Morphological basis for the assessment of steatosis, steatohepatitis and fibrosis in patients with non-alcoholic fatty liver disease associated with obesity and pathology of the biliary tract
Journal Title: Гастроентерологія - Year 2017, Vol 51, Issue 3
Abstract
Background. The purpose was to study the histopathological features of steatosis, steatohepatitis and liver fibrosis in fatty liver disease of non-alcoholic etiology and to establish the linkages between the degree of steatosis, histological markers of fibrosis and increase of body mass index (BMI) in patients with non-alcoholic hepatic steatosis (NAHS) and non-alcoholic steatohepatitis (NASH) associated with obesity and pathology of the biliary tract. Materials and methods. The study included 70 patients with non-alcoholic fatty liver disease (NAFLD), including 48 individuals with NAHS combined with obesity (group 1), and 22 patients with NASH and obesity (group 2). Depending on the degree of increase in BMI, patients with NAHS, NASH and associated obesity were divided into three groups: BMI 25–29.9 kg/m2 — overweight; BMI 30–34.9 kg/m2 — I degree obesity; BMI 35–39.9 kg/m2 — II degree obesity. For histological diagnosis of NAHS/NASH, as well as to determine the stage of liver fibrosis, we used МЕТАVIR and BRUNT criteria. Results. The dependence of the severity of hepatic steatosis on BMI was detected in patients with different clinical forms of fatty liver disease, which was confirmed by the results of correlation analysis: NAHS — rs = 0.798 (p < 0.001), NASH — rs = 0.678 (p < 0.001). With increasing BMI, fibrous processes are exacerbated, from the presence of F0 stage in overweight patients with NAHS to F3 stage in II degree obesity in patients with NASH. The coefficients of correlation between BMI and the stage of liver fibrosis are: in NAHS — rs = 0.464 (p < 0.001), in NASH — rs = 0.759 (p < 0.001). Conclusions. In most cases of NAHS (58.3 %) and NASH (45.4 %,) macrovesicular steatosis was identified. Patients with NAHS more often had F1 and F2 fibrosis stages (50.0 %), while patients with NASH — F2 and F3 stages of fibrosis (77.3 %). Mixed type of liver fibrosis is characteristic of the comorbid course of NAFLD.
Authors and Affiliations
Yu. M. Stepanov, A. Yu. Filippova
Keywords
Related Articles
- EP ID EP231301
- DOI 10.22141/2308-2097.51.3.2017.112636
- Views 70
- Downloads 0
Topicality of identification of free fatty acids pattern in biologic substrates n the diagnosis of gastroenterological diseases
The article shows the role of free fatty acids in the pathogenesis of metabolic and gastroenterological disorders. An expediency of gas chromatography method for determination of free fatty acids pattern in biologic samp...
Comprehensive therapy of gastroesophageal reflux disease combined with anxiety-depressive states in antiterrorist operation participants
Background. The purpose was to establish the incidence and severity of anxiety-depressive disorders in antiterrorist operation (ATO) participants with different clinical endoscopic forms of gastroesophageal reflux diseas...
Features of Colon Microbiocenosis and Faecal Calprotectin Level in Patients with Chronic Inflammatory Bowel Diseases Depending on the Nutritional Status
The article deals with an actual problem — the state of the microflora of the colon and faecal calprotectin level in patients with chronic inflammatory bowel diseases with different nutritional status. The study involve...
Clinical Case of Autoimmune Hepatitis in 59-year-old Woman with Effective Treatment with Budesonide
Autoimmune hepatitis is a necroinflammatory liver disease of unknown etiology. According to the histology the disease is characterized by lobular hepatitis, in blood chemistry — increasing the level of aspartate aminotra...
Morphological basis for the assessment of steatosis, steatohepatitis and fibrosis in patients with non-alcoholic fatty liver disease associated with obesity and pathology of the biliary tract
Background. The purpose was to study the histopathological features of steatosis, steatohepatitis and liver fibrosis in fatty liver disease of non-alcoholic etiology and to establish the linkages between the degree of st...