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| ID | Type | Description | Link |
|---|---|---|---|
| N-41-2019 | Other Identifier | Cairo University ethical committee approval number |
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| Name | Class |
|---|---|
| Ain Shams University | OTHER |
| Mansoura University | OTHER |
| Alexandria University | OTHER |
| Fayoum University |
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Getting a rough indicator about the prevalence of different grade of severity of NAFLD (NASH & liver fibrosis), and Correlate the severity of fatty liver with different serological risk factors of metabolic syndrome and diseases progression as well as the prevalence of hepatocellular carcinoma related to NAFLD with the use of ; nutritional assessment designed and conducted by the investigators in this research, simple blood test (lipid profile and blood sugar), and easy cheap non-invasive radiological tool as screening to predict NASH.
This study is a prospective cross-sectional Multicenter National study, will include 1080 participants with BMI ≥ 24kg/m 2 with or without elevated liver enzymes. All will be subjected to; dietary history by already prepared food quality and quantity questionnaire, anthropometric data (BMI & waist circumference), Clinical examination, Laboratory work include: total lipid profile (LDL-C, HDL-C, VLDL (very low-density lipoprotein)& TGs (Triglyceride)), fasting blood glucose and insulin (HOMA-IR (Insulin Resistance) will be calculated), HbA1c%, liver biochemistry tests (ALT, GGT (Gammaglutamyl transpeptidase), AST (aspartate aminotransferase), and bilirubin), Liver function testes (INR & albumin), HCV (Hepatitis C virus) antibody, HBV (Hepatitis B virus) surface antigen, TSH (thyroid-stimulating hormone) , Free T3 & T4 will be done for all participants. Imaging; Liver ultrasound including measurement of the subcutaneous fat in front of the left lobe of liver as well as at the umbilical region and assessment of liver stiffness by Fibroscan.
The novelty of this study is that, if it showed a successful outcome, the investigators will get a rough indicator about the prevalence of different grade of severity of NAFLD, and Correlate the severity of fatty liver with different risk factors of metabolic syndrome and life style modifications among Egyptians, and trying to confirm the great variability between different races regarding BMI classes and overweight & obesity cut-off values, confirming the high level of insulin resistance in non-diabetic participants with NAFLD compared to other races, identify types of food that are at risk for development and progression of NAFLD thus getting a healthy food recommendations for Egyptians and get a recommendation for another studies for metabolic syndrome redefinition with NAFLD part of it (not just considering as known in the present time), and working on the Triglycerides, LDL, and HDL cut off values. investigators also hope through this research to modify dietary habits in the Egyptian society encouraging healthy nutrition through dietary assessment (already prepared food quality and quantity questionnaire), that can lead to not only NAFLD but also progress to NASH, so participants can promote healthy dietary habits and proper life style among different health care providers thus decreasing incidence of obesity, one of main risk factors of fatty liver diseases and its consequences especially Hepatocellular Cancer.
Investigators also hope through this research to modify dietary habits in the Egyptian society encouraging healthy nutrition through promoting professional nutritional assessment and questionnaire among different health care providers thus decreasing incidence of obesity, one of main risk factors of fatty liver diseases and its consequences especially Hepatocellular Cancer.
