Study of Erythropoietin and Lipid Profile and Some Trace Elements in Patients with Fatty Liver Disease in Thi-Qar Province, Iraq

Muna Hameed  Kazem; Jamal Harbi Hussein  Alsaadi

Muna Hameed Kazem Department of Chemistry, College of Science, University of Thi-Qar, Thi-Qar, Iraq
Jamal Harbi Hussein Alsaadi Department of Chemistry, College of Science, University of Thi-Qar, Thi-Qar, Iraq

Keywords: Non-alcoholic fatty liver disease (NAFLD), erythropoietin, lipid Profile, triglycerides (TG), cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), very low-density lipoprotein (V-LDL), Selenium (Se), Iron (Fe)

Abstract

Non-alcoholic fatty liver disease (NAFLD) is an increasing worldwide health issue marked by fat buildup in more than 5% of liver cells. This disease is primarily caused by the obesity epidemic and affects approximately 25% of the world's population. NAFLD might lead to various degrees of cirrhosis in a persistent liver illness. Lastly, NAFLD could result in the development of cancer of the liver. This review aims to describe and estimate erythropoietin levels and lipid levels (TG, TC, HDL, LDL, V-LDL) and some trace elements (Selenium (Se), Iron(Fe)) in patients with fatty liver disease. Serum erythropoietin and lipid levels (triglycerides (TG), cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), very low-density lipoprotein (V-LDL)) and selenium and iron levels were determined in 96 volunteers from men and women: 73 patients and 23 healthy control group. Patients were diagnosed by an internist medicine specialist. Inclusion Criteria: The cases included in this study are patients with non-alcoholic fatty liver disease, diabetes, and hypertension. Exclusion Criteria: The cases excluded from this study are patients with alcoholic fatty liver disease or fatty liver with other diseases such as heart and kidney disease. An important increase in focus of erythropoietin in fatty liver in the DM also fatty liver in the DM and HTN cohorts compared to fatty liver and controls groups (p≤0.05), An important increase in focus of TC in patients cohorts compared in the controls groups (p≤0.05), An important increase in focus of TG and VLDL in patients groups compared to controls groups (p≤0.05), An important increase in focus of LDL in patients groups compared to controls groups (p≤0.05),and An important decrease in focus of HDL in patients groups compared to controls groups (p≤0.05). An important increase in focus of Se in patients groups compared to controls groups (p≤0.05). An important increase in focus of Fe in patients groups compared to controls groups (p≤0.05). The study indicated that there was an increase in the levels of erythropoietin, as well as an increase in the level of (TG, TC, LDL, V-LDL), Se, Fe, and a decrease in the level of (HDL) in patient’s fatty liver.

References

K. S. Kim, S. Hong, H. Y. Ahn, and C. Y. Park, "Metabolic dysfunction-associated fatty liver disease and mortality: a population-based cohort study," Diabetes & Metabolism Journal, vol. 47, no. 2, p. 220, 2023.

Z. M. Younossi et al., "From NAFLD to MAFLD: implications of a premature change in terminology," Hepatology, vol. 73, no. 3, pp. 1194-1198, 2021.

S. A. P. J. M. B. R. A. T. H. L. &. Y. Z. M. Alqahtani, "Poor awareness of liver disease among adults with NAFLD in the United," Hepatology Communications, vol. 5, no. 11, pp. 1833-1847, 2021.

J. P. Marrow, "Novel Roles of Cardiac-derived Erythropoietin in Disease," Doctoral dissertation, Univer-sity of Guelph, 2024.

K. M. Lappin, K. I. Mills, and T. R. Lappin, "Erythropoietin in bone homeostasis—Implications for effica-cious anemia therapy," Stem Cells Translational Medicine, vol. 10, no. 6, pp. 836-843, 2021.

J. She, Z. Yuan, Y. Wu, J. Chen, and J. Kroll, "Targeting erythropoietin protects against proteinuria in type 2 diabetic patients and in zebrafish," Molecular Metabolism, vol. 8, pp. 189-202, 2018.

K. Kodo et al., "Erythropoietin (EPO) ameliorates obesity and glucose homeostasis by promoting ther-mogenesis and endocrine function of classical brown adipose tissue (BAT) in diet-induced obese mice," PloS One, vol. 12, no. 3, p. e0173661, 2017.

T. Hong et al., "Erythropoietin alleviates hepatic steatosis by activating SIRT1-mediated autophagy," Bio-chimica et Biophysica Acta (BBA)-Molecular and Cell Biology of Lipids, vol. 1863, no. 6, pp. 595-603, 2018.

T. Hong et al., "Erythropoietin suppresses hepatic steatosis and obesity by inhibiting endoplasmic retic-ulum stress and upregulating fibroblast growth factor 21," International Journal of Molecular Medicine, vol. 44, no. 2, pp. 469-478, 2019.

S. Matsui et al., "Neuronal SIRT1 regulates macronutrient-based diet selection through FGF21 and oxyto-cin signalling in mice," Nature Communications, vol. 9, no. 1, p. 4604, 2018.

M. S. Sekhar et al., "Physiological role of cholesterol in human body," in Dietary Sugar, Salt and Fat in Human Health, Academic Press, pp. 453-481, 2020.

A. Taan, H. R. Faraj, and R. M. Hannon, "Clinical Study for Serum Lipid Profile and Lipid Peroxidation in Patients with Gallstones in Thi-Qar Governorate-Iraq," University of Thi-Qar Journal of Medicine, vol. 16, no. 2, pp. 193-199, 2018.

G. S. Getz, "Lipid Transfer Proteins: Introduction to the Thematic Review," Journal of Lipid Research, vol. 59, no. 5, pp. 745-748, 2018.

