Obesity-related non-alcoholic steatohepatitis and TGF-beta1 serum levels in relation to morbid obesity.
Non-alcoholic steatohepatitis (NASH) can vary from mild hepatic inflammation and steatosis to cirrhosis, and is most frequently associated with obesity, Type 2 diabetes mellitus, hypertension, and the female gender. The prevalence of fatty liver and NASH in the general population is 20% and 3%, respectively. In Western countries, 15-20% of the population is obese and 74-90% of them exhibit fatty changes in liver biopsies. We assessed the prevalence of NASH in morbidly obese patients and evaluated serum TGF-beta1 concentrations in different stages of liver fibrosis. Thirty-five obese patients were evaluated, nine male and 26 female. Their mean body mass index (BMI) was 43.62 +/- 7.92 kg/m2. Liver biopsies were evaluated by light microscopy; graded and staged according to Brunt's system. Serum obtained from patients was used to detect TGF-beta1 concentrations by an ELISA method. Serum alanine transaminase (ALT) levels were elevated in four of the patients and the mean level was 49.98 +/- 94.7 (8-65 IU/L). NASH was diagnosed in 32 (91%) of the biopsies, and the most common pattern seen was mixed, predominantly macrovesicular steatosis. Some degree of fibrosis was seen in 34 (97%) of the biopsies and 22 (63%) were at stage 2 (range 1-3). Serum concentrations of TGF-beta1 had no relationship with the stages of fibrosis. In conclusion, NASH and fibrosis are common in our obese patients, as observed in other studies. TGF-beta1 may play a key role in liver fibrogenesis.
Sepúlveda-Flores
Ricardo N
RN
Departamento de Gastroenterología, Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Ave. Madero y Gonzalitos, C.P.660210 Monterrey, Nuevo León, México.
Vera-Cabrera
Lucio
L
Flores-Gutiérrez
Juan P
JP
Maldonado-Garza
Héctor
H
Salinas-Garza
Ricardo
R
Zorrilla-Blanco
Pablo
P
Bosques-Padilla
Francisco J
FJ
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D018450:Disease Progression; D005234:Fatty Liver / Q000209:etiology* / Q000473:pathology; D005260:Female; D006505:Hepatitis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000201:enzymology / Q000209:etiology / Q000473:pathology; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications*; D009994:Osmolar Concentration; D016212:Transforming Growth Factor beta / Q000378:metabolism*; D053773:Transforming Growth Factor beta1
C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D000410:Alanine Transaminase