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Nonalcoholic fatty liver disease (NAFLD) refers except alcohol and other explicit liver damage factors caused by diffuse liver cells bullous fat becomes the main feature clinicopathologic syndrome, including simple fatty liver and its evolution of non-alcoholic steatohepatitis (referred to as NASH), fibrosis and cirrhosis. NAFLD prevalence showed a clear upward trend at home and abroad, mainly with over the past 20 years the prevalence of obesity, especially abdominal obesity increased significantly related. The main feature of abdominal obesity abdominal fat, particularly intra-abdominal fat deposition. Abdominal fat distribution and different parts of the adipose tissue lipid hormone expression changes with NAFLD relationship has not been reported. This study by detecting the clinical characteristics of patients with NAFLD, abdominal fat distribution, the level of intra-abdominal and subcutaneous fat and plasma lipid hormone (adiponectin, visfatin) and the correlation between the degree of fatty change in liver tissue, to investigate patients with non-alcoholic fatty liver disease distribution of abdominal fat, fat hormone changes and relationship to clinical pathology, new methods and strategies for the prevention and treatment of NAFLD. Clinical data and methods: gallstone surgery in our hospital and signed test consent 45 patients, 18 males, age 34 to 69 years, with an average age of 45.3 years; 27 females, aged 28 to 70 years old, the average age of was 42.7 years old. NAFLD patients with clinical and biochemical indicators of liver ultrasound B liver disease of Science detection measurement weight, waist circumference, hip circumference, fasting plasma glucose (FPG), fasting insulin (FINS), lipids (TC, TG, HDL-C, LDL-C, ApoB , LPA1, FFA), ALT, AST, ALB, PLT. Calculate body mass index (BMI), waist-to-hip ratio, homeostasis model assessment of insulin resistance (HOMA-IR). B-mode ultrasound. The intraoperative take liver tissue in patients with 1g, subcutaneous, omental adipose tissue 3g. Liver tissue ordinary HE staining, Masson Ⅲ collagen fiber dyeing. Slice the hepatology credits according to the Chinese Medical Association developed non-alcoholic fatty liver disease treatment guidelines histopathological diagnostic criteria for diagnosis. NAFLD determine its F, G, S classification (F: fatty liver indexing, G: inflammation grade, S: fibrosis stage). Used in patients according to the severity of hepatic steatosis in accordance with the degree of the degree of steatosis of the liver tissue is divided into: F0 control group of 12 patients, NAFLD/F1 group 19 cases, NAFLD/F2 of 13 cases, NAFLD/F3 of patients (liver The fatty degeneration occupy a range of the amount of obtained liver tissue specimens lt; 5% F0; 5% to 30% as F1; 31% to 50% as F2; ??51% to 75% is F3, F3 group only one case, do not statistically classified as F2). NAFLD patients with 64-slice CT detection were randomly selected from the 45 patients, 16 cases, 8 males, age 37 to 69 years, with an average age of 46.1 years; 8 females, aged 41 to 65 years, with an average age of 49.6 years. 64 rows of the CT since phrenic top to perineum following plane scanning. Take four planes (the top of the liver, the hepatic portal cephalic and the hepatic portal caudal and right lobe the lower edge) Determination of CT values, each plane four CT values ??were measured in the liver and spleen 2 CT value. Related software measured umbilical plane abdominal fat, visceral fat and subcutaneous fat area, measuring the abdominal fat, visceral fat, subcutaneous fat volume. 3 NAFLD serum, intra-abdominal adipose tissue and subcutaneous adipose tissue fat adiponectin, visfatin detection of serum adiponectin (adiponectin) were measured by ELISA, the concentration of visfatin (visfatin), using real time RT-PCR Western blot detection of adiponectin, visfatin mRNA and protein expression levels change. Results: 1.NAFLD patients with clinical and biochemical indicators of liver B and liver pathology displayed by the correlation analysis of bi-ordered R × C table rows and columns: liver tissue specimens degree of steatosis and inflammation, fiber installments of no significant correlation. The F0 F1 group, F2 group between the groups ALT, AST, ALB, PLT difference was not significant. Spearman's correlation analysis of liver tissue degree of steatosis and waist circumference (r = 0.357, P = 0.028), waist-to-hip ratio (r = 0.463, P = 0.002) as a positive correlation. Degree of hepatic steatosis TC (r = 0.386, P = 0.009), TG (r = 0.346, P = 0.021), LDL-C (r = 0.415, P = 0.005), ApoB (r = 0.433, P = 0.003 ), LDL-C/HDL-C (r = 0.416, P = 0.005) were positively correlated. HDL-C, the LPA1, FFA and liver tissue fat becomes no significant correlation. FPG, HOMA-IR (F1 and F2) of the fatty liver group than in the control group (F0 group). B-missed in this study was 27.27%, and 100% positive predictive value, negative predictive value of 57.14%. NAFLD patients with 64-slice CT detection Spearman's correlation analysis showed: liver CT values ??(r = -0.772, P = 0.000), liver and spleen ratio (r = -0.703, P = 0.002) and liver tissue fat becomes negative correlation. Spearman's relevant analysis show: liver tissues and fat becomes the degree into a positive correlation umbilical plane abdominal fat area (r = 0.857, P = 0.000), umbilical plane intra-abdominal fat area (r = 0.806, P = 0.000), umbilical plane subcutaneous fat area (r = 0.532, P = 0.034), total abdominal fat volume (r = 0.514, P = 0.041), intra-abdominal fat volume (r = 0.823, P = 0.000). Umbilical plane abdominal fat area and hepatic steatosis degree of relationship most closely followed by intraabdominal fat volume and the umbilical plane of intra-abdominal fat area. NAFLD patients with serum, intra-abdominal adipose tissue and subcutaneous adipose tissue fat adiponectin, visfatin detection of patients with NAFLD, serum adiponectin, visceral fat vegetarian with fat variable degree aggravated the trend is decreasing. Omental adipose tissue adiponectin mRNA and protein expression: F1 group was lower than F0; F2 group than in the F0 group; the F2 group than in the F1 group tends to decrease, do not differ significantly. Subcutaneous adipose tissue adiponectin mRNA and protein expression of the difference between the groups was not significant; omental adipose tissue and subcutaneous adipose tissue adiponectin mRNA and protein expression do not differ significantly. Omental adipose tissue visfatin mRNA and protein expression: F1 group than in the F0 group have decreased, but the difference is not significant; F2 group than in the F0 group, the difference is very significant; F2 group than in the F1 group has been decreasing, do not differ significantly. Subcutaneous adipose tissue visfatin mRNA and protein expression between the groups do not differ significantly; omental adipose tissue and subcutaneous adipose tissue visfatin mRNA and protein expression do not differ significantly. Conclusion: In patients with NAFLD, with waist circumference, waist-to-hip ratio, and increased the TC increased degree of fatty degeneration of the liver tissue; transaminase high and low and can not accurately reflect the pathological changes of the liver tissue; lipids ApoB and NAFLD high correlation , can be used as a routine test indicators; 2. liver ultrasound B patients with no abnormal liver histopathological examination may steatosis; liver CT value gradually reduce hepatic steatosis degree aggravated; the hepatocyte were not accurately reflect fat differences in the degree of liver. Play a key role in liver histopathology in NAFLD diagnosis; abdominal obesity and NAFLD is closely related to the incidence of intra-abdominal fat accumulation than subcutaneous fat accumulation more susceptible of NAFLD; 4 Low adiponectin expression promote the occurrence of NAFLD; NAFLD patients with intra-abdominal adipose tissue visfatin secretion reduced, increasing the degree of NAFLD steatosis. Intra-abdominal fat hormone secreted by adipose tissue has an important influence NAFLD occurrence.
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