Clinical Study Of The Relationship Between Nonalcoholic Fatty Liver Disease And Small Intestinal Bacterial Overgrowth

Objective:Explore the relationship between nonalcoholic fatty liver disease (NAFLD) and small intestinal bacterial overgrowth (SIBO), further to learn the incidence of SIBO whether associated with liver function, and observation the efficacy of NAFLD which treated with bifid tripleviable preparations, providing the clinical basis for the prevention and treatment of NAFLD.Methods:Selected74patients with NAFLD in Tianjin Medical University General Hospital outpatient from December2011to October2012according to the nonalcoholic fatty liver disease diagnostic and treatment guidelines (revised edition) developed by Chinese Medical Association of Hepatology fatty liver and alcoholic liver disease study group in2010, while select30healthy controls. Collect the clinical data including lipids and liver function, SIBO was assessed by lactulose H2breath test (LHBT).74patients were divided into SIBO-positive and SIBO-negative group according to the results of LHBT. SIBO-positive patients test LHBT and related indicators after4weeks treatment for bifid triple viable capsule, and then analysis of its efficacy. All statistical analysis were carried out with SPSS17.0and P＜0.05was considered significant.Results:1.SIBO was present in54.1%of NAFLD group, compared with the healthy control group (10%), the difference was statistically significant (P＜0.05).2. SIBO positive group was higher than negative group in ALT, AST, FPG and TC, negative group was also higher than the healthy control group, the differences were both statistically significant (P＜0.05); BMI, GGT and TG in SIBO positive group and negative group was no significant difference (P＞0.05), but significantly higher than the healthy control group (P＜0.01); TBIL was no significant difference among the three groups (P=0.247).3. Before treatment, the mean concentration of hydrogen in the breath of each time point in SIBO positive group was higher than negative group and the healthy control group, and the or-ocecal transit time(OCTT) of SIBO positive group significantly prolong compared with the two latter groups, the differences were statistically significant (P＜0.05);After treatment, these two indicators between the two latter groups were no significant difference(P＞0.05);The mean hydrogen concentration was significantly decreased after treatment in patients of positive group (P＜0.05); The difference of OCTT was statistically significant after treatment (82±20min vs58±11min,P＜0.01).4. After treatment, ALT, AST, GGT and TC value was significantly decreased after treatment (P＜0.05), after treatment TBIL, BMI and FPG has also been improved, but there was no significant difference (P＞0.05).5. After treatment, SIBO seroconversion rate was72.5%(29/40).6.Clinical symptoms and biochemical parameters were also improved,16cases (55.2%)and10cases(34.5%) were retrieved, and3cases failed (10.3%), total effective rate in seroconversion group was89.7%(26/29)and54.5%in another group, there was significant difference betwwen the two groups (P＜0.05).Conclusion:1.There had a higher incidence of SIBO in NAFLD patients with increased ALT, AST, suggesting that this may be related to liver injury in patients with NAFLD.2. Regulation of intestinal flora could improve the small intestinal motility disorders and biochemical characters by correcting SIBO, the clinical signs and symptoms can also be alleviated, so maybe we can prevent or delay the progress of nonalcoholic fatty liver disease by correcting SIBO.3.SIBO and intestinal dysfunction may be initiating factors of liver damage in patients with NAFLD.However, large-scale and rigorous clinical research were needed due to the limited number of patients in our study.