Differentiating non-alcoholic steatohepatitis (NASH) from simple steatosis: assessment and validation of novel metabolic markers of non-alcoholic fatty liver disease (NAFLD) severity

Abstract Objectives The aim of the study was to compare food patterns in patients with simple steatosis (SS) and non-alcoholic steatohepatitis (NASH). Methods Prospective study was approved by LEC and enrolled subjects with confirmed non-alcoholic fatty liver disease (SS or NASH group). Nutrilogic software (Nutrilogic, Russia) was used for diet assessment. Dietary patterns were assessed according to the Healthy Eating Index (HEI): amounts of the major groups of foods and food products (grains, fruits, vegetables, dairy products, meats, fats and confectioneries) consumption were compared to the levels described in the HEI, and individual deviation rates were obtained. Nonparametric statistics (Mann-Whitney U test) was used to compare deviation rates found in subjects of SS and NASH groups. Results Subjects in NASH group (n = 22) were younger (Mean ± SD: 48.6 ± 13.4 y.o.) than those in SS group (n = 156; 56.5 ± 12.3 y.o., P = 0.008). Main macronutrients consumption did not differ between the groups. Although dietary patterns of major groups of foods consumption did not differ between SS and NASH groups, analysis of the foods subgroups revealed dissimilarity in the structure of vegetables and fats consumption. Patients with NASH consumed larger amounts of potatoes (0.14 ± 0.08 vs 0.11 ± 0.15, P = 0.006), and lower – of onions (0.02 ± 0.03 vs 0.07 ± 0.1, P = 0.006); they also consumed lower amounts of dairy butter (0.14 ± 0.44 vs 0.15 ± 0.21, P = 0.009) compared to subjects with simple steatosis. No other difference in the structure of vegetables (beans, root crops, leafy and other vegetables), fats (animal fats, vegetable oils, margarines) and other major groups of foods consumption was revealed. Conclusions Dietary patterns of patients with non-alcoholic steatohepatitis and simple steatosis differ. The obtained results may help in diet modification in patients with NAFLD in case of confirmation in larger multicenter trials. Funding Sources Russian Science Foundation, grant #1976-30014.

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372 USEFULNESS OF SERUM HIGH-SENSITIVITY CRP MEASUREMENT IN DIFFERENTIATING NON-ALCOHOLIC STEATOHEPATITIS AND SIMPLE STEATOSIS IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE

Journal of Hepatology ◽

10.1016/s0168-8278(10)60374-1 ◽

2010 ◽

Vol 52 ◽

pp. S154

Author(s):

S. Siramolpiwat ◽

C. Pramoolsinsap ◽

N. Wisedopas

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

High Sensitivity ◽

Alcoholic Fatty Liver ◽

Simple Steatosis ◽

Alcoholic Steatohepatitis ◽

Alcoholic Fatty Liver Disease

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Correlation of serum aspartate aminotransferase level to platelet count ratio index with non-alcoholic fatty liver disease activity score

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v12i3.43327 ◽

2019 ◽

Vol 12 (3) ◽

pp. 142-145

Author(s):

Dulal Chandra Das ◽

Shahinul Alam ◽

Sheikh Mohammad Noor-E-Alam ◽

Mohammed Kamal ◽

Forhadul H. Mollah ◽

...

Keyword(s):

Platelet Count ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Simple Steatosis ◽

Alcoholic Steatohepatitis ◽

Serum Aspartate Aminotransferase ◽

The Mean ◽

Alcoholic Fatty Liver Disease

In case of non-alcoholic fatty liver disease, the ratio of serum aspartate aminotransferase (AST) level to platelet count index has been proposed as a non-invasive and readily available tool for the assessment of non-alcoholic steatohepatitis. The study was conducted on 50 non-alcoholic fatty liver disease patient (25 non-alcoholic steatohepatitis and 25 simple steatosis). The mean (± SD) serum AST level in the non-alcoholic steatohepatitis group was 55.2 ± 30.1 IU/L whereas in simple steatosis group it was 33.6 ± 20.0 IU/L. The mean platelet count in the non-alcoholic steatohepatitis group was 303.1 ± 68.7 x 109 /L whereas in the simple steatosis group it was 327.8 ± 66.8 x 109/L. The mean AST platelet ratio index (APRI) score in non-alcoholic steatohepatitis group was 0.5 ± 0.3 and in the simple steatosis group it was 0.3 ± 0.2. In conclusion, the APRI was significantly higher in the non-alcoholic steatohepatitis group than the simple steatosis group.

