Study Early Detection of Serum Transthyretin in Nonalcoholic Fatty Liver Disease and Its Complex Relation with Type 2 Diabetes Mellitus by Sonographic Features
Keywords:
Transthyretin (TTR), Nonalcoholic Fatty Liver Disease (NAFLD); Type 2 Diabetes Mellitus (T2DM); Metaboliciated Fatty Liver Disease (MAFLD); sonographer features.Abstract
Background: Study role important in understand and treat the pathology of obesity and NAFLD to prevent metabolic syndrome. Treatments for obesity and NAFLD commonly include lifestyle management through weight loss, dietary restriction, exercise, etc. Objective: This study was aim to investigate the role of TTR, in the nonalcoholic fatty liver disease and nonalcoholic fatty liver disease (NAFLD) among the patients with type 2 diabetes mellitus (T2DM). The study will be, done at the National Diabetes Center of Mustansiriyah University. One hundred thirty-five subjects with age ranged from (35-65) years were in the serum TTR; concentrations were measured by radioimmunoassay in 150 patients. Diabetic patients were chosen from almost diagnosed patients on follow up visits to the center. The NAFLD diabetic patients were chosen according to clinical features of liver diseases had liver ultrasonic appearance and abnormal liver function tests. Patients were distributed; three study groups as following: Group one: 50 patients, T2DM with NAFLD Group two: 50 patients, T2DM without NAFLD; Group three 50 healthy controls. Results: There was a significant increase it was discovered that there is a positive relationship between transthyretin and that this relationship is statistically significant FSG HbA1c, LDL VLDL, were found to be positively correlated with. Transthyretin were found to be positively correlated at a moderate effect size and echogenicity.it is decrease HDL level found negative correlated with HDL. Conclusions: This study found that diabetic patients with NAFLD had a significant increase in serum levels of TG, LDL, and VLDL as compared to T2D, and lower levels of HDL. Treatment options for NAFLD patients include lifestyle intervention and weight loss and anti-diabetic drugs that target IR or bring benefits of weight loss have yielded positive results. More clinical data is needed to make a firm recommendation about the optimal treatment.
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References
Cho, N. H., Shaw, J. E., Karuranga, S., Huang, Y., da Rocha Fernandes, J.
D., Ohlrogge, A. W., ... & IDF Diabetes Atlas Committee. (2018). IDF
Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and
projections for 2045. Diabetes Research and Clinical Practice, 138,
-281.
Nasif, H. H., & Al-Nassir, S. (2023). Discrete Optimal Control
Mathematical Model of Diabetes Population. Iraqi Journal of
Science, 64(4), 1925-1934.
Alaa Abdul Sattar F. Warka'a T. AL-Sa'adi. Evaluation of Adiponectin,
Irisin, Vitamin D Levels and Their Relation in Iraqi Patients with
Nonalcoholic Fatty Liver Diseas. Journal homepage:
jih.uobaghdad.edu.iq. Apr 2023, IHJPAS.36; (2), 241-250.Benvenga,S., & Robbins, J. (2011). Enhancing thyroid hormone availability to
tissues: Role of transcytosis. In Expert Review of Endocrinology &
Metabolism (Vol. 6, No. 5, pp. 681-692)
Saad, L. O., & Miranda, E. (2020).Transthyretin:More than meets the eye. In
Ophthalmic Genetics, 41(6), 529-537,dol :
1080/13816810.2020.182343.
Martins, M., Bolognesi, B., & Ramirez, M. R. (2014). Role of transthyretin in
Alzheimer's disease: Is it a protector or a risk factor? In Ageing Research
Reviews, 13, 228-248,doi: 10.1016/j.arr.2013.12.005.
Vieira, M., Saraiva, M. J., & Coelho, T. (2019). Effects of transthyretin on the
peripheral nervous system: clinical implications. In Molecular
Neurobiology, 56(1), 27-39, doi: 10.1007/sl2035-018-1145-x.
Friedman,S. L., Neuschwander-Tetri, B. A., Rinella,M., &Sanyal, A.J. (2018).
Mechanisms of NAFLD development and therapeutic strategies. In
Nature Medicine, 24(7), 908-922.doi: 10.1038/s41591-018-0104-9.
Targher, G., & Byrne, C. D. (2019). Non-alcoholic fatty liver disease: an
emerging driving force in chronic kidney disease. In Nature Reviews
Nephrology, 15(6), 391-410. doi:10.1038/s41581-019-0140-0.
Donnelly, K. L., Smith, C. I., Schwarzenberg, S. J., Jessurun, J., Boldt, M. D., &
Parks, E. J. (2005). Sources of fatty acids stored in liver and secreted via
lipoproteins in patients with nonalcoholicfattyliver disease. In Journal of
Clinical Investigation, 115(5), 1343-1351. Doi: 10.1172/JCI23621.
Makela, K. M., Ala-Korpela, M., & Jauhiainen, M. (2017). VLDL-derived
lipoprotein particles carrying apoE are more susceptible to oxidation and
more often found in atherosclerotic lesions than LDL and HDL. In
International Journal of Molecular Sciences, 18(6), 1257. doi:
3390/ijms18061257.
