Hıstopathologıcal, metabolıc features and ace gene polymorphism comparıson of non alcoholıc fatty lıver dısease

The aim of the present study is to investigate the effects of ACE and ACE gene polymorphism on histological and clinical characteristics and progression of the disease in patients with NAFLD.31 Nonalcoholic fatty liver disease patients and 40 healthy controls, totally 71 individual were included to the study. Age and sex was not different significantly between the groups.Liver function tests, hepatitis markers, autoanticors, body mass index, waist-hip ratio, waist circumstance, lipid parameters, ferritin, fasting blood glucose, HbA1c, HOMA-IR, ACE and ACE gene polymorphism was determined in the whole study group. DM and hypertension was present in 4 of (12.9%) NAFLD patients and in none of the control cases. ACE level was comparable in cases with or without DM or hypertension (p=0.71 for hypertension, p=0.10 for DM). AST, ALT, GGT, total cholesterol, LDL, VLDL, triglyceride, ferritin, fasting blood glucose (p<0.001), ALP, HOMA-IR (p=0.002), HbA1c (p=0.001), insulin (p=0.03) levels were significantly higher in the NAFLD group compared to the control group. Other parameters did not differ significantly. ACE level was 11.69±1.99 in the NAFLD group, and 11.52±1.72 in the control group (p=0.70). Mean ACE level was 11.56±1.79 in males, and 11.64±1.95 in females and the difference was not significant (p=0.87). ACE level was compared with respect to AST/ALT, ALT, CRP, BMI, HOMA-IR and the difference was significant only for the HOMA-IR (p=0.008). The study group was divided into four groups according to ACE gene polymorphism (D/D homozygot, I/I homozygot, D/I heterozygot, I/D heterozygot). No difference was found with respect to age and sex in the whole group. However, there was significant difference between the D/I and I/D subgroups in terms of age (p=0.39). Fasting blood glucose was also significantly among the D/D, I/D ile D/I, I/D subgroups(p=0.02). No significant difference was found among the other biochemical parameters. In the NAFLD group; 48.38% was grade 1, 51.6% grade 2-3 and 45.16% was stage 1, and 54.8% stage 2-3. ACE levels were comparable in various grade and stages (p was 0.68 for grade and stage). ACE gene polymorphism was also not different among the different grade and stages (p was 0.42 for grade and 0.92 for stage).In conclusion, ACE I/D gene polymorphism suggested to be related with fibrosis was shown to be inconsistent in different diseases with a basis of fibrosis. In the present study, the effect of ACE and ACE gene polymorphism on NAFLD was investigated and no clinical, biochemical and histopathological difference was found among the gene polymorphisms.Key words: Non-alcoholic fatty liver diseases, ACE and ACE gene polymorphism