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Colak Y, Bozbey G, Erim T, Caklili OT, Ulasoglu C, Senates E, Mutlu HH, Mesci B, Doğan MS, Tasan G, Enc FY, Tuncer I. Impaired Gallbladder Motility and Increased Gallbladder Wall Thickness in Patients with Nonalcoholic Fatty Liver Disease. J Neurogastroenterol Motil 2016; 22:470-6. [PMID: 26932908 PMCID: PMC4930302 DOI: 10.5056/jnm15159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 11/22/2015] [Accepted: 01/29/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND/AIMS Nonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease worldwide. Along with the increase in the incidence of NAFLD and associated obesity, an increase in gallbladder disease (GD) has been noted. This has led to the identification of a new disease entity called fatty GD. There is a gap in the literature on the dynamics of gallbladder function in patients with NAFLD. METHODS An observational case-control study, a total of 50 patients with biopsy proven NAFLD without gallbladder stone/sludge and 38 healthy comparison subjects were enrolled. Fasting, postprandial gallbladder volumes (PGV), gallbladder ejection fraction (GEF), and fasting gallbladder wall thickness (FGWT) were measured by real-time 2-dimensional ultrasonography. RESULTS Fasting gallbladder wall thickness, fasting gallbladder volumes and PGV were significantly higher in patients with NAFLD than control subjects (P < 0.001, P = 0.006, and P < 0.001, respectively). Gallbladder ejection fraction was significantly lower in the NAFLD group than the controls (P = 0.008). The presence of NAFLD was an independent predictor for GEF, PGV, and FGWT. Also, steatosis grade was an independent predictor for GEF, and GEF was significantly lower in the nonalcoholic steatohepatitis (NASH) subgroup than the controls. CONCLUSIONS Gallbladder dysfunction and increase in gallbladder wall thickness exists in asymptomatic (without stone/sludge and related symptoms) patients with NAFLD and are useful in identifying fatty GD. Measurement of these variables in NAFLD patients may be useful in identifying those at higher risk for GD.
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Affiliation(s)
- Yasar Colak
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey.,Department of Gastroenterology, Cleveland Clinic Florida, Weston, FL, USA
| | - Gulcin Bozbey
- Department of Radiology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Tolga Erim
- Department of Gastroenterology, Cleveland Clinic Florida, Weston, FL, USA
| | - Ozge Telci Caklili
- Department of Internal Medicine, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Celal Ulasoglu
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Ebubekir Senates
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Hasan Huseyin Mutlu
- Department of Family of Medicine, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Banu Mesci
- Department of Internal Medicine, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Mehmet Sait Doğan
- Department of Radiology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Guralp Tasan
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Feruze Yilmaz Enc
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Ilyas Tuncer
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
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Colak Y, Yesil A, Mutlu HH, Caklili OT, Ulasoglu C, Senates E, Takir M, Kostek O, Yilmaz Y, Yilmaz Enc F, Tasan G, Tuncer I. A potential treatment of non-alcoholic fatty liver disease with SIRT1 activators. J Gastrointestin Liver Dis 2015; 23:311-9. [PMID: 25267960 DOI: 10.15403/jgld.2014.1121.233.yck] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Sirtuins (SIRTs) are members of the silent information regulator-2 family and act as nicotinamide adenine dinucleotide (NAD+)-dependent histone/protein deacetylases. The de-acetylation of proteins and histones results in an up- or down-regulation of gene transcription and protein function. In recent years, the regulatory action of the deacetylation activity of SIRT1 has been shown to have a positive impact on the pathophysiological mechanisms of nonalcoholic fatty liver disease (NAFLD). Among the effects of SIRT1 are: its healing activity on insulin sensitivity, thereby ameliorating glycemic regulation; its mimetic activity on calorie restriction; its antihyperlipidemic activity on lipid homeostasis via the liver, adipose tissues and skeletal muscles; its anti-inflammatory activities; its protective effects against cardiovascular events and endothelial dysfunction; its positive influence on autophagy, apoptosis and cancer; and finally, its anti-aging activity. The current approach for the treatment of NAFLD involves the treatment of etiological factors and recommendation of life-style changes including more physical activity and a low-calorie diet. However, there is no specific medical treatments for NAFLD. The therapeutic potential of SIRT1 activity in the treatment of NAFLD discovered in humans has been presented in this article. In this review, the potential effects of SIRT1 activation on NAFLD-related pathophysiological mechanisms and on the treatment of NAFLD are discussed.
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Affiliation(s)
- Yasar Colak
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul,
| | - Atakan Yesil
- Department of Gastroenterology, Haydarpasa Training and Research Hospital, Istanbul, Turkey
| | - Hasan Huseyin Mutlu
- Department of Family Medicine, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Ozge Telci Caklili
- Department of Internal Medicine, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Celal Ulasoglu
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Ebubekir Senates
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Mumtaz Takir
- Department of Endocrinology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Osman Kostek
- Department of Internal Medicine, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Yusuf Yilmaz
- Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Feruze Yilmaz Enc
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Guralp Tasan
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Ilyas Tuncer
- Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
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Abstract
BACKGROUND/AIM Metabolic syndrome (MetS) is a clinical condition characterized by central obesity, elevated triglycerides, low-high density lipoproteins, impaired fasting glucose, and hypertension. There is insufficient data on the prevalence of MetS in patients with inflammatory bowel disease (IBD). This study sought to determine the prevalence of MetS in a Turkish cohort of patients with IBD and the association between insulin resistance (IR) and the MetS parameters, in this population. PATIENTS AND METHODS A total of 177 patients over 18 years of age (62 with Crohn's disease (CD) and 115 with ulcerative colitis (UC)) were enrolled in the study. The presence of at least three criteria of the International Diabetes Federation (IDF) was accepted for the diagnosis of MetS. The Homeostasis Model Assessment (HOMA) was used to determine IR. HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR. RESULTS MetS frequency was higher in patients n=34 (29.5%) with UC than in patients n=11 (17.7%) with CD (P < 0.01). MetS was detected in 12 of the 117 patients (10.3%) with IBD, under 45 years of age, and in 33 of 60 patients (55%) over 45 years of age. HOMA value in n=31 patients (27%) with UC was > 2.5. Body mass index, insulin (P < 0.001), waist circumference, fasting plasma glucose, leukocyte count (P < 0.01), triglycerides, C-reactive protein, and uric acid values (P < 0.05) were significantly higher in UC patients with IR than those without IR. CONCLUSION Frequent occurrence of MS with increasing age in IBD, particularly in UC, showed the importance of early diagnosis and treatment of cardiovascular disease risk factors in the long-term follow-up of these diseases.
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Affiliation(s)
- Elif Yorulmaz
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey.
| | - Gupse Adali
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey
| | - Hatice Yorulmaz
- Department of Nursing, Halic University School of Nursing, Istanbul, Turkey
| | - Celal Ulasoglu
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey
| | - Guralp Tasan
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey
| | - Ilyas Tuncer
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey
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