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Nuclear Factor-Kappa B Expression and Acyl-Ghrelin in Egyptian Patients with Non-Alcoholic Fatty Liver

— BACKGROUND Ghrelin is an inflammation inhibitor hormone. It is secreted from the gastrointestinal tract. It is involved in energy metabolism. Nuclear factor-kappa B (NF- κB) takes part in the initiation and the progression of the cardiovascular and adipose tissue inflammation. The combined role of Ghrelin and NF- κB in non-alcoholic fatty liver disease (NAFLD) pathogenesis is unclear . AIM : To investigate whether acyl-ghrelin level and NF- κB could interplay a role in lipid metabolism and inflammatory injury in NAFLD. PATIENTS AND METHODS: Ninety three adult participates were included in the study, 30 patients had proved nonalcoholic steatohepatitis (NASH), and 38 patients had simple steatosis, as well 25 healthy subjects, as a healthy control group. The control group matches the patients in age, gender and BMI. Full history and clinical examination, abdominal ultrasonography and liver biopsy were done when indicated. Liver function tests, lipid profile, blood sugar, insulin and C- peptide, fasting insulin, and plasma acyl-ghrelin concentrations were measured. Nuclear NF-kB mRNA expression was measured by quantitative RT-PCR. RESULTS: There are significant increase in fasting insulin, insulin C-peptide, HOMA-IR, AST, ALT and  -GT and a significant decrease in HDL-C was in NAFLD patients compared to control group. In addition, a significant increase in ALT,  -GT, fasting insulin, insulin C peptide and HOMA-IR were detected in the NASH group compared to group of simple steatosis. The plasma levels of Acyl-ghrelin was significantly decreased in NAFLD groups compared to normal control group, the lowest level was detected in NASH group as compared to group of simple steatosis. There was a significant increase in the expression of NF-kB mRNA in NAFLD groups more than in the normal control group. A significant increase in its level was in NASH than in simple steatosis patients. There