Percentage Of Steatosis Research Articles

Euphorbia milii and propolis combination tea reduced hepatic steatosis and hepatocyte apoptosis in high-fat diet rat model

Background: Dyslipidemia can cause various organ disorders, such as fatty liver disease. Over time, fatty liver disease has become more commonplace worldwide and may cause mortality if the progression worsens. Natural components from Euphorbia milii (E. milii) and propolis (EMP) have been demonstrated as immunomodulators that reduce total cholesterol levels.Objective: To prove the effect of EMP tea on inhibiting fatty liver and hepatocyte apoptosis in high-fat diet (HFD)-induced rats.Methods: This study applied a post-test-only control group design using 18 Wistar rats, which were divided into three groups: K0 (received standard feed), KN (received HFD of 2 g/200 g Body weight (BW) in a day), and P (received HFD of 2 g/200 g BW in a day and EMP of tea 40 mg/100 g BW in a day). The interventions were conducted for 30 days, followed by termination on day 31 for liver tissue collection and analysis. We calculated the hepatic steatosis with the help of hematoxylin-eosin (HE) staining. Hepatocyte apoptosis was also determined with terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining.Results: The K0 group had a lower hepatic steatosis percentage (17.87 ± 1.81) than KN (63.75 ± 15.88). We also found no hepatocyte apoptosis in the K0 but a high hepatocyte apoptosis index in the KN (3.98 ± 0.29). The combination of EMP tea in HFD-induced rats significantly reduced hepatic steatosis and apoptosis percentage (25.33 ± 1.17 and 0.91 ± 0.61, respectively). Conclusion: We demonstrated that combining EMP tea reduced hepatic steatosis and hepatocyte apoptotic index in HFD-induced rats, suggesting its potential as a treatment for these conditions.

Prevalence and predictors of hepatic steatosis among HIV patients with and without chronic hepatitis C

Background and purpose of the studyHepatic steatosis (HS) is a common and important histologic finding in patients with chronic hepatitis C virus (HCV) infection. However, little is known about this finding in HCV patients co-infected with human immunodeficiency virus (HIV).Purpose of the studyTo evaluate the prevalence and predictors of HS among HIV patients with and without HCV.MethodsA cross-sectional including 47 HIV mono-infected and 50 HIV/HCV patients. Detailed demographic, laboratory and clinical data were collected. A transient elastography (TE) examination with the controlled attenuation parameter (CAP) was performed for all patients. Steatosis was scored on a scale from 0 to 3 according to the percentage of steatosis involving hepatocytes.ResultsHS was detected in 18 /50 (36%) HIV/HCV co-infected patients and 22 /47 (46.8%) HIV mono-infected patients. In addition, HCV mono-infected patients were more likely to have grade 2 steatosis as compared with HIV/HCV co-infected individuals (25.5% vs. 12%). LSM was significantly higher among HIV/HCV co-infected patients (p = 0.003). When dividing HIV/HCV co-infected and HIV mono-infected group according to CAP values. BMI, abdominal wall thickness, and bright liver were significantly associated with SHS (CAP ≥ 238 dB/m) in both groups. Diabetes was only significantly associated with SHS in HIV/HCV co-infected group BMI was the only independent predictor of SHS among the whole group and subgroup analysis.ConclusionThe prevalence of HS was lower in HIV/HCV co-infected patients compared to HIV mono-infected patients; we cannot say that HCV has a protective role against HS in co-infected patients. More fibrosis progression was common in the HIV/HCV co-infected patients.

Histopatologi Hepar Tikus Dengan Induksi Pakan Tinggi Lemak Setelah Pemberian Biji Mahoni

High accumulation of lipids in hepatocytes can trigger an increase in the production of radical compounds, leading to fatty liver disease. This condition induces histological changes in the liver, especially in hepatocytes, and affects the surrounding structures. Mahogany seeds have the potential to act as a hypolipidemic agent in treating fatty liver. Mahogany seeds are known to contain phytochemical compounds which act as antioxidants. This study aimed to determine liver histopathology of rats by inducing high-fat diet after giving mahogany seeds ethanol extract which was observed through the percentage of steatosis, hepatocyte diameter, and hepatosomatic index. This study involved thirty male Sprague Dawley rats, divided into 6 groups: P0 (given commercial feed), P1 (given high-fat diet), P2 (given high-fat diet and simvastatin at a dose of 8 mg/200 g BW), P3, P4, and P5 (given high-fat diet and mahogany seeds ethanol extract at a dose of 14, 28, and 56 mg/200 g BW). The results showed that the hepatosomatic index among all treatment groups did not differ significantly; however, the percentage of steatosis and hepatocyte diameter in the groups given mahogany seeds ethanol extract significantly differed from the group given only high-fat feed. Based on these results, it can be concluded that mahogany seed ethanol extract can maintain the histological structure of the liver in male Sprague Dawley rats with fatty liver. Keywords: hepatocyte, hepatosomatic index, high-fat diet, mahogany seeds, steatosis

Liver damage of autopsied patients with acquired immunodeficiency syndrome and antirretroviral therapy effect

Aim: To evaluate steatosis percentage and hepatic interstitial fibers of autopsied patients with Acquired Immunodeficiency Syndrome (AIDS), relating to the use of antiretroviral therapy (ART). Methods: 62 liver fragments from patients with and without AIDS autopsied from 1996 to 2017, matched by age (18-49), gender and race. These patients were divided in two groups: patients with AIDS (n=31) and patients without AIDS (n=31). Patients with AIDS were analyzed according to treatment on ART (n=15) or non-ART (n=16). In the histomorphometric analysis sections were made and stained with hematoxylin-eosin, picrosirius and reticulin for steatosis, type I and type III collagen analysis, respectively. Results: Patients with AIDS showed significantly larger steatosis percentage (26.05 vs 21.95%, p<0.001), type I collagen (1.63 vs 1.01%, p<0.001) and type III collagen (8.68 vs 7.83%, p<0.001). Patients with AIDS on ART showed significantly lower steatosis percentage (25.45 vs 26.36%, p<0.001) and type I collagen (1.52 vs 1.75%, p<0.001). Patients with AIDS on ART showed lower percentage of type III collagen (8.52 vs 8.77%, p<0.96), however it was not statistically significant. Conclusion: AIDS increases in hepatocyte fat accumulation and steatosis and liver fibrosis. However, ART has a decreased beneficial role in hepatocyte fat accumulation and fibrosis development since the medication detains both processes.

Association between Transfusion-Related Iron Overload and Liver Fibrosis in Survivors of Pediatric Leukemia: A Cross-Sectional Study.

Patients who receive frequent blood transfusions are at an elevated risk of developing hepatic fibrosis due to iron overload in the liver. In this study, we evaluated the effectiveness of transient elastography (TE) (FibroScan®) for assessing liver fibrosis in patients with pediatric cancer. We enrolled 106 consecutive cases of acute leukemia in individuals under 21 years of age. The participants were followed for 2 years. Based on their serum ferritin (SF) levels, the patients were divided into two groups: group 1 (SF≥300 ng/mL) and group 2 (SF<300 ng/mL). A liver FibroScan® was performed, and a p-value of less than 0.05 was considered statistically significant. Among the various parameters in the liver function test (LFT), alkaline phosphatase was significantly higher in a subgroup of patients aged 5-8 years in group 2 compared to those in group 1. The indices of liver fibrosis determined by TE, including the FibroScan score, controlled attenuation parameter score, steatosis percentage, and meta-analysis of histological data in viral hepatitis score, as well as indirect serum markers of liver fibrosis such as the aminotransferase (AST)/alanine aminotransferase (ALT) ratio, Fibrosis 4 score, and AST to platelet ratio index, did not differ significantly between the two groups. The association between the TE results and LFT parameters was only significant for ALT. Transfusion-associated iron overload does not have a significant correlation with severe liver fibrosis. FibroScan® is not a sensitive tool for detecting early stages of fibrosis in survivors of pediatric leukemia.

