OBJECTIVES: Few published studies have examined the results obtained from repeat liver biopsies in obese patients with nonalcoholic fatty liver disease (NAFLD). The progressive form of this disease may be largely limited to a subgroup of NAFLD patients with nonalcoholic steatohepatitis (NASH). The presence of intralobular fibronectin (Fn) and other variables was investigated in relation to subsequent fibrosis progression. METHODS: In this prospective study, 271 obese patients admitted to the hospital with NAFLD and abnormal liver enzymes were scheduled to undergo a repeat liver biopsy at least 5 years after the initial biopsy. After excluding cirrhotic patients, basal biopsy specimens obtained from patients who underwent a second liver biopsy were stained with antibodies against Fn. The progression of fibrosis in the follow-up sample was correlated with the amount of Fn and other clinicopathological variables. RESULTS: We obtained a second liver biopsy from 149 patients after a median time of 6.4 years. Of these, 132 showed suitable Fn staining for semi-quantitative assessments. In all, 44 out of 83 patients (53%) with basal NASH showed fibrosis progression by at least one stage in the second liver biopsy. The amount of Fn (odds ratio=14.1; P<0.001), a diagnosis of hypertension (odds ratio=4.8; P=0.028), and homeostasis model assessment parameter of insulin resistance (HOMA-IR) scores (>8, odds ratio=1.9; P=0.004) were independent predictive factors of worsening fibrosis. CONCLUSIONS: A semi-quantitative assessment of the amount of parenchymal Fn present at an early stage in obese patients with NASH is valuable for predicting the progression of fibrosis. Similarly, lobular Fn deposition may be a sensitive and early indicator of active fibrogenetic processes in the liver. Hypertension and higher HOMA-IR scores are other clinical independent risk factors that predict the progression of fibrosis.
OBJECTIVES: Few published studies have examined the results obtained from repeat liver biopsies in obesepatients with nonalcoholic fatty liver disease (NAFLD). The progressive form of this disease may be largely limited to a subgroup of NAFLD patients with nonalcoholic steatohepatitis (NASH). The presence of intralobular fibronectin (Fn) and other variables was investigated in relation to subsequent fibrosis progression. METHODS: In this prospective study, 271 obesepatients admitted to the hospital with NAFLD and abnormal liver enzymes were scheduled to undergo a repeat liver biopsy at least 5 years after the initial biopsy. After excluding cirrhotic patients, basal biopsy specimens obtained from patients who underwent a second liver biopsy were stained with antibodies against Fn. The progression of fibrosis in the follow-up sample was correlated with the amount of Fn and other clinicopathological variables. RESULTS: We obtained a second liver biopsy from 149 patients after a median time of 6.4 years. Of these, 132 showed suitable Fn staining for semi-quantitative assessments. In all, 44 out of 83 patients (53%) with basal NASH showed fibrosis progression by at least one stage in the second liver biopsy. The amount of Fn (odds ratio=14.1; P<0.001), a diagnosis of hypertension (odds ratio=4.8; P=0.028), and homeostasis model assessment parameter of insulin resistance (HOMA-IR) scores (>8, odds ratio=1.9; P=0.004) were independent predictive factors of worsening fibrosis. CONCLUSIONS: A semi-quantitative assessment of the amount of parenchymal Fn present at an early stage in obesepatients with NASH is valuable for predicting the progression of fibrosis. Similarly, lobular Fn deposition may be a sensitive and early indicator of active fibrogenetic processes in the liver. Hypertension and higher HOMA-IR scores are other clinical independent risk factors that predict the progression of fibrosis.
Authors: Trevor W Reichman; George Therapondos; Maria-Stella Serrano; John Seal; Rachel Evers-Meltzer; Humberto Bohorquez; Ari Cohen; Ian Carmody; Emily Ahmed; David Bruce; George E Loss Journal: World J Hepatol Date: 2015-06-18
Authors: José G González-González; Jorge R Violante-Cumpa; Miguel Zambrano-Lucio; Erick Burciaga-Jimenez; Patricia L Castillo-Morales; Mariano Garcia-Campa; Ricardo César Solis; Alejandro D González-Colmenero; René Rodríguez-Gutiérrez Journal: High Blood Press Cardiovasc Prev Date: 2022-10-01
Authors: Elisabeth M Meier; Lisa Rein-Fischboeck; Rebekka Pohl; Josef Wanninger; Andrew J Hoy; Thomas Grewal; Kristina Eisinger; Sabrina Krautbauer; Gerhard Liebisch; Thomas S Weiss; Christa Buechler Journal: Mol Cell Biochem Date: 2016-06-23 Impact factor: 3.396
Authors: April M Chow; Mingqian Tan; Darwin S Gao; Shu Juan Fan; Jerry S Cheung; Kwan Man; Zheng-Rong Lu; Ed X Wu Journal: Invest Radiol Date: 2013-01 Impact factor: 6.016