Presence and significance of microvesicular steatosis in nonalcoholic fatty liver disease.
Presence and significance of microvesicular steatosis in nonalcoholic fatty liver disease.
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DOI：
10.1016/j.jhep.2010.11.021
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发表时间：
2011-09
影响因子：
25.7
通讯作者：
Chalasani, Naga
中科院分区：
文献类型：
--
作者：
Tandra, Sweta;Yeh, Matthew M.;Brunt, Elizabeth M.;Vuppalanchi, Raj;Cummings, Oscar W.;Uenalp-Arida, Aynur;Wilson, Laura A.;Chalasani, Naga
非酒精性脂肪性肝病（NAFLD）患者的肝活检有时表现为肝细胞微泡性脂肪变性的非地带性聚集，但其患病率和意义尚不清楚。在这项研究中，我们在大量NAFLD肝活检样本中评估了微泡性脂肪变性的频率，并评估了其与疾病严重程度的组织学标志物的关系。这项横断面研究纳入了参与NASH临床研究网络（NASH CRN）开展的两项研究的大量成人肝脏活检。肝脏组织学被集中评估，各种组织学特征以系统的方式评分。在控制年龄、性别、种族、体重指数和糖尿病因素后，通过多元logistic回归检验了微泡性脂肪变性与NAFLD的各种组织学特征之间的关系。在1022例肝活检中，102例（10%）有微泡性脂肪变性。在患有或不患有微泡性脂肪变性的患者之间没有统计学差异。微泡性脂肪变性的存在与较高程度的脂肪变性（p<0.001）、球囊性细胞损伤（p<0.001）、Mallory-Denk小体的存在（p<0.007）、大线粒体的存在（p<0.0001）、较高的NAS评分（p<0.0001）、更晚期的纤维化（p<0.0001）和边缘性或明确NASH的诊断（p<0.0001）相关。微泡性脂肪变性与NAFLD的晚期组织学相关。需要纵向研究来解决微泡脂肪变性在介导NAFLD细胞损伤和疾病进展中的作用。
Liver biopsies from patients with nonalcoholic fatty liver disease (NAFLD) sometimes exhibit non-zonal aggregates of hepatocytes with microvesicular steatosis, but its prevalence and significance are unclear. In this study, we have evaluated the frequency of microvesicular steatosis and assessed its association with histological markers of disease severity in a large sample of NAFLD liver biopsies. Liver biopsies from a large cohort of adults who participated in two studies conducted by the NASH Clinical Research Network (NASH CRN) were included in this cross-sectional study. Liver histology was assessed centrally and various histological features scored in a systematic fashion. The relationship between microvesicular steatosis and various histological features that characterize NAFLD was tested by multiple logistic regression, after controlling for age, gender, race, body mass index, and diabetes. Among 1022 liver biopsies included, 102 (10%) had microvesicular steatosis. No demographic differences were noted between patients with or without microvesicular steatosis. The presence of microvesicular steatosis was associated with higher grades of steatosis (p<0.001), ballooning cell injury (p<0.001), presence of Mallory-Denk bodies (p<0.007), presence of megamitochondria (p<0.0001), higher NAS scores (p<0.0001), more advanced fibrosis (p<0.0001) and diagnosis of borderline or definite NASH (p<0.0001). Microvesicular steatosis correlates with more advanced histology of NAFLD. Longitudinal studies are needed to address the role of microvesicular steatosis in mediating cellular injury and disease progression in NAFLD.
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影响因子：
13.5
作者：
POWELL, EE;COOKSLEY, WGE;POWELL, LW
通讯作者：
POWELL, LW
DOI：
10.1161/01.atv.0000179676.41064.d4
发表时间：
2005-09-01
影响因子：
8.7
作者：
Boström, P;Rutberg, M;Olofsson, SO
通讯作者：
Olofsson, SO
影响因子：
5.1
作者：
Caldwell, Stephen H;Chang, Charissa Y;Krugner-Higby, Lisa
通讯作者：
Krugner-Higby, Lisa
影响因子：
29.4
作者：
Matteoni, CA;Younossi, ZM;McCullough, AJ
通讯作者：
McCullough, AJ
影响因子：
13.5
作者：
Kleiner, DE;Brunt, EM;Sanyal, AJ
通讯作者：
Sanyal, AJ