Digital imaging software versus the "eyeball" method in quantifying steatosis in a liver biopsy.

Steatotic livers represent a potentially underutilized resource to increase the donor graft pool; however, 1 barrier to the increased utilization of such grafts is the heterogeneity in the definition and the measurement of macrovesicular steatosis (MaS). Digital imaging software (DIS) may better standardize definitions to study posttransplant outcomes. Using HALO, a DIS, we analyzed 63 liver biopsies, from 3 transplant centers, transplanted between 2016 and 2018, and compared macrovesicular steatosis percentage (%MaS) as estimated by transplant center, donor hospital, and DIS. We also quantified the relationship between DIS characteristics and posttransplant outcomes using log-linear regression for peak aspartate aminotransferase, peak alanine aminotransferase, and total bilirubin on postoperative day 7, as well as logistic regression for early allograft dysfunction. Transplant centers and donor hospitals overestimated %MaS compared with DIS, with better agreement at lower %MaS and less agreement for higher %MaS. No DIS analyzed liver biopsies were calculated to be >20% %MaS; however, 40% of liver biopsies read by transplant center pathologists were read to be >30%. Percent MaS read by HALO was positively associated with peak aspartate aminotransferase (regression coefficient= 1.04 1.08 1.12 , p <0.001), peak alanine aminotransferase (regression coefficient = 1.04 1.08 1.12 , p <0.001), and early allograft dysfunction (OR= 1.10 1.40 1.78 , p =0.006). There was no association between HALO %MaS and total bilirubin on postoperative day 7 (regression coefficient = 0.99 1.01 1.04 , p =0.3). DIS provides reproducible quantification of steatosis that could standardize MaS definitions and identify phenotypes associated with good clinical outcomes to increase the utilization of steatite livers.

Reduced Wheel Running via a High-Fat Diet Is Reversed by a Chow Diet with No Added Benefit from Fecal Microbial Transplants.

Chronic overfeeding via a high-fat/high-sugar (HFHS) diet decreases wheel running and substantially alters the gut metabolome of C57BL/6J mice. In this study, we tested the hypothesis that fecal microbial transplants can modulate the effect of diet on wheel running. Singly housed, 6-wk-old male C57BL/6J mice were fed either a grain-based diet (CHOW) or HFHS diet and provided a running wheel for 13 wk. Low-active, HFHS-exposed mice were then either switched to a CHOW diet and given an oral fecal microbial transplant from mice fed the CHOW diet, switched to a CHOW diet and given a sham transplant, or remained on the HFHS diet and given a fecal microbial transplant from mice fed the CHOW diet. Total wheel running, nutrient intake, body composition, fecal microbial composition, fecal metabolite composition, and liver steatosis were measured at various times throughout the study. We found that an HFHS diet decreases wheel running activity, increases body fat, and decreases microbial alpha diversity compared with a CHOW diet. Improvements in wheel running, body composition, and microbial alpha diversity were accomplished within 2 wk for mice switched from an HFHS diet to a CHOW diet with no clear evidence of an added benefit from fecal transplants. A fecal transplant from mice fed a CHOW diet without altering diet did not improve wheel running or body composition. Wheel running, body composition, fecal microbial composition, fecal metabolite composition, and liver steatosis percentage were primarily determined by diet. Our results suggest that diet is a primary mediator of wheel running with no clear effect from fecal microbial transplants.

A Simple Rapid Method for Measuring Liver Steatosis Using Bioelectrical Impedance.

