Thesis (Ph. D.)--University of Wisconsin--Madison, 1956. / Typescript. Vita. With this is bound: Some effects of dietary threonine, trytophan, and choline on liver enzymes and fat, [by] Dorothy Arata, et. al., reprinted from Proceedings of the Society for Experimental Biology and Medicine, v. 87 (1954), p. 544-549. Includes bibliographical references.

No description available.

Inaug.-Diss.--Zürich. / Vita. Bibliography: p. 16-17.

Obesity in adults and children is associated with increased cardiovascular mortality and morbidity. This is forecast to increase markedly in the next decade as childhood obesity is a burgeoning epidemic. Excess weight is clearly associated with insulin resistance, increased circulating triglycerides, and hypertension, all of these are related to progressive heart and liver disease. Ectopic fat deposition within organs is reported to cause lipotoxicity, which may lead to dysfunction and disease, but there have been few human studies to confirm this. This doctoral thesis set out to study the early pathophysiology of obesity in adults and children using in vivo magnetic resonance (MR) imaging and spectroscopy to assess the composition and function of the heart and liver in lean and obese individuals. The central tenet of this project was to establish and validate a clinically viable method for measuring the fat content of viscera safely and accurately, and to determine a normal range for the triglyceride content of the heart and liver. The initial study demonstrated that the heart remodels in response to weight loss, with over 20% reduction in LV mass, confirming that excess weight is genuinely a modifiable risk factor. Then, using spectroscopy, it was established that the healthy myocardium has a median triglyceride content of 0.37% (IQR 0.24% - 0.47%), which increases linearly in overweight and obese adults. Obesity, in the absence of any confounders, was also associated with a 10% reduction in cardiac contractile function. In comparison, healthy liver median lipid content was 0.67% (IQR 0.44% – 0.88%), which increased in obese adults to 2.9% (IQR 1.6% - 7.6%). There was a graded association between ectopic fat deposition in the liver and dyslipidaemia in adults, characterised by increased circulating triglycerides and reduced high-density lipoprotein. This dyslipidaemia may impair reverse cholesterol transport, and thus could be expected to exacerbate weight gain. Among obese and overweight subjects, there were some with severe steatosis and evidence of coexistent hepatic inflammation and fibrosis. To verify the accuracy of these spectroscopic measures for ectopic fat, a blinded, prospective comparison of non-invasive assessment of unselected liver disease in liver biopsy patients was completed. Liver disease presents with one or more of steatosis, fibrosis and haemosiderosis, all of which are associated with adverse cardiovascular outcomes. Fifty patients were recruited, and interobserver variability among pathologists was measured for histological reference standards for fat, fibrosis and iron deposition. MR measures of each of these metrics predicted the fibrosis, steatosis and haemosiderosis scores accurately. This enabled precise tissue characterisation of all forms of liver disease, including steatohepatitis, with one non-invasive test, to allow the diagnosis and monitoring of hepatic conditions. Lastly, all these new biomarkers of early cardiac and liver disease associated with excess weight were applied to obese and lean children, to understand whether ectopic fat played a substantial role in early life. Obese children had increased ectopic fat in their hearts and livers, as well as impaired strain, evidence of dyslipidaemia, and in some cases evidence of active steatohepatitis, comparable to adults with severe disease. The thesis therefore demonstrates that in vivo magnetic resonance techniques can be used for accurate measurement of visceral lipid content. Furthermore, there is evidence of significant ectopic fat deposition in both adults and children, with evidence of organ dysfunction, which raises the possibility that cardiovascular magnetic resonance may be of value to risk stratify obese individuals based on organ involvement. Finally, the developed methods may have broader applicability and offer a promising new method for the non-invasive diagnosis of chronic liver disease in other clinical settings.

No description available.

The aim of this thesis was to investigate the effects of dietary fatty acids on body composition and ectopic fat in humans, with emphasis on the role of the omega-6 polyunsaturated fatty acid (PUFA) linoleic acid (18:2n-6) and the saturated fatty acid (SFA) palmitic acid (16:0). The overall hypothesis was that linoleic acid would be beneficial compared with palmitic acid during overfeeding, as previously indicated in animals. Papers I, II and IV were double-blinded, randomized interventions in which different dietary fats were provided to participants and Paper III was a cross-sectional study in a community-based cohort (PIVUS) in which serum fatty acid composition was assessed as a biomarker of dietary fat intake. In Paper I, overfeeding with sunflower oil (n-6 PUFA) for 7 weeks caused less accumulation of liver fat, visceral fat and total body fat (as assessed by MRI) compared with palm oil (SFA) in young and lean subjects despite similar weight gain among groups. Instead, sunflower oil caused a larger accumulation of lean tissue. In Paper II, plasma from Paper I was analyzed with NMR-based metabolomics, aiming to identify metabolites differentially affected by the two dietary treatments. Acetate decreased by PUFA and increased by SFA whereas lactate increased by PUFA and decreased by SFA. In Paper III, the proportion of linoleic acid in serum was inversely associated with contents of visceral-, subcutaneous- and total body adipose tissue whereas the proportion of palmitic acid was directly associated with visceral- and total body adipose tissue in 70-year old men and women. In Paper IV, overfeeding with sunflower oil for 8 weeks caused less accumulation of liver fat compared with palm oil also in overweight and obese subjects. SFA increased visceral fat in men only. Accumulation of lean tissue was similar between groups. In conclusion, SFA (palmitic acid) from palm oil promotes marked liver fat accumulation in both normal-weight and overweight/obese subjects during overeating, whereas n-6 PUFA (linoleic acid) from sunflower oil prevents such liver fat accumulation. Diverging effects of SFA and PUFA on visceral adipose tissue and lean tissue may only be applicable in some groups and/or circumstances. These results imply that negative effects associated with weight gain (e.g. fatty liver) may be partly counteracted by the type fat in the diet, overall supporting a beneficial role of diets higher in unsaturated fat compared with saturated fat for preventing liver fat accumulation.

Defects in fat metabolism are central to the aetiology and pathogenesis of obesity and type II diabetes. The liver plays a central role in these disease states via its regulation of glucose and fat metabolism. In addition, accumulation of fat within the liver has been associated with changes in key pathways of carbohydrate and fat metabolism. However a number of questions remain. It is hypothesised that fat accumulation within the liver is a primary defect in the aetiology and pathogenesis of obesity and type II diabetes. Fat accumulating in the liver is the result of changes in the gene expression of key enzymes and proteins involved with fat uptake, fat transport, fat oxidation, fat re-esterification or storage and export of fat from the liver and these changes are regulated by key lipid responsive transcription factors. To study these questions Psammomys obesus was utilised. This polygenic rodent model of obesity and type II diabetes develops obesity and diabetes in a similar pattern to susceptible human populations. In addition dietary and environmental changes to Psammomys obesus were employed to create different states of energy balance, which allowed the regulation of liver fat gene expression to be examined. These investigations include: 1) Measurement of fat accumulation and fatty acid binding proteins in lean, obese and diabetic Psammomys obesus. 2) Characterisation of hepatic lipid enzymes, transport protein and lipid responsive transcription factor gene expression in lean, obese and diabetic Paammomys obesus. 3) The effect of acute and chronic energy restriction on hepatic lipid metabolism in Psammomys obesus. 4) The effect of sucrose feeding on the development of obesity and type II diabetes in Psammomys obesus. 5) The effect of nicotine treatment in lean and obese Psammomys obesus, 6) The effect of high dose leptin administration on hepatic fat metabolism in Psammomys obesus. The results of these studies demonstrated that fat accumulation within the liver was not a primary defect in the aetiology and pathogenesis of obesity and type II diabetes. Fat accumulating in the liver was not the result of changes in the gene expression of key enzymes and proteins involved in hepatic fat metabolism. However changes in the mRNA level of the transcription factors PPAR∝ and SREBP-1C was associated with the development of diabetes and the gene expression of these two transcription factors was associated with changes in diabetic status.

