[A prospective study on the prevalence and clinical significance of autoantibodies in patients with suspected nonalcoholic fatty liver disease].
OBJECTIVE
Exclusion of liver disease from other causes such as autoimmune hepatitis is necessary for diagnosis of nonalcoholic fatty liver disease (NAFLD). However, there has been no study on the prevalence and significance of autoantibodies in the patients with clinically suspected NAFLD in Korea, where hepatitis B is endemic and autoimmune hepatitis is relatively uncommon.


METHODS
We prospectively tested for anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and anti-mitochondrial antibody (AMA) in 135 serially enrolled patients with suspected NAFLD. We compared the clinical characteristics and biochemical indices of the ANA-positive or ASMA-positive group with those of the autoantibody-negative group.


RESULTS
Sixteen patients (11.8%) had serum autoantibodies; there was ANA in 8 patients (5.9%), ASMA in 7 (5.1%), and AMA in 2 (1.5%). Both ANA and AMA were positive in one patient. The ANA-positive or ASMA-positive group showed an older age (49.5+/-13.0 vs. 42.0+/-10.9 years, respectively, P=0.018) and higher levels of serum globulin (3.1+/-0.4 vs. 2.9+/-0.4 g/dL, respectively, P=0.037), compared with the autoantibody-negative group. Two cases with positive ANA or ASMA fulfilled the diagnostic criteria for probable autoimmune hepatitis and two cases with positive AMA were suspected as primary biliary cirrhosis.


CONCLUSIONS
These findings suggest that autoantibodies could be found in some patients with suspected NAFLD in Korea, AMA-positivity or ASMA-positivity could be associated with old age and high serum globulin, and some of the autoantibody-positive cases could be diagnosed as autoimmune hepatitis or primary biliary cirrhosis. Further studies are necessary to clarify the clinical significance of autoantibody positivity in those patients.
Cho
Dae Hyeon
DH
Department of Medicine, Samsung Medical Center, Seoul, Korea.
Choi
Moon Seok
MS
Kim
Dong Hee
DH
Kim
Do Young
DY
Shim
Sang Goon
SG
Lee
Joon Hyeok
JH
Koh
Kwang Cheol
KC
Paik
Seung Woon
SW
Yoo
Byung Chul
BC
Rhee
Jong Chul
JC
D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000032:analysis; D001323:Autoantibodies / Q000097:blood*; D005234:Fatty Liver / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000276:immunology
D000974:Antibodies, Antinuclear; D001323:Autoantibodies