Original Article
Analysis of clinicopathological characteristics of non-alcoholic fatty liver disease
Li Jiao, Yang Yefan, Sun Miaomiao, Gong Yingyun, Zhou Hongwen, Zhang Zhihong
Published 2023-05-08
Cite as Chin J Pathol, 2023, 52(5): 486-491. DOI: 10.3760/cma.j.cn112151-20221229-01080
Abstract
ObjectiveTo investigate the clinical and pathologic characteristics of obese adults with nonalcoholic fatty liver disease (NAFLD) and to aid the diagnosis of nonalcoholic steatohepatitis (NASH).
MethodsA total of 262 patients eligible for inclusion who received volume reduction metabolism surgery and liver biopsy in the First Affiliated Hospital of Nanjing Medical University from June 2018 to September 2019 were selected. HE staining, reticular fiber staining and Masson staining were performed. Statistical analysis was performed using SPSS 20.0.
ResultsThe patients ranged in age from 18 to 66 years. Among the 262 cases, 65 cases (65/262, 24.8%) were male and 197 cases (197/262, 75.2%) were female. Sixty-one cases (61/262, 23.3%) were non-NAFLD, 201 cases (201/262, 76.7%) were NAFLD including 27 cases (27/201, 13.4%) of nonalcoholic fatty live (NAFL) and 174 cases (174/201, 86.6%) of NASH. The main lesions of NAFLD were in hepatic acinus zone 3. There were significant differences in age, alanine aminotransferase (ALT), glutamic oxaloacetic transaminase (AST), body mass index (BMI), fasting blood-glucose (FPG) and apolipoprotein A (APOA) levels among the non-NAFLD group, NAFL group and NASH group (P<0.05). Patients with BMI≥35 m/kg2 combined with type 2 diabetes had a higher prevalence of NASH. Multiple logistic regression showed that ALT and APOA were independent predictors of NASH (P<0.001, OR=1.05, 95%CI: 1.020-1.082; P=0.027, OR=0.916, 95%CI: 0.878-0.941). Total cholesterol (CHO) and high-density lipoprotein (HDL) were independent predictors of lobular inflammation (P=0.043, 95%CI: 0.010-0.634; P=0.024, 95%CI:-3.068--0.216). AST and HDL were independent predictors of fibrosis stage (P=0.029, 95%CI: 0.001-0.021; P<0.001, 95%CI:-2.670--0.645).
ConclusionsBiochemical indicators of NAFLD are closely related to its pathology. The histological lesions of NAFLD are mainly present in hepatic acinar area 3. The diagnosis of NASH is supported by extensive steatosis and high levels of CHO, ALT, AST and BMI, low levels of HDL and ApoA in biochemical markers, but pathological examination is still the gold standard for it.
Key words:
Fatty liver; Histology; Pathology
Contributor Information
Li Jiao
Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Yang Yefan
Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Sun Miaomiao
Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Gong Yingyun
Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Zhou Hongwen
Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Zhang Zhihong
Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
