Evaluation of ballooned hepatocytes as a risk factor for future progression of fibrosis in patients with non-alcoholic fatty liver disease
Evaluation of ballooned hepatocytes as a risk factor for future progression of fibrosis in patients with non-alcoholic fatty liver disease
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DOI：
10.1007/s00535-018-1468-9
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发表时间：
2018-12-01
影响因子：
6.3
通讯作者：
Takikawa, Yasuhiro
中科院分区：
文献类型：
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作者：
Kakisaka, Keisuke;Suzuki, Yuji;Takikawa, Yasuhiro
背景非酒精性脂肪性肝病（NAFLD）的患病率呈上升趋势。非酒精性脂肪性肝炎（NASH）显示NAFLD中肝纤维化的进展。目前尚不清楚哪些NAFLD患者会出现肝纤维化进展。因此，我们的目的是调查与NAFLD.MethodsThis观察性研究纳入157例活检证实的NAFLD患者的肝纤维化进展的危险因素。32例患者因缺乏数据而被排除。估计肝纤维化的公式的准确性，即，比较FIB-4指数、APRI和Forns指数。使用肝纤维化最佳配方的系列变化，我们确定了与肝纤维化进展相关的因素。组织学肝纤维化定量使用Brunt stage. ResultsSixty 3例患者被诊断为NASH。FIB-4指数为肝纤维化提供了最佳的诊断准确性[Brunt分期0与1-4，曲线下面积（AUC）0.74; 0-1与2-4，AUC 0.77; 0-2与3-4，AUC 0.78; 1-3与4，AUC 0.87]。采用多变量分析评价NASH患者的体重指数、性别、观察期和组织学检查结果（肝脂肪含量、桥接纤维化和肝细胞气球样变）与FIB-4指数变化之间的相关性。在这些因素中，肝细胞气球样变与FIB-4 index.ConclusionThe FIB-4指数的增加是最好的公式估计肝纤维化活检证实NAFLD患者，气球样肝细胞的存在是肝纤维化进展的危险因素。
BackgroundThe prevalence of non-alcoholic fatty liver disease (NAFLD) has increased. Non-alcoholic steatohepatitis (NASH) shows progression of liver fibrosis in NAFLD. It remains unclear which patients with NAFLD will show progression of liver fibrosis. Therefore, we aimed to investigate the risk factor associated with the progression of liver fibrosis among patients with NAFLD.MethodsThis observational study enrolled 157 patients with biopsy-proven NAFLD. Thirty-two patients were excluded because of lack of data. The accuracy of the formulae for estimating liver fibrosis, i.e., the FIB-4 index, APRI, and Forns index, was compared. Using serial changes of the best formula for liver fibrosis, we identified factors associated with the progression of liver fibrosis. Histological liver fibrosis was quantified using the Brunt stage.ResultsSixty-three patients were diagnosed as having NASH. The FIB-4 index provided the best diagnostic accuracy for liver fibrosis [Brunt stage 0 versus 1-4, areas under the curve (AUC) 0.74; 0-1 versus 2-4, AUC 0.77; 0-2 versus 3-4, AUC 0.78; and 1-3 versus 4, AUC 0.87]. The association between body mass index, sex, observation period, and histological findings (liver fat content, bridging fibrosis, and hepatocyte ballooning) with the change in the FIB-4 index was evaluated among patients with NASH, using multivariate analysis. Among these factors, hepatocyte ballooning was associated with an increase in the FIB-4 index.ConclusionThe FIB-4 index was the best formula for estimating liver fibrosis in patients with biopsy-proven NAFLD, and the presence of ballooned hepatocytes was a risk factor for the progression of liver fibrosis.