Online ISSN: 2515-8260

Keywords : Liver cirrhosis

Contemporary directions in fatty liver disease in light of low-carbohydrate approach: a review by public health India

Abhinav V Pathare, Anup B Chaudhary

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 808-817

This study aims to equip health professionals with essential directions for their practice and
research in fatty liver disease. In fatty liver disease, excess fat is accumulated in the liver
cells, and it mainly has two types: Alcoholic Fatty Liver Disease (AFLD) and Non-Alcoholic
Fatty Liver Disease (NAFLD). AFLD is widely accepted to be associated with excessive
alcohol consumption. However, in NAFLD's case, although the name acknowledges that it is
not associated with excessive alcohol consumption, the exact cause of NAFLD remains
ambiguous. Furthermore, for almost four decades, without specialised treatments and
prevention strategies, NAFLD has constantly increased, affecting more than a quarter of the
world's population. Meanwhile, although the current dietary recommendations for NAFLD
patients orbit around the conventional High-Carbohydrate Low-Fat diets, mounting evidence
advocates the broader benefits of Low-Carbohydrate High-Fat (LCHF) diets in this regard.
Therefore, focusing on the databases such as PubMed, Cochrane Library, and Google
Scholar, the authors have carried out an advanced literature search reporting on the efficacy
of LCHF diets on NAFLD. After a comprehensive search—using appropriate "keywords and
Boolean operators" and "inclusion & exclusion criteria"—the authors selected a potentially
relevant set of existing peer-reviewed articles for this narrative review. After critically
investigating the LCHF-NAFLD theme, the authors found that LCHF diets may significantly
decrease liver fat and may even reverse the disease by targeting the key causes of hepatic fat
storage, i.e., high insulin levels, excessive calorie consumption (mainly from carbohydrates),
and excessive consumption of refined carbohydrates. Additionally, LCHF diets may provide
a comprehensive health benefit beyond liver health. The authors conclude that the LCHFNAFLD
theme represents a rich vein of research opportunities. The authors encourage and
call researchers, doctors, nutritionists, dieticians, and related-health professionals to engage
more with the LCHF-NAFLD theme.

Serum Prolactin: A Possible New Marker for Severity of Liver Cirrhosis

Deepak Raj Sakhnani, Chetanya Kumar Sharma, Ajay Mathur, RajendraKasana, SandeepSaini

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 53-59

Background: Liver cirrhosis (LC) is an irreversible condition which results from necrosis
of hepatocytes with loss of reticular network and nodular regeneration of residual liver
tissue. This study was undertaken to assess the relation between serum prolactin levels and
the severity of the liver cirrhosis.Materials & methods: This cross-sectional observational
study was conducted during one calendar year at a tertiary care center in Western India
among 50 cases of established liver cirrhosis. Serum Prolactin was estimated using ADVIA
Centaur® CP Immunoassay System (Siemens®) by Chemiluminescent technique. The
modified Child Pugh score was calculated for each study participant. The patients were
categorized into Classes A, B or C based on the score obtained. Hepatic encephalopathy
was diagnosed and graded as per West Haven classification system. The grade I-II were
taken as mild and grade III-IV as advanced hepatic encephalopathy for calculation of the
modified Child-Pugh score. Ascites was graded as mild, moderate and severe. All the data
were stored in excel sheet using Microsoft® Office 2007. Results: The mean serum
prolactin, serum albumin, serum Bilirubin and INR were 48.1±26.8 ng/ml, 2.8±0.6 g/dl,
4.8±4.9 mg/dl and 2.2±1.0 respectively. (Table No. 1) The mean serum prolactin level in
alcoholic cirrhosis (49.2±25.1 ng/ml) does not statistically differ from non-alcoholic
cirrhosis (46.6±29.4 ng/ml) cases (p > 0.05). The mean serum prolactin level was
statistically significantly higher among cases in Modified Child Pugh Class-C (68.91 ±
17.80 ng/ml) compared to Class B (33.26 ± 7.41 ng/ml) and Class A (10.03 ± 4.01ng/ml)
cases. The mean serum prolactin level was 81.36 ± 19.85 ng/ml in cases with severe ascites,
60.09 ± 18.05 ng/ml in moderate ascites cases, 36.1583 ± 15..06 ng/ml in mild ascites cases
and 19.79 ± 12.29 ng/ml in cirrhosis cases without ascites. The difference in mean serum
prolactin level was significant among different severity of ascites. The serum prolactin
level was 81.08 ± 18.04 ng/ml in cases with advanced hepatic encephalopathy, 56.89 ±
15.05 ng/ml in cases with mild hepatic encephalopathy and 26.16 ± 13.99 ng/ml in
cirrhosis cases without encephalopathy. Conclusion: Serum Prolactin levels showed
positive correlation with Modified Child Pugh Score and Fibroscan in predicting the
severity of disease.