Adult ; Fatty Liver ; diagnosis ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Waist-Hip Ratio

OBJECTIVETo observe the intervening effects of Xuezhikang Capsule (XZK) on levels of blood lipid and other related indices in patients with different Chinese medical syndrome patterns of non-alcoholic fatty liver disease complicated carotid atherosclerosis (NAFLD-CAS), and to seek out the most appropriate pattern to indicate XZK for making guidance of its utilization.

METHODSChinese medical syndrome in 74 patients of NAFLD-CAS were classified into 4 patterns, 34 of Pi-deficiency phlegm-dampness pattern (A), 24 of dampness-heat accumulation pattern (B), 12 of phlegm-stasis intertwined pattern (C), and 4 of Gan-Shen yin-deficiency pattern (D). Excepting those of pattern D were excluded due to too small samples, all patients were treated with XZK for 3 months. Blood levels of blood lipids, including triglyceride (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C), as well as high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor alpha (TNF-alpha) were detected and compared before and after treatment.

RESULTSThe effective rate of XZK on patients of the three patterns, in A-C order, was 97.06%, 91.67%, 91.67%, respectively, with the optimal overall efficacy showed on pattern A. All the indices detected significantly decreased after treatment in all three patterns (P < 0.01), among them, excepting the difference of TG level between groups showed no significance (P > 0.05), the decrements of others were more significant in pattern A than in other two patterns (P < 0.05 or P < 0.01).

CONCLUSIONXZK could reduce the levels of blood lipids, hs-CRP and TNF-alpha in NAFLD-CAS patients, and the Pi-deficiency phlegm-dampness syndrome pattern was the optimal indication of XZK treatment.

Aged ; Carotid Artery Diseases ; complications ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; complications ; diagnosis ; drug therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Phytotherapy ; Treatment Outcome

The prevalence of non-alcoholic fatty liver disease (NAFLD) is estimated to be 25-30% of the population, and is the most common cause of elevated liver enzymes in Korea. NAFLD is a "hot potato" for pharmaceutical companies. Many clinical trials are underway to develop a first-in-class drug to treat NAFLD. However, there are several challenging issues regarding the diagnosis of NAFLD. Currently, liver biopsy is the gold standard method for the diagnosis of NAFLD and steatohepatitis. Ideally, globally recognized standards for histological diagnosis and methods to optimize observer agreement on biopsy interpretation should be developed. Liver biopsy is the best method rather than a perfect one. Recently, multi-parametric magnetic resonance imagery can estimate the amount of intrahepatic fat successfully and is widely used in clinical trials. But no diagnostic method can discriminate between steatohepatitis and simple steatosis. The other unresolved issue in regard to NAFLD is the absence of satisfactory treatment options. Vitamin E and obeticholic acid have shown protective effects in randomized controlled trials, but this drug has not been approved for use in Korea. This study will provide a description of diagnostic methods and treatments that are currently recommended for NAFLD.
Biomarkers/analysis ; Chenodeoxycholic Acid/analogs & derivatives/therapeutic use ; Clinical Trials as Topic ; Fatty Liver/diagnosis ; Fibrosis ; Humans ; Liver/diagnostic imaging/pathology ; Magnetic Resonance Imaging ; Non-alcoholic Fatty Liver Disease/*diagnosis/drug therapy ; Tomography, X-Ray Computed ; Ultrasonography ; Vitamin E/therapeutic use

OBJECTIVETo explore the therapeutic effect and the hemorrheology change of berberine in new diagnosed patients with type 2 diabetes combining nonalcoholic fatty liver disease.

METHODSixty patients, in our department from March 2009 to March 2010, with type 2 diabetes and nonalcoholic fatty liver disease were randomly divided into two groups. One group was given berberine, another group was given Xuezhikang, both for 12 weeks. The indicators, include B-ultrasound of liver, triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspertate aminotransferase (AST), hemorrheology, were detected before and after treatment.

RESULTAfter treatment by berberine, B-ultrasound of liver were better than before, the effective rate was 70%, vs 73.3% after treatment by Xuezhikang. ALT, AST, TC, TG, LDL-L, hemorrheology (including the whole blood viscosity, whole blood viscosity, high cutting reduction of whole blood viscosity, plasma cutting reductive low viscosity, blood sedimentation, RBC deposited, fibrinogen) were significantly lower than before, however, HDL-L significantly increased (P<0.05). The therapeutic effect of xuezhikang was the same as berberine. The distance between the indicators of the two groups was no different.

CONCLUSIONBerberine can obviously improve the conditions of new diagnostic T2DM patients with nonalcoholic liver lesions, effectively reduce hemorrheology indicators, and has good application prospect.

Adult ; Alanine Transaminase ; blood ; Berberine ; therapeutic use ; Diabetes Mellitus, Type 2 ; blood ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; blood ; diagnosis ; drug therapy ; Female ; Humans ; Lipoproteins, HDL ; blood ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Treatment Outcome ; Triglycerides ; blood

BACKGROUND/AIMS: Vitamin E improves the biochemical profiles and liver histology in nonalcoholic steatohepatitis, but the role of vitamin E is not clearly defined in the management of nonalcoholic fatty liver disease (NAFLD) which includes both simple steatosis and steatohepatitis. Co-morbid metabolic syndrome increases the probability of steatohepatitis in NAFLD. In this study, we aimed to determine the short-term effects of vitamin E and off-treatment durability of response in a propensity-score matched cohort of NAFLD patients with metabolic syndrome. METHODS: A retrospective cohort was constructed by retrieving 526 consecutive NAFLD patients from the electronic medical record data warehouse of a tertiary referral hospital in South Korea. Among them, 335 patients (63.7%) had metabolic syndrome and were eligible for vitamin E therapy. In order to assess the effect of vitamin E, propensity score matching was used by matching covariates between control patients (n=250) and patients who received vitamin E (n=85). RESULTS: The PS-matched vitamin E group (n=58) and control group (n=58) exhibited similar baseline metabolic profiles. After 6 months of vitamin E therapy, the mean ALT levels decreased significantly compared to PS-matched control (P<0.01). The changes in metabolic profiles (body weight, lipid and glucose levels) did not differ between control and vitamin E groups during the study period. CONCLUSIONS: Short-term vitamin E treatment significantly reduces ALT levels in NAFLD patients with metabolic syndrome, but metabolic profiles are not affected by vitamin E.
Adult ; Aged ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Body Weight ; Cohort Studies ; Female ; Humans ; Lipoproteins, HDL/blood ; Lipoproteins, LDL/blood ; Liver/pathology ; Male ; Metabolic Syndrome X/*complications/diagnosis/drug therapy ; Middle Aged ; Non-alcoholic Fatty Liver Disease/*complications/diagnosis/*drug therapy ; Propensity Score ; Republic of Korea ; Retrospective Studies ; Vitamin E/*therapeutic use