Elevated plasma homocysteine concentrations as a predictor of steatohepatitis in patients with non-alcoholic fatty liver disease.
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.
Gulsen
Mustafa
M
Department of Gastroenterology, Gulhane School of Medicine, Ankara, Turkey.
Yesilova
Zeki
Z
Bagci
Sait
S
Uygun
Ahmet
A
Ozcan
Ayhan
A
Ercin
C Nuri
CN
Erdil
Ahmet
A
Sanisoglu
S Yavuz
SY
Cakir
Erdinç
E
Ates
Yuksel
Y
Erbil
M Kemal
MK
Karaeren
Necmettin
N
Dagalp
Kemal
K
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
D006710:Homocysteine