Doulberis Michael, Srivastava Simone, Polyzos Stergios A, Kountouras Jannis, Papaefthymiou Apostolis, Klukowska-Rötzler Jolanta, Blank Annika, Exadaktylos Aristomenis K, Srivastava David S
Department of Gastroenterology and Hepatology, University of Zurich, Zurich 8091, Switzerland.
Second Medical Clinic, School of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki 54642, Macedonia, Greece.
J Clin Med. 2020 Mar 30;9(4):933. doi: 10.3390/jcm9040933.
Nonalcoholic fatty liver disease (NAFLD) emerges as an important global burden and infection (-I) has been suggested as a risk NAFLD, although controversy exists. This retrospective study aimed to investigate a potential impact of active -I on NAFLD severity in morbidly obese patients, subjected to bariatric surgery and gastric biopsy for documentation of -I. Of 64 eligible participants, 15 (23.4%) were diagnosed with active -I, showing higher rates of nonalcoholic steatohepatitis (NASH) than those without -I (86.7% vs. 26.5%, respectively; < 0.001). Concerning histological lesions, steatosis grade ( = 0.027), ballooning ( < 0.001), lobular inflammation ( = 0.003), and fibrosis stage ( < 0.001) were also more severe in -I positive patients. Likewise, liver function tests, insulin resistance, dyslipidemia, and arterial hypertension were significantly higher in -I positive patients. -I was independently positively associated with NASH (beta = 3.27; = 0.002), severe NASH (beta = 2.37; = 0.018), and the presence of fibrosis (beta = 3.86; = 0.001) in a binary regression model, after adjustment for potential confounders. In conclusion, active -Ι was independently associated with NASH and fibrosis, findings offering potential clinical implication.
非酒精性脂肪性肝病(NAFLD)已成为一项重要的全球负担,尽管存在争议,但感染(-I)已被认为是NAFLD的一个风险因素。本回顾性研究旨在调查活动性-I对病态肥胖患者NAFLD严重程度的潜在影响,这些患者接受了减肥手术并进行了胃活检以记录-I情况。在64名符合条件的参与者中,15名(23.4%)被诊断为活动性-I,其非酒精性脂肪性肝炎(NASH)的发生率高于无-I者(分别为86.7%和26.5%;<0.001)。关于组织学病变,-I阳性患者的脂肪变性分级(=0.027)、气球样变(<0.001)、小叶炎症(=0.003)和纤维化分期(<0.001)也更严重。同样,-I阳性患者的肝功能检查、胰岛素抵抗、血脂异常和动脉高血压也显著更高。在对潜在混杂因素进行调整后,在二元回归模型中,-I与NASH(β=3.27;=0.002)、重度NASH(β=2.37;=0.018)和纤维化的存在(β=3.86;=0.001)独立呈正相关。总之,活动性-Ι与NASH和纤维化独立相关,这些发现具有潜在的临床意义。