K. H. Cho, "The current status of research on high-density lipoproteins (HDL): a paradigm shifts from HDL quantity to HDL quality and HDL functionality," International Journal of Molecular Sciences, vol. 23, no. 7, p. 3967, 2022.

M. M. Quetglas-Llabrés et al., "Status and metabolic parameters in NAFLD patients: A 24-month lifestyle intervention study," Antioxidants, vol. 13, no. 4, p. 480, 2024.

J. G. Neels, G. Leftheriotis, and G. Chinetti, "Atherosclerosis calcification: focus on lipoproteins," Metabo-lites, vol. 13, no. 3, p. 457, 2023.

K. R. Feingold, "Introduction to lipids and lipoproteins," Endotext [internet], 2024.

N. Wang et al., "Supplementation of micronutrient selenium in metabolic diseases: its role as an antioxi-dant," Oxidative Medicine and Cellular Longevity, vol. 2017, no. 1, p. 7478523, 2017.

M. L. Ojeda et al., "Binge drinking during the adolescence period causes oxidative damage-induced car-diometabolic disorders: A possible ameliorative approach with selenium supplementation," Life Sciences, vol. 301, p. 120618, 2022.

J. H. Alsaadi and R. N. Altaiee, "A Clinical Investigative Study for Homocysteine and Some Trace Elements Levels in Pregnant with Preeclampsia and Premature BI," Türk Fizyoterapi ve Rehabilitasyon Dergisi/Turkish Journal of Physiotherapy and Rehabilitation, vol. 32, no. 3, pp. 5111-5120, 2024.

L. Lin et al., "Nanomedicine targets iron metabolism for cancer therapy," Cancer Science, vol. 113, no. 3, pp. 828-837, 2022.

S. Altamura et al., "Iron aggravates hepatic insulin resistance in the absence of inflammation in a novel db/db mouse model with iron overload," Molecular Metabolism, vol. 51, p. 101235, 2021.

K. Maiese, "Novel applications of trophic factors, Wnt and WISP for neuronal repair and regeneration in metabolic disease," Neural Regeneration Research, vol. 10, no. 4, pp. 518-528, 2015.

K. Nishimura et al., "The effect of hemin‐induced oxidative stress on erythropoietin production in HepG2 cells," Cell Biology International, vol. 38, no. 11, pp. 1321-1329, 2014.

S. J. Korzeniewski et al., "Elevated endogenous erythropoietin concentrations are associated with in-creased risk of brain damage in extremely preterm neonates," PLoS One, vol. 10, no. 3, p. e0115083, 2015.

N. Ueda and K. Takasawa, "Impact of inflammation on ferritin, Hepcidin and the management of iron deficiency anemia in chronic kidney disease," Nutrients, vol. 10, no. 9, p. 1173, 2018.

L. Toro et al., "Erythropoietin induces bone marrow and plasma fibroblast growth factor 23 during acute kidney injury," Kidney International, vol. 93, no. 5, pp. 1131-1141, 2018.

H. Zou, R. S. Wong, and X. Yan, "Erythropoietin hyporesponsiveness in non‐alcoholic fatty liver disease," Clinical and Experimental Pharmacology and Physiology, vol. 51, no. 6, p. e13869, 2024.

J. H. Alsaadi, N. H. Alrikabi, and H. M. Younis, "Clinical Study of Changes Selenium, Zinc, Lead and Lipid Profile in Serum with Retinopathy Diabetic Patients in Thi Qar Governorate," History of Medicine, vol. 9, no. 1, pp. 1038-1047, 2023.

S. Davidović et al., "Serum erythropoietin concentration and its correlation with stage of diabetic reti-nopathy," BMC Ophthalmology, vol. 19, pp. 1-8, 2019.

P. Puri et al., "A lipidomic analysis of nonalcoholic fatty liver disease," Hepatology, vol. 46, no. 4, pp. 1081-1090, 2007.

H. Chatrath, R. Vuppalanchi, and N. Chalasani, "Dyslipidemia in patients with nonalcoholic fatty liver disease," Seminars in Liver Disease, vol. 32, no. 1, pp. 22-29, 2012.

T. P. Johnston et al., "Apolipoprotein E expression and its role in the pathogenesis of dyslipidemia, obesity, and insulin resistance: Insights from experimental models," International Journal of Molecular Sciences, vol. 22, no. 12, p. 6421, 2021.

S. Petersen and K. D. Shulman, "Etiology of insulin resistance," The American Journal of Medicine, vol. 119, no. 5, pp. 10-16, 2006.

A. R. Saltiel, "Insulin resistance in the pathogenesis of dyslipidemia," Current Diabetes Reports, vol. 15, no. 4, p. 41, 2015.

Y. Wang et al., "Endoplasmic reticulum stress is associated with inflammation in obese women with polycystic ovarian syndrome," Endocrine, vol. 54, no. 3, pp. 731-738, 2016.

K. A. Bradshaw, "Insulin signaling in health and disease: novel insights from lipidomics," Trends in Endo-crinology and Metabolism, vol. 27, no. 3, pp. 235-247, 2016.

E. Marwaha et al., "The role of adipose tissue in metabolic dysregulation in nonalcoholic fatty liver dis-ease," Metabolism, vol. 64, no. 8, pp. 1066-1074, 2015.

B. A. Neuschwander-Tetri, "Efficacy and safety of dietary supplements in nonalcoholic fatty liver disease," Clinics in Liver Disease, vol. 18, no. 1, pp. 115-133, 2014.

G. P. Aithal, "Treating non-alcoholic fatty liver disease," BMJ, vol. 362, p. k2734, 2018.