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.
PY - 2012/1/1
Y1 - 2012/1/1
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
VL - 6
SP - 379
EP - 385
JO - Hepatology International
JF - Hepatology International
SN - 1936-0533
IS - 1
ER -