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Abstract SUMMARY This study was conducted on 39 cases proved to have bright liver on sonographic basis and fatty liver on histopathological examination. As well as 12 cases with no sonographic evidence of fatty liver. All cases submitted to complete clinical assessment, laboratory investigations with special emphasis on serological markers for hepatitis C virus, lipid profile, blood sugar and body mass index. This study showed that fatty liver was a disease of both sexes (M: F ratio I: 1.05), it occurs mostly in forth and fifth decades of life. As regards physical examination, hepatomegaly was present in 76.9% of the patients. Laboratory investigations showed that ALT level was high in (71.8%) and AST level was high in (46.1%) the ASTI ALT ratio was less than one. Ultrasound examination IS of great value in detecting hepatic fatty infiltration, however, the diagnosis can be established definitively by liver biopsy and histopathological examination. Fatty liver was found in all cases with chronic hepatitis C virus infection (56.4%). There was significant correlation between positive hepatitis C virus infection and body weight and the mean body mass index in cases with positive HCV antibody or antigen was significantly lower than the mean body mass index in cases with negative hepatitis C virus. HCV positive cases (antibody or antigen) had cholesterol levels higher than cases with negative HCY cases, therefore the findings of the present work seem to suggest that the pathogenesis offatty liver in HCY positive patients is multifactorial. It may be a direct viral effect and other metabolic factors are also important and potentiate this effect. Thirty percent of the cases had obesity as non alcoholic fatty liver disease increases by a factor of 4.6 in obese people and this is due to reduction in insulin sensitivity, with decreased insulin effects on both glucose and lipid metabolism. Thirty five percent of the patients had type II diabetes mellitus and this may be due to high concentrations of circulating free fatty acids and the presence of type II diabetes mellitus significantly increase the risk and severity of non alcoholic fatty liver disease. As regard hyperlipidemia twenty six percent had low level of highdensity lipoprotein. Collectively speaking most patients of fatty liver have multiple risk factors, including HCV, obesity, type 2 diabetes and hyperlipidemia. Sixteen percent of the patients with fatty liver were asymptomatic. The most common complaints were right hypochondrial pain, dyspepsia, fullness and easy fatigue . .•-...ftlJa .• |