Abstract
INTRODUCTION Non-alcoholic fatty liver disease (NAFLD) is a well-known risk factor for Type 2 Diabetes Mellitus (T2DM) that poses a public health issue. According to the Lancet, Malaysia is Asia's most obese country, with obese people having a 3.5-fold increased chance of getting NAFLD and indirectly increasing the number of patients with T2DM. There is now no treatment that can help to cure NAFLD, hence drug or medication development is critical. Complementary medicine has been developed as a medicinal agent for decades due to its promising effects. For example, artemisinin is a highly successful natural product-derived medicine that is well-known worldwide. As a result, the objective of this pilot study is to evaluate if Alfacholine can mitigate T2DM patients with NAFLD to maintain coagulation homeostasis in vitro . METHODS Fifty-four subjects were recruited and separated into three groups: healthy subjects (n=20; mean ± SD age: 39.25 ±10.88; mean ± SD BMI: 22.33 ±1.77; FBS: 4.8 ±0.32), T2DM patients (n=14; mean ± SD age: 45.5 ±16.03; mean ± SD BMI: 21.92 ±1.78; FBS: 8.02 ±3.0) and T2DM patients diagnosed with NAFLD (n=20; mean ± SD age: 44.75 ±10.19; mean ± SD BMI: 36.45 ±4.03; FBS: 8.21 ±2.57). The blood was collected and processed to obtain plasma in order to determine the coagulation effect (PT, APTT, and fibrinogen) before and after the addition of Alfacholine.
RESULTS After treating the plasma with Alfacholine, paired t-tests revealed a significant mean difference in PT of the healthy ( p <0.05) and T2DM with NAFLD ( p <0.001) but not in T2DM subjects. Furthermore, all three groups revealed a decrease of fibrinogen in blood coagulation activity ( p <0.001). Interestingly, only plasma from healthy patients treated with Alfacholine exhibited a significant decrease in APTT ( p <0.05). DISCUSSION Alfacholine improves not only the PT coagulation result in T2DM with NAFLD patients via an extrinsic pathway but also the coagulation result of fibrinogen in T2DM patients via a common pathway, according to the findings. To show the mitigation is from only Alfacholine itself, chi-square analysis revealed there is no association between coagulation assays and other parameters (age, weight, height, BMI, waist measurement, total cholesterol, LDL, ALT, ALP) after Alfacholine treatment for all subjects. To summarize, Alfacholine helps individuals with T2DM and T2DM with NAFLD by improving the insulin resistance in the liver through a different pathway.
Links
- https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-33.pdf
- https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed1909[...]
BibTeX (Download)
@proceedings{APCPH2022-P-33,
title = {Dawn of hope for NAFLD? Alfacholine significantly improve in vitro coagulation homeostasis of T2DM and T2DM with NAFLD patients},
author = {Fui Fui Lem and Valerie Toh and Fong Tyng Chee and Sylvia Aloysius Mobijin and Wan Nursolehah Wan Mohamed and Pamella Michelle Pekit and Norhidayah Danial and Clarice Evey Anjum and Hui Rong Yee and Shing Yi Pan},
url = {https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-33.pdf
https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed19095a89ed/conference-poster-according-to-template-74c1ed807005be854dede1e03e67dc7b.pdf},
year = {2022},
date = {2022-08-02},
urldate = {2022-08-02},
issue = {7},
abstract = {INTRODUCTION Non-alcoholic fatty liver disease (NAFLD) is a well-known risk factor for Type 2 Diabetes Mellitus (T2DM) that poses a public health issue. According to the Lancet, Malaysia is Asia's most obese country, with obese people having a 3.5-fold increased chance of getting NAFLD and indirectly increasing the number of patients with T2DM. There is now no treatment that can help to cure NAFLD, hence drug or medication development is critical. Complementary medicine has been developed as a medicinal agent for decades due to its promising effects. For example, artemisinin is a highly successful natural product-derived medicine that is well-known worldwide. As a result, the objective of this pilot study is to evaluate if Alfacholine can mitigate T2DM patients with NAFLD to maintain coagulation homeostasis in vitro . METHODS Fifty-four subjects were recruited and separated into three groups: healthy subjects (n=20; mean ± SD age: 39.25 ±10.88; mean ± SD BMI: 22.33 ±1.77; FBS: 4.8 ±0.32), T2DM patients (n=14; mean ± SD age: 45.5 ±16.03; mean ± SD BMI: 21.92 ±1.78; FBS: 8.02 ±3.0) and T2DM patients diagnosed with NAFLD (n=20; mean ± SD age: 44.75 ±10.19; mean ± SD BMI: 36.45 ±4.03; FBS: 8.21 ±2.57). The blood was collected and processed to obtain plasma in order to determine the coagulation effect (PT, APTT, and fibrinogen) before and after the addition of Alfacholine.
RESULTS After treating the plasma with Alfacholine, paired t-tests revealed a significant mean difference in PT of the healthy ( p \<0.05) and T2DM with NAFLD ( p \<0.001) but not in T2DM subjects. Furthermore, all three groups revealed a decrease of fibrinogen in blood coagulation activity ( p \<0.001). Interestingly, only plasma from healthy patients treated with Alfacholine exhibited a significant decrease in APTT ( p \<0.05). DISCUSSION Alfacholine improves not only the PT coagulation result in T2DM with NAFLD patients via an extrinsic pathway but also the coagulation result of fibrinogen in T2DM patients via a common pathway, according to the findings. To show the mitigation is from only Alfacholine itself, chi-square analysis revealed there is no association between coagulation assays and other parameters (age, weight, height, BMI, waist measurement, total cholesterol, LDL, ALT, ALP) after Alfacholine treatment for all subjects. To summarize, Alfacholine helps individuals with T2DM and T2DM with NAFLD by improving the insulin resistance in the liver through a different pathway.},
howpublished = {published online at https://apcph.cphm.my},
note = {Type: POSTER PRESENTATION; Organisation: Clinical Research Centre; Universiti Malaysia Sabah; Luyang Health Clinic; Pejabat Kesihatan Kawasan Kota Kinabalu; Baden Research \& Testing Lab (Asia Pac) Sdn Bhd},
keywords = {},
pubstate = {published},
tppubtype = {proceedings}
}