الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Nonalcoholic fatty liver disease (NAFLD) is currently recognized as one of the most prevalent etiologies of chronic liver disease worldwide. NAFLD is estimated to afflict approximately 80-100 million adults in the United
States. NAFLD is broadly classified into nonalcoholic fatty liver, the non-progressive form of NAFLD, and nonalcoholic steatohepatitis (NASH), the progressive form of NAFLD. Patients with NASH have a higher risk of progression to cirrhosis and hepatocellular carcinoma and are at an increased risk of liver-related morbidity and mortality.
Liver biopsy remains the gold standard for characterizing liver histology in patients with NAFLD. However, it is expensive and carries some morbidity and very rare mortality risk. Thus, it should be performed in those who would benefit the most from diagnostic, therapeutic guidance, and prognostic perspectives.
Previous similar studies have shown that NAFLD is a heritable trait.
Several studies confirmed that has a statistically and clinically significant shared gene effect with both hepatic steatosis and fibrosis. These results suggest a common genetic basis underlying the susceptibility towards NAFLD related fibrosis and 3-(4-hydroxyphenyl) lactate pathway and their joint association with the gut microbiome. The shared gene-effect between NAFLD and this gut microbiome-derived metabolite provide insights into the emerging linkage between gut microbiome and NAFLD related fibrosis. It is plausible that targeting 3-(4-hydroxyphenyl) lactate may influence shared genetic or epigenetic pathways associated with the development of NAFLD.
The main goal of our study was study the diagnostic significance of serum phenyl lactic acid in non-alcoholic fatty liver disease.
The study was performed on 80 patients recruited from the Gastroenterology and Hepatology Unit of the Internal Medicine Department at Ain Shams University Hospital.
Patients were classified into 3 groups;
group 1: 20 normal patients with no fatty liver included 14 males (70%) 6 female (30%).
group 2: 30 patients non Alcoholic Fatty Liver Disease with normal AST & ALT included 20 males (66.67%) 10 female (33.33%).
group 3: 30 patient non Alcoholic steatohepatitis included 13 males (43.33%) 17 females (56.67%).
Patients in the three groups were subjected to full history taking, thorough clinical examination and laboratory investigations including phenyl lactic acid together with abdominal ultrasonography, NAFLI, FLI and APRI score.
In the present study phenyl lactic acid was significantly positively correlated with ALT & AST levels and APRI score. Negatively correlated with triglycerides, S. cholestrol, S. GGT, S. ALB. S. CR, BUN, waist, height, weight and BMI and this mean more increase level of phenyl lactic acid increase level of AST&ALT and increase risk of steatosis and fibrosis and this refer to may be use phenyl lactic acid as diagnostic and prognostic marker in NAFLD.
Our study expands on these observations by Mounting evidence suggests that the Phenyl lactic acid represent as diagnostic test in non-alcoholic liver disease and may use as prognostic test to identify the degree of steatosis & fibrosis.