OBJECTIVE:This study was performed to evaluate the effects of metabolic parameters and thyroid dysfunction on the development of non-alcoholic fatty liver disease (NAFLD).METHODS:The current study evaluated a total of 115 patients, 75 female and 40 male. Physical examination and anthropometric measurements were applied to all participants. Hypothyroidism was considered at a thyroid stimulating hormone level ≥ 4.1 mIU/L. Patients with euthyroidism and patients with hypothyroidism were compared. Abdominal ultrasonography was used to diagnose non-alcoholic fatty liver disease. The participants were further compared with regard to the presence of non-alcoholic fatty liver disease. Logistic regression modeling was performed to identify the relationship between non-alcoholic fatty liver disease and independent variables, such as metabolic parameters and insulin resistance.RESULTS:Non-alcoholic fatty liver disease was identified in 69 patients. The mean waist circumference, body mass index, fasting plasma insulin, HOMA-IR (p<0.001) and FT3/FT4 ratio (p=0.01) values were significantly higher in the patients with NAFLD compared to those without it. Multivariate regression analysis revealed that FT3/FT4 ratio, waist circumference and insulin resistance were independent risk factors for non-alcoholic fatty liver disease.CONCLUSION:Insulin resistance, enlarged waist circumference, elevated body mass index, higher FT3/FT4 ratio and hypertriglyceridemia are independent risk factors for NADLF, whereas hypothyroidism is not directly related to the condition.

Background Factors causing progression from nonalcoholic fatty liver to nonalcoholic steatohepatitis (NASH) and liver cirrhosis remain relatively unknown. We aimed to evaluate the power and effectiveness of the free triiodothyronine (FT3)-to-free thyroxine (FT4) ratio to predict non-alcoholic fatty liver disease (NAFLD)/liver fibrosis and NASH cirrhosis severity. Methods Patients (n = 436) with NASH-associated liver cirrhosis (n = 68), patients with liver biopsy-proven NAFLD (n = 226), or healthy participants (n = 142) were enrolled between January 2010 and January 2020. The aspartate aminotransferase-to-thrombocyte ratio (APRI), NAFLD fibrosis score, albumin–bilirubin score (ALBI), aspartate aminotransferase (AST)-to-alanine aminotransferase (ALT) ratio, FT3-to-FT4 ratio, and Fibrosis-4 (FIB-4) were calculated and evaluated. Results All parameters were significantly higher in NASH cirrhosis than in the healthy group. Body mass index, ALT, fasting insulin, homeostatic model assessment for insulin resistance, and triglyceride levels were significantly higher in liver biopsy-proven NAFLD than in the healthy group. The APRI, NAFLD fibrosis score, ALBI, AST-to-ALT ratio, FT3-to-FT4 ratio, and FIB-4 were significantly higher in the NASH cirrhosis group than in the healthy group. In patients with biopsy-proven NAFLD, the FT3-to-FT4 ratio was significantly lower than in the healthy group. Conclusion The FT3-to-FT4 ratio is an effective and useful indicator to predict NAFLD/liver fibrosis and NASH cirrhosis severity.

Background: This study is performed to evaluate vitamin D levels and metabolic parameters in patients with prediabetes, compared to healthy controls.Methods: This study was conducted between October and December 2013 in İstanbul Haseki Training and Research Hospital, internal medicine department. We enrolled total 247 individuals, 122 prediabetic (PreDM) patients (79 female, 43 male) and 125 control healthy individuals (94 female, 31 male) between 20-65 ages who admitted randomizely to the outpatient clinic with non spesific complaints. FPG, urea, creatinine, calcium, phosphate, albumin, alkaline phosphatase, thyriod stimulan hormon (TSH), 25 hydroxy vitamin D (25[OH]D), parathormon (PTH), c-peptide, insulin were analyzed.Results: Pre DM patients’ mean plasma 25[OH]D level (25.7±14.9 nmol/l) was statistically lower than the control group (31.4±17.8 nmol/l). Pre DM patients’ mean plasma insulin, c-peptide, calcium, PTH, HOMA-IR (10.8±8.7 IU/ml, 3.3±2.0 ng/ml, 9.7±0.4 mg/dl, 56.5±22.5 pg/ml, 3.0±2.68, respectively) levels were statistically higher than the control group’s (6.3±3.8 IU/ml, 2.4±1.0 ng/ml, 9.5±0.5 mg/dl, 44.0±16.0 pg/ml, 1.4±0.8, respectively) mean levels. There were negative correlations between 25[OH]D and BMI (r:- 0.13, p:0.03), FBG (r:- 0.14, p:0.02) and plasma insulin (r:-0.16, p:0.01) values. A multivariate logisitic regression model for prediabetes was performed and variables as female gender, age, HOMA-IR and lower 25[OH]D values were risk factors for pre DM.Conclusions: Serum low 25[OH]D level correlated with insulin resistance and metabolic parameters in prediabetic patients. Also, it may play an important role in the development of type 2 diabetes.

No abstract

No abstract