title: Elevated plasma homocysteine concentrations as a predictor of steatohepatitis in patients with non-alcoholic fatty liver disease.
abstract: BACKGROUND
  Although steatosis is common in patients with severe hyperhomocysteinemia due to deficiency of cystathionine beta-synthase, there are no satisfactory data on homocysteine concentrations in patients with non-alcoholic fatty liver disease. The main aim of the present study was to evaluate the clinical significance of plasma homocysteine concentrations in patients with non-alcoholic fatty liver disease.
  
  
  METHODS
  Seventy-one non-alcoholic fatty liver disease patients, 36 patients with chronic viral hepatitis and 30 healthy persons were enrolled in the study. Homocysteine levels were measured by high-performance liquid chromatography. Insulin, folate, vitamin B(12) and lipoprotein levels were also determined in all groups.
  
  
  RESULTS
  Homocysteine in the non-alcoholic fatty liver disease group was found to be significantly higher than other groups. Homocysteine was found to be significantly higher in the non-alcoholic steatohepatitis group when compared with simple steatosis group. A positive correlation was found between homocysteine and triglyceride, very-low-density-lipoprotein (VLDL) cholesterol, insulin, and index of insulin resistance in the non-alcoholic fatty liver disease group, and a negative correlation was found between homocysteine and folate, or vitamin B(12) in all groups. The homocysteine threshold for the prediction of steatohepatitis was 11.935 ng/mL. Furthermore; plasma homocysteine was a statistically significant predictor for severity of necroinflammatory activity in non-alcoholic steatohepatitis.
  
  
  CONCLUSIONS
  The plasma homocysteine concentrations were significantly higher in patients with non-alcoholic fatty liver disease, while the concentrations were not affected by chronic viral hepatitis. Plasma homocysteine is a parameter for discriminating steatohepatitis from simple steatosis. Determining the plasma homocysteine concentrations may facilitate selection of steatosis patients in whom a liver biopsy should be performed.
authors.affiliation: Department of Gastroenterology, Gulhane School of Medicine, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gulsen
authors.forename: Zeki
authors.initials: Z
authors.lastname: Yesilova
authors.forename: Sait
authors.initials: S
authors.lastname: Bagci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Uygun
authors.forename: Ayhan
authors.initials: A
authors.lastname: Ozcan
authors.forename: C Nuri
authors.initials: CN
authors.lastname: Ercin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Erdil
authors.forename: S Yavuz
authors.initials: SY
authors.lastname: Sanisoglu
authors.forename: Erdinç
authors.initials: E
authors.lastname: Cakir
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Ates
authors.forename: M Kemal
authors.initials: MK
authors.lastname: Erbil
authors.forename: Necmettin
authors.initials: N
authors.lastname: Karaeren
authors.forename: Kemal
authors.initials: K
authors.lastname: Dagalp
mesh_terms: D000328:Adult; D005234:Fatty Liver / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006505:Hepatitis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D006710:Homocysteine / Q000009:adverse effects* / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
chemical_list: D006710:Homocysteine