Easy measurement of liver steatosis without pathological diagnosis may help improve donor surgery efficiency and increase the chances of organ donations. We analyzed the correlations between bioelectrical impedance (BI) in human livers, liver fat content, and pathological findings. Sixteen tumor-free liver specimens resected during elective oncological surgery were analyzed. All samples were stored in ice chilled saline before BI measurement. The BI measurement was performed using a device with the tetrapolar circuit method in which the current and voltage electrodes are independent. Liver cholesterol and triglyceride levels were investigated from the same specimen using the Soxhlet extraction method. Pathological findings were examined by counting the number of hepatocytes with fatty changes per high-power field. The median liver steatosis percentage was 0.4%. The liver steatosis percentage was significantly correlated with the intrahepatic triglyceride content (r=0.82, p<0.001). Linear regression of the measurements and predicted values yielded an r2 of 0.63 between the BI at 100 kHz and liver steatosis, indicating reasonable agreement (p<0.001). BI analysis is a simple, non-invasive method that can be easily applied to evaluate liver steatosis.

Review of Clinical Guidelines in the Diagnosis of Pediatric Nonalcoholic Fatty Liver Disease.

Review of Clinical Guidelines in the Diagnosis of Pediatric Nonalcoholic Fatty Liver Disease.

Gastric Bypass Increases Circulating Bile Acids and Activates Hepatic Farnesoid X Receptor (FXR) but Requires Intact Peroxisome Proliferator Activator Receptor Alpha (PPARα) Signaling to Significantly Reduce Liver Fat Content

BackgroundWe interrogate effects of gastric bypass (RYGB), compared with a low-calorie diet, on bile acid (BA), liver fat, and FXR, PPARα, and targets in rats with obesity and non-alcoholic fatty liver disease (NAFLD). MethodsMale Wistar rats received a high-fat diet (obese/NAFLD, n=24) or standard chow (lean, n=8) for 12 weeks. Obese/NAFLD rats had RYGB (n=11), sham operation pair-fed to RYGB (pair-fed sham, n=8), or sham operation (sham, n=5). Lean rats had sham operation (lean sham, n=8). Post-operatively, five RYGB rats received PPARα antagonist GW6417. Sacrifice occurred at 7 weeks. We measured weight changes, fasting total plasma BA, and liver % steatosis, triglycerides, and mRNA expression of the nuclear receptors FXR, PPARα, and their targets SHP and CPT-I. ResultsAt sacrifice, obese sham was heavier (p<0.01) than all other groups that had lost similar weight loss. Obese sham had lower BA levels and lower hepatic FXR, SHP, and CPT-I mRNA expression than lean sham (P<0.05, for all comparisons). RYGB had increased BA levels compared with obese and pair-fed sham (P<0.05, for both), while pair-fed sham had BA levels, similar to obese sham. Compared with pair-fed sham, RYGB animals had increased liver FXR and PPARα expression and signaling (P<0.05). Percentage of steatosis was lower in RYGB and lean sham, relative to obese and pair-fed sham (P<0.05, for all comparisons). PPARα inhibition after RYGB resulted in similar weight loss but higher liver triglyceride content (P=0.01) compared with RYGB alone. ConclusionsRYGB led to greater liver fat loss than low-calorie diet, an effect associated to increased fasting BA levels and increased expression of modulators of liver fat oxidation, FXR, and PPARα. However, intact PPARα signaling was necessary for resolution of NAFLD after RYGB.

Doppler perfusion index in adolescents with non-alcoholic fatty liver disease

Introduction: Non-alcoholic fatty liver disease (NAFLD) as a multi-factorial disorder is the most common cause of abnormal liver function tests in adolescents. Objectives: The present study aimed to assess Doppler perfusion index (DPI) in adolescents with NAFLD as compared with healthy subjects. Patients and Methods: Thirty-seven adolescents with NAFLD and 25 healthy individuals were enrolled in the study. Hemodynamic indices were measured using a color Doppler ultrasound machine. Severity of fatty liver disease and steatosis grade were assessed using FibroScan. The measured indices were peak systolic velocity (PSV), resistive index (RI), end-diastolic velocity (EDV), time-averaged mean velocity (TAMV), time-averaged peak velocity (TAPV), portal venous blood flow (PVBF) volume, hepatic arterial blood flow (HABF) volume, and DPI. Results: The mean of DPI in the case and control groups was 0.31±0.11 and 0.31±0.09, respectively (P=0.972). HABF volume was significantly lower in the case group as compared with the control group (103.8 versus 153.3 respectively, P=0.015). PSV, TAMV, mean velocity, and PVBF volume were significantly lower in the case group as compared with the control group (P&lt;0.05). Patients with a higher steatosis grade indicated a significantly lower mean of PSV and TAMV portal than controls (P&lt;0.05). Conclusion: DPI was similar in adolescents with NAFLD and healthy subjects and was not associated with severity of fatty liver disease and steatosis grade. In addition, the percentage of steatosis would be increased with increased liver span.

