| Autor: |
Mattias Ekstedt, Stergios Kechagias, Thierry Poynard, J. Dixon, E. Fassio, R. Olsson, Elisabetta Bugianesi, Vlad Ratziu, Frédéric Charlotte |
| Rok vydání: |
2007 |
| Předmět: |
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| Zdroj: |
Alimentary Pharmacology & Therapeutics. 26:821-830 |
| ISSN: |
0269-2813 |
| DOI: |
10.1111/j.1365-2036.2007.03425.x |
| Popis: |
Background: In non-alcoholic fatty liver disease, histological lesions display a significant sampling variability that is ignored when interpreting histological progression during natural history or therapeutic interventions. Aim: To provide a method taking into account sampling variability when interpreting crude histological data, and to investigate how this alters the conclusions of available studies. Methods: Natural history studies detailing histological progression and therapeutic trials were compared with the results of a previously published sampling variability study. Results: Natural history studies showed an improvement in steatosis, which was significantly higher than expected from sampling variability (47% vs. 8%, P < 0.0001). In contrast, no study showed a change in activity grade or ballooning higher than that of sampling variability. There was only a marginal effect on fibrosis with no convincing demonstration of a worsening of fibrosis, a conclusion contrary to what individual studies have claimed. Some insulin sensitizing drugs and anti-obesity surgery significantly improved steatosis, while most did not significantly impact on fibrosis or activity. Conclusions: Sampling variability of liver biopsy is an overlooked confounding factor that should be considered systematically when interpreting histological progression in patients with non-alcoholic fatty liver disease. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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