Problem: Die Leberverfettung wird als eine der wichtigsten metabolischen Störungen in der Frühlaktation bei Milchkühen und als Grund für Gesundheits- einschließlich Reproduktionsstörungen angesehen. Zielstellung: Deshalb wurden in dieser Studie folgende Fragestellungen bearbeitet: a) Bedeutung der klinischen und labordiagnostischen Befunde bei der Erstuntersuchung kranker Kühe, insbesondere des Leberfettes, b) Beziehungen zwischen dem Leberfettgehalt und verschiedenen Laborparametern, c) Beziehungen zwischen dem Leberfettgehalt, den Krankheiten und dem Behandlungserfolg, d) prognostische Bedeutung des Leberfettgehaltes sowie klinisch-chemischer und hämatologischer Blutparameter. Material und Methoden: Dazu wurden chronologisch 312 in die MTK Leipzig eingelieferte Rinderpatienten entsprechend klinisch und labordiagnostisch einschließlich Leberbiopsie untersucht und die Befunde der Erstuntersuchung ausgewertet. Ergebnisse: Bei 312 Rinderpatienten wurden in 18 Krankheitsgruppen, z.T. nach Verlauf und Schweregraden untersetzt, 196 links- und 40 rechtseitige Labmagenverlagerungen (LMV), 11 Labmagen- (LM) Ulcera, 182 Ketosen, 96 Mastitiden, 178 Endometritiden, 7 Retentio. sec., 7 puerperale Septikämien und 6 Multiorganversagen, 42 Indigestion, 31 Enteritis, 46 Peritonitiden, 30 Festlieger und 18 Pneumonien diagnostiziert. Die Kühe verteilten sich auf vier Leberfettklassen wie folgt: ≤6% =14,7%; 6 bis ≤15% = 37,5%; 15 bis ≤30% = 31,1% sowie >30% = 16,7%. Die Heilungsrate betrug in den ersten drei Leberfettklassen 80,4%, 83,8% bzw. 86,6%. Ein Zusammenhang zwischen der Heilungsrate und dem Leberfettgehalt war bis zu ≤30% nicht erkennbar. In der Leberfettklasse >30% sank die Heilungsrate auf 61,5%; bei >40% verschlechterte sie sich unter 50%. Dem entsprach das Verhalten verschiedener Laborparameter. Erst bei einem Leberfettgehalt >30%, besonders bei >45%, wurden, z.T. unabhängig vom Krankheitsausgang, die BHB-, Bilirubin- und Glucose-Konzentrationen sowie AST-, CK-, LDH-, GGT- und GLDH-Aktivitäten signifikant höher bzw. die anorg. Phosphat- (Pi) und Cholesterol-Konzentrationen niedriger. Mit dem Leberfettgehalt korrelierten am engsten (p<0,001) die Parameter BHB (0,620) und FFS (0,615), LDH (0,579), Bilirubin (0,367), AST (0,359), Cholesterol (-0,278), Laktat (-0,253), Hämoglobin (0,214), CK (0,207), Leukozyten (-0,202) sowie innere Körpertemperatur (0,210). Die Bedeutung dieser Beziehungen ist relativ. Sowohl Sensitivität und Spezifität waren für Pi (<1,25 mmol/l) >0,7, für Cholesterol (< 1,5 mmol/l) und Albumin (<30 g/l) >0,6 sowie für BHB, Harnstoff und Gesamteiweiß >0,5. Eine hohe Spezifität >0,8 bei geringer Sensitivität hatten K (<3,0 mmol/l) und segmentkernige neutrophile Granulozyten (< 4,6 G/l), eine hohe Sensitivität >0,8, aber geringe Spezifität Bilirubin (>5,3 μmol/l), AST (>80 U/l) sowie CK (>200 U/l). Hinsichtlich Krankheitsausgang und damit der prognostischen Nutzbarkeit waren die Flächen (AUC) unter den ROC-Kurven nur für K (0,37), Bilirubin (0,62), AST (0,61) und für Leberfett (0,60) schwach gesichert. Die leberspezifischen Enzyme GGT und GLDH korrelierten nur schwach mit 0,126 (p<0,05) sowie 0,192 (p<0,001) mit dem Leberfett. Das stellt ihre diagnostische Bedeutung nicht in Frage, sondern verdeutlicht, dass bei den analysierten Krankheiten