Izvorni znanstveni članak
Predictors of Nonalcoholic Steatohepatitis in Patients with Elevated Alanine Aminotransferase Activity
Željko Puljiz
; Department of Gastroenterology, University Hospital Center Split, Split, Croatia
Davor Štimac
; Department of Gastroenterology, University Hospital Center Rijeka, Rijeka, Croatia
Dražen Kovač
; Clinical Institute of Pathology, University Hospital Center Rijeka, Rijeka, Croatia
Mario Puljiz
; University Hospital for Tumors, Zagreb, Croatia
Andro Bratanić
; Department of Gastroenterology, University Hospital Center Split, Split, Croatia
Vedran Kovačić
; Department of Gastroenterology, University Hospital Center Split, Split, Croatia
Duško Kardum
; Institute of Gastroenterology, University Hospital Dubrava, Zagreb,Croatia
Damir Bonacin
; Department of Gastroenterology, University Hospital Center Split, Split, Croatia
Izet Hozo
; Department of Gastroenterology, University Hospital Center Split, Split, Croatia
Sažetak
Incidence of obesity and hepatic steatosis is increasing worldwide. Almost one quarter of western countries population suffer from non alcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the frequency and predictors of nonalcoholic steatohepatitis (NASH) in patients with unexplained alanine aminotransferase activity elevation (ALT), and therefore avoid unnecessary biopsies in cases of simple steatosis. Earlier studies provided different results and have not answered the question how to distinguish NASH from simple steatosis. Ultrasound (US), computed tomography (CT) and magnetic resonance (MRI) can detect steatosis with great sensitivity level, but not NASH. This study included 50 patients (18 women and 32 men) with mean age 43±9 years, and with defined selected biochemical, anthropometric and hormone biomarkers. The average BMI was 27.1±3.81 (kg/m2), insulin resistance HOMA IR 3.89± 3.81. All patients underwent liver biopsy and NASH was staged by NASH activity score (NAS) from 1 to 8. Results are compared to pathohistological finding as relevant method. The results show that 90% of patients (n=45) had NAFLD (minimal stage at least), and 15 (30%) had nonalcoholic steatohepatitis (NASH). High triglyceride, low HDL and high ferritin serum levels correspond with NASH. As in earlier studies, insulin resistance as basic mechanism of NAFLD and NASH was confirmed.
Ključne riječi
fatty liver; steatohepatitis; metabolic syndrome; insulin resistance
Hrčak ID:
51722
URI
Datum izdavanja:
25.3.2010.
Posjeta: 1.933 *