Microvesicular steatosis: a missed item in the management of nonalcoholic fatty liver disease?

ballooning injury macrovesicular steatosis megamitochondria microvesicular steatosis nonalcoholic fatty liver disease

Journal

Acta gastro-enterologica Belgica
ISSN: 1784-3227
Titre abrégé: Acta Gastroenterol Belg
Pays: Belgium
ID NLM: 0414075

Informations de publication

Date de publication:
Historique:
entrez: 15 12 2020
pubmed: 16 12 2020
medline: 18 12 2020
Statut: ppublish

Résumé

Nonalcoholic fatty liver disease (NAFLD) is among the most common causes of chronic liver disease and cirrhosis. In NAFLD, histological course of steatosis is usually macrovesicular (MacroS), but it may be accompanied by varying degrees of microvesicular steatosis (MicroS). Thus, in this study, we aimed to evaluate the prevalence and significance of MicroS in subjects with NAFLD. A retrospective analysis of clinical and laboratory data of patients with histologically proven NAFLD was performed. The liver biopsy specimens which stained with hematoxylin eosin, reticulin, and Masson's Trichrome stains were evaluated by single expert liver pathologist. Scoring and semiquantitative assessment of steatosis and NAFLD severity was done according to Kleiner scale known as NAFLD activity score (NAS). Grading for steatosis, steatosis type, zonal distribution of steatosis and other histological findings were also determined. The prevalence of MicroS among the study population (n= 191) was 30.4%. There was no difference regarding the demographic and biochemical parameters between patients with or without MicroS. On the other hand, the prevalence of ballooning injury and megamitochondria were higher in patients with MicroS (p= 0.019 and p= 0.036, respectively). There was a significant association of MicroS with ballooning injury (OR 2.65, 95% CI= 1.26-5.55 ; p= 0.005) and the presence of megamitochondria (OR 3.72, 95% CI= 1.00-13.72 ; p= 0.037). MicroS is common in patients with NAFLD and is associated with early histological findings in this clinically relevant condition. Further longitudinal studies are needed to characterize the role of MicroS in the natural history of NAFLD.

Sections du résumé

BACKGROUND BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is among the most common causes of chronic liver disease and cirrhosis. In NAFLD, histological course of steatosis is usually macrovesicular (MacroS), but it may be accompanied by varying degrees of microvesicular steatosis (MicroS). Thus, in this study, we aimed to evaluate the prevalence and significance of MicroS in subjects with NAFLD.
METHODS METHODS
A retrospective analysis of clinical and laboratory data of patients with histologically proven NAFLD was performed. The liver biopsy specimens which stained with hematoxylin eosin, reticulin, and Masson's Trichrome stains were evaluated by single expert liver pathologist. Scoring and semiquantitative assessment of steatosis and NAFLD severity was done according to Kleiner scale known as NAFLD activity score (NAS). Grading for steatosis, steatosis type, zonal distribution of steatosis and other histological findings were also determined.
RESULTS RESULTS
The prevalence of MicroS among the study population (n= 191) was 30.4%. There was no difference regarding the demographic and biochemical parameters between patients with or without MicroS. On the other hand, the prevalence of ballooning injury and megamitochondria were higher in patients with MicroS (p= 0.019 and p= 0.036, respectively). There was a significant association of MicroS with ballooning injury (OR 2.65, 95% CI= 1.26-5.55 ; p= 0.005) and the presence of megamitochondria (OR 3.72, 95% CI= 1.00-13.72 ; p= 0.037).
CONCLUSION CONCLUSIONS
MicroS is common in patients with NAFLD and is associated with early histological findings in this clinically relevant condition. Further longitudinal studies are needed to characterize the role of MicroS in the natural history of NAFLD.

Identifiants

pubmed: 33321012

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

565-570

Informations de copyright

© Acta Gastro-Enterologica Belgica.

Déclaration de conflit d'intérêts

The authors declare that they have no conflict of interest

Auteurs

G Celebi (G)

Department of Gastroenterology, Health Sciences University, Gulhane Medical School, Etlik, Ankara, 06010, Turkey.

A F Cicek (AF)

Department of Pathology, Health Sciences University, Gulhane Medical School, Etlik, Ankara, 06010, Turkey.

H Gurel (H)

Department of Gastroenterology, Education and Research Hospital, Ilkadim, Samsun, 55090, Turkey.

H Genc (H)

Department of Gastroenterology, Batigoz Hospital, Balcova, Izmir, 35330, Turkey.

A Kirik (A)

Department of Internal Medicine, Balikesir University Medical School, Cagis, Balikesir, 10145, Turkey.

C N Ercin (CN)

Department of Gastroenterology, Health Sciences University, Gulhane Medical School, Etlik, Ankara, 06010, Turkey.

T Dogru (T)

Department of Gastroenterology, Balikesir University Medical School, Cagis, Balikesir, 10145, Turkey.

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