Abstract
OBJECTIVE:With the increasing prevalence of steatosis, the number of steatotic liver grafts from deceased donors is also increasing. Thus, determining the prevalence and the population risk factors of steatosis may assist in risk stratification. The aim of this study was to evaluate the prevalence and predictors of steatosis and steatohepatitis among livers from adults who died due to non-burn trauma.METHODS:Specimens were collected from 224 adults undergoing autopsy at a regional autopsy referral center from September 2011 to April 2013. Histopathological examination was performed on six samples obtained from different lobes of each liver. The outcomes of interest were the presence of steatosis, steatohepatitis, NASH inflammation and NASH fibrosis. The main predictors were body mass index, abdominal circumference, liver weight and volume, presence of cholelithiasis, and siderosis. Our modeling strategy made use of a series of generalized linear models with a binomial family.RESULTS:Our sample had a mean age of 40 years; steatosis was diagnosed in 48.2% of cases, and steatohepatitis was diagnosed in 2.7%. The presence of a high proportion of fatty changes was more prevalent among males and older individuals, with the most affected age group being 41-60 years. When evaluating the crude odds ratio for steatosis, the factors significantly associated with an increased risk of steatosis were greater abdominal circumference, BMI, and liver weight and the presence of siderosis.CONCLUSION:Our study reinforces the role of older age, obesity and hepatomegaly as predictors of fatty liver disease. These variables should be considered in the assessment of fatty changes in the livers of potential liver donors.
Highlights
Steatosis or the abnormal retention of triglycerides and other fat vacuoles in hepatocytes is a common cause of hepatic disease [1]
Participant characteristics A total of 697 cases were assessed initially, with 225 excluded either because the time of death was more than 24 hours prior to autopsy, the hospitalization duration was over 24 hours, the liver was severely damaged by trauma, the cause of death was undetermined, the individual was younger than 18 years of age or the family did not provide consent
Steatosis was diagnosed in 48.2% of all cases, with steatohepatitis being detected in 2.7% of the cases (Table 1)
Summary
Steatosis or the abnormal retention of triglycerides and other fat vacuoles in hepatocytes is a common cause of hepatic disease [1]. It has a high prevalence among heavy alcohol drinkers [2], as well as those with diagnoses of hepatitis C infection [1], diabetes, and dyslipidemia and obese individuals [3]. Non-alcoholic fatty liver disease (NAFLD) can occur concomitantly with hepatocyte inflammation, in which case it is referred to as non-alcoholic steatohepatitis (NASH) [1,3]. Received for publication on November 27, 2018. Accepted for publication on July 17, 2019
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