Tarantino Giovanni, Conca Paolo, Riccio Antonio, Tarantino Marianna, Di Minno Matteo N, Chianese Domenico, Pasanisi Fabrizio, Contaldo Franco, Scopacasa Francesco, Capone Domenico
Federico II University Medical School of Naples, Department of Clinical and Experimental Medicine, Naples, Italy.
J Transl Med. 2008 Nov 27;6:72. doi: 10.1186/1479-5876-6-72.
Inside the spectrum of non-alcoholic fatty liver disease, simple fatty liver is generally thought of as being "non progressive", differently from non-alcoholic steatohepatitis, which increases in severity due to the presence of apoptosis/inflammation and fibrosis. The "benignity" of fatty liver is widely accepted but conceptually difficult to maintain because the mechanisms underlying this entity are the same ones that determine the more severe form.Findings provide evidence that iron overload is associated with increased liver damage and collagen deposition. Transforming growth factor-beta1 released by hepatic stellate cells during chronic liver injury plays a critical role in liver apoptosis and fibrogenesis.
To verify whether both the forms of non-alcoholic fatty liver disease were really dissimilar, evaluating the serum profile of two key parameters, indexes of severity.
A total of 123 patients (57 females) participated, forming three groups: forty five patients with fatty liver, 42 patients with non-alcoholic steatohepatitis and 36 with chronic hepatitis C. All had a biopsy-proven diagnosis.
Serum concentrations of transforming growth factor-beta1 and ferritin.
High concentrations of transforming growth factor-beta1 were noticed in patients suffering from both fatty liver and non-alcoholic steatohepatitis, 129.1 (45.4) versus 116.8 (42.2) ng/mL, P = 0.2; they were significantly superior to those of chronic hepatitis C patients 87.5 (39.5) ng/mL, P < 0.001. Ferritin levels were on average above normal values and similar in the three groups (P = 0.9), also when adjusted for gender (P = 0.5) and age (P = 0.3).
No difference between serum concentrations of transforming growth factor-beta1 and ferritin in fatty liver and non-alcoholic steatohepatitis suggests that these forms share more common aspects, regarding their progression, than previously thought.
在非酒精性脂肪性肝病范围内，单纯性脂肪肝通常被认为是“非进行性的”，这与非酒精性脂肪性肝炎不同，后者因存在细胞凋亡/炎症和纤维化而病情加重。脂肪肝的“良性”已被广泛接受，但在概念上难以维持，因为该疾病的潜在机制与决定更严重形式的机制相同。研究结果提供了证据表明铁过载与肝脏损伤增加和胶原蛋白沉积有关。肝星状细胞在慢性肝损伤期间释放的转化生长因子-β1在肝脏细胞凋亡和纤维化形成中起关键作用。
通过评估两个关键参数（严重程度指标）的血清水平，验证两种形式的非酒精性脂肪性肝病是否真的不同。
共有123名患者（57名女性）参与，分为三组：45例脂肪肝患者、42例非酒精性脂肪性肝炎患者和36例慢性丙型肝炎患者。所有患者均经活检确诊。
血清转化生长因子-β1和铁蛋白浓度。
脂肪肝和非酒精性脂肪性肝炎患者的转化生长因子-β1浓度均较高，分别为129.1（45.4）与116.8（42.2）ng/mL，P = 0.2；显著高于慢性丙型肝炎患者的87.5（39.5）ng/mL，P < 0.001。铁蛋白水平平均高于正常值，三组相似（P = 0.9），在按性别（P = 0.5）和年龄（P = 0.3）调整后也是如此。
脂肪肝和非酒精性脂肪性肝炎患者血清转化生长因子-β1和铁蛋白浓度无差异，表明这些形式在进展方面比以前认为的有更多共同之处。
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