Links between donor macrosteatosis, interleukin-33 and complement after liver transplantation.

BACKGROUNDAs prevalence of nonalcoholic fatty liver disease increases in the population, livers with steatosis will continue to infiltrate the donor pool. Safe utilization of these extended criteria grafts is paramount given the increased risk associated with their use in transplantation. Prognostic factors that can predict liver dysfunction immediately after transplantation with macrosteatotic grafts are lacking.AIMTo understand the relationship between interleukin-33 (IL-33) and complement in recipients immediately following liver reperfusion as a marker of liver dysfunction.METHODSCohort consisted of patients who received a liver transplant from September 2016–September 2019 at our institution. Clinical variables were retrospectively extracted from the electronic medical record. Back-table donor biopsies were obtained with donor steatosis percentage retrospectively determined by a board-certified pathologist. Blood samples were available immediately following liver transplantation. Quantification of plasma IL-33 and complement proteins, C3a and C5a, were determined by enzyme-linked immunosorbent assay. For mRNA expression, RNA was extracted from donor biopsies and used against a 780 gene panel.RESULTSCohort consisted of 99 donor and recipients. Donor median age was 45 years and 55% male. Recipients had a median age of 59 years with 62% male. The main etiologies were alcoholic hepatitis, nonalcoholic steatohepatitis, and hepatocellular carcinoma. Median MELD-Na at transplant was 21. Donors were grouped based on moderate macrosteatosis (≥ 30%). Recipients implanted with moderate macrosteatotic grafts had significantly higher peak alanine aminotransferase/aspartate aminotransferase (P < 0.001 and P < 0.004), and increased incidence of early allograft dysfunction (60% compared to 18%). Circulating IL-33 levels were significantly elevated in recipients of ≥ 30% macrosteatotic grafts (P < 0.05). Recipients with detectable levels of circulating IL-33 immediately following reperfusion had significantly higher alanine aminotransferase/aspartate aminotransferase (P < 0.05 and P < 0.01). Activated complement (C3a and C5a) were elevated in recipients implanted with moderate macrosteatotic grafts. RNA expression analysis of donor biopsies revealed moderate steatotic grafts upregulated genes inflammatory processes while downregulated hepatocyte-produced complement factors.CONCLUSIONCirculating IL-33 and activated complement levels immediately following liver reperfusion in recipients of moderate macrosteatotic grafts may identify which patients are at risk of early allograft dysfunction.

Fully automated quantitative assessment of hepatic steatosis in liver transplants

BackgroundThe presence of macro- and microvesicular steatosis is one of the major risk factors for liver transplantation. An accurate assessment of the steatosis percentage is crucial for determining liver graft transplantability, which is currently based on the pathologists’ visual evaluations on liver histology specimens. MethodThe aim of this study was to develop and validate a fully automated algorithm, called HEPASS (HEPatic Adaptive Steatosis Segmentation), for both micro- and macro-steatosis detection in digital liver histological images. The proposed method employs a hybrid deep learning framework, combining the accuracy of an adaptive threshold with the semantic segmentation of a deep convolutional neural network. Starting from all white regions, the HEPASS algorithm was able to detect lipid droplets and classify them into micro- or macrosteatosis. ResultsThe proposed method was developed and tested on 385 hematoxylin and eosin (H&E) stained images coming from 77 liver donors. Automated results were compared with manual annotations and nine state-of-the-art techniques designed for steatosis segmentation. In the TEST set, the algorithm was characterized by 97.27% accuracy in steatosis quantification (average error 1.07%, maximum average error 5.62%) and outperformed all the compared methods. ConclusionsTo the best of our knowledge, the proposed algorithm is the first fully automated algorithm for the assessment of both micro- and macrosteatosis in H&E stained liver tissue images. Being very fast (average computational time 0.72 s), this algorithm paves the way for automated, quantitative and real-time liver graft assessments.

