fasting insulin, HOMA-IR (P<0.001).
Also, ferritin showed significantly higher values in MAFLD patients when compared to controls (P<0.001).
MAFLD patients showed significantly lower values of LAL and NREP, in contrast FGF21showed significantly higher values in MAFLD patients (P<0.001).
Our results showed that the mutant genotype of CETP gene (AA) is encountered significantely more in lean non diabetic patients with MAFLD.
While the wild type (CC) more prevalent in MAFLD patients with obesity and diabetes.