The Prevalence of Non-Alcoholic Fatty Pancreas by Abdominal Ultrasonography

( Nyam Biziya ),( Bayarmaa Nyamaa ),( Bolormaa Purev ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: Pancreatic steatosis or fatty pancreas refers to the fat accumulation in the pancreas, which can lead to inflammation and fibrosis, β-cell dysfunction, fibrosis, and, possibly, pancreatic cancer. The aim of this study was to investigate the prevalence and risk factors of fatty pancreas in patients referred to an ultrasonography center of Dornod Medical center. Methods: A cross-sectional study. During 12 months, 627 patients who were referred to our abdominal ultrasonography center for various reasons were evaluated for fatty pancreas. Fatty pancreas was defined as hyperechoic pancreas echotexture compared with spleen echotexture. All patients had gone through laboratory tests and abdominal ultrasonography. Results: The prevalence of fatty pancreas was 45.8%. The fatty pancreas patients had higher levels of aspartate aminotransferase, alanine aminotransferase, serum uric acid, fasting blood glucose, total cholesterol, triglycerides and low-density lipoprotein, and lower levels of high-density lipoprotein than did the non-fatty pancreas patients (all p < 0.05). Conclusions: Fatty pancreas is a common disorder. The prevalence of fatty pancreas in the examined population is approximately 45.8%. Increased age, central obesity and fatty liver disease are independent risk factors for fatty pancreas.

Vitamin D Deficiency in Chronic Liver Disease patients

( Nyam Biziya ),( Bayarmaa Nyamaa ),( Bayarjargal Altankhuyag ),( Shinebayar Narantuya ),( Borkhuukhen Derem ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: One of the most nutritional deficiency in the world is the deficiency of 25-hydroxyvitamin D [25(OH)D]. Study assessed that there are more than 1 billion people living in the world that has serum 25(OH)D<20 ng/ml deficiency. Vitamin D deficiency is widespread in individuals irrespective of their age, gender, race and geography. Deficiency of 25(OH)D not only causes children’s arthritis but to a range of common chronic diseases in adulthood such as diabetes, cancer, infectious diseases, cardiovascular disease, and autoimmune disease, this continuous to be a major public health problem in the world. Methods: Study participants were 102 chronic liver disease over the age of 18 from the citizens of “Choibalsan” city, “Dornod” province, who were referred to the outpatient of Dornod Medical center, Dornod, Mongolia. Overnight fasting blood samples were collected. All patients had tests for blood 25(OH)D were measured by ELISA and 28 patients who took 6 questionnaire tests. Results: Of all patients, 66 were men (68.1%) and 34 were women (31.9%). The mean age was 46 (between 18 and 89 years). There were 55 patients with cirrhosis (54%), and were 47 patients with chronic hepatitis B and C in the study group. 94 (92%) participants had 25(OH)D<20 ng/ml deficiency. Age and season had no correlation on the 25(OH)D level. From the results of the questionnaire test we can see that 5 have efficient 25(OH)D, 17 had the possibility of deficiency of 25(OH) D, and 6 had to reapply for the tests but these participants had 25(OH)D<10 ng/ml and this has no relevance on the level 25(OH)D (Pearson r=0.07, P=0.5). Conclusions: In conclusion, our pilot results show that patients as in 92% have 25(OH)D deficiency.

Prevalence and Risk Factors of Metabolic-Associated Fatty Liver Disease among Hospital Staff, Single Center Study

( Nyam Biziya ),( Saranchimeg Udirsad ),( Uugantuya Tumenjargal ),( Bayaraa Sanga ) 대한간학회 2024 춘·추계 학술대회 (The Liver Week) Vol.2024 No.1

Prevalence of Non-Alcoholic Fatty Pancreas Disease (NAFLD) among AduIt Medical Check-Up Patients

( Nyam Biziya ),( Bayarmaa Nyamaa ),( Saranchimeg Udirsad ) 대한간학회 2023 춘·추계 학술대회 (The Liver Week) Vol.2023 No.1

The Major Changes of Gilbert’s Syndrome and UGT1A1 Gene Abnormalities in Mongolians Are Western Type

