Non-alcoholic fatty liver disease in an area of southern Italy: main clinical, histological, and pathophysiological aspects.
OBJECTIVE
Studies on non-alcoholic fatty liver disease (NAFLD) have included chronic liver damage attributed to various causes. Our investigation was held to observe the main clinical, histological, and pathophysiological aspects of NAFLD in patients not exposed to any known cause of chronic liver disease.


METHODS
We evaluated, in 84 in-patients (male/female, 66/18; median age, 36 years), the clinical and biochemical characteristics of NAFLD, and particularly its association with diabetes, dyslipidemia, hyperinsulinemia and/or with the increase of parameters of oxidative stress (blood levels of malonyldialdehyde, 4-hydroxynonenal and total plasma antioxidant capacity).


RESULTS
Ninety percent of patients had an increased body mass index (BMI), 35% had dyslipidemia, 40% had sub-clinical diabetes (only 3% had overt diabetes), 60% had hyperinsulinemia, and more than 90% had enhanced levels of lipid peroxidation markers. In 48 patients who had consented to liver biopsy, we found: 14 with simple steatosis, 32 with steatohepatitis, and two with cirrhosis.


CONCLUSIONS
Our data indicate that in our country, NAFLD may occur in young males with an increased BMI, with or without hyperinsulinemia, dyslipidemia and diabetes, generally associated with disorders of redox status, and that it may be differentiated from steatosis to steatohepatitis or cirrhosis only with a liver biopsy.
Loguercio
C
C
Gastroenterology School, Faculty of Medicine, 2nd University of Naples, Via Foria, 58, 80137 Naples, Italy. caloguer@tin.it
De Girolamo
V
V
de Sio
I
I
Tuccillo
C
C
Ascione
A
A
Baldi
F
F
Budillon
G
G
Cimino
L
L
Di Carlo
A
A
Di Marino
M P
MP
Morisco
F
F
Picciotto
F
F
Terracciano
L
L
Vecchione
R
R
Verde
V
V
Del Vecchio Blanco
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000428:Alcohol Drinking / Q000453:epidemiology; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000235:genetics; D002149:Energy Intake; D005234:Fatty Liver / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism; D000078790:Insulin Secretion; D007501:Iron / Q000097:blood; D007558:Italy; D008107:Liver Diseases / Q000235:genetics; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D008875:Middle Aged; D012727:Sex Characteristics; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D008315:Malondialdehyde; D002784:Cholesterol; D007501:Iron; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase