A. Somani 1 , V. Dixit 2 , A. Jain 2 , S. Somani 3 1 Navjeevan hospital, 2 IMS, BHU, VARANASI, 3 Suvidha Background: Normal levels of alanine aminotransaminase (ALT) have been demonstrated in NAFLD patients. ALT levels are also modulated by age, gender, BMI, fasting glucose, and serum triglyceride levels. We performed a prospective study of patients with histologically confirmed NAFLD and having ALT < 1.5 times and compared them with those having raised ALT to determine (a) clinico-pathologic features of NAFLD patients with normal ALT (b) to observe any differences between them. Methods: Patients with fatty liver on sonography had under gone biopsy for histological confirmation after excluding other causes of fatty liver. Participants were divided into two groups (a) Those having ALT > 1.5 times normal (n=97) (b) Those having normal ALT (n=47) Results: Mean age was comparable with slight male predominance. There were significant differences in anthropometric measurements like BMI (p=0.0001) and WHR (0.90±3.57 and 0.88±3.23, p=0.0071). Mean BP, lipid profile, fasting glucose, insulin, and HOMA R were comparable. There were significant differences in both mean AST (50.2±5 and 37.4±3.21, p=0.0001) and ALT (104±7.29 and 69.9±11.5, p=0.0001) levels. Metabolic syndrome was present in >75% of patients and Individual components were comparable except for increased waist circumference which was significantly more in those with raised ALT (78.35% and 44.68%, p<0.001). Majority of our patients were having only steatosis, while NASH was present in (27.82% and 8.5%, p<0.05) of patients. Conclusion: NAFLD can exist in patients with normal ALT values. Although more work is needed to determine who should be screened for NAFLD and how such individuals should be evaluated, this study is a step toward the identification and characterization of NAFLD patients with normal ALT. We can suggest that patients having metabolic syndrome or insulin resistance, despite having normal ALT, should be screened for NAFLD. Also ALT values should be adjusted for variables like BMI to appropriately screen NAFLD patients. Background: Scientific evidence has demonstrated that Traditional Chinese Medical (TCM) approaches and products can be beneficial for managing Non-alcoholic Fatty Disease (NAFLD), but few rigorous criteria of patterns of TCM therapy are available to guide practitioners in deciding the CAM interventions. Objectives: To evaluate criteria of patterns of TCM therapy for the management of NAFLD identified by biomedicine. Methods: literature research, clinical epidemiological investigation and mathematical statistics were employed to make information collecting tables and to establish database. Descriptive analysis, factor analysis, and cluster analysis were involved. Results: (1) Background/Aim: Serum uric acid level has been suggested to be associated with factors that contribute to the metabolic syndrome. The aim of this study was to investigate the association of serum uric acid level with nonalcoholic fatty liver disease (NAFLD). Methods: A cross-sectional study was performed among the employees of Zhenhai Refining & Chemical Company Ltd., Ningbo, China. Results: The study included 8925 subjects (6008 men) with a mean age of 43 years. The prevalence rate of NAFLD and hyperuricemia was 11.78% and 14.71%, respectively. NAFLD patients had significantly higher level of serum uric acid than controls (370.3 ± 86.6 vs. 321.1 ± 82.6 mol/L; P < 0.001). The prevalence rate of NAFLD was significantly higher in the subjects with hyperuricemia than those without hyperuricemia (24.75% vs. 9.54%; P < 0.001), and the prevalence rate increased along with serum uric acid levels (P value for trend < 0.001). Multiple regression analysis showed that hyperuricemia was associated with increased risk for NAFLD (odds ratio [OR]: 1.291, 95% confidence interval [CI]: 1.067 -1.564; P < 0.001). Conclusion: Serum uric acid level is significantly associated with NAFLD, and increased serum uric acid level is an independent risk factor for NAFLD. Background: Development of fatty liver is believed to be an early and reversible consequence of excessive alcohol consumption. However, the cellular and molecular events in the early development of alcoholic liver diseases (ALD) and the contributory effects of a high fat diet are not fully understood. Methods: This study was designed to quantify specific enzymatic and cytokinetic activity as well as the development of hepatic steatosis in a rat model of alchohol-induced liver injury without high fat diet. Results: Ethanol-fed rats exhibited high blood ethanol levels (0.85+0.31%) and significant increases in serum ALT (67.7+ 13.4 unit/L), AST (136.3+ 60.2 unit/L), and ALP (400+108.9 unit/L) when compared with control rats (p<0.01, respectively). Histopathological examination found unevenly raised Knodell scores (5.33+1.15 in the ethanol-fed livers vs. 0.33+0.58 in control), which were characterized by scattered hepatocyte ballooning, portal inflammation and collagen fiber deposition. However, typical steatosis lesions were absent. qPCR demonstrated up-regulation of genes in the ethanol-fed livers, including hepatocyte metabolism enzymes/receptor (ADH1, P<0.05; cytochrome P450 2E1, CYP2E1, P<0.05; GSTA2, P<0.01; PPAR , P<0.05), and genes coding for pro-inflammatory cytokines (IL-1 , p<0.01 vs. control livers; TNF-p<0.05; TGF -, p<0.05; RANTES P<0.05), ECM components and proteinases (collagen-1, P<0.01; SMA, p<0.01; MMP -9, P<0.05 and TIMP-1, P<0.05). Conclusion: Chronic administration of ethanol to rats without high fat diet productively induces alcohol hepatitis in the absence of fatty liver, suggesting that alcohol hepatitis may precede steatosis in the development of ALD. The aim of the present study was to evaluate the changes of several cytokines associated with inflammatory liver disease and liver regeneration by Molecular Adsorbent Recirculating System (MARS) in 15 ACLF patients versus 15 patients treated with Medical Standard Therapy (SMT) that presented alcoholic liver disease etiology and similar Model End-stage Liver Disease (MELD). Methods: MARS Group: Fifteen (10 male and 5 female) patients were treated with MARS® (Gambro). Five patients were excluded by study.The number of MARS applications was about 9, the length of applications was about 10h. SMT Group: Fifteen patients (10 male and 5 female) were treated medical standard therapy such as prophylaxis against bacterial infections, albumin and fresh plamsa and judicious use of diuretics. Three patients were excluded by the study. The patients were valued during 30 days from inclusion with a survival follow up a three months. Results: MARS Group: we observed a significant changes in levels of IL-6(p<0.01), IL-1(p<0.002), IL-8(p<0.04) and TNF-alfa (p<0.03) in association with improvement of hepatic growth factor (p<0.001). The patient's survival at three months was 50%. SMT Group: we observed only a significant changes in IL-1(p<0.01) and TNF-alfa (p<0.2). The patient's survival at three months was 33%. Conclusion: The MARS liver support device has corrective effects on disturbed pathophysiology of ACLF and may be used to enhance spontaneous recovery or as bridge to transplant.