( Nyam Biziya ),( Nyamaa Bayarmaa ),( Jui-ting Hu ),( May-jen Huang ),( Ching-shan Huang ),( Sien-sing Yang ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Hereditary abnormalities of uridinediphosphoglucuronate-glucuronosyltransferase 1A1 (UGT1A1) gene is the major cause of unconjugated hyper-bilirubinemia. The abnormalities of UGT1A1 gene in Mongolian population remain uninvestigated. Eight in 99 consecutive Mongolian adults developed indirect hyperbilirubinemia. We therefore studied Mongolian patients for GS and UGT1A1 abnormalities. Methods: Between 2007 and 2014, ninety-nine consecutive Mongolian adult patients of chronic liver disease from the Department of Gastroenterology, Mongolian National University of Medical Sciences were studied. Eight (8.1%) of them developed indirect hyperbilirubinemia. All patients were tests for blood chemistries, hemoglobin, international normalized ratio (INR), mean corpuscular volume (MCV), glucose-6-phosphate dehydrogenase (G6PD) levels as well as UGT1A1 genetic abnormalities. We genotyped the UGT1A1 gene for the A(TA)6TAA (6) or A(TA)7TAA (7) promoter variant, and the coding region for nucleotide mutations (nt)-211 G to A, nt-686 C to A, nt-1091 C to T and nt-1456 T to G. Results: Among the eight patients that developed indirect hyperbilirubinemia, six were male and two were female. All patients had hemoglobin, INR, MCV and G6PD levels within normal limit and we excluded possibility of anemia, decompensated liver function, thalassemia and G6PD deficiency. Our data confirms two variants of the UGT1A1 gene among the Mongolian patients. Two case were homozygous for nt-211G>A mutation, two case heterozygous for 6/7 promoter variants and nt-211G>A mutation, whereas four case were typical GS with homozygous 7/7 promoter genotype with no mutation in the coding region None of our Mongolian patients had mutations at nt-686, nt-1091 or nt-1456. Conclusions: Our pilot results show that GS and UGT1A1 abnormalities are common in Mongolians. Prevalence of the UGT1A1 promoter abnormalities in Mongolians are similar to the Western population; whereas the high prevalence of nt-211G>A variant is similar to the Asians. Further studies with much larger number of patients are necessary to confirm the genetic status of GS and UGT1A1 variants in Mongolians.

Prevalence of Hepatitis Delta Virus in Eastern Province Mongolia

( Nyam Biziya ),( Bayarmaa Nyamaa ),( Gankhurel Denzen ),( Shinebayar Narantuya ),( Bolormaa Purev ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Hepatitis delta virus (HDV) is a serious cause of liver-related morbidity and mortality worldwide. The aim of our study was to determine the prevalence of HDV infection among patients positive for hepatitis B surface antigen (HBsAg) living in the Dornod province, which is in Eastern Mongolia. Methods: Forty three HBsAg-positive subjects were tested for antibody to HDV (anti-HDV) by radioimmunoassay. All patients were tests for ALT (0-45 u/l). Anti-HDV-positive individuals were examined to determine HDV-RNA level by polymerase chain reaction (PCR). Results: Of all patients, 19 were men (68.1%) and 24 were women (31.9%). The mean age was 42.8 ± 7.5 (between 19 and 64 years). Anti-HDV was positive in 73% of the patients (31/43). Among the 31 anti-HDV-positive patients, all were checked for HDV RNA and 100% were found positive (31/31). Mean HDVRNA level was 1684574 IU/ml. Chronic HDV infection rate was therefore present in at least 73% of the whole study group (31/42). There were 23 patients with cirrhosis (54%) in the study group. Anti-HDV seroprevalence and HDV RNA presence were higher in those with cirrhosis (29/93%). HDV-RNA-positive patients had significantly higher ALT (94 U/L) levels when compared to HDV-RNA-negative patients. Conclusions: Our study showed a higher prevalence of hepatitis delta virus infection in HBsAg positive patients suggests that hepatitis delta virus infection increases the severity of chronic hepatitis B virus infection in the Eastern (Dornod province) Mongolia.