Armstrong, M. J., Gaunt, P., Aithal, G. P., Barton, D., Hull, D., Parker, R.,... &
Taylor, G. (2016). Liraglutide safety and efficacy in patients with non¬
alcoholic steatohepatitis (LEAN): a multicentre, double-blind,
randomised, placebo-controlled phase 2 study. In The Lancet,
(10019), 679-690. Doi:10.1016/S0140-6736(15)00803-X.
avies,M.J., D'Alessio, D.A., Fradkin,J., Kernan,W. N.,Mathieu,C.,Mingrone,G.,
... & Buse, J. B. (2018). Management of hyperglycemiain type 2 diabetes, 2018.
A consensus report by the American Diabetes Association (ADA) and the
European Association for the Study of Diabetes (EASD). In Diabetes Care,
(12), 2669-2701. doi: 10.2337/dci18-0033.
Vanni, E., Bugianesi, E., Kotronen, A., De Minicis, S., Yki-Jarvinen, H., &
Svegliati-Baroni, G. (2010). From the metabolic syndrome to NAFLD or
vice versa? In Digestive and Liver Disease, 42(5), 320-330. doi:
1016/j.dld.2009.08.002.
Tsochatzis, E. A., & Newsome, P. N. (2016). Non-alcoholic fatty liver disease
and the interface between primary and secondary care. In The Lancet
Gastroenterology & Hepatology, 1(6), 504-515. doi: 10.1016/S2468-
(16)30088-6.
Kargiotis et al. (2019)- "Fasting plasma glucose levels are associated with non¬
alcoholic fatty liver disease independent of visceral obesity in Japanese
Americans." This study examined the association between FSG levels and
NAFLD in Japanese Americans and found that higher FSG levels were
independently associated with an increased risk of NAFLD, regardless of
visceral obesity.
Musso G, Cassader M, Rosina F, Gambino R. Impact of current
treatments on liver disease, glucose metabolism and cardiovascular
risk in non-alcoholic fatty liver disease (NAFLD): A systematic
review and meta-analysis of randomised controlled trials (RCTs).
Diabetologia. 2012; 55(4):885-904.
- Suhayla Khalied Mohammed Al-Obaidy.The link between serum
Fetuin A , hepatic F box
protein(FBXW7) and cardio-metabolic index in
diabetes mellitus Type2 treated with metformin
and not treated. PhD thesis. College of Science for women: University of
Baghdad; 2020.
Targher G, Mantovani A, Pichiri I, et al. Non-alcoholic fatty liver disease
is associated with an increased incidence of atrial fibrillation in
patients with type 2 diabetes. PLoS One. 2013;8(2):e57183.
Targher G, Bertolini L, Poli F, et al. Nonalcoholic fatty liver disease and
risk of future cardiovascular events among type 2 diabetic patients.
Diabetes. 2005;54(12):3541-3546. doi:10.2337/diabetes.54.12.3541.
- Younossi ZM, Baranova A, Ziegler K, et al. A genomic and proteomic
study of the spectrum of nonalcoholic fatty liver disease. Hepatology.
; 42(3):665-674. doi:10.1002/hep.20868.
Kim HY, Kim CW, Park CH, et al. Non-alcoholic fatty liver disease,
metabolic syndrome and subclinical cardiovascular changes in the
general population: The Study of Health Assessment and Risk in
Ethnic groups (SHARE). Atherosclerosis. 2017; 263:249-256.
Lee JH, Kim D, Kim HJ, et al. Hepatic steatosis index: a simple screening
tool reflecting insulin resistance and liver damage in patients with
type 2 diabetes. Hepatology. 2010; 51(6):1972-1981.
doi:10.1002/hep.23576.
Bhalodkar NC, et al. High-density lipoprotein cholesterol is inversely
associated with glycosylated hemoglobin in patients with type 2
diabetes mellitus. Metabolism. 2003 Mar; 52(3):395-401. doi:
1053/meta.2003.50061.
Cheng, A. Y., Leiter, L. A., & Diabetes Canada Clinical Practice
Guidelines Expert Committee. (2018). Pharmacotherapy for type 2
diabetes: Overview and key recommendations for patients with type
diabetes. Canadian Journal of Diabetes, 42(Supplement 1), S163-
S167.
Eslam, M., Sanyal, A. J., George, J., & International Consensus Panel.
(2020). MAFLD: A consensus-driven proposed nomenclature for
metabolic associated fatty liver disease. Gastroenterology, 158(7),
-2014.
Ballestri S, Zona S, Targher G, Romagnoli D, Baldelli E, Nascimbeni F,
Roverato A, Guaraldi G, Lonardo A. Nonalcoholic fatty liver disease
is associated with an almost twofold increased risk of incident type 2
diabetes and metabolic syndrome. Evidence from a systematic review
and meta-analysis. J Gastroenterol Hepatol. 2016 May; 31(5):936-44.
Al-Zaidy, H.G and Ahmed.S.H. Study the Role of Serum Apelin, Obesity,
and Duration of the Disease in Type 2 Diabetes Mellitus. Iraqi J.
Comm. Med., July. 2018 (4).
He Y., et al. (2019). Decreased levels of serum transthyretin in patients
with type 2 diabetes and nonalcoholic fatty liver disease. Journal of
Diabetes Research,2019,2385412.Doi: 10.1155/2019/2385412.
Kuno T., et al. (2020). Lower serum transthyretin levels are associated
with severe nonalcoholic fatty liver disease in patients with type 2
diabetes. Internal Medicine,59(1),49-
doil0.2169/internalmedicine.35
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