Development of noninvasive procedure for diagnosis of NASH and of therapeutic strategy

NASH的病理特征与酒精性肝病本身最常见的病理特征有关。然而，肝活检是一种外科手术，严重的并发症是不可避免的，发生率很低。在这项研究中，我们研究寻找一种非侵入性的诊断NASH的方法。多因素分析显示，以肝/脾比值和50岁年龄定义的严重肝脂肪变性患者是两个最重要的因素。血浆铁蛋白和血小板计数也是诊断NASH的有用指标。静脉切割术是治疗铁蛋白水平升高的NASH的有效策略。使用二甲双胍和PPAR-γ配体的随机治疗试验正在进行中。

The pathological features of NASH are associated with the pathological features most commonly seen in alcoholic liver disease itself. However, liver biopsy is a surgical procedure and a serious complication is inevitable at a very low rate. In this study, we investigated to find a noninvasive procedure for a diagnosis of NASH. A multivariated analysis revealed that patients with severe hepatic steatosis defined by using liver/spleen ratio<0 and age>50 years old were two most important factors. Plasma ferritin and platelet number were also useful markers of NASH. Venosection was a useful strategy for NASH with elevated ferritin levels. Randomized therapeutic trial using metformin and PPAR-γ ligand is in process.