Abstract
BackgroundNonalcoholic steatohepatitis (NASH) progresses from simple nonalcoholic fatty liver (NAFL) and has a poor prognosis. Abnormal lipid metabolism is closely related to the occurrence and development of nonalcoholic fatty liver disease (NAFLD). This study aimed to study the relationships between serum lipid metabolites and NASH, and to improve the early diagnosis of NASH.MethodsThis study included 86 NAFLD patients (23 NASH and 63 NAFL), and 81 unaffected individuals as controls from West China Hospital between October 2018 and May 2019. With lipid metabolites as the focus of the study, the differences in lipid metabolites were compared between the control group, NAFL patients, and NASH patients. Logistic regression analysis was used to examine the risk factors of NASH. Finally, receiver operating characteristic curve (ROC curve) was used to analyze the efficacy of the metabolites in NASH prediction.ResultsThe levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lipoprotein A (LPA) increased with the severity of NAFLD. In NAFLD patients, LPA (OR:1.61; 95%CI: 1.03–2.52) was a potential risk factor for NASH, and ROC analysis showed that the combination of LPA, ALT, and AST had a greater predictive efficiency for NASH.ConclusionsAbnormal apolipoprotein/lipoprotein is closely related to lipid metabolism disorder in patients with NAFLD. In NAFL, the combination of LPA, ALT, and AST contributes to predicting the occurrence of NASH. LPA may be a potential biomarker and therapeutic target for diagnosing and treating NASH.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is a clinical and pathological syndrome characterized by excessive intracellular fat deposition [1], which is closely related to heredity and environment [2]
This study aimed to examine the predictive value of serum lipid metabolites in Nonalcoholic steatohepatitis (NASH), and to improve the early detection of NASH
For patients who had nonalcoholic fatty liver disease (NAFLD) but without indications of liver biopsy, experienced clinicians will comprehensively judge the condition of the patients based on the results of ultrasound examination, hepatic biochemical indicators, and hepatic transient elastic imaging techniques (e.g., Fibroscan), and include the patients meeting the requirements in nonalcoholic fatty liver (NAFL) group
Summary
Nonalcoholic fatty liver disease (NAFLD) is a clinical and pathological syndrome characterized by excessive intracellular fat deposition [1], which is closely related to heredity and environment [2]. NAFLD includes two pathologically distinct conditions with different prognoses: nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH) [7]. NAFL rarely progresses [8], whereas NASH can lead to cirrhosis and even liver cancer [4]. This differential prognosis makes early identification of NASH and NAFL important. This study aimed to examine the predictive value of serum lipid metabolites in NASH, and to improve the early detection of NASH. Nonalcoholic steatohepatitis (NASH) progresses from simple nonalcoholic fatty liver (NAFL) and has a poor prognosis. Abnormal lipid metabolism is closely related to the occurrence and development of nonalcoholic fatty liver disease (NAFLD). This study aimed to study the relationships between serum lipid metabolites and NASH, and to improve the early diagnosis of NASH
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