keine stärkeren Leberschäden auftraten. Die bei den Korrelations-, Sensitivitäts- und Spezifitätsberechnungen sowie z.T. ROC-/AUC-Analysen informativen Parameter LDH, AST, CK, K, Pi, Bilirubin (>20 μmol/l) und Leukozyten weisen auf entzündliche Prozesse hin. Die in allen Leberfettklassen erhöhten Glucose-Konzentrationen, bes. bei >30% Leberfett und Ex. letalis, ordnen sich damit zumindest teilweise als Folge einer Insulinresistenz ein. Kühe mit LMV hatten i.d.R. zusätzliche Störungen: zu 58% Ketosen, 57% Endometritiden, 6,4% Retentio sec., puerperale Septikämie und Multiorganversagen, 30,8% Mastitiden, 14,7% Peritonitiden, 9,9% Enteritiden, 9,6% Festliegen, 5,8% Pneumonien sowie 3,5% Labmagenulcera. Außerdem kamen zu 13,5% Indigestionen vor. Die Heilungsrate lag bei links- und rechtseitigen LMV, Mastitiden, Endometritiden und Enteritiden zwischen 89% bis 70% und bei Indigestionen sowie akuten Peritonitiden zwischen 70 und 60%. Bei chronischen Peritonitiden, Pneumonien, Retentio sec., puerperalen Septikämien, Festliegen, LM-Ulcera und Multiorganversagen sank sie von 50% bis auf 0%. Der Leberfettgehalt schwankte bei LMV, Mastitiden, Endometritiden, chronischen Peritonitiden und Indigestionen zwischen 6% und 19%. Er stieg mit schlechterem Therapieergebnis bei Retentio sec., Pneumonien, akuten Peritonitiden puerperalen Septikämien, LM-Ulcera und Enteritiden bis gegen 30% und betrug bei Festliegern, hochgradigen Endometritiden sowie Multiorganversagen bis gegen 40%. Schlussfolgerungen: Leberfett bis ≤30% ist klinisch unbedeutend. Der Trend zu höherem Leberfett und schlechterer Heilungsrate unterstreicht die Bedeutung stark entzündlicher Grundkrankheiten für die Krankheitsentwicklung und den Therapieerfolg. Die Leberschwimmprobe kann für die Anwendung in der Praxis empfohlen werden. / Problem: The fatty liver is considered to be one of the most important metabolic disorders in early lactation in dairy cows and is a reason for poor health, including reproductive disorders. Objective: Therefore the following questions in this study were studied: a) importance of the clinical and laboratory findings at the initial examination of sick cows, especially the liver fat, b) relationships between liver fat content and various laboratory parameters, c) the relationship between the liver fat content, diseases and the treatment success, d) prognostic significance of liver fat content and clinical-chemical and hematological blood parameters. Material and Methods: For 312 bovine patients, provided chronological to the MTK Leipzig, were examined according to clinical and laboratory investigations including liver biopsy and evaluated the findings of the initial examination. Results: In 312 cattle, divided in 18 disease groups, 196 left and 40 right-sided abomasal displacements (LMV), 11 abomasal ulcers, 182 ketoses, 96 mastitis, endometritis 178, 7 Retentio sec., puerperal sepsis, 7 and 6 multi organ failure, 42 Indigestion, 31 enteritis, 46 peritonitis, 30 downer cows and 18 pneumonia diagnosed. The cows were grouped in four liver fat classes as follows: ≤6% = 14.7%; 6 to ≤15% = 37.5%; 15 to ≤30% = 31.1% and> 30% = 16.7%. The cure rate was in the first three classes of liver fat 80.4%, 83.8% and 86.6% respectively. A relationship between the cure rate and the liver fat content