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。
