Clinical significance of serum autoantibodies in patients with NAFLD: Results from the nonalcoholic steatohepatitis clinical research network

Raj Vuppalanchi, Robert J. Gould, Laura Wilson, Aynur Unalp-Arida, Oscar W. Cummings, Naga Chalasani, Kris V. Kowdley

Research output: Contribution to journalArticle

Abstract

Purpose Some studies have suggested that autoantibodies might define a subcategory and phenotype of nonalcoholic fatty liver disease (NAFLD) associated with advanced histological features. We evaluated the relationship between the presence of serum autoantibodies and liverhistology in a large cohort of well-characterized patients with NAFLD. Methods A total of 864 NAFLD patients participating in two prospective multicentre clinical studies underwent testing for serum autoantibodies within 24 months of a liver biopsy. Liver histology was compared between the patients with and without ANA C ≥: 160 or ASMA C ≥: 40 or both. Results Autoantibodies were present in 182 patients (21%). There was no difference in age, gender, race, body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR), or history of diabetes between the two groups. Biopsies in subjects with autoantibodies were less likely to have moderate-to-severe steatosis (i.e., >33%) compared to controls (57.1 vs. 43.0%, P value = 0.0006). Lobular inflammation (46.7 vs. 47.5%), ballooning degeneration (38.5 vs. 42.5%), and advanced fibrosis (33.2 vs. 29.3%) were not different between the two groups. Histologic evidence of 'definite' NASH did not differ significantly between the two groups (55.5 vs. 58.9%). After adjusting for age, gender, BMI, race, and diabetes, the presence of autoantibodies was independently associated with lower prevalence of moderate- to-severe steatosis [odds ratio (OR), 0.58; 95% confidence interval (CI), 0.41-0.82; P = 0.01]. Conclusion Autoantibodies are frequently positive in NAFLD in the absence of autoimmune hepatitis and their occurrence is not associated with more advanced histologic features.

Original languageEnglish (US)
Pages (from-to)379-385
Number of pages7
JournalHepatology International
Volume6
Issue number1
DOIs
StatePublished - Jan 2012

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Autoantibodies
Serum
Research
Body Mass Index
Biopsy
Autoimmune Hepatitis
Liver
Non-alcoholic Fatty Liver Disease
Multicenter Studies
Insulin Resistance
Histology
Homeostasis
Fibrosis
Odds Ratio
Confidence Intervals
Inflammation
Phenotype

Keywords

  • Autoantibodies
  • Liver histology
  • NAFLD
  • NASH

ASJC Scopus subject areas

  • Hepatology

Cite this

Clinical significance of serum autoantibodies in patients with NAFLD : Results from the nonalcoholic steatohepatitis clinical research network. / Vuppalanchi, Raj; Gould, Robert J.; Wilson, Laura; Unalp-Arida, Aynur; Cummings, Oscar W.; Chalasani, Naga; Kowdley, Kris V.

In: Hepatology International, Vol. 6, No. 1, 01.2012, p. 379-385.

Research output: Contribution to journalArticle

Vuppalanchi, Raj ; Gould, Robert J. ; Wilson, Laura ; Unalp-Arida, Aynur ; Cummings, Oscar W. ; Chalasani, Naga ; Kowdley, Kris V. / Clinical significance of serum autoantibodies in patients with NAFLD : Results from the nonalcoholic steatohepatitis clinical research network. In: Hepatology International. 2012 ; Vol. 6, No. 1. pp. 379-385.
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abstract = "Purpose Some studies have suggested that autoantibodies might define a subcategory and phenotype of nonalcoholic fatty liver disease (NAFLD) associated with advanced histological features. We evaluated the relationship between the presence of serum autoantibodies and liverhistology in a large cohort of well-characterized patients with NAFLD. Methods A total of 864 NAFLD patients participating in two prospective multicentre clinical studies underwent testing for serum autoantibodies within 24 months of a liver biopsy. Liver histology was compared between the patients with and without ANA C ≥: 160 or ASMA C ≥: 40 or both. Results Autoantibodies were present in 182 patients (21{\%}). There was no difference in age, gender, race, body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR), or history of diabetes between the two groups. Biopsies in subjects with autoantibodies were less likely to have moderate-to-severe steatosis (i.e., >33{\%}) compared to controls (57.1 vs. 43.0{\%}, P value = 0.0006). Lobular inflammation (46.7 vs. 47.5{\%}), ballooning degeneration (38.5 vs. 42.5{\%}), and advanced fibrosis (33.2 vs. 29.3{\%}) were not different between the two groups. Histologic evidence of 'definite' NASH did not differ significantly between the two groups (55.5 vs. 58.9{\%}). After adjusting for age, gender, BMI, race, and diabetes, the presence of autoantibodies was independently associated with lower prevalence of moderate- to-severe steatosis [odds ratio (OR), 0.58; 95{\%} confidence interval (CI), 0.41-0.82; P = 0.01]. Conclusion Autoantibodies are frequently positive in NAFLD in the absence of autoimmune hepatitis and their occurrence is not associated with more advanced histologic features.",
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AB - Purpose Some studies have suggested that autoantibodies might define a subcategory and phenotype of nonalcoholic fatty liver disease (NAFLD) associated with advanced histological features. We evaluated the relationship between the presence of serum autoantibodies and liverhistology in a large cohort of well-characterized patients with NAFLD. Methods A total of 864 NAFLD patients participating in two prospective multicentre clinical studies underwent testing for serum autoantibodies within 24 months of a liver biopsy. Liver histology was compared between the patients with and without ANA C ≥: 160 or ASMA C ≥: 40 or both. Results Autoantibodies were present in 182 patients (21%). There was no difference in age, gender, race, body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR), or history of diabetes between the two groups. Biopsies in subjects with autoantibodies were less likely to have moderate-to-severe steatosis (i.e., >33%) compared to controls (57.1 vs. 43.0%, P value = 0.0006). Lobular inflammation (46.7 vs. 47.5%), ballooning degeneration (38.5 vs. 42.5%), and advanced fibrosis (33.2 vs. 29.3%) were not different between the two groups. Histologic evidence of 'definite' NASH did not differ significantly between the two groups (55.5 vs. 58.9%). After adjusting for age, gender, BMI, race, and diabetes, the presence of autoantibodies was independently associated with lower prevalence of moderate- to-severe steatosis [odds ratio (OR), 0.58; 95% confidence interval (CI), 0.41-0.82; P = 0.01]. Conclusion Autoantibodies are frequently positive in NAFLD in the absence of autoimmune hepatitis and their occurrence is not associated with more advanced histologic features.

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