TY - JOUR
T1 - Clinical significance of serum autoantibodies in patients with NAFLD
T2 - Results from the nonalcoholic steatohepatitis clinical research network
AU - Vuppalanchi, Raj
AU - Gould, Robert J.
AU - Wilson, Laura A.
AU - Unalp-Arida, Aynur
AU - Cummings, Oscar W.
AU - Chalasani, Naga
AU - Kowdley, Kris V.
N1 - Funding Information:
Acknowledgements The authors declare that they do not have anything to disclose regarding funding from industries or conflicts of interest with respect to this manuscript. This work is supported by the National Institute of Diabetes & Digestive & Kidney Diseases and the National Institute of Child health and Human Development. A list of members of the Nonalcoholic Steatohepatitis Clinical Research Network is located in Appendix. The Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (grants U01DK061718, U01DK061728, U01DK061731, U01DK061732, U01DK061734, U01DK061737, U01DK061738, U01DK061730, U01DK061713), and the National Institute of Child Health and Human Development (NICHD). Several clinical centres use support from General Clinical Research Centres or Clinical and Translational Science Awards in conduct of NASH CRN Studies (grants UL1RR024989, M01RR000750, M01RR00188, UL1RR02413101, M01RR000827, UL1RR02501401, M01RR000065, M01RR020359, DK-02957-KK).
PY - 2012/1
Y1 - 2012/1
N2 - 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.
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.
KW - Autoantibodies
KW - Liver histology
KW - NAFLD
KW - NASH
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U2 - 10.1007/s12072-011-9277-8
DO - 10.1007/s12072-011-9277-8
M3 - Article
C2 - 21557024
AN - SCOPUS:84862903129
SN - 1936-0533
VL - 6
SP - 379
EP - 385
JO - Hepatology International
JF - Hepatology International
IS - 1
ER -