MeThODs This double-blind, placebo-controlled randomised clinical trial was conducted on a total of 67 overweight patients with T2DM for a duration of three months. Of these 67 patients, 32 received 2 g purified EPA daily, while 35 received a placebo of 2 g corn oil daily. The patients' fasting plasma glucose (FPG), serum insulin, glycated haemoglobin (HbA1c) and insulin sensitivity indices were assessed.ResUlTs After three months of EPA supplementation, the group that received EPA showed significant decreases in FPG (p < 0.001), HbA1c (p = 0.01) and homeostasis model assessment of insulin resistance (HOMA-IR) (p = 0.032), when compared to the placebo group. EPA supplementation resulted in decreased serum insulin levels, with the levels between the EPA and placebo groups showing a significant difference (p = 0.004). CONClUsIONThe results of our study indicate that EPA supplementation could improve insulin sensitivity. It was able to decrease serum insulin, FPG, HbA1c and HOMA-IR. EPA could have beneficial effects on glycaemic indices in patients with T2DM.

Objective: This study explored the association between serum nicotinamide phosphoribosyltransferase (NAMPT) and hepatic de novo lipogenesis (DNL) in nonalcoholic fatty liver disease (NAFLD) and determined whether or not this association is sex dependent. Subjects and Methods: In this cross-sectional study, 62 consecutive patients (32 males, 30 females) with NAFLD were recruited. Serum NAMPT (by ELISA), palmitic acid, and the DNL index of erythrocyte membranes as markers of hepatic DNL (by gas chromatography) were analyzed. The controlled attenuation parameter (CAP) and body impedance analyzer were used to assess hepatic and body fat, respectively. Univariate and multiple linear regressions (to adjust for confounders) were used to analyze the association of serum NAMPT with palmitic acid, DNL index, CAP, and body fat. Results: The respective values of serum NAMPT (2.44 ± 1.03 vs. 2.45 ± 1.13 ng/mL, p = 0.98), DNL index (3.11 [2.60-3.71] vs. 3.05 [2.40-3.59], p = 0.90), and palmitic acid (20.55% [15.34-24.04] vs. 22.64% [21.15-25.95], p = 0.07) were not significantly different between men and women, but those of CAP (326 [300-340] vs. 300 [261.25-329], p = 0.002) and body fat (37.71 ± 3.80 vs. 26.60 ± 5.70, p < 0.001) were significantly higher in women. In women, serum NAMPT had a significant negative association with the DNL index (β = -0.56, p = 0.01). The DNL index also had a significant negative association with body fat (β = -0.46, p = 0.02). In men, the only significant association was the positive association between serum NAMPT and CAP (β = 0.35, p = 0.035). Conclusion: Higher serum NAMPT in women was associated with a lower hepatic DNL index, while in men it was associated with higher hepatic fat and had no association with the DNL index. Therefore, the serum NAMPT level interpretation for NAFLD prognosis is probably sex dependent.

These data suggest that quercetin can significantly improve bone strength particularly due to increasing bone formation in biliary cirrhosis.

Background: De novo lipogenesis (DNL) increases in NAFLD and nicotinamide phosphoribosyltransferase (NAMPT) up regulates two essential enzymes in this pathway. On the other hand, NAMPT function could be affected by the promoter region polymorphism and sex hormones. Objectives: This study explored the association of -4689 G/T polymorphism in the promoter region of NAMPT gene with markers of hepatic injury and DNL in patients with NAFLD in order to see whether or not these associations are the same for both sexes. Methods: In this cross-sectional study, 62 consecutive patients (32 men and 30 women) with NAFLD were recruited. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to identify -4689 G/T polymorphism. DNL index of erythrocyte membrane as the marker of hepatic DNL was analyzed by gas chromatography. Fasting serum NAMPT, Caspase-cleaved cytokeratin 18 (cCK18), total soluble cytokeratin 18 (CK18), liver enzymes (AST, ALT, ALKP, GGT), and lipid-glucose profile were measured. Anthropometric measurements, Fibroscan, assessment of dietary intake and physical activity were also performed. Twoindependent sample t test, chi-square test, one-way analysis of variance, and multiple linear regression were used to analyze the data. Results: Serum NAMPT and erythrocyte membrane DNL index were not significantly different among the three genotypes in both sexes. In men, serum AST (P = 0.04) and ALT (P = 0.03) were significantly higher in GT genotype than GG genotype. Serum CK18, cCK18, and CAP also had the highest levels in GT genotype but not statistically significant. In women, the markers of hepatic injury were not significantly different between GG and GT genotypes. Serum AST (P = 0.01), ALT (P = 0.01) and cCK18 (P = 0.001) levels were significantly higher in TT genotype. Serum GGT, CK18, and CAP also had the highest level in TT genotype but not statistically significant. These associations remained significant even after adjustment for confounding variables in multiple linear regression. Conclusions: -4689 G/T polymorphism was not associated with hepatic DNL index but T allele in this polymorphism was associated with increased biomarkers of hepatic inflammation, apoptosis and necrosis in patients with NAFLD especially in men, as one T allele (GT genotype) was enough for increased biomarkers of hepatic injury in men but not in women.

Background: Studies on the association between visfatin and nonalcoholic fatty liver disease (NAFLD) have contradictory results and the role of this adipokine in NAFLD pathogenesis has remained unclear. In vitro studies indicate that visfatin expression could be regulated by sex hormones. Testosterone down-regulates visfatin expression in pre-adipocytes and estrogen increases its expression in adipocytes. Objectives: This study aimed at exploring whether the association between serum visfatin and markers of hepatic injury is the same for both genders in patients with NAFLD. Methods: In this cross-sectional study, 62 consecutive patients (32 males and 30 females) with NAFLD were recruited. Fasting serum visfatin, caspase-cleaved cytokeratin 18 (cCK18), total soluble cytokeratin 18 (CK18), liver enzymes (AST and ALT), insulin, and lipidglucose profile was measured. Anthropometric measurements, fibroscan and assessment of dietary intake and physical activity level, were performed for each participant. Two independent sample t tests, chi-square test, univariate, and multiple linear regression (to adjust for confounding factors) were used to analyze the data. Results: In males, serum visfatin had a significant positive association with serum Aspartate Aminotransferase (AST) (B = 0.47, P = 0.009), alanine aminotransferase (ALT) (B = 0.40, P = 0.035), CK18 (B = 0.50, P = 0.008), and cCK18 (B = 0.47, P = 0.012). In females, serum visfatin only had a weak association with CK18 (B = 0.37, P = 0.045). Instead, higher body mass index (BMI) was significantly associated with increased serum CK18 (B = 0.44, P = 0.02), cCK18 (B = 0.42, P = 0.02), controlled attenuation parameter (CAP) (B = 0.39, P = 0.049), and liver stiffness measurement (LSM) (B = 0.40, P = 0.03) in females. Higher waist to hip ratio was also significantly related to serum AST (B = 0.37, P = 0.04), ALT (B = 0.50, P = 0.02), CK18 (B = 0.41, P = 0.03), cCK18 (B = 0.37, P = 0.04), and CAP (B = 0.39,