TY - JOUR
T1 - Relationship of steatosis grade and zonal location to histological features of steatohepatitis in adult patients with non-alcoholic fatty liver disease
AU - Chalasani, Naga
AU - Wilson, Laura
AU - Kleiner, David E.
AU - Cummings, Oscar W.
AU - Brunt, Elizabeth M.
AU - Ünalp, Aynur
N1 - Funding Information:
Authors declare no relevant conflicts of interest. This work is supported by the National Institute of Diabetes & Digestive & Kidney Diseases (Grants U01 DK 061713, UO1 DK 061718, U01 DK 061728, U01 DK 061730, U01 DK 061731, U01 DK 061732, U01 DK 061734, U01 DK 061737, U01 DK 061738) and the National Institute of Child Health and Human Development.
PY - 2008/5
Y1 - 2008/5
N2 - Background/Aims: The relationship between severity and zonal location of steatosis and the presence of steatohepatitis and various histological features that define NASH has not been formally studied. Methods: We conducted a study to examine the relationship of severity and zonal location of steatosis to the presence of NASH and to other histological features that define NASH in adult patients with NAFLD. Steatosis was graded as mild, moderate or severe. We examined the relationship between severity and zonal location of steatosis and the following: lobular inflammation, presence of ballooning, Mallory bodies, fibrosis score, and definite steatohepatitis. Results: Mild, moderate and severe steatosis was present in 44%, 31% and 25% of biopsies, respectively. Definite steatohepatitis was present in 59% and advanced fibrosis in 29% of liver biopsies. Increasing levels of steatosis severity were positively associated with lobular inflammation (p < 0.0001), zone 3 fibrosis (p < 0.001), and definite steatohepatitis (p = 0.02), but were unrelated to ballooning, Mallory bodies, or advanced fibrosis. As compared to zone 3 steatosis, pan-acinar steatosis was more often associated with ballooning, Mallory bodies, and advanced fibrosis. Conclusions: Patients with severe steatosis are more likely to have steatohepatitis. More studies are needed to confirm this observation and to explore its significance.
AB - Background/Aims: The relationship between severity and zonal location of steatosis and the presence of steatohepatitis and various histological features that define NASH has not been formally studied. Methods: We conducted a study to examine the relationship of severity and zonal location of steatosis to the presence of NASH and to other histological features that define NASH in adult patients with NAFLD. Steatosis was graded as mild, moderate or severe. We examined the relationship between severity and zonal location of steatosis and the following: lobular inflammation, presence of ballooning, Mallory bodies, fibrosis score, and definite steatohepatitis. Results: Mild, moderate and severe steatosis was present in 44%, 31% and 25% of biopsies, respectively. Definite steatohepatitis was present in 59% and advanced fibrosis in 29% of liver biopsies. Increasing levels of steatosis severity were positively associated with lobular inflammation (p < 0.0001), zone 3 fibrosis (p < 0.001), and definite steatohepatitis (p = 0.02), but were unrelated to ballooning, Mallory bodies, or advanced fibrosis. As compared to zone 3 steatosis, pan-acinar steatosis was more often associated with ballooning, Mallory bodies, and advanced fibrosis. Conclusions: Patients with severe steatosis are more likely to have steatohepatitis. More studies are needed to confirm this observation and to explore its significance.
KW - NAS
KW - NASH
KW - NASH CRN
KW - Non-alcoholic fatty liver disease
KW - Steatosis
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U2 - 10.1016/j.jhep.2008.01.016
DO - 10.1016/j.jhep.2008.01.016
M3 - Article
C2 - 18321606
AN - SCOPUS:40949141827
SN - 0168-8278
VL - 48
SP - 829
EP - 834
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 5
ER -