Sorrentino Paolo, Tarantino Giovanni, Conca Paolo, Perrella Alessandro, Terracciano Maria Luigi, Vecchione Raffaella, Gargiulo Giovanna, Gennarelli Nicola, Lobello Roberto
Section of Hepatology in Internal Medicine, Department of Clinical and Experimental Medicine, Federico II University Medical School, Via S. Pansini 5, 80131 Naples, Italy.
J Hepatol. 2004 Nov;41(5):751-7. doi: 10.1016/j.jhep.2004.07.010.
BACKGROUND/AIMS: We studied the prevalence of non-alcoholic fatty liver disease and non-alcoholic-steatohepatitis in patients with metabolic-syndrome but normal liver enzymes. The histological findings of patients with normal liver enzymes and non-alcoholic-steatohepatitis were compared with those of a control-group with persistently abnormal liver enzymes.
Patients presenting with normal liver enzymes were enrolled in the study and underwent liver biopsy. Prevalence of non-alcoholic-steatohepatitis and risk factors for fibrosis and cirrhosis were evaluated. Data from a control-group with non-alcoholic-steatohepatitis and abnormal liver enzymes were used to compare the histological findings.
Fifty-eight of the 80 patients enrolled had varying degrees of non-alcoholic steatohepatitis, of these 26 had fibrosis and 8 silent cirrhosis. The association of metabolic-syndrome, female-sex, a long-history of obesity and body mass index>45 were considered to be independent risk-factors for fibrosis. Comparing the histological findings of cases and controls we found a similar severity of steatosis and fibrosis, with a greater prevalence of ballooning degeneration and glycogenated-nuclei rather than lobular-inflammation.
In the subjects selected according to our criteria, liver enzyme levels could not be used as surrogate markers of non-alcoholic-steatohepatitis. Histological hallmarks of patients with metabolic-syndrome, normal liver enzymes and non-alcoholic-steatohepatitis consist to a lesser degree of lobular-inflammation and a more severe ballooning and glycogenated-nuclei.
背景/目的：我们研究了代谢综合征患者中肝酶正常情况下非酒精性脂肪性肝病和非酒精性脂肪性肝炎的患病率。将肝酶正常且患有非酒精性脂肪性肝炎患者的组织学结果与肝酶持续异常的对照组进行比较。
纳入肝酶正常的患者进行研究并接受肝活检。评估非酒精性脂肪性肝炎的患病率以及纤维化和肝硬化的危险因素。使用来自非酒精性脂肪性肝炎且肝酶异常的对照组数据比较组织学结果。
纳入研究的80例患者中，58例有不同程度的非酒精性脂肪性肝炎，其中26例有纤维化，8例有静止性肝硬化。代谢综合征、女性、肥胖病史长和体重指数>45被认为是纤维化的独立危险因素。比较病例组和对照组的组织学结果，我们发现脂肪变性和纤维化的严重程度相似，气球样变性和糖原核的患病率更高，而非小叶性炎症。
在根据我们的标准选择的受试者中，肝酶水平不能用作非酒精性脂肪性肝炎的替代标志物。代谢综合征、肝酶正常且患有非酒精性脂肪性肝炎患者的组织学特征是小叶性炎症程度较轻，气球样变性和糖原核更严重。
