单位：[1]Liver Research Center, Beijing Friendship Hospital, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Capital Medical University, 95 Yong‑An Road, Xi‑Cheng District, Beijing 100050, China临床科室国家中心肝病分中心首都医科大学附属北京友谊医院[2]Clinical Epidemiology and EBM Unit, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, China医技科室北京市临床医学研究所国家消化中心（方法学平台）首都医科大学附属北京友谊医院[3]Indiana University Health Pathology Laboratory, Department of Pathology, Indiana University School of Medicine, 350 West 11th Street, #4014, Indianapolis, IN 46202, USA[4]Department of Pathology and Medical Biology, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands
Background and aims Non-alcoholic fatty liver disease (NAFLD) commonly affects subjects with obesity, yet non-obese NAFLD is increasingly being recognized. We aimed to investigate the clinicopathological and genetic characteristics of non-obese NAFLD patients. Methods The clinical, histological and genetic data of 84 NAFLD patients with biopsy for abnormal liver function test were reviewed. Both NAS-CRN and SAF scoring systems were applied for histopathological evaluation. PNPLA3 and TMS6F2 genotyping were also performed. Results All of the 84 patients were histologically diagnosed with non-alcoholic steatohepatitis (NASH), with 36 of them (42.9%) being non-obese (BMI < 25 kg/m2). Compared with the obese group, non-obese group were predominantly females (88.9% vs 52.1%, p < 0.001), tended to have higher prevalence of diabetes (p = 0.068). More importantly non-obese patients had a significant higher prevalence of advanced fibrosis (F = 3) (58.3% vs 29.2%, p = 0.013), and a trend of higher degree of ballooning (p = 0.061). In addition, values of liver stiffness measurement were also significantly higher in non-obese group (12.1 kPa vs 8.1 kPa, p = 0.032). There was also a trend of higher prevalence of TM6SF2 T allele in non-obese group (p = 0.085), while the prevalence of PNPLA3 risk allele did not differ between two groups. Multivariate analysis showed that higher fasting glucose (p = 0.038) and lower serum platelets (p = 0.040) were two independent predictors for advanced fibrosis in non-obese patients. Conclusions Non-obese NASH patients have a female predominance and more advanced fibrosis. Liver biopsy is crucial to evaluate the severity of disease in non-obese patients especially those with abnormal liver biochemistry. Clinical trial number NCT03386890.
基金：
Beijing Municipal Administration of Hospitals Clinical Medicine Development of special funding support [XMLX201606]; Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals [XXZ03]; Research Foundation of Beijing Friendship Hospital, Capital Medical University [yyqdkt2017-8]
第一作者单位：[1]Liver Research Center, Beijing Friendship Hospital, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Capital Medical University, 95 Yong‑An Road, Xi‑Cheng District, Beijing 100050, China
通讯作者：
推荐引用方式(GB/T 7714)：
Wang Qianyi,You Hong,Ou Xiaojuan,et al.Non-obese histologically confirmed NASH patients with abnormal liver biochemistry have more advanced fibrosis[J].HEPATOLOGY INTERNATIONAL.2019,13(6):766-776.doi:10.1007/s12072-019-09982-z.
APA：
Wang, Qianyi,You, Hong,Ou, Xiaojuan,Zhao, Xinyan,Sun, Yameng...&Jia, Jidong.(2019).Non-obese histologically confirmed NASH patients with abnormal liver biochemistry have more advanced fibrosis.HEPATOLOGY INTERNATIONAL,13,(6)
MLA：
Wang, Qianyi,et al."Non-obese histologically confirmed NASH patients with abnormal liver biochemistry have more advanced fibrosis".HEPATOLOGY INTERNATIONAL 13..6(2019):766-776
医学