The relationship of serum bilirubin level with histopathological parameters in patients with nonalcoholic fatty liver disease

Abstract

Objectives: Non-alcoholic fatty liver disease (NAFLD) is among the most common causes of chronic liver disease and is known as a part of metabolic syndrome (MetS), and the role of bilirubin in the pathogenesis of NAFLD is unclear. This study aimed to evaluate the relationship between bilirubin levels and histopathological findings in patients with NAFLD having no confounding factors such as morbid obesity, diabetes mellitus (DM), and hypertension.
 Methods: A retrospective analysis of clinical and laboratory data of patients with biopsy-proven NAFLD was performed. The relationship between the bilirubin levels and histopathologic findings was evaluated. 
 Results: The subjects in the nonalcoholic steatohepatitis (NASH) group had greater AST (p < 0.001) and ALT (p < 0.001) levels than the non-NASH group. We found no difference between NASH and non-NASH groups regarding bilirubin levels. The levels of AST (p = 0.001), ALT (p = 0.011), insulin (p = 0.029), and HOMA-IR index (p = 0.027) were higher in fibrosis group comparing non-fibrosis group. However, bilirubin levels were not different comparing the fibrosis and non-fibrosis group. We couldn’t find any relation between bilirubin levels and other parameters in correlation analysis. 
 Conclusion: We couldn’t find any relation between the bilirubin levels and histopathological findings of the patient with NAFLD having no confounding factors such as morbid obesity, DM, and hypertension. The difference, shown in the other studies, may be the effect of other diseases related to MetS.