期刊
CLINICAL SCIENCE
卷 111, 期 2, 页码 135-143出版社
PORTLAND PRESS LTD
DOI: 10.1042/CS20050346
关键词
chronic liver disease; fatty liver; microsomal function; mitochondrial function; non-alcoholic steatohepatitis; obesity
Effectively assessing subtle hepatic metabolic functions by novel non-invasive tests might be of clinical utility in scoring NAFLD (non-alcoholic fatty liver disease) and in identifying altered metabolic pathways. The present study was conducted on 39 (20 lean and 19 obese) hypertransaminasemic patients with histologically proven NAFLD {ranging from simple steatosis to severe steatohepatitis [NASH (non-alcoholic steatohepatitis)] and fibrosis} and 28 (20 lean and eight overweight) healthy controls, who underwent stable isotope breath testing ([C-13]methacetin and [C-13]ketoisocaproate) for microsomal and mitochondrial liver function in relation to histology, serum hyaluronate, as a marker of liver fibrosis, and body size. Compared with healthy subjects and patients with simple steatosis, NASH patients had enhanced methacetin demethylation (P = 0.001), but decreased (P = 0.001) and delayed (P = 0.006) ketoisocaproate decarboxylation, which was inversely related (P = 0.001) to the degree of histological fibrosis (r = -0.701), serum hyaluronate (r = -0.644) and body size (r = -0.485). Ketoisocaproate decarboxylation was impaired further in obese patients with NASH, but not in patients with simple steatosis and in overweight controls. NASH and insulin resistance were independently associated With an abnormal ketoisocaproate breath test (P = 0.001). The cut-off value of 9.6% cumulative expired (CO2)-C-13 for ketoisocaproate at 60 min was associated with the highest prediction (positive predictive value, 0.90; negative predictive value, 0.73) for NASH, yielding an overall sensitivity of 68% and specificity of 94%. In conclusion, both microsomal and mitochondrial functions are disturbed in NASH. Therefore stable isotope breath tests may usefully contribute to a better and non-invasive characterization of patients with NAFLD.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据