Ultrasound-based lipid content quantification using double Nakagami distribution model in rat liver steatosis

Quantitative ultrasound (QUS) methods have been widely used for soft tissue characterization. Spatial resolution (i.e. ultrasound frequency) is an important factor for QUS methods. In a previous study, a double Nakagami (DN) distribution model to echo signals from fatty livers using a 15 MHz transducer was used to permit fine-resolution QUS. This study used a filtering approach to quantify steatosis progression using three QUS parameters obtained by fitting a DN distribution model to experimental envelope data. The filter was designed using QUS parameters obtained from three healthy liver. A strong correlation (r = 0.96, p < 0.001) was found between histologically quantified steatosis percentage and the percentage of the liver having non-healthy liver features. This approach was able to successfully diagnose fatty livers (>20% steatosis percentage) in a dataset of 12 livers ranging from 0% to 90% steatosis.

Evaluation of Sucrose‐enriched Diet Consumption in the Development of Risk Factors Associated to Type 2 Diabetes, Atherosclerosis and Non‐alcoholic Fatty Liver Disease in a Murine Model

IntroductionOverconsumption of sucrose has been associated with negative metabolic effects related to non‐communicable diseases. However, this relationship continues to be a controversial topic and further studies are needed to generate scientific evidence to help clarify existing questions and which can be used in the future for the implementation of prevention and control strategies of this important health problem.ObjectiveThe aim of this study was to evaluate the sucrose‐enriched diet consumption in the development of risk factors associated to type 2 diabetes, atherosclerosis and non‐alcoholic fatty liver disease in a murine model.MethodologyTwelve healthy male Wistar rats were randomly divided into two experimental groups (n=6 each) which received one of two different diets for twenty five weeks. Control group (CG) was fed with a standard laboratory diet and tap water. Sucrose group (SG) received the same laboratory diet and water enriched with 50% w/v of sucrose. Body weight, food, macronutrient and total caloric intake were determined. After intervention period, blood samples, hepatic and aortic tissues were collected. Glucose, insulin, total cholesterol, triglycerides, very low‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol levels were determined in serum. Insulin resistance was calculated and total hepatic cholesterol was measured. Histopathological analysis was made for liver and aortic tissues. Results of parametric tests were expressed as mean values ± standard errors of the mean and for non‐parametric tests, results were expressed as medians and ranks. A p value of &lt; 0.05 was considered significant.ResultsSucrose‐enriched diet‐fed rats showed a decrease in food, lipids and protein intake as well as in serum total cholesterol levels, an increase in carbohydrates intake, glucose, insulin, triglycerides, very low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol levels, the development of insulin resistance, a higher percentage of steatosis and a greater degree of non‐alcoholic steatohepatitis. No significant differences were found in body weight, total caloric intake, low‐density lipoprotein cholesterol and hepatic cholesterol between the experimental groups. In aortic tissue samples, both groups showed a slight wall thickening.ConclusionOur results show that sucrose‐enriched diet consumption during twenty five weeks contribute to the development of risk factors associated to type 2 diabetes, atherosclerosis and non‐alcoholic fatty liver disease in male Wistar rats.

Evaluation of Plateletcrit and Platelet Distribution Width in Patients with Non-Alcoholic Fatty Liver Disease: A Retrospective Chart Review Study.