was not recognizable to ≤30%. In the liver fat class> 30% cure rate dropped to 61.5%; at> 40% it worsened <50%. This corresponded to the behavior of various laboratory parameters. Only when liver fat content> 30%, particularly at> 45%, were partly regardless of the outcome of the disease, the BHB, bilirubin and glucose concentrations as well as AST, CK, LDH, GGT and GLDH activities were significantly higher and the inorg. Phosphate (Pi) and cholesterol concentrations low. The liver fat content correlated most closely (p <0.001), the parameters BHB (0.620) and FFS (0.615), LDH (0.579), bilirubin (0.367), AST (0.359), cholesterol (-0.278), lactate (-0.253), hemoglobin (0.214), CK (0.207), leukocytes (-0.202) and internal body temperature (0.210). The significance of these relationships is relative. Sensitivity and specificity were Pi (<1.25 mmol / l)> 0.7, to cholesterol (<1.5 mmol / l) and albumin (<30 g / l)> 0.6, and for BHB, urea, and total protein> 0.5. High specificity> 0.8 for low sensitivity had K (<3.0 mmol / l) and segment neutrophilic granulocytes (<4.6 g / l), a high sensitivity> 0.8, but low specificity bilirubin (> 5 , 3 mol / l) AST (> 80 U / l) and CK (> 200 U / l). With regard to disease outcome and thus the prognostic value of the area under the curve (AUC) for K (0.37), bilirubin (0.62), AST (0.61) and liver fat (0.60) were weakly secured. The liver-specific enzymes GGT and GLDH correlated only weakly with 0.126 (p <0.05) and 0.192 (p <0.001) with the liver fat. This do not challenges their diagnostic significance, but it makes clear that in the studied diseases no greater liver damage occurred. Whereas the correlation, sensitivity and specificity calculations as well as some ROC/AUC analysis informative parameter LDH, AST, CK, C, Pi, bilirubin (> 20 μmol/l) and leukocytes indicate inflammatory processes. The increased liver fat in every group glucose concentrations, esp. at liver fat > 30% and ex. letalis, thus organize at least partially as a result of insulin resistance. Cows with DA had usually. additional disorders: 58% ketoses, 57% endometritis, 6.4% Retention sec, puerperal septicemia and multi-organ failure, 30.8% mastitis, 14.7% of peritonitis, enteritis 9.9%, 9.6% recumbency, 5.8% pneumonia and 3.5% ulceration of the abomasum. Furthermore, came to 13.5% before indigestion. The cure rate of left and right DA, mastitis, endometritis and enteritis were between 89% to 70% and for indigestion and acute peritonitis 70-60%. In chronic peritonitis, pneumonia, Retention sec., Puerperal septicemia, recumbency, abomasum ulcers and multiple organ failure they fell from 50% to 0%. The liver fat content varied with DA, mastitis, endometritis, chronic peritonitis and indigestion between 6% and 19%. He rose with a worse clinical outcome in Retentio sec., Pneumonia, acute peritonitis puerperal septicemia, DA ulcers and enteritis up to 30% and was at Festliegern, high-grade endometritis and multiorgan failure until about 40%. Conclusions: Liver fat to ≤30% is clinically insignificant. The trend towards higher liver fat and poorer cure rate underscores the importance of strong inflammatory diseases reason for the disease development and therapeutic success. The copper sulphate test according to Herdt can be recommended for use in practice.

