The non-invasive (13)C-methionine breath test detects hepatic mitochondrial dysfunction as a marker of disease activity in non-alcoholic steatohepatitis.
The non-invasive (13)C-methionine breath test detects hepatic mitochondrial dysfunction as a marker of disease activity in non-alcoholic steatohepatitis.
复制标题
DOI：
10.1186/2047-783x-16-6-258
复制
发表时间：
2011-06-21
影响因子：
4.2
通讯作者：
Goetze O
中科院分区：
文献类型：
--
作者：
Banasch M;Ellrichmann M;Tannapfel A;Schmidt WE;Goetze O
线粒体功能障碍在非酒精性脂肪性肝病（NAFLD）的一般发病机制中起着核心作用，增加了发生脂肪变性和随后肝细胞炎症的风险。我们的目的是评估肝线粒体功能的非侵入性13 C-蛋氨酸呼吸试验（MeBT）在组织学证实的NAFLD患者。对118例NAFLD患者和18例健康对照者进行MeBT检查。根据NASH评分系统评价肝活检标本。更高级别的NASH活动和纤维化与累积13 C-呼气（表示为cPDR（%））的显著减少独立相关。与单纯脂肪变性或临界诊断患者相比，NASH和NASH肝硬化患者的cPDR 1.5h显著降低（cPDR 1.5h：3.24 ± 1.12%和1.32 ± 0.94%分别vs. 6.36 ± 0.56%和4.80 ± 0.88%; p < 0.001）。在存在与NASH活性相关的晚期纤维化的情况下，13 C-呼气进一步下降（r = 0.36）。NASH诊断的ROC曲线下面积（AUROC）在总队列中估计为0.87，在无纤维化或轻度纤维化患者中估计为0.83（F0-1）。13 C-蛋氨酸呼气试验表明非酒精性脂肪肝患者的线粒体功能障碍，并预测疾病活动的更高阶段。因此，它可能是一个有价值的诊断补充纵向监测肝（线粒体）功能在非酒精性脂肪肝疾病。
Mitochondrial dysfunction plays a central role in the general pathogenesis of non-alcoholic fatty liver disease (NAFLD), increasing the risk of developing steatosis and subsequent hepatocellular inflammation. We aimed to assess hepatic mitochondrial function by a non-invasive 13C-methionine breath test (MeBT) in patients with histologically proven NAFLD. 118 NAFLD-patients and 18 healthy controls were examined by MeBT. Liver biopsy specimens were evaluated according to the NASH scoring system. Higher grades of NASH activity and fibrosis were independently associated with a significant decrease in cumulative 13C-exhalation (expressed as cPDR(%)). cPDR1.5h was markedly declined in patients with NASH and NASH cirrhosis compared to patients with simple steatosis or borderline diagnosis (cPDR1.5h: 3.24 ± 1.12% and 1.32 ± 0.94% vs. 6.36 ± 0.56% and 4.80 ± 0.88% respectively; p < 0.001). 13C-exhalation further declined in the presence of advanced fibrosis which was correlated with NASH activity (r = 0.36). The area under the ROC curve (AUROC) for NASH diagnosis was estimated to be 0.87 in the total cohort and 0.83 in patients with no or mild fibrosis (F0-1). The 13C-methionine breath test indicates mitochondrial dysfunction in non-alcoholic fatty liver disease and predicts higher stages of disease activity. It may, therefore, be a valuable diagnostic addition for longitudinal monitoring of hepatic (mitochondrial) function in non-alcoholic fatty liver disease.