Digestive and Liver Disease - Volume 48 - Supplement 2 - February 2016

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Abstracts of the 22nd National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231 e131
group by Mediterranean diet and BIL (active components: silymarin
75 mg, chlorogenic acid 3.75 mg, protopine 0.02 mg, L-methionine
75 mg, and L-glutathione 75 mg), orally twice daily. All patients
underwent clinical and biochemical evaluations, and ultrasound
staging of liver steatosis according to the Hamaguchi score, in pre-
and post-intervention period, after six months follow up.
Results: Before the treatment there was no significant difference
between the two groups with respect to average age, BMI and
gender, lipid profile, transaminase levels, serum insulin level,
Homeostasis Model Assessment (HOMA) index for insulin-resistance
and ultrasound degree of steatosis. After six months treatment, a
statistically significant reduction was observed in BMI (p<0.001),
lipid profile (p<0.007), transaminase levels (p<0.01), and liver
steatosis degree (p<0.01) in both groups. However, a statistically
significant reduction in serum insulin (p<0.01) and glucose levels
(p<0.05), and HOMA index (p<0.03) was observed in Mediterranean
diet plus BIL group.
Conclusions: Our data suggest the efficacy of Mediterranean diet
plus BIL, on transaminase levels, BMI and hepatic fat accumulation
in overweight patients with NAFLD. Also we report the improvement
of glucose and lipid metabolisms.
P.01.4
ENDOCAN AS SERUM MARKER OF ENDOTHELIAL DYSFUNCTION
IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND/
OR TYPE 2 DIABETES
Dallio M.*1, Caprio G.G.1, Masarone M.2, Abbatecola A.1, Tuccillo C.1,
Gravina A.G.1, Romano M.1, Sasso F.C.1, Persico M.2, Loguercio C.1,
Federico A.1
1Department of Clinical and Experimental Medicine, Second University
of Naples, Naples, Italy, 2Department of Medicine and Surgery,
University of Salerno, Salerno, Italy
Background and aim: Nonalcoholic fatty liver disease (NAFLD) is
the most common chronic liver disease in Western countries, and is
emerging as an independent cardiovascular risk factor.
Recently, Endocan, a 50 kDa circulating proteoglycan, produced
specifically by non sinusoidal endothelial cells has been studied as
an early marker of endothelial dysfunction. Aim of the study was to
evaluate the serum levels of Endocan in patients with diagnosis of
NAFLD and/or type 2 diabetes.
Material and methods: We enrolled 56 patients: 19 with NAFLD and
37 with type 2 diabetes, compared to 25 healthy controls. Endocan
was measured by using ELISA EndoMark H1 assay (Lunginnov SAS,
Lille, France).
Results: Endocan has been found to increase in NAFLD patients,
independently from the presence of type 2 diabetes (1.23±1.51 vs
0.68±0.4 ng/mL; p=0.016), and in diabetes patients itself, compared
to healty subject (1.54±1.76 vs 0.68±0.4 ng/mL; p=0.01).
Specifically, we showed a statistically significant increase (p=0,047)
in diabetes subject without liver disease, compared to NAFLD
patients without diabetes (1.61±1.61 vs 0.72±0.58 ng/mL); moreover,
we observed that Endocan was more elevated in NAFLD patients
with diabetes compared to non diabetic ones (1.56±0.81 vs 0.72±0.58
ng/mL), even without statistic significance (p=0.05). Non diabetic
patients didn’t reach a relevant result compared to controls, even
though they showed higher serum levels of our marker (0.72±0.58
vs 0.68±0.4 ng/mL; p=n.s.). Finally, we observed an increase of
circulating Endocan in patients with metabolic syndrome vs controls
(p=n.s.), especially with the adding of NASH (2.86±3.15 vs 0.68±0.4
ng/mL; p=0.047), based on the impact that this syndrome has on
vascular system.