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The Relevance of Noninvasive Tools To Assess Fibrosis in Non-Alcoholic Fatty Liver Disease

Current Pharmaceutical Design ◽

10.2174/1381612826666200521133307 ◽

2020 ◽

Vol 26 (32) ◽

pp. 3928-3938

Author(s):

Grazia Pennisi ◽

Ciro Celsa ◽

Antonina Giammanco ◽

Federica Spatola ◽

Salvatore Petta

Keyword(s):

Liver Disease ◽

Liver Biopsy ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Assessment Tools ◽

Hepatic Decompensation ◽

Alcoholic Fatty Liver ◽

Simple Steatosis ◽

Life Threatening ◽

Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is a growing cause of chronic liver diseases worldwide, involving about 25% of people. NAFLD incorporates a large spectrum of pathological conditions, from simple steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis and its complications include hepatic decompensation and hepatocellular carcinoma (HCC). This progression occurs, over many years, in an asymptomatic way, until advanced fibrosis appears. Thus, the differentiation of NASH from simple steatosis and identification of advanced hepatic fibrosis are key issues. To date, the histological assessment of fibrosis with liver biopsy is the gold standard, but obviously, invasiveness is the greater threshold. In addition, rare but potentially life-threatening complications, poor acceptability, sampling variability and cost maybe restrict its use. Furthermore, due to the epidemic of NAFLD worldwide and several limitations of liver biopsy evaluation, noninvasive assessment tools to detect fibrosis in NAFLD patients are needed.

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Prevalence, diagnosis and treatment with 3 different statins of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis in military personnel. Do genetics play a role?

Current Vascular Pharmacology ◽

10.2174/1570161118666201015152921 ◽

2020 ◽

Vol 18 ◽

Author(s):

Georgios Sfikas ◽

Michael Psallas ◽

Charalambos Koumaras ◽

Konstantinos Imprialos ◽

Evangelos Perdikakis ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Military Personnel ◽

Fatty Liver Disease ◽

Exercise Group ◽

Severe Form ◽

Laboratory Evaluation ◽

Alcoholic Fatty Liver ◽

Alcoholic Steatohepatitis ◽

Alcoholic Fatty Liver Disease

Background: Non-alcoholic fatty liver disease (NAFLD) and its severe form, non-alcoholic steatohepatitis (NASH), are major health problems worldwide. Genetics may play a role in the pathogenesis of NAFLD/NASH. Aim: To investigate the prevalence of NAFLD/NASH in 5,400 military personnel and evaluate the effect of treatment with 3 statins on NAFLD/NASH using 2 non-invasive scores [NAFLD Activity Score (NAS); Fibrosis-4 score (FIB-4)]. Methods: During the mandatory annual medical check-up, military personnel underwent a clinical and laboratory evaluation. Participants with NAFLD/NASH were randomised to 4 groups (n=151 each): dietexercise, atorvastatin, rosuvastatin or pitavastatin for 1 year (i.e. until the next routine evaluation). Results: From all the participants, 613 had NAFLD/NASH (prevalence 11.3 vs 39.8% in the general population, p<0.001); 604 consented to participate in the study. After a year of treatment, the diet-exercise group showed no significant changes in both scores (NAS 4.98 baseline vs 5.62, p=0.07; FIB-4 3.42 vs 3.52, p=0.7). For the atorvastatin group, both scores were reduced (NAS 4.97 vs 1.95, p<0.001, FIB-4 3.56 vs 0.83, p<0.001), for rosuvastatin (NAS 5.55 vs 1.81, p<0.001, FIB-4 3.61 vs 0.79, p<0.001), and for pitavastatin (NAS 4.89 vs 1.99, p<0.001, FIB-4 3.78 vs 0.87, p<0.001). Conclusions : Atorvastatin, rosuvastatin and pitavastatin have a beneficial and safe effect in NAFLD/NASH patients as recorded by the improvement in the NAS (representing NAFLD activity) and FIB-4 (representing liver fibrosis) scores. Since both those with and without NAFLD/NASH shared several baseline characteristics, genetics may play a role in the pathogenesis of NAFLD/NASH and its treatment with statins.

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