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| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of different grads of severity of NAFLD and Correlation with Its main risk Factors among Egyptians | In the Middle East, till the present time, no data about the incidence, prevalence of NAFLD early identification of patients with NASH prior to the onset of advanced fibrosis would be helpful in guiding aggressive interaction. | April 2019 to March 2021 |
| Dietary history | Food Frequency Checklist will be done. Mean daily consumption of selected food items will be calculated Optimal level of intake and optimal range of intake :
| April 2019 to March 2021 |
| Risk factors of NAFLD | The prevalence of NAFLD has risen rapidly in parallel with the dramatic rise in population levels of obesity and diabetes and the entire world follow the European BMI classification and the parameters for metabolic syndrome diagnosis, except for the modification done by china. | April 2019 to March 2021 |
| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of NAFLD among different ethnic groups | Trying to confirm the great variability between different races regarding BMI classes and overweight & obesity cut-off values | April 2019 to March 2020 |
| Prevalence of Insulin resistance |
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Inclusion Criteria:
Exclusion Criteria:
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This study is a prospective cross-sectional Multicenter National study, including 1080 participants with BMI ≥ 24kg/m diagnosed with a high probability of NAFLD using ultrasound with or without elevated liver enzymes
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mona A Hegazy, MD | Contact | 0201001421551 | monahegazy@cu.edu.eg | |
| Ahmed M Abdul Ghani, MD | Contact | 0201005150375 | Abdelgany@staff.cu.edu.eg |
| Name | Affiliation | Role |
|---|---|---|
| Mona A Hegazy, MD | Professor of Internal Medicine Hepatology, Faculty of medicine, Cairo University | Principal Investigator |
| Ahmed M Abdul Ghani, MD | Lecturer of Internal Medicine & Hepatology, Faculty of Medicine, Cairo University |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medicine Cairo University | Recruiting | Cairo | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19065650 | Background | Vuppalanchi R, Chalasani N. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: Selected practical issues in their evaluation and management. Hepatology. 2009 Jan;49(1):306-17. doi: 10.1002/hep.22603. | |
| 18304679 | Background | de Alwis NM, Day CP. Non-alcoholic fatty liver disease: the mist gradually clears. J Hepatol. 2008;48 Suppl 1:S104-12. doi: 10.1016/j.jhep.2008.01.009. Epub 2008 Feb 4. |
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| ID | Term |
|---|---|
| D065626 | Non-alcoholic Fatty Liver Disease |
| D007333 | Insulin Resistance |
| D005234 | Fatty Liver |
| ID | Term |
|---|---|
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D006946 | Hyperinsulinism |
| D044882 | Glucose Metabolism Disorders |
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| OTHER |
| Tanta University | OTHER |
| National Cancer Institute (NCI) | NIH |
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Confirming the high level of insulin resistance in non-diabetic compared to other races
| April 2019 to March 2020 |
| Prevalence of Metabolic syndrome | if all the patients diagnosed as have metabolic syndrome according to international criteria, have NAFLD. Also the results of the present study will cover the cut of value of waist circumference in criteria of metabolic syndrome and the present study will show that those cut-of applied on Egyptians or not. So a recommendation for another studies for metabolic syndrome redefinition with NAFLD part of it (not just considering as known in the present time), and working on the Triglycerides, HDL cut off values & changing blood sugar with the HOMA-IR (Homeostatic model assessment-insulin resistance) in Egyptians will be one of the present study expected outcomes recommendation | April 2019 to March 2020 |
| NASH staging | Trying to get a cut-off value for LSFT (subcutaneous fat in front of left lobe of liver) and USFT (subcutaneous fat at umbilical region) as the investigators previous published work concluded that: LSFT, and USFT had high sensitivity and specificity as simple non-invasive screening method to identify the presence of NASH as prediction of NAFLD progression, so working on a large scale study as a novel method for easy identification and staging of NAFLD. | April 2019 to March 2020 |