Conclusions: Our study demonstrate the increase of Endocan serum
levels in NAFLD patients. In patients with type 2 diabetes and/or
metabolic syndrome, Endocan serum levels are even higher, because
of a more important scientific evident endothelial dysfunction in
these pathologies.
P.01.5
NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) AS POTENTIAL
RISK FACTOR OF CARDIOVASCULAR DISEASE AND ONCOLOGICAL
DISEASE IN DIABETIC TYPE 2 PATIENTS
Caroli D.*1, Nogara A.1, Rosa-rizzotto E. 2, De Lazzari F.2,
Boscolo Bariga A.2
1Ospedale di Chioggia, Chioggia (Ve), Italy, 2Ospedale S. Antonio,
Padova, Italy
Background and aim: NAFLD is an increasingly cause of liver
damage in western countries associated with obesity, hypercaloric
diet and the sedentary lifestyle. The increasingly high prevalence
of Nafld and its possible damage on several organs due to its
inflammatory effects (cardiovascular risk and oncological risk)
will lead to a prioritary health care problem in the next future.
Validated prognostic scores for NAFLD and for cardiovascular risk
in diabetics patients were respectively Fatty liver index (FLI) and
UK Prospective Diabetes Study (UKPDS risk engine).The aims of our
study are to assess the real correlation between FLI and UKPDS risk
with cardiovascular (CE) and oncological events (OE) in a cohort of
diabetic type 2 patients, in order to identify with accurancy the best
predictor.
Material and methods: 2004 patients referred to our Diabetics
Center Ambulatory and in a regular follow-up were retrospectively
tested. UKPDS risk and FLI were calcolated for each patient. Data
such as CE, OE, anthropometric, biochemical and metabolic features
were also collected. T test for unpaired data and Pearson Chi-squared
test were performed.
Results: 304/2004 pt (15%), 211 M and 93 F, were FLI >60; in this
group we observed 14 (5%) OE (7 M and 7 F) and 81 (27%) CE (64
M and 17 F). 743/2004 pt (37%), 638 M and 17 F), were FLI < 20; in
this other group we observed 9 (1%) OE (6 M and 3 F) and 74 (10%)
CE (47 M and 27 F). The statistical analysis showed that patients
with FLI>60 have a higher risk of OE (p=0.0006) or CE (p=0.0001)
compared to patients FLI<20. We identified also two peculiar profiles
of cardiovascular risk, in fact male gender patients with FLI>60
presented a significant higher risk of developing CE than female
(p<0.05); instead female gender patients with FLI<20 presented a
significant higher risk of developing CE than male (p<0.001). No
statistical significance was found between FLI > 60 +UKPDS >20 and
CE (p=0,754). FLI>60 and FLI<20 patients also significantly differed
respectively for mean age 62,2 vs 68,4 y (p=0.02), duration of
diabetes 4,9 y vs 13,24 y (p=0.002) and mean glycated hemoglobin
8.7y vs 7,9 (p=0.009).
Conclusions: An early and aggressive program of follow-up and
treatment could be established in diabetic type 2 patientswith FLI>60
and so with reasonable suspicion of NAFLD because this population
have higher risk to develop CE and OE in comparison to FLI<20 (or
FLI negative and not suspicion of NAFLD). The simultaneous UKPDS
and FLI positivity doesen’t improve accuracy in predicting CE.
P.01.6
HEPATIC ENCEPHALOPATHY IS ASSOCIATED WITH PERSISTENT
COGNITIVE DEFICITS DESPITE ADEQUATE MEDICAL TREATMENT:
A MULTI-CENTER, INTERNATIONAL STUDY
Nardelli S.*1, Gioia S.1, Mullen K.2, Bajaj J.3, Riggio O.1
1Policlinico Umberto I, Rome, Italy, 2Gastroenterology, Metrohealth
Medical Center, Case Western Reserve University, Cleveland, United
States, 3Gastroenterology, Hepatology and Nutrition, VCU and McGuire
VAMC, Richmond, United States