Das, K., Das, K., Mukherjee, P.S., Ghosh, A., Ghosh, S., Mridha, A.R., Dhibar, T., Bhattacharya, B., Bhattacharya, D., Manna, B., Dhali, G.K., Santra, A. and Chowdhury, A. (2010) Nonobese Population in a Developing Country Has a High Prevalence of Nonalcoholic Fatty Liver and Significant Liver Disease. Hepatology, 51, 1593-1602.
https://doi.org/10.1002/hep.23567

has been cited by the following article:

• TITLE: Role of Endotoxin and TNF in Developing NAFLD in Non-Obese Egyptian Patients

  AUTHORS: Ehab F. Mostafa, Alaa A. Farag, Ashraf Metwally, Engy F. Tantawy, Farida Omran

  KEYWORDS: NAFLD, NASH, TNF Alpha, Endotoxin, Insulin Resistance

  JOURNAL NAME: Journal of Biosciences and Medicines, Vol.5 No.7, July 13, 2017

  ABSTRACT: Background and aim of the work: Non-alcoholic fatty liver disease (NAFLD) was considered the hepatic presentation of insulin resistance and obesity for a long time. Studies on lean weighted Asian subjects with NAFLD revealed that NAFLD pathogenesis may be multifactorial. NAFLD is associated with disturbances in gut flora and excess expression of inflammatory mediators. This study aims to find out the relation of endotoxins absorbed from gut and the tumor necrosis factor alpha with NAFLD in non-obese Egyptian patient in comparison to obese patients and healthy control subjects. Patients and methods: This study was performed on three groups group I: Patients with NAFLD and body mass index 2. Group II: Patients with NAFLD and body mass index >25 kg/m2. Group III: healthy control subjects. Results: Group I had significantly higher endotoxin, tumor necrosis factor(TNF) alpha and ALT than group II (endotoxin 11.7 ± 1.7 ug/L vs 9.5 ± 1.4) (TNF 14.8 ± 5.3 vs 11.3 ± 3.3) (ALT 67.8 ± 5.3 IU/L vs 51.8 ± 4.2). There was a highly significant correlation between TNF, endotoxin levels and level of liver enzymes in group I and II. Conclusion: Endotoxemia and TNF alpha may contribute in the pathogenesis of NAFLD especially in non-obese patients.