Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder, affecting 10%-24% of the general population, and the incidence is much higher (70% -80% ) in type 2 diabetic patients. Recent studies indicate that fatty liver is an emerging problem in the Asia-Pacific region and China. The community prevalence of NAFLD in Shanghai is 15%. A large body of evidences suggests that NAFLD is the hepatic manifestation of the metabolic syndrome. NAFLD is not only associated with the metabolic syndrome, it also predicts the development of type 2 diabetes and cardiovascular disease (CVD). The liver is a central organ for controlling and regulating glucose and lipids metabolism; intrahepatocellular lipid accumulation plays a key role in the development of metabolic-ally related disorders. It is crucial that specialists, especially endocrinologists, and practising clinicians should be aware of the strong association between NAFLD and increased risks of diabetes and CVD, NAFLD should be diagnosed correctly and defined timely in regarding its role as risk factors of underlying diabetes and CVD.

The progress in nonalcoholic fatty liver disease(NAFLD) research has shown an important role of hepatic steatosis in triggering insulin resistance and glucose/lipid metabolic disorders.As an early reversible therapeutic target for metabolic diseases,NAFLD has attracted increasing attention from endocrinologists and gastroenterologists,as well as deeping the studies in this field.Based on the recent progress in NAFLD research,this review mainly presents the new understanding and concept of NAFLD,discusses the features of the new guidelines and concensus for NAFLD treatment,and introduces some updated developments in NAFLD diagnosis and therapy.Furthermore,future directions of NAFLD research are also predicted in the article.

Researches in type 2 diabetes and non-alcoholic fatty liver disease have been made in recent years.The intimate connection between these two diseases has been analysed and explored.Whether non-alcoholic fatty liver disease is a hepatic complication of type 2 diabetes remains to be elucidated.The poor outcome of liver disease in patients with type 2 diabetes should be emphasized.

Diabetes Mellitus, Type 2 ; complications ; Humans ; Non-alcoholic Fatty Liver Disease ; complications

An early diagnosis of nonalcoholic fatty liver disease ( NAFLD) is meaningful to the prevention and cure of diabetes and cardiovascular disease ( CVD). The sensitivity and specificity of qualitative methods vary greatly, and these methods do not quantify liver fat content. Pathological diagnosis is a quantitative method, but it is invasive and inappropriate for clinical application. The establishment of H Magnetic Resonance Spectrum (1H MRS) opened up a brand-new era for noninvasive liver fat quantification. This review systemically introduces the new progress in noninvasive diagnosis of NAFLD.

Nonalcoholic fatty liver disease(NAFLD)has become one of the most common liver diseases in the world.Considering the important role of insulin resistance in its pathogenic mechanisms,insulin sensitizers are becoming the promising pharmacological strategies for NAFLD.We collected and analyzed the relevant articles in recent years and found that pioglitazone,rosiglitazone and metformin could improve liver enzymes and insulin sensitivity of NAFLD.However,only pioglitazine was supported in ameliorating liver histology by envidences from randomized,double-blinded,controlled clinical trials.There were no much obvious adverse effects in NAFLD patients who received insulin senitizers.Small or medium samples and no more than 2 years of treatment course may be the major limitation of current studies.Future information derived from well-designed running trials will be useful in defining the clinical implications of insulin sensitizers in the treatment of NAFLD.

Accurate determination of hepatic fat content is essential for investigating the quantitative association between hepatic steatosis and multiple metabolic disorders,and is of great significance in determining the beginning and goal for clinical intervention.More attention has been focused on establishing a non-invasive,simple and accurate method for determining hepatic fat content.Recently,a computer-aided ultrasound quantitative method may provide a new way for single and accurate estimation of hepatic fat content.

Three cellulose derivatives were synthesized and used as chiral stationary phases based on silica gel.The effects of adsorbances on the column numbers and stabilities have been investigated.These stationary phases exhibited high chiral recognition for various racemates.At the same time,the on-line curves of polarimeter were obtained by high performance liquid chromatography with polarimeter as on-line detector.

Objective To analyze the correlation of discomfort experience and factual recollection (FR) in patients of intensive care unit (ICU). Methods Fifty-five ICU patients and 63 ward patients par-ticipated in the study. Standardized questionnaires were used to evaluate all patients" FR and the results underwent analysis. Results The prevalence of recollection of any type of discomfort in the ICU patients was 64%. The presence of an endotracheal tube, pain and hallucinations were identified as sources of dis-comfort.The median score for FR in the ICU patients was 7.25. The median score for FR in the ward pa-tients was 13.50. The difference between them was highly significant (t =3.34, P < 0.01 ). Logistic analysis revealed that discomfort, especially discomfort caused by the presence of an endotracheal tube, pain and hallucinations, was positively related to FR, 0R95%CI (1.2～2.1), P < 0.01. Conclusions The presence of an endotracheal tube, pain and hallucinations were most frequently reported as sources of discomfort in ICU patients and their memory was often impaired. FR and recollection of discomfort appear to be related significantly in ICU patients.

Nonalcoholic fatty liver disease (NAFLD) is associated with obesity, type 2 diabetes,dyslipidemia, hypertension, and metabolic syndrome.It likely represents hepatic manifestation of metabolic syndrome. The prevalence of NAFLD has been estimated to be 20％-30％ in the general population. However, it is much higher in type 2 diabetic patients. Several epidemiological studies indicate that NAFLD is linked to an increased risk of cardiovascular disease( CVD), which is independent of underlying cardiometabolic risk factors. This suggests that NAFLD may also be actively involved in the pathogenesis. The possible molecular mediators linking NAFLD and atherosclerosis(AS) include the release of pro-atherogenic factors by oxidative stress and inflammation as well as atherogenic dyslipidemia, abnormal adipose factors, and insulin resistance, finally aggravating progression of CVD. In this article, the relationship and possible mechanisms between NAFLD and AS are reviewed.