TY  - BOOK
AU  - Heba Mahmoud Mohamed Ibrahim
AU  - Laila Ahmed Rashed , 
AU  - Mohamed Sherif Mogawer , 
AU  - Mona Abdelmonem Hegazy , 
TI  - Association between serum IGF-1, HOMA-IR,  estimated glomerular filtration rate in obese patients  with different stages of  hepatic steatosis / 
PY  - 2015///
CY  - Cairo : 
PB  - Heba Mahmoud Mohamed Ibrahim , 
KW  - IGF-I
KW  - NAFLD
KW  - NASH
N1  - Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine; Issued also as CD
N2  - Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver injury in many countries around the world. The histological changes range over a wide spectrum, extending from simple steatosis, which is generally progressive, to non alcoholic  steatohepatitis (NASH) which may progress to liver fibrosis, liver cirrhosis, liver cell failure, and sometimes even hepatocellular carcinoma. Liver biopsy is recommended as a gold standard method for the diagnosis and staging of steatosis and fibrosis in patients with NAFLD. low IGF-I level are a consequence of the presence of both NASH/advanced fibrosis in adult  patients proved by liver biopsy which is a features of abdominal obesity and insulin resistance (HOMA-IR) and all contribute to the reduced eGFR. Objectives: Assessing the link between HOMA-IR, IGF-I level and  eGFR in obese patient with different grades of severity of hepatic steatosis  proved by liver biopsy. Results: There were a significant difference between NAFLD patients and normal control participants regarding anthropometric measurements, liver  enzymes (ALT, AST and GGT), fasting blood sugar and total lipid profile. HOMA-IR was higher in NAFLD patients compared to control participant and reached higher level in NASH patients compared to simple steatosis  patients. IGF-I; was highly significantly lower in NAFLD patients compared to control participants and was higher in non-NASH compared to NASH  patients. eGFR was significantly lower in NAFLD patients compared to  control participant, to reach below 60ml/min in NASH subgroup resulting in p value of 0.004 when compared to patients with border line NASH and  non-NASH. Conclusion: There was a definitive association betweenlow IGF-1 ,high  level of HOMA-IR ,and reduced eGFR with the incidence of NAFLD with  different grades of severity. In NAFLD patients eGFR was lower than  90ml/min, and lower than 60ml/min in NASH and border line NASH  patients
ER  -