Jamali Raika, Hatami Neda, Kosari Farid
Research Development Center, Digestive Disease Research Institute, Sina Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Sina Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Hepat Mon. 2016 Apr 20;16(5):e37412. doi: 10.5812/hepatmon.37412. eCollection 2016 May.
Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic hepatitis, which can lead to cirrhosis and hepatocellular carcinoma.
The aim of the study was to evaluate the correlation between serum adipocytokines and the histologic findings of the liver in patients with non-alcoholic fatty liver disease (NAFLD).
This case-control study was performed on those with persistent elevated liver enzymes and with evidence of fatty liver in ultrasonography. After exclusion of patients with other etiologies causing abnormal liver function tests, the resulting patients underwent liver biopsies. NAFLD was diagnosed based on liver histology according to the Brunt scoring system.
Waist circumferences and levels of blood glucose (after fasting), insulin, triglycerides, alanine aminotransferases (ALT), and aspartate aminotransferases (AST) were higher in patients with NAFLD than in those in the control group. ALT, AST, and gamma glutamine transferase (GGT) levels were lower in patients with liver steatosis of a grade of less than 33% than those with higher degrees of steatosis. Serum low-density lipoprotein (LDL), cholesterol, and hepcidin levels were significantly higher in those with lobular inflammation of grade 0 - 1 than in those with inflammation of grade 2 - 3 (Brunt score). Meanwhile, AST was significantly lower in those with lobular inflammation of grade 1 than in those with grade 2-3. Hepcidin and resistin levels were significantly higher in patients with moderate to severe fibrosis than in those with mild fibrosis.
It seems that surrogate liver function tests and adipocytokine levels were correlated with the histologic findings of the liver.
非酒精性脂肪性肝病（NAFLD）是慢性肝炎的常见病因，可导致肝硬化和肝细胞癌。
本研究旨在评估非酒精性脂肪性肝病（NAFLD）患者血清脂肪细胞因子与肝脏组织学检查结果之间的相关性。
本病例对照研究针对那些肝酶持续升高且超声检查有脂肪肝证据的患者。在排除其他导致肝功能检查异常的病因患者后，对剩余患者进行肝活检。根据Brunt评分系统，基于肝脏组织学诊断NAFLD。
NAFLD患者的腰围、空腹血糖、胰岛素、甘油三酯、丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）水平高于对照组。脂肪变性程度小于33%的患者的ALT、AST和γ-谷氨酰转移酶（GGT）水平低于脂肪变性程度较高的患者。小叶炎症为0 - 1级的患者的血清低密度脂蛋白（LDL）、胆固醇和铁调素水平显著高于炎症为2 - 3级的患者（Brunt评分）。同时，小叶炎症为1级的患者的AST显著低于2 - 3级的患者。中度至重度纤维化患者的铁调素和抵抗素水平显著高于轻度纤维化患者。
似乎替代肝功能检查和脂肪细胞因子水平与肝脏组织学检查结果相关。