The increasing prevalence of abdominal obesity worldwide poses a serious public health problem and hence, presents a target for research designed to improve the assessment or treatment of abdominal obesity. Specifically, the first study in this thesis investigated the influence of age and gender on visceral (VAT) and abdominal subcutaneous adipose tissue (ASAT) for a given waist circumference (WC) in 481 men and women varying widely in age and BMI. Significant gender differences in VAT and ASAT for a given WC were observed, however, only the relationship between WC and VAT was substantially influenced by age. The second study examined whether the associations between VAT, ASAT and the metabolic syndrome (MetS) were altered depending on measurement methodology used to assess VAT and ASAT. The odds ratio (OR) for MetS was higher for total VAT volume (OR=7.26) and the partial volumes at T12-L1 (OR=7.46) and L1-L2 (OR=8.77) compared to the classic L4-L5 (OR=3.94) measurement. The OR for MetS was not substantially different among the ASAT measures (OR~2.6). Measurement site for VAT, but not ASAT, has a substantial influence on the magnitude of the association with MetS. The third study examined the independent associations between VAT, ASAT, liver fat and all-cause mortality in 291 men (97 decedents and 194 controls, mortality follow-up of 2.2±1.3 years). In a model including VAT, ASAT, liver fat, age, and length of follow-up, only VAT (1.93 [1.15-3.23]) remained a significant predictor of mortality. We concluded that VAT is a strong, independent predictor of all-cause mortality in men. The purpose of the final study was to determine the effect of aerobic exercise dose (energy expenditure) on WC in sedentary, overweight/obese postmenopausal women (n=424). The women were randomly assigned to a control group or one of three aerobic exercise groups that exercised at energy expenditures of 4-, 8-, or 12-kcal/kg body weight/week. By comparison to control, there were significant reductions in WC in the exercise groups (~3 cm, P <0.05), which were independent of weight loss. However, the amount of exercise performed was not associated with reductions in WC in a dose dependent manner. / Thesis (Ph.D, Kinesiology & Health Studies) -- Queen's University, 2007-05-17 19:24:06.777

Problem: Die Leberverfettung wird als eine der wichtigsten metabolischen Störungen in der Frühlaktation bei Milchkühen und als Grund für Gesundheits- einschließlich Reproduktionsstörungen angesehen. Zielstellung: Deshalb wurden in dieser Studie folgende Fragestellungen bearbeitet: a) Bedeutung der klinischen und labordiagnostischen Befunde bei der Erstuntersuchung kranker Kühe, insbesondere des Leberfettes, b) Beziehungen zwischen dem Leberfettgehalt und verschiedenen Laborparametern, c) Beziehungen zwischen dem Leberfettgehalt, den Krankheiten und dem Behandlungserfolg, d) prognostische Bedeutung des Leberfettgehaltes sowie klinisch-chemischer und hämatologischer Blutparameter. Material und Methoden: Dazu wurden chronologisch 312 in die MTK Leipzig eingelieferte Rinderpatienten entsprechend klinisch und labordiagnostisch einschließlich Leberbiopsie untersucht und die Befunde der Erstuntersuchung ausgewertet. Ergebnisse: Bei 312 Rinderpatienten wurden in 18 Krankheitsgruppen, z.T. nach Verlauf und Schweregraden untersetzt, 196 links- und 40 rechtseitige Labmagenverlagerungen (LMV), 11 Labmagen- (LM) Ulcera, 182 Ketosen, 96 Mastitiden, 178 Endometritiden, 7 Retentio. sec., 7 puerperale Septikämien und 6 Multiorganversagen, 42 Indigestion, 31 Enteritis, 46 Peritonitiden, 30 Festlieger und 18 Pneumonien diagnostiziert. Die Kühe verteilten sich auf vier Leberfettklassen wie folgt: ≤6% =14,7%; 6 bis ≤15% = 37,5%; 15 bis ≤30% = 31,1% sowie >30% = 16,7%. Die Heilungsrate betrug in den ersten drei Leberfettklassen 80,4%, 83,8% bzw. 86,6%. Ein Zusammenhang zwischen der Heilungsrate und dem Leberfettgehalt war bis zu ≤30% nicht erkennbar. In der Leberfettklasse >30% sank die Heilungsrate auf 61,5%; bei >40% verschlechterte sie sich unter 50%. Dem entsprach