BackgroundPlatelets are considered to be essential in proinflammatory environments, including atherosclerosis. The degree of platelet activation has been demonstrated to be correlated with plateletcrit and platelet distribution width. The main purpose of this study was to assess the relationship between plateletcrit (PCT), platelet distribution, and the degree of hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD).Material/MethodsWe enrolled 225 biopsy-proven NAFLD patients and 142 control subjects without NAFLD. NAFLD patients were separated into 2 groups according to percentage of steatosis. Demographic and clinical data were collected retrospectively.ResultsPCT level was significantly higher in NAFLD group I and group II than in the control group. PCT was higher in the NAFLD groups than in the control group. However, there was no difference according to PCT and PDW levels between NAFLD groups.ConclusionsIn this study, a relationship was found between PCT and hepatosteatosis, but no relationship was found with PDW. PCT might be a useful biomarker for early detection of steatohepatitis in patients with nan-alcoholic fatty liver disease.

Comparing hepatic steatosis distribution patterns between non-alcoholic fatty liver disease and fatty liver disease with chronic hepatitis B by second-harmonic generation/two-photon excited fluorescence method

Introduction and objectivesHepatitis B virus (HBV) might be an etiological factor modulating fat distribution in steatotic livers. We aim to compare hepatic steatosis distribution patterns between NAFLD and FL&CHB patients with second-harmonic generation (SHG)/two-photon excited fluorescence (TPEF) method. Patients and methods42 patients with NAFLD, 46 with FL&CHB and 55 without steatosis were enrolled in the study. Overall and regional steatosis in liver sections were quantified by SHG/TPEF method. The accuracy of which was validated by pathologist evaluation and magnetic resonance spectroscopy (MRS). Difference in degree of overall and regional steatosis between NAFLD and FL&CHB groups was analyzed by Mann–Whitney U test. Multivariable linear regression analysis was used to model factors contributing to steatosis distribution. ResultsThe hepatic steatosis measured by SHG/TPEF method was highly correlated with pathologist grading (r=0.83, p<0.001) and MRS measurement (r=0.82, p<0.001). The level of overall steatosis in FL&CHB group is significantly lower than that in NAFLD group (p<0.001). In NAFLD group, periportal region has significantly lower steatosis percentage than lobule region and overall region (p<0.001); while in FL&CHB group there is no difference among regions. The ratio of steatosis at periportal region to lobule region is significantly higher in FL&CHB group than that in NAFLD group (p<0.05). Multivariable linear regression analysis shows that HBV infection is the major contributing factor (β=0.322, p<0.01). ConclusionsSHG/TPEF method is an accurate and objective method in hepatic steatosis quantification. By quantifying steatosis in different histological regions, we found steatosis distribution patterns are different between FL&CHB and NAFLD patients.

Sitagliptin-Dependent Differences in the Intensity of Oxidative Stress in Rat Livers Subjected to Ischemia and Reperfusion.

Purpose Ischemia/reperfusion (IR) is the main cause of liver damage after transplantation. We evaluated the effect of sitagliptin (STG) on oxidative stress parameters in the rat liver under IR. Methods Rats were treated with STG (5 mg/kg) (S and SIR) or saline solution (C and CIR). Livers from CIR and SIR were subjected to ischemia (60 min) and reperfusion (24 h). During reperfusion, aminotransferases (ALT and AST) were determined in blood samples. Thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), catalase (CAT), paraoxonase-1 (PON1), glutathione peroxidase (GPx), and the mRNA expression of SOD1 were determined in liver homogenates after reperfusion. Different regions of livers were also histologically evaluated. Results The PON1 activity was higher, and the TBARS level was lower in SIR than in CIR. There was an inverse relationship between TBARS and PON1 levels in the whole cohort. The GPx activity was lower in ischemic than in nonischemic groups regardless of the STG treatment. In SIR, the SOD1 activity was higher compared to that in CIR. In S, the expression of SOD1 mRNA was the highest of all examined groups and positively correlated with the SOD1 activity in the whole animal cohort. During IR aminotransferases, the activity in the drug-treated group was lower in all examined points of time. In drug-treated groups, the percentage of steatosis was higher than that in nontreated groups regardless of IR. Conclusions The protective effect of STG on the rat liver, especially its antioxidant properties, was revealed under IR conditions.

