Madan Kaushal, Batra Yogesh, Gupta S Datta, Chander Bal, Rajan K D Anand, Tewatia M S, Panda S K, Acharya S K
Department of Gastroenterology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
World J Gastroenterol. 2006 Jun 7;12(21):3400-5. doi: 10.3748/wjg.v12.i21.3400.
To evaluate the clinical and biochemical profile of patients with non alcoholic fatty liver disease (NAFLD) and to assess their histological severity at presentation.
Consecutive patients presenting to the liver clinic of All India Institute of Medical Sciences (AIIMS) with raised transaminases to at least 1.5 times upper limit of normal, and histologically confirmed non-alcoholic fatty liver disease were included. Patients who had significant alcohol intake or positive markers of other liver diseases or who were taking drugs known to produce fatty liver were excluded. The clinical, biochemical and histological profile of this group was studied.
Fifty-one patients with NAFLD formed the study population. Their median age and BMI were 34(17-58) years and 26.7(21.3-32.5) kg/m(2) respectively and 46 (90.1%) were males. The majority of the patients had mild inflammation, either grade 1 [32 (63%)] or grade 2 [16 (31%)] and only 3 (6%) patients had severe (grade 3) inflammation. Twenty-three (45%), 19 (37%), 8(16%) and 1(2%) patient had stage 0, 1, 2 and 3 fibrosis respectively on index biopsy and none had cirrhosis. On univariate analysis, triglyceride levels more than 150 mg % (OR = 7.1; 95% CI: 1.6-31.5, P = 0.002) and AST/ALT ratio>1 (OR = 14.3; 95% CI: 1.4-678.5, P = 0.008) were associated with high grades of inflammation and none was associated with advanced fibrosis. On multivariate logistic regression analysis, hypertriglyceridemia >150 mg% was the only factor independently associated with presence of high grade of inflammation (OR = 1.6; 95% CI: 1.3-22.7, P = 0.02), while none was associated with advanced fibrosis. Triglyceride levels correlated positively with inflammatory grade (r = 0.412; P = 0.003).
NAFLD in North Indian patients is a disease of young over-weight males, most of whom are insulin resistant and they tend to have a mild histological disease at presentation.
评估非酒精性脂肪性肝病（NAFLD）患者的临床和生化特征，并在就诊时评估其组织学严重程度。
纳入全印度医学科学研究所（AIIMS）肝病门诊连续就诊的转氨酶升高至至少正常上限1.5倍且经组织学证实为非酒精性脂肪性肝病的患者。排除有大量酒精摄入或其他肝病阳性标志物或正在服用已知可导致脂肪肝药物的患者。研究该组患者的临床、生化和组织学特征。
51例NAFLD患者构成研究人群。他们的年龄中位数和BMI分别为34（17 - 58）岁和26.7（21.3 - 32.5）kg/m²，46例（90.1%）为男性。大多数患者有轻度炎症，1级[32例（63%）]或2级[16例（31%）]，只有3例（6%）患者有重度（3级）炎症。初次活检时，23例（45%）、19例（37%）、8例（16%）和1例（2%）患者分别处于0、1、2和3期纤维化，无患者有肝硬化。单因素分析显示，甘油三酯水平超过150mg%（OR = 7.1；95%CI：1.6 - 31.5，P = 0.002）和AST/ALT比值>1（OR = 14.3；95%CI：1.4 - 678.5，P = 0.008）与高度炎症相关，且均与晚期纤维化无关。多因素逻辑回归分析显示，高甘油三酯血症>150mg%是唯一与高度炎症存在独立相关的因素（OR = 1.6；95%CI：1.3 - 22.7，P = 0.02），而均与晚期纤维化无关。甘油三酯水平与炎症分级呈正相关（r = 0.412；P = 0.003）。
北印度患者的NAFLD是一种年轻超重男性的疾病，他们大多有胰岛素抵抗，就诊时组织学病变往往较轻。
