Nonalkolik steatohepatitte histolojik hasari öngörüde klinik ve laboratuvarin yeri
The value of clinical and laboratory findings in non-alcoholic steohepatitis
- Ana Sayfa
- Sayılar
- Nonalkolik steatohepatitte histolojik hasari öngörüde klinik ve laboratuvarin yeri...
Ankara Ünivesitesi Tip Fakültesi, Patoloji Anabilim Dali2, Ankara
Özet
Giris ve amaç: Nonalkolik steatohepatite bagli transaminaz yüksekligi, sismanligin ve diyabetin günümüzde gittikçe yayginlasmasi sonucu hepatoloji polikliniklerine basvurularin önde gelen nedenlerindendir. Bu hastalarda klinik ve laboratuar parametrelerinin histoloji ile ne kadar uyum gösterdigini arastirmayi amaçladik. Gereç ve yöntem: Karaciger biyopsisi ile nonalkolik steatohepatit tanisi konan 64 hastanin demografik özellikleri, vücut kitle indeksleri, lipid ve transaminazlari, diabetik olmayanlarin oral glukoz tolerans testleri bakildi ve bunlarin histolojik bulgularla uyumu arastirildi. Bulgular: Histolojik siddetli nonalkolik steatohepatit tanisi konanlarda hafif hastaligi olanlara göre diabetes mellitus yada bozuk oral glukoz tolerans testleri (%70 e karsin % 32) daha sikti p<0,05. Vücut kitle indeksleri ile yaglanma ve inflamasyonun siddeti arasinda iliski anlamli iken fibrosis ile iliski anlamli degildi. Cinsiyetle yaglanma siddeti arasinda fark gözlenmezken kadinlarda inflamasyon ve fibrosis erkeklere göre daha siddetli idi (kadinlarda siddetli nonalkolik steatohepatit % 27.8; erkeklerde % 2.1) (p<0.01). Sonuç: Asikar diyabetes mellitusyada bozulmus glukoz toleransi ile kadin cinsiyet nonalkolik karaciger yaglanmasi hastaligi düsünülenlerde ileri karaciger hastaligi olabileceginin göstergeleri olabilir.
Abstract
Background and aim: Non-alcoholic steatohepatitisis one of the commonest causes of elevated liver function tests in patients referred to hepatology out-patient clinics, due to an increasing incidence of obesity and diabetes mellitus. The aim of this study was to assess the value of clinical and laboratory findings in determining the histological severity of this disease. Materials and methods: Sixty-four patients with nonalcoholic steatohepatitis (diagnosis based on liver biopsy) were included in this study. The following data were then evaluated: demographic findings, liver function tests, lipid levels and body mass index. In additon, oral glucose tolerance test was performed on all patients except manifest diabetes mellitus. Results: Presence of diabetes mellitus or impaired oral glucose tolerance test was found to be higher in patients with severe non-alcoholic steatohepatitis than in those with mild non-alcoholic steatohepatitis disease (70% vs 32%) p<0.05. No relationship was found between the severity of fibrosis and body mass index but there was significant correlation between the degree of inflammation, steatosis and body mass insex. The degree of inflammation and steatosis was higher in women than men (27.8% vs 2.1% respectively) p <0.01, although the severity of steatosis was similar in males and females. Conclusion: It was determined that female sex, manifest diabetes mellitus and impaired oral glucose tolerance test may be poor prognostic factors in non-alcoholic steatohepatitis.
