ⅠA Cross-sectional Study On The Analysis For Risk Factors Related To Non-alcoholic Fatty Liver Among Health Examination People In Inland City Of Shandong ⅡThe Study Of Thyroid-stimulating Hormone In Regulating Cholesteryl Ester Transfer Protein

Background:Fatty liver disease is a clinical syndrome refers to the excessive deposition of fat in the liver. With the improvement of living standards and lifestyle changes, the incidence of fatty liver disease increased a lot, it is reported that its incidence can be to around 10%. At present, the fatty liver disease has become the second liver disease after viral hepatitis danger to human health. Fatty liver disease is clinically with nonalcoholic fatty liver disease and alcoholic fatty liver disease.Nonalcoholic fatty liver disease is a clinical syndrome caused by reasons except alcohol and other specific can leading liver damage, character with diffuse fatty bullae hepatocytes, including simple fatty liver disease, and evolutionary steatohepatitis and liver cirrhosis. Insulin resistance and genetic susceptibility have closely relation to its happening. With increased incidence of obesity and diabetes, nonalcoholic fatty liver disease has become one of common chronic liver disease in our country. But because different regions have a quite different lifestyles and eating habits, the prevalence of nonalcoholic fatty liver disease and distribution characteristics also have different. This paper aimes to analyze the prevalence distribution characteristics and risk factors of nonalcoholic fatty liver disease in Shandong inland people provide for the prevention and treatment of nonalcoholic fatty liver disease.Objectives:1. Analysis the prevalence of nonalcoholic fatty liver disease (NAFLD) in inland cities in Shandong province and its distribution characteristics.2. Study the risk factors of non-alcoholic fatty liver disease (NAFLD) and its relationship to metabolic syndrome (MS), providing for the prevention and treatment of it.Methods:1. This was a cross-sectional study with 5688 health check-up subjects who were treated in Shandong Provincial Hospital affiliated to Shandong University in 2011. The subjects were categorized as NAFLD group and non-NAFLD group based on abdominal ultrasonography examination results and alcohol consumption less than 140g/week and 70g/week for men and women respectively in the absence of other causes of liver disease.2. Analysis the detection rate of NAFLD in our study crowd and if there is a difference between different genders.3. Categorize all the eligible population by age and body size (divided into normal, overweight and obesity group according to BMI), observing if there is differences of prevalence of NAFLD in different age and body size groups.4. Comparing the differences of basic information including age, gender, and other metabolic elements in the two groups.5. Analysis the prevalence of the four type dyslipidemia and the detection rate of the metabolic syndrome and its components in the two groups.6. Search the risk factors of NAFLD by binary logistic regression.Results:1. The study included a total of 5688 subjects (1615 cases with NAFLD vs.4073 controls). The detection rate of NAFLD in men was significantly higher than in women (38.09% vs.21.00%, P＜.001).2. Prevalence rate (PR) of NAFLD was significantly increased with progressively fatter body building (normal weight, over weight and obesity) and older age groups (P <0.001). There also has statistical significance in PR of NAFLD between different body type groups at varied ages, with the highest at age of 51-60.3. Mean or median of body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), serum uric acid (SUA), fast blood glucose (FBG), serum creatinine (SCr) and blood urea nitrogen (BUN) were significantly higher in NAFLD group than those in non-NAFLD group, which high density lipoprotein cholesterol (HDL-C) has opposite trend in that two groups.4. Prevalence of the four types of dyslipidemia was significantly higher in NAFLD group than those in non-NAFLD group, with the highest of high TG (55.11%). The PR of MS and other related metabolic diseases were significantly increased in NAFLD group.5. According to Conditional logistic regression analysis results, men, age, BMI, SUA, FBG, TG and LDL-C were the risk factors of NAFLD while the HDL-C was a protective factor.Conclusion:Overweight, obesity, dyslipidemia, hyperglycemia and hyperuricemia were closely associated with the occurrence of NAFLD. Procedures which control of body weight and blood metabolic factors level are important to preventing increase of NAFLD prevalence.Background:Subclinical hypothyroidism (SCH), which is defined by elevated serum thyroid-stimulating hormone (TSH) and normal serum free thyroxine (FT4), having an increased incidence in recent years. It is one of the most important modifiable risk factors for dyslipidemia and it can promote the development of atherosclerosis, has been received increasing attention nowadays.One reason of the anomaly of the composition and the transfer function of lipoprotein in thyroid disease may connect with significant change of cholesterol ester transfer protein (cholesteryl ester transfer protein, CETP) activity. CETP is a hydrophobic glycoprotein that mediates the net transfer of neutral lipids between lipoproteins by stimulating the heteroexchange of cholesteryl esters and triglycerides. It redistributes cholesteryl esters formed by lecithin:cholesterol acyltransferase in high-density lipoprotein (HDL) to the less dense apolipoprotein B (apo B)-containing lipoproteins. Therefore, it plays an important role in the metabolism of HDL and apo A-I and in the reverse cholesterol transport pathway.Objectives:1. To observe the changes of CETP activity in hypothyroidism and Subclinical hypothyroidism.2. Study the influence of TSH to CETP expression and its activity in vitro.Methods:1. Collect the plasma of subject meeting the experimental conditions who accept examination in Shandong provincial hospital, including patients with hypothyroidism, subclinical hypothyroidism and control. Detect the CETP activity of them, and analyze the difference between them.2. Treat hepG2 cells with different concentrations of bTSH, observing the change of CETP mRNA and protein expression.3. Treate hepG2 cells with different concentrations of bTSH, observing the change of CETP activity.Results:1. Mean of CETP activity was significantly higher in control group than in hypothyroidism and subclinical hypothyroidism group, hypothyroidism group was lower than subclinical hypothyroidism group.2. The result showed that there performed a concentration-dependent effect of TSH on the CETP mRNA and protein expression in HepG2 cells.3. The result showed that there performed a concentration-dependent effect of TSH on the CETP activity in HepG2 cells.Conclusion:TSH has negative relationship with CETP activity in plasma and it can down regulated hepatic CETP expression.