das Verhalten verschiedener Laborparameter. Erst bei einem Leberfettgehalt >30%, besonders bei >45%, wurden, z.T. unabhängig vom Krankheitsausgang, die BHB-, Bilirubin- und Glucose-Konzentrationen sowie AST-, CK-, LDH-, GGT- und GLDH-Aktivitäten signifikant höher bzw. die anorg. Phosphat- (Pi) und Cholesterol-Konzentrationen niedriger. Mit dem Leberfettgehalt korrelierten am engsten (p<0,001) die Parameter BHB (0,620) und FFS (0,615), LDH (0,579), Bilirubin (0,367), AST (0,359), Cholesterol (-0,278), Laktat (-0,253), Hämoglobin (0,214), CK (0,207), Leukozyten (-0,202) sowie innere Körpertemperatur (0,210). Die Bedeutung dieser Beziehungen ist relativ. Sowohl Sensitivität und Spezifität waren für Pi (<1,25 mmol/l) >0,7, für Cholesterol (< 1,5 mmol/l) und Albumin (<30 g/l) >0,6 sowie für BHB, Harnstoff und Gesamteiweiß >0,5. Eine hohe Spezifität >0,8 bei geringer Sensitivität hatten K (<3,0 mmol/l) und segmentkernige neutrophile Granulozyten (< 4,6 G/l), eine hohe Sensitivität >0,8, aber geringe Spezifität Bilirubin (>5,3 μmol/l), AST (>80 U/l) sowie CK (>200 U/l). Hinsichtlich Krankheitsausgang und damit der prognostischen Nutzbarkeit waren die Flächen (AUC) unter den ROC-Kurven nur für K (0,37), Bilirubin (0,62), AST (0,61) und für Leberfett (0,60) schwach gesichert. Die leberspezifischen Enzyme GGT und GLDH korrelierten nur schwach mit 0,126 (p<0,05) sowie 0,192 (p<0,001) mit dem Leberfett. Das stellt ihre diagnostische Bedeutung nicht in Frage, sondern verdeutlicht, dass bei den analysierten Krankheiten keine stärkeren Leberschäden auftraten. Die bei den Korrelations-, Sensitivitäts- und Spezifitätsberechnungen sowie z.T. ROC-/AUC-Analysen informativen Parameter LDH, AST, CK, K, Pi, Bilirubin (>20 μmol/l) und Leukozyten weisen auf entzündliche Prozesse hin. Die in allen Leberfettklassen erhöhten Glucose-Konzentrationen, bes. bei >30% Leberfett und Ex. letalis, ordnen sich damit zumindest teilweise als Folge einer Insulinresistenz ein. Kühe mit LMV hatten i.d.R. zusätzliche Störungen: zu 58% Ketosen, 57% Endometritiden, 6,4% Retentio sec., puerperale Septikämie und Multiorganversagen, 30,8% Mastitiden, 14,7% Peritonitiden, 9,9% Enteritiden, 9,6% Festliegen, 5,8% Pneumonien sowie 3,5% Labmagenulcera. Außerdem kamen zu 13,5% Indigestionen vor. Die Heilungsrate lag bei links- und rechtseitigen LMV, Mastitiden, Endometritiden und Enteritiden zwischen 89% bis 70% und bei Indigestionen sowie akuten Peritonitiden zwischen 70 und 60%. Bei chronischen Peritonitiden, Pneumonien, Retentio sec., puerperalen Septikämien, Festliegen, LM-Ulcera und Multiorganversagen sank sie von 50% bis auf 0%. Der Leberfettgehalt schwankte bei LMV, Mastitiden, Endometritiden, chronischen Peritonitiden und Indigestionen zwischen 6% und 19%. Er stieg mit schlechterem Therapieergebnis bei Retentio sec., Pneumonien, akuten Peritonitiden puerperalen Septikämien, LM-Ulcera und Enteritiden bis gegen 30% und betrug bei Festliegern, hochgradigen Endometritiden sowie Multiorganversagen bis gegen 40%. Schlussfolgerungen: Leberfett bis ≤30% ist klinisch unbedeutend. Der Trend zu höherem Leberfett und schlechterer Heilungsrate unterstreicht die Bedeutung stark entzündlicher Grundkrankheiten für die Krankheitsentwicklung und den Therapieerfolg. Die Leberschwimmprobe kann für die Anwendung in der Praxis empfohlen werden. / Problem: The fatty liver is considered to be one of the most important metabolic disorders in early lactation in dairy cows and is a reason for poor health, including reproductive disorders. Objective: Therefore the following questions in this study were studied: a) importance of the clinical and laboratory findings at the initial examination of sick cows, especially the liver fat, b) relationships between liver fat content and various laboratory parameters, c) the relationship between the liver fat content, diseases and the treatment success, d) prognostic significance of liver fat content and clinical-chemical and hematological blood parameters. Material and Methods: For 312 bovine patients, provided chronological to the