Non-Alcoholic Fatty Liver Disease in Pregnant Women

( Khishigmaa Lkhagvadorj ),( Nyam Biziya ),( Nyamaa Bayarmaa ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: Non-alcoholic fatty liver disease (NAFLD) is considered the commonest liver disease in the last year. The most common risk factor associated with NAFLD is the presence of the metabolic syndrome and type 2 diabetes. There are no studies of NAFLD in pregnant women in Mongolia. We aimed to investigate pregnancy outcomes in NAFLD. Methods: Pregnant volunteers (n=31) were referred to the obstetric medicine clinic of Dornod Medical center, Dornod, Mongolia. All pregnant had tests for blood chemistries ALT (0-45 u/l), AST (0-35 u/l), cholesterol (349 mg/dl), triglyceride (<453 mg/ dl), HBsAg, Anti-HCV, BMI (calculator.net), gestational age and abdominal ultrasound scans using accepted criteria. Results: The BMI in before pregnancy 1 (3.2%) women as underweight, 16 (51.6%) as normal weight, 7 (22.5%) as overweight and 8 (25.8%) as obese. During the pregnancy BMI were 13 (41.9%) as overweight and 14 (45.1%) as obese, compared to before pregnancy increased percent overweight and obese. The average of BMI before pregnancy was 26.2 ± 5.4 and during pregnancy BMI average 30,39 ± 5.1 (P value 3.5 * 10-5), this was shown to increasing obesity during pregnancy. Nineteen pregnant had fatty liver on ultrasound, in 16 (84.2%) increased than the weight should be, during pregnancy. Among the five patients that developed abnormal liver function test. One patient with hypercholestrinemia, and another one with hyperglycemia. Conclusions: Ultrasound is a noninvasive and useful diagnostic tool in the detection of NAFLD. Most of pregnant women with NAFLD have normal AST and ALT. This study has shown that having are overweight and obesity increased in pregnant women is associated with increased risks for diagnosis of NAFLD.

Oral Administration of Hydrolysed Casein Based Supplements on Chronic Liver Disease Patients

( Bayarmaa Nyamaa ),( Nyam Biziya ),( Enkhtuya Dorjderem ),( Delgermaa Lhagvadorj ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Medical conditions that may lead to malnutrition include: Gastrointestinal disease, chronic kidney disease, cardiovascular disease, after surgery and infections such as cancer. Malnutrition - hypoalbuminemia can present edema, appetite loss, muscle weakness, ascites, plural effusion and several other complications. Regardless of its cause, hypoalbuminemia has strong predictive value on mortality and morbidity. Methods: Thirty adult patients with liver cirrhosis Child Pugh classification B and C were referred to the outpatient of Dornod Medical center, Dornod, Mongolia. Appeton Wellness Recovery is a breakthrough nutritional formulation that is specially formulated with hydrolyzed casein and calcium 198 mg, potassium 270 mg etc. For patients, we dissolved Appeton Wellness Recovery (55g) into 210 ml of warm water to prepare a 250 ml drink during the period of 30 days. Before and after the treatment, overnight fasting blood samples were collected. All patients had tests for blood chemistries ALT (0-45 u/l), AST (0-35 u/l), total protein (66.0-83.0 g/l), albumin (35.0-50.0 g/l), potassium (3-3.5 mg/dl), calcium (8.5-10.2 mg/dl), and abdominal ultrasound. Results: Oral supplement had significantly increased total level of protein from 70,34±6.8 to 75.25±6.2 (P<7.1^*10^-16), albumin from 33.38± 4.61 to 38.37±4.62 (P<4.6^*10^-11), potassium from 3.5±1.0 to 4.7±0.7 (P<1.631^*10^-08), calcium from 8±1.1 to 9.2±1.6 (0.007). Assessments of biochemical parameters of oral supplement before and after the examination are shown in table 1. Eight patients had ascites, and after oral supplement, in two cases ascites were removed, in four cases ascites fluid were decreased, and in two cases they were not increased. Conclusions: In conclusion, specially formulated with hydrolysed casein supplement is safe and effective in improving serum protein, albumin, potassium, calcium in patients with liver cirrhosis.

The Evaluation of Pancreatic Enzyme Replacement Therapy for Chronic Pancreatitis Patients

( Bayarmaa Nyamaa ),( Nyam Biziya ),( Dagiisuren Bavuu ) 대한간학회 2023 춘·추계 학술대회 (The Liver Week) Vol.2023 No.1

Post-Vaccination Immunity against Hepatitis B among between the Ages 10 to 35 Years

( Doljinsuren Enkhbayar ),( Nyam Biziya ),( Saranchimeg Udirsad ),( Uugantuya Tumenjargal ),( Bayaraa Sanga ) 대한간학회 2024 춘·추계 학술대회 (The Liver Week) Vol.2024 No.1