1139 High Prevalence of Non-Alcoholic Steatohepatitis in Veterans With Non Alcoholic Fatty Liver Disease Undergoing Sleeve Gastrectomy

INTRODUCTION: Sleeve gastrectomy leads to significant weight loss and improves features of metabolic syndrome. The prevalence of non-alcoholic fatty liver disease (NAFLD) in the general population undergoing bariatric surgery is reported at 84% -95%. Prevalence of Non Alcoholic Steatohepatitis (NASH) in this population is 25%- 50%. Around 10% of these patients have advanced fibrosis at the time of surgery. The prevalence of NAFLD/NASH or advanced fibrosis in the veteran population undergoing sleeve gastrectomy has not been previously reported. NASH may be underrecognized prior to time of surgery, particularly if there are no associated laboratory abnormalities. This study aims to assess the prevalence of NASH and advanced fibrosis in veterans undergoing sleeve gastrectomy. METHODS: This is a retrospective study of 39 patients who underwent sleeve gastrectomy between January 1, 2018- April 30, 2019 at a Veterans Affairs Hospital. Patients with known alcohol use, cirrhosis or without liver biopsy at the time of surgery were excluded. A single pathologist reviewed the liver biopsies and provided a NASH Activity Score (NAS) for each sample. A Fib 4 score and NAFLD fibrosis score were calculated. Summary statistics was used to determine the prevalence of NAFLD at time of surgery. RESULTS: Patients baseline characteristics are outlined in Table 1. Only 13% of patients had an abnormal ALT at the time of surgery. There was no evidence of liver synthetic dysfunction with normal INR, bilirubin and albumin. Median NAFLD fibrosis score was -0.8 and median FIB-4 was 0.9 which rules out advance fibrosis. 59% of patients had NAFLD and 61% of these patients had evidence of NASH on pathologic exam. Advanced fibrosis was seen in 8% of patients. 70% of patients had NAS score of 4 or below. Percentage of steatosis, inflammation, ballooning and fibrosis score have been summarized in Table 2. CONCLUSION: More than half of our NAFLD patients had characteristics features of NASH on biopsy. This is higher than reported in the general population and close to what has been reported in diabetic patients. However, prevalence of diabetes in the NAFLD patients was only 26%, which would not explain the high number of NASH patients. Advanced fibrosis was only seen in 8% of patients at the time of surgery, which is similar to previous studies. This is the first study to our knowledge to report high prevalence of NASH in a VA population undergoing surgery in the absence of high rate of concomitant diabetes.

Relationship Between Serum Uric Acid Levels and Nonalcoholic Fatty Liver Disease in Non-Obese Patients.

Background and objectives: Nonalcoholic fatty liver disease (NAFLD) is associated with multiple factors such as hypertension, diabetes, dyslipidemia, obesity, and hyperuricemia. We aim to investigate the relationship between uric acid and NAFLD in a non-obese and young population. Materials and Methods: This study was performed in January 2010–2019 with a group of 367 (225 patients in the NAFLD group and 142 in the control group) patients with liver biopsy-proven NAFLD or no NAFLD. Patients with NAFLD were classified according to the percentage of steatosis as follows, group I had 1–20% and group II >20%. Demographic, clinical, and laboratory (biochemical parameters) features were collected retrospectively. Results: The mean body mass index (BMI) and age of the patients were 26.41 ± 3.42 and 32.27 ± 8.85, respectively. The BMI, homeostatic model of assessment (HOMA-IR), and uric acid (UA) values of the NAFLD group were found to be significantly higher than those of the controls. A positive correlation was found between the NAFLD stage and UA. The following factors were independently associated with NAFLD: BMI, HOMA-IR, and UA. In addition, the cut-off value of UA was 4.75 mg/dl with a sensitivity of 45.8% and a specificity of 80.3%. Conclusions: UA is a simple, non-invasive, cheap, and useful marker that may be used to predict steatosis in patients with NAFLD.