Non alkolik steatohepatitli hastalarda antinükleer antikor prevalansi ve önemi
Prevalence and significance of antinuclear antibodies in patients with non-alcoholic steatohepatitis
Özet
Giris ve amaç: Non alkolik steatohepatitli (NASH) hastalarda anti nükleer antikor (ANA) pozitifligi gösterilmis olmasina ragmen, ANA pozitifliginin prevalansi ve önemi halen tam olarak bilinmemektedir. Bu çali smanin amaci NASH hastalarinda ANA prevalansi ve ANA pozitifliginin biyokimyasal parametreler ile iliskisini incelemektir. Gereç ve yöntem: Histolojik olarak NASH tanisi almis toplam 55 hastanin laboratuvar verileri retrospektif olarak degerlendirildi. ANA Hep2 hücreleri ve maymun karaciger dokusu kullanilarak indirek immunfloresan teknigi ile arastirildi. 1:100 ve üzeri pozitif olarak degerlendirildi. Bulgular: Hastalari n yas ortalamasi 43.1±10.4 yil idi. Toplam 55 NASH hastasinin 21’i (%38) kadindi. Hastalarin ortalama vücut kitle indeksi (VKI) 29.9±3.1 kg/m2 idi. ANA 55 hastanin 14’ünde (%25) pozitif bulundu. ANA pozitif ve negatif gruplar birbiri ile karsilastirildiginda yas, cinsiyet dagilimi, VKI, ALT, AST, GGT, ALP, albumin, total kolesterol, trigliserid ve ferritin açisindan gruplar arasinda istatistiksel fark saptanmazken (p>0.05) globulin seviyesi ANA pozitif grupta istatistiksel olarak anlamli yüksek bulundu (p<0.5). Sonuç: Çalismamizda NASH’li hastalarin dörtte birinde ANA pozitif saptanmistir. ANA pozitif NASH hastalarinda anlamli olarak yüksek saptanan globulin degerleri NASH hastaliginin seyrinde konakçi ile immun etkilesimi düsündürmektedir.
Abstract
Background/aim: Antinuclear antibodies (ANA) have been shown in patients with non-alcoholic steatohepatitis (NASH), although their prevalence and significance are uncertain. The aim of this study was to evaluate the prevalence and to determine whether their presence has any biochemical significance. Materials and methods: Laboratory data from 55 patients with a histologic diagnosis of NASH were reviewed retrospectively. ANA were detected by indirect immunofluorescence on HEp2 cells and monkey liver tissue, with a dilutional titer of 1:100 and above considered positive. Results: The mean age of the study population was 43.1±10.4 years. Thirty-eight percent (21/55) of subjects were women. The mean body mass index (BMI) was 29.9±3.1 kg/m2. Twenty-five percent (14/55) of patients with NASH had positive ANA titers. Age, gender, BMI, ALT, AST, GGT, ALP, albumin, total cholesterol, triglycerides and ferritin levels were similar between ANA-positive and negative cases (p>0.05). ANA-positive patients were associated with higher levels of globulin (p<0.5). Conclusions: In our study, ANAs were present in one- fourth of the patients with NASH. High globulin levels detected in ANA-positive patients in our study suggests host immune interactions during the disease process of NASH.