MTK Leipzig, were examined according to clinical and laboratory investigations including liver biopsy and evaluated the findings of the initial examination. Results: In 312 cattle, divided in 18 disease groups, 196 left and 40 right-sided abomasal displacements (LMV), 11 abomasal ulcers, 182 ketoses, 96 mastitis, endometritis 178, 7 Retentio sec., puerperal sepsis, 7 and 6 multi organ failure, 42 Indigestion, 31 enteritis, 46 peritonitis, 30 downer cows and 18 pneumonia diagnosed. The cows were grouped in four liver fat classes as follows: ≤6% = 14.7%; 6 to ≤15% = 37.5%; 15 to ≤30% = 31.1% and> 30% = 16.7%. The cure rate was in the first three classes of liver fat 80.4%, 83.8% and 86.6% respectively. A relationship between the cure rate and the liver fat content was not recognizable to ≤30%. In the liver fat class> 30% cure rate dropped to 61.5%; at> 40% it worsened <50%. This corresponded to the behavior of various laboratory parameters. Only when liver fat content> 30%, particularly at> 45%, were partly regardless of the outcome of the disease, the BHB, bilirubin and glucose concentrations as well as AST, CK, LDH, GGT and GLDH activities were significantly higher and the inorg. Phosphate (Pi) and cholesterol concentrations low. The liver fat content correlated most closely (p <0.001), the parameters BHB (0.620) and FFS (0.615), LDH (0.579), bilirubin (0.367), AST (0.359), cholesterol (-0.278), lactate (-0.253), hemoglobin (0.214), CK (0.207), leukocytes (-0.202) and internal body temperature (0.210). The significance of these relationships is relative. Sensitivity and specificity were Pi (<1.25 mmol / l)> 0.7, to cholesterol (<1.5 mmol / l) and albumin (<30 g / l)> 0.6, and for BHB, urea, and total protein> 0.5. High specificity> 0.8 for low sensitivity had K (<3.0 mmol / l) and segment neutrophilic granulocytes (<4.6 g / l), a high sensitivity> 0.8, but low specificity bilirubin (> 5 , 3 mol / l) AST (> 80 U / l) and CK (> 200 U / l). With regard to disease outcome and thus the prognostic value of the area under the curve (AUC) for K (0.37), bilirubin (0.62), AST (0.61) and liver fat (0.60) were weakly secured. The liver-specific enzymes GGT and GLDH correlated only weakly with 0.126 (p <0.05) and 0.192 (p <0.001) with the liver fat. This do not challenges their diagnostic significance, but it makes clear that in the studied diseases no greater liver damage occurred. Whereas the correlation, sensitivity and specificity calculations as well as some ROC/AUC analysis informative parameter LDH, AST, CK, C, Pi, bilirubin (> 20 μmol/l) and leukocytes indicate inflammatory processes. The increased liver fat in every group glucose concentrations, esp. at liver fat > 30% and ex. letalis, thus organize at least partially as a result of insulin resistance. Cows with DA had usually. additional disorders: 58% ketoses, 57% endometritis, 6.4% Retention sec, puerperal septicemia and multi-organ failure, 30.8% mastitis, 14.7% of peritonitis, enteritis 9.9%, 9.6% recumbency, 5.8% pneumonia and 3.5% ulceration of the abomasum. Furthermore, came to 13.5% before indigestion. The cure rate of left and right DA, mastitis, endometritis and enteritis were between 89% to 70% and for indigestion and acute peritonitis 70-60%. In chronic peritonitis, pneumonia, Retention sec., Puerperal septicemia, recumbency, abomasum ulcers and multiple organ failure they fell from 50% to 0%. The liver fat content varied with DA, mastitis, endometritis, chronic peritonitis and indigestion between 6% and 19%. He rose with a worse clinical outcome in Retentio sec., Pneumonia, acute peritonitis puerperal septicemia, DA ulcers and enteritis up to 30% and was at Festliegern, high-grade endometritis and multiorgan failure until about 40%. Conclusions: Liver fat to ≤30% is clinically insignificant. The trend towards higher liver fat and poorer cure rate underscores the importance of strong inflammatory diseases reason for the disease development and therapeutic success. The copper sulphate test according to Herdt can be recommended for use in practice.