38, 95% CI -0.14 to -0.62), P=0.0016) demonstrated significant improvement compared to placebo. Lobular inflammation (P=0.08) and fibrosis (P=0.62) did not demonstrate significant change with vitamin E. ALT (P=0.20) and weight (P=0.46) did not show significant change with vitamin E compared to placebo. Conclusion: In patients with NAFLD, TZDs and Vitamin E improve liver histologic scores but metformin does not. learn more Insulin resistance also improves with both TZD and metformin. Fibrosis does not improve with any of the
agents. Disclosures: The following people have nothing to disclose: Ahmed Akhter, Adnan Said Introduction: Nonalcoholic fatty liver disease (NAFLD) is frequent in obese children. A reliable non-invasive biomarker for monitoring CCI-779 cost of progression to liver fibrosis would be useful. Serum bile acid (BA) levels are elevated in cirrhosis, probably for mechanical reasons. Interestingly, BA can influence glucose and lipid metabolism by stimulating insulin release via the TGR5/GLP1 pathway; and, reciprocally, insulin can down-regulate BA synthesis
from cholesterol via the FXR/SHP and/or the PI3K/AKT pathways. We hypothesized that changes in BA levels in NAFLD vary depending on grade of fibrosis. Methods: In this multicenter study adolescents with NAFLD (n=92) were classified between stages of fibrosis (non-fibrosis n=27; fibrosis ≥ 1 n=65) based on liver-biopsy findings. Metabolic and cholestatic status was assessed by blood tests (glucose, insulin, cholesterol, LDL,
HDL, AST, bilirubin, ALT, GGT). The full BA pool, including 15 BA species, was measured by HPLC-MS/ MS and compared to healthy controls (n=105). Results: Both groups showed hyperglycemia (non-fibrosis 126±44; fibrosis 119±18 mg/dl), hyperinsulinism (83±33 vs 88±41 μE/ml), and elevated ALT levels (63±20 vs 87±58 U/l). Non-fibrotic adolescents had significantly (p<0.001) decreased median BA levels (1.28; range 1.18 - 2.34 μmol/l) compared to controls (3.36; range 2.16 - 4.69 μmol/l). In fibrosis BA values increased (1.86; 1.05 - 3.22 μmol/l; p<0.001). Non-fibrotic patients lacked glycine-conjugated BA with a significant (p<0.05) predominance of unconjugated BA. In fibrosis, glycine-conjugated BA values rose and the BA pool MCE公司 resembled that in healthy controls. Other values did not differ significantly between the groups. Conclusion: BA levels decrease in early NAFLD and seem to increase continuously during progression to fibrosis and cirrhosis. BA may serve as a non-invasive biomarker for progression of disease. Disclosures: Jörg Jahnel – Grant/Research Support: Fresenius-Kabi, CRTS labaratories The following people have nothing to disclose: Zoehrer Evelyn, Günter Fauler, Hubert Scharnagl, Tatjana Stojakovic, Valerio Nobili Background and Aims. Non-alcoholic fatty liver disease (NAFLD) is characterized by the excessive accumulation of triglycerides (TG) in the liver due to the increased inflow of free fatty acids (FFAs).