Predictors reflecting the pathological severity of non-alcoholic fatty liver disease: Comprehensive study of clinical and immunohistochemical findings in younger Asian patients
Predictors reflecting the pathological severity of non-alcoholic fatty liver disease: Comprehensive study of clinical and immunohistochemical findings in younger Asian patients
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DOI：
10.1111/j.1440-1746.2006.04758.x
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发表时间：
2007-04-01
影响因子：
4.1
通讯作者：
Park, Sill Moo
中科院分区：
文献类型：
--
作者：
Park, Joong-Won;Jeong, Gyu;Park, Sill Moo
背景和目的：非酒精性脂肪性肝病（NAFLD）的范围从单纯性脂肪变性到重度脂肪性肝炎（NASH）。我们研究的目的是确定临床预测区分NASH脂肪变性和研究NASH的发病机制在一个年轻的韩国population.Methods：临床和生化变量从39活检NAFLD患者进行了回顾性分析。所有肝活检标本均行免疫组化检测Kupffer细胞（CD 68、CD 14）、肿瘤坏死因子-α（TNF-α）和线粒体解偶联蛋白2（UCP-2）的表达。NASH（28.4 +/- 3.4 kg/m2）和脂肪变性（25.8 +/- 2.8 kg/m2）患者的体重指数（BMI）值（kg/m2）之间存在显著差异（P < 0.025），BMI 28.9 kg/m2代表区分NASH和脂肪变性患者的最佳阈值。BMI与肝纤维化程度显著相关（P < 0.01）。CD 68 + Kupffer细胞在NASH患者肝脏中的表达明显高于对照组（P < 0.05），TNF-α和UCP-2在所有NASH患者肝脏中均有表达，且与炎症和纤维化程度相关（P < 0.05）。高BMI和低丙氨酸氨基转移酶（ALT）值倾向于提示NASH中存在严重的纤维化，而CD 68 + Kupffer细胞的数量以及TNF-α和UCP-2的染色强度与NAFLD患者的一般病理严重程度相关。
Background and Aims: The spectrum of non-alcoholic fatty liver disease (NAFLD) ranges from simple steatosis to severe steatohepatitis (NASH). The aim of our study was to identify clinical predictors distinguishing NASH from steatosis and to study the pathogenesis of NASH in a young Korean population.Methods: Clinical and biochemical variables from 39 biopsied NAFLD patients were retrospectively analyzed. All liver biopsy specimens were immunohistochemically examined for Kupffer cells (CD68, CD 14), as well as expression of tumor necrosis factor-alpha (TNF-alpha) and mitochondrial uncoupling protein 2 (UCP-2).Results: There were no significant differences in serum biochemistry between the two groups (15 steatosis vs 24 NASH). There was a significant difference between the body mass index (BMI) values (kg/m(2)) of the NASH (28.4 +/- 3.4 kg/m(2)) and steatosis (25.8 +/- 2.8 kg/m(2)) patients (P < 0.025), with a BMI of 28.9 kg/m(2) representing the best threshold for distinguishing NASH from steatosis patients. BMI was significantly related to the degree of fibrosis (P < 0.01). CD68+ Kupffer cells were more common in the livers of NASH patients (P < 0.05), and TNF-alpha and UCP-2 were expressed in all NASH specimens and were related with the severity of inflammation and fibrosis (P < 0.05).Conclusions: BMI could be used to distinguish NASH from steatosis in younger Korean patients. A high BMI with a low alanine aminotransferase (ALT) value tended to suggest the presence of severe fibrosis in NASH, while the number of CD68+ Kupffer cells and the staining intensity of TNF-alpha and UCP-2 were correlated with general pathologic severity in patients with NAFLD.