Kosari Farid, Jamali Raika, Ramim Tayeb, Mosavi Jahan Abad Ebrahim
Associate Professor, Dept of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Associate Professor, Research Development Center of Sina Hospital, Digestive Disease Research Institute, NAFLD Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Pathol. 2019 Winter;14(1):17-25. doi: 10.30699/IJP.14.1.17. Epub 2018 Dec 27.
BACKGROUND & OBJECTIVE: The aim of this present study was to assess the relationship between serum zinc levels and liver histopathological findings in non-alcoholic steatohepatitis (NASH) patients.
This case-control study was performed in consecutively selected NASH patients who had been referred to a general hospital. The control group consisted of age and sex-matched individuals with normal physical examinations, laboratory findings, and liver ultrasounds. Serum zinc level was measured using atomic absorption spectrophotometry. Liver histopathological findings were determined based on non-alcoholic fatty liver activity score.
A cohort of eighty biopsy-proven NASH patients and eighty controls were enrolled in the study. The mean serum zinc level was significantly lower in the NASH group compared with the controls. The mean serum zinc concen- tration was significantly lower in moderate and severe lobular inflammation groups than the mild group. After multiple adjustments for potential contributing variables, serum zinc level was associated with the severity of lobular inflam- mation. Nonetheless, it was not associated with liver steatosis and fibrosis. A serum zinc value of 89 (µg/dl) yielded a sensitivity and specificity of 93% and 86%, respectively, characterizing patients with lobular inflammation of less than two inflammatory foci per high-power field (HPF) from more advanced groups. Furthermore, a value of 79.55 (µg/dl) yielded a sensitivity and specificity of 87% and 100%, respectively, distinguishing those with a lobular inflammation grade of less than four foci per HPF from more advanced cases.
Serum zinc level might be associated with the severity of lobular inflammation in NASH.
本研究旨在评估非酒精性脂肪性肝炎（NASH）患者血清锌水平与肝脏组织病理学结果之间的关系。
本病例对照研究在连续入选的转诊至综合医院的NASH患者中进行。对照组由年龄和性别匹配、体格检查、实验室检查结果及肝脏超声均正常的个体组成。采用原子吸收分光光度法测定血清锌水平。基于非酒精性脂肪性肝病活动评分确定肝脏组织病理学结果。
本研究纳入了80例经活检证实的NASH患者和80例对照。NASH组的平均血清锌水平显著低于对照组。中度和重度小叶炎症组的平均血清锌浓度显著低于轻度组。在对潜在影响变量进行多次校正后，血清锌水平与小叶炎症的严重程度相关。然而，它与肝脏脂肪变性和纤维化无关。血清锌值为89（μg/dl）时，敏感性和特异性分别为93%和86%，可区分每高倍视野（HPF）炎症灶少于两个的小叶炎症患者与病情更严重的患者。此外，值为79.55（μg/dl）时，敏感性和特异性分别为87%和100%，可区分每HPF小叶炎症分级少于四个灶的患者与病情更严重的患者。
血清锌水平可能与NASH中小叶炎症的严重程度相关。