| 21352073 | Background | Marchesini G, Moscatiello S, Agostini F, Villanova N, Festi D. Treatment of non-alcoholic fatty liver disease with focus on emerging drugs. Expert Opin Emerg Drugs. 2011 Mar;16(1):121-36. doi: 10.1517/14728214.2011.531700. |
| 24042449 | Background | Loomba R, Sanyal AJ. The global NAFLD epidemic. Nat Rev Gastroenterol Hepatol. 2013 Nov;10(11):686-90. doi: 10.1038/nrgastro.2013.171. Epub 2013 Sep 17. |
| 21875310 | Background | Smith BW, Adams LA. Non-alcoholic fatty liver disease. Crit Rev Clin Lab Sci. 2011 May-Jun;48(3):97-113. doi: 10.3109/10408363.2011.596521. |
| 25952508 | Background | Zhan Y, Zhao F, Xie P, Zhong L, Li D, Gai Q, Li L, Wei H, Zhang L, An W. Mechanism of the effect of glycosyltransferase GLT8D2 on fatty liver. Lipids Health Dis. 2015 May 8;14:43. doi: 10.1186/s12944-015-0040-3. |
| 23041539 | Background | White DL, Kanwal F, El-Serag HB. Association between nonalcoholic fatty liver disease and risk for hepatocellular cancer, based on systematic review. Clin Gastroenterol Hepatol. 2012 Dec;10(12):1342-1359.e2. doi: 10.1016/j.cgh.2012.10.001. Epub 2012 Oct 4. |
| 18956290 | Background | Lazo M, Clark JM. The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis. 2008 Nov;28(4):339-50. doi: 10.1055/s-0028-1091978. Epub 2008 Oct 27. |
| 12667353 | Background | Zhou B; Coorperative Meta-Analysis Group Of Working Group On Obesity In China. [Prospective study for cut-off points of body mass index in Chinese adults]. Zhonghua Liu Xing Bing Xue Za Zhi. 2002 Dec;23(6):431-4. Chinese. |
| 12201871 | Background | Omagari K, Kadokawa Y, Masuda J, Egawa I, Sawa T, Hazama H, Ohba K, Isomoto H, Mizuta Y, Hayashida K, Murase K, Kadota T, Murata I, Kohno S. Fatty liver in non-alcoholic non-overweight Japanese adults: incidence and clinical characteristics. J Gastroenterol Hepatol. 2002 Oct;17(10):1098-105. doi: 10.1046/j.1440-1746.2002.02846.x. |
| 19014878 | Background | Fan JG, Farrell GC. Epidemiology of non-alcoholic fatty liver disease in China. J Hepatol. 2009 Jan;50(1):204-10. doi: 10.1016/j.jhep.2008.10.010. Epub 2008 Nov 6. |
| 17400323 | Background | Lee JY, Kim KM, Lee SG, Yu E, Lim YS, Lee HC, Chung YH, Lee YS, Suh DJ. Prevalence and risk factors of non-alcoholic fatty liver disease in potential living liver donors in Korea: a review of 589 consecutive liver biopsies in a single center. J Hepatol. 2007 Aug;47(2):239-44. doi: 10.1016/j.jhep.2007.02.007. Epub 2007 Mar 6. |
| 27376998 | Background | Heron M. Deaths: Leading Causes for 2014. Natl Vital Stat Rep. 2016 Jun;65(5):1-96. |
| 19105205 | Background | Guerrero R, Vega GL, Grundy SM, Browning JD. Ethnic differences in hepatic steatosis: an insulin resistance paradox? Hepatology. 2009 Mar;49(3):791-801. doi: 10.1002/hep.22726. |
| 24868321 | Background | Pan JJ, Fallon MB. Gender and racial differences in nonalcoholic fatty liver disease. World J Hepatol. 2014 May 27;6(5):274-83. doi: 10.4254/wjh.v6.i5.274. |
| 11117562 | Background | Assy N, Kaita K, Mymin D, Levy C, Rosser B, Minuk G. Fatty infiltration of liver in hyperlipidemic patients. Dig Dis Sci. 2000 Oct;45(10):1929-34. doi: 10.1023/a:1005661516165. |
| 14571229 | Background | Schwimmer JB, Deutsch R, Rauch JB, Behling C, Newbury R, Lavine JE. Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. J Pediatr. 2003 Oct;143(4):500-5. doi: 10.1067/S0022-3476(03)00325-1. |
| 27275239 | Background | Salman A, Hegazy M, AbdElfadl S. Combined Adiponectin Deficiency and Resistance in Obese Patients: Can It Solve Part of the Puzzle in Nonalcoholic Steatohepatitis. Open Access Maced J Med Sci. 2015 Jun 15;3(2):298-302. doi: 10.3889/oamjms.2015.057. Epub 2015 May 30. |
| 29699348 | Background | Hegazy M, Abo-Elfadl S, Mostafa A, Ibrahim M, Rashed L, Salman A. Serum Resistin Level and Its Receptor Gene Expression in Liver Biopsy as Predictors for the Severity of Nonalcoholic Fatty Liver Disease. Euroasian J Hepatogastroenterol. 2014 Jul-Dec;4(2):59-62. doi: 10.5005/jp-journals-10018-1102i. Epub 2014 Jul 28. |
| 31372020 | Background | Hegazy MA, Samy MA, Tawfik A, Naguib MM, Ezzat A, Behiry ME. Abdominal subcutaneous fat thickness and homeostasis model assessment of insulin resistance as simple predictors of nonalcoholic steatohepatitis. Diabetes Metab Syndr Obes. 2019 Jul 11;12:1105-1111. doi: 10.2147/DMSO.S202343. eCollection 2019. |
| D008659 |
| Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |