Akuta Norio, Kawamura Yusuke, Arase Yasuji, Suzuki Fumitaka, Sezaki Hitomi, Hosaka Tetsuya, Kobayashi Masahiro, Kobayashi Mariko, Saitoh Satoshi, Suzuki Yoshiyuki, Ikeda Kenji, Kumada Hiromitsu
Department of Hepatology, Toranomon Hospital, and Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
Liver Research Laboratory, Toranomon Hospital, Tokyo, Japan.
Gut Liver. 2016 May 23;10(3):437-45. doi: 10.5009/gnl15163.
BACKGROUND/AIMS: It is important to determine the noninvasive parameters of histological features in nonalcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the value of genetic variations as surrogate markers of histological features.
The parameters that affected the histological features of NAFLD were investigated in 211 Japanese patients with biopsy-proven NAFLD. The relationships between genetic variations in PNPLA3 rs738409 or TM6SF2 rs58542926 and histological features were analyzed. Furthermore, the impact of genetic variations that affected the pathological criteria for the diagnosis of nonalcoholic steatohepatitis (NASH) (Matteoni classification and NAFLD activity score) was evaluated.
The fibrosis stage of PNPLA3 GG was significantly more progressive than that of CG by multiple comparisons. Multivariate analysis identified PNPLA3 genotypes as predictors of fibrosis of stage 2 or more, but the impact tended to decrease at stage 3 or greater. There were no significant differences among the histological features of the three genotypes of TM6SF2. PNPLA3 genotypes partly affected the definition of NASH by the NAFLD activity score, but TM6SF2 genotypes did not affect the definition of NASH.
In Japanese patients with biopsy-proven NAFLD, PNPLA3 genotypes may partly affect histological features, including stage of fibrosis, but the TM6SF2 genotype does not affect histological features.
背景/目的:确定非酒精性脂肪性肝病(NAFLD)组织学特征的非侵入性参数很重要。本研究的目的是探讨基因变异作为组织学特征替代标志物的价值。
在211例经活检证实为NAFLD的日本患者中,研究影响NAFLD组织学特征的参数。分析PNPLA3 rs738409或TM6SF2 rs58542926基因变异与组织学特征之间的关系。此外,评估影响非酒精性脂肪性肝炎(NASH)诊断病理标准(Matteoni分类和NAFLD活动评分)的基因变异的影响。
通过多重比较,PNPLA3 GG基因型的纤维化阶段比CG基因型明显更严重。多变量分析确定PNPLA3基因型是2期或更高级别纤维化的预测因子,但在3期或更高级别时这种影响趋于降低。TM6SF2三种基因型的组织学特征之间无显著差异。PNPLA3基因型部分影响NAFLD活动评分对NASH的定义,但TM6SF2基因型不影响NASH的定义。
在经活检证实为NAFLD的日本患者中,PNPLA3基因型可能部分影响组织学特征,包括纤维化阶段,但TM6SF2基因型不影响组织学特征。