Microvesicular Steatosis in Individuals with Obesity: a Histological Marker of Non-alcoholic Fatty Liver Disease Severity.

Autor: Germano CW; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, SP, CEP 13085-000, Campinas, Brazil., Mega PF; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, SP, CEP 13085-000, Campinas, Brazil., Mattosinho TJAP; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, SP, CEP 13085-000, Campinas, Brazil., Dias LLC; School of Medicine, Pontíficia Universidade Católica de Campinas (PUCCAMP), Campinas, Brazil., Gestic MA; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, SP, CEP 13085-000, Campinas, Brazil., Utrini MP; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, SP, CEP 13085-000, Campinas, Brazil., Chaim FDM; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, SP, CEP 13085-000, Campinas, Brazil., Callejas-Neto F; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, SP, CEP 13085-000, Campinas, Brazil., Chaim EA; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, SP, CEP 13085-000, Campinas, Brazil., Cazzo E; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, SP, CEP 13085-000, Campinas, Brazil. notrevezzo@yahoo.com.br.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2023 Mar; Vol. 33 (3), pp. 813-820. Date of Electronic Publication: 2023 Jan 24.
DOI: 10.1007/s11695-023-06467-9
Abstrakt: Background: In non-alcoholic fatty liver disease (NAFLD), steatosis can manifest through two distinct forms: macrovesicular (macroS) and microvesicular (microS).
Objective: To investigate the prevalence of microS and its association with biochemical parameters and NAFLD-related histological findings in individuals with obesity.
Methods: This is an observational retrospective cross-sectional study, enrolling individuals who underwent bariatric surgery and liver biopsy at a university hospital. A 1:2 propensity matching was performed to pair microS with isolated macroS; this matching enrolled variables "age," "gender," "body mass index (BMI)," and "obesity-associated medical problems." Clinical, biochemical, and histopathological aspects were then analyzed and compared.
Results: Of 115 participants, 88.7% were female; average age was 40.5 ± 5 years and mean BMI was 37.9 ± 3.3 kg/m 2 . Steatosis occurred in 82.6% (67.8% isolated macroS and 14.8% microS). MicroS is significantly associated with higher levels of alanine aminotransferase (ALT) (39.8 ± 26.4 vs. 26.7 ± 17.5; p = 0.04) and glucose (103.8 ± 52.6 vs. 83.3 ± 10.8; p = 0.03) and higher frequencies of moderate to severe macroS (41.2% vs. 2.0%; p < 0.001), portal fibrosis (100% vs. 50%; p < 0.001), perisinusoidal fibrosis (100% vs. 55.9%; p < 0.001), lobular inflammation (100% vs. 41.1%; p < 0.001), and portal inflammation (100% vs. 41.1%; p < 0.001). An independently positive association was observed between intensities of microS and macroS (p < 0.001).
Conclusion: MicroS is significantly associated with higher levels of ALT and glucose and higher frequencies of moderate to severe macroS, hepatocellular ballooning, portal fibrosis, perisinusoidal fibrosis, lobular inflammation, and portal inflammation. These findings indicate that microS could be considered a reliable histological marker of NAFLD severity.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: