High Dietary Sodium Intake Assessed by Estimated 24-h Urinary Sodium Excretion Is Associated with NAFLD and Hepatic Fibrosis

<div><p>Background</p><p>Although high sodium intake is associated with obesity and hypertension, few studies have investigated the relationship between sodium intake and non-alcoholic fatty liver disease (NAFLD). We evaluated the association between sodium intake assessed by estimated 24-h urinary sodium excretion and NAFLD in healthy Koreans.</p><p>Methods</p><p>We analyzed data from 27,433 participants in the Korea National Health and Nutrition Examination Surveys (2008–2010). The total amount of sodium excretion in 24-h urine was estimated using Tanaka’s equations from spot urine specimens. Subjects were defined as having NAFLD when they had high scores in previously validated NAFLD prediction models such as the hepatic steatosis index (HSI) and fatty liver index (FLI). BARD scores and FIB-4 were used to define advanced fibrosis in subjects with NAFLD.</p><p>Results</p><p>The participants were classified into three groups according to estimated 24-h urinary excretion tertiles. The prevalence of NAFLD as assessed by both FLI and HSI was significantly higher in the highest estimated 24-h urinary sodium excretion tertile group. Even after adjustment for confounding factors including body fat and hypertension, the association between higher estimated 24-h urinary sodium excretion and NAFLD remained significant (Odds ratios (OR) 1.39, 95% confidence interval (CI) 1.26–1.55, in HSI; OR 1.75, CI 1.39–2.20, in FLI, both <i>P</i> < 0.001). Further, subjects with hepatic fibrosis as assessed by BARD score and FIB-4 in NAFLD patients had higher estimated 24-h urinary sodium values.</p><p>Conclusions</p><p>High sodium intake was independently associated with an increased risk of NAFLD and advanced liver fibrosis.</p></div

Characteristics of the study population according to tertiles of estimated 24-h sodium excretion.

<p>Data presented as mean ± standard deviation or n (%) for categorical variables</p><p>^§: The difference between 1^st and 2^nd: p <0.05 after ANOVA followed by Scheffé post hoc comparison</p><p>^†: The difference between 1^st and 3^rd: p <0.05 after ANOVA followed by Scheffé post hoc comparison</p><p>^‡ The difference between 2^nd and 3^rd: p <0.05 after ANOVA followed by Scheffé post hoc comparison</p><p>E24UNA, Estimated 24-hour urine sodium excretion; BMI, body mass index; ASM, appendicular skeletal mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; LDL, low-density lipoprotein; HDL, high-density lipoprotein; AST, aspartate aminotransaminase; ALT, alanine aminotransferase; GGT, gamma-glutamyl transferase; HTN, hypertension; FLI, fatty liver; HSI, hepatic steatosis index</p><p>Characteristics of the study population according to tertiles of estimated 24-h sodium excretion.</p

Association of estimated 24-h sodium excretion with prevalence of NAFLD assessed by FLI and elevated serum ALT levels.

<p>Elevated ALT levels were defined as >33 IU/L for males and >25 IU/L for females. * P-value < 0.05.</p

Differences in estimated 24-h urinary sodium excretion levels among groups with and without hepatic fibrosis defined by BARD score (A) and FIB-4 (B) in subjects with NAFLD.

<p>** Data presented as mean + standard deviation.</p

Nanoparticles as Blood–Brain Barrier Permeable CNS Targeted Drug Delivery Systems

Research in the field of nano-neuroscience is becoming a promising future direction given the advantages presented by nanosystems for central nervous system (CNS) drug delivery. Since the blood–brain barrier (BBB) represents an invincible obstacle for the majority of drugs such as antineoplastic agents and a variety of psychoactive drugs such as neuropeptides, “smart” CNS drug delivery systems with high ability to deliver substances across the BBB are highly desired and will not only enable drugs to reach the CNS but also target specific areas of the CNS. Thus, injectable biodegradable nanoparticles have an important potential application in the treatment of a variety of neurological and psychiatric disorders. Therefore, in the following, we will highlight the requirement and importance of CNS drug delivery systems with particular emphasis on nano-scale systems. It is the objective of this article to offer a perspective on the complexity and challenges in fabrication of nanostructures, in vivo nano–bio interactions and also to highlight some of the most used nanosystems for drug delivery into the CNS