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.
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.
Authors: Raj Vuppalanchi; Oscar W Cummings; Romil Saxena; Thomas M Ulbright; Nikhil Martis; David R Jones; Navin Bansal; Naga Chalasani Journal: J Clin Gastroenterol Date: 2007-02 Impact factor: 3.062
Authors: David E Kleiner; Elizabeth M Brunt; Mark Van Natta; Cynthia Behling; Melissa J Contos; Oscar W Cummings; Linda D Ferrell; Yao-Chang Liu; Michael S Torbenson; Aynur Unalp-Arida; Matthew Yeh; Arthur J McCullough; Arun J Sanyal Journal: Hepatology Date: 2005-06 Impact factor: 17.425
Authors: Mary E Rinella; Richard McCarthy; Kiran Thakrar; John Paul Finn; Sambasiva M Rao; Alan J Koffron; Michael Abecassis; Andres T Blei Journal: Liver Transpl Date: 2003-08 Impact factor: 5.799
Authors: James E Nelson; Laura Wilson; Elizabeth M Brunt; Matthew M Yeh; David E Kleiner; Aynur Unalp-Arida; Kris V Kowdley Journal: Hepatology Date: 2010-11-29 Impact factor: 17.425
Authors: Elizabeth K Speliotes; Johannah L Butler; Cameron D Palmer; Benjamin F Voight; Joel N Hirschhorn Journal: Hepatology Date: 2010-09 Impact factor: 17.425
Authors: Stephen Caldwell; Yoshihiro Ikura; Daniela Dias; Kosuke Isomoto; Akito Yabu; Christopher Moskaluk; Patcharin Pramoonjago; Winsor Simmons; Harriet Scruggs; Nicholas Rosenbaum; Timothy Wilkinson; Patsy Toms; Curtis K Argo; Abdullah M S Al-Osaimi; Jan A Redick Journal: J Hepatol Date: 2010-06-25 Impact factor: 25.083
Authors: Marianna Argentou; Dina G Tiniakos; Menelaos Karanikolas; Maria Melachrinou; Maria G Makri; Christos Kittas; Fotis Kalfarentzos Journal: Obes Surg Date: 2009-07-15 Impact factor: 4.129