title: Relationship among histologic, radiologic, and biochemical assessments of hepatic steatosis: a study of human liver samples.
abstract: OBJECTIVE
  In patients with nonalcoholic fatty liver disease, there is not a consistent relationship between severity of steatosis and the presence of steatohepatitis. This leads to the possibility that severity of steatosis is not an important factor in the pathogenesis of nonalcoholic steatohepatitis. Alternatively, it is possible that currently used method to quantify hepatic steatosis (histologic grading) may not accurately reflect hepatic lipid content. Therefore, we examined the relationship between hepatic triglyceride (TG) content and nonbiochemical assessment of steatosis in 38 human liver samples.
  
  
  METHODS
  Hepatic steatosis was histologically graded by the 3 hepatopathologists and hepatic TG levels were determined from liver homogenate. Additionally, we characterized the relationship between (a) hepatic steatosis quantified by magnetic resonance spectroscopy (MRS) and histologic grading and hepatic TG content and (b) hepatic long-chain polyunsaturated fatty acid n-6/n-3 ratio and the severity of steatosis.
  
  
  RESULTS
  Twenty-two samples had <5% steatosis, 9 had 5% to 33% steatosis and 7 had >33% steatosis. The mean (+/-SD) hepatic TG was 1.8+/-1.3 mg/mg of protein and MRS fat score was 6.4+/-6.0. There was a significant correlation between histologic grading and hepatic TG content (r=0.64, P<0.001). A significant correlation existed between MRS fat score and histologic grading (r=0.61, P=0.006), and hepatic TG (r=0.63, P=0.004). Severity of steatosis as graded histologically had significant correlation with n-6/n-3 ratio (r=0.61, P<0.001).
  
  
  CONCLUSIONS
  Hepatic steatosis quantified by histologic grading or by MRS is significantly reflective of hepatic TG content. Further research is needed to investigate the relationship we observed between n-6/n-3 ratio and the severity of steatosis.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
authors.forename: Raj
authors.initials: R
authors.lastname: Vuppalanchi
authors.forename: Oscar W
authors.initials: OW
authors.lastname: Cummings
authors.forename: Romil
authors.initials: R
authors.lastname: Saxena
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Ulbright
authors.forename: Nikhil
authors.initials: N
authors.lastname: Martis
authors.forename: David R
authors.initials: DR
authors.lastname: Jones
authors.forename: Navin
authors.initials: N
authors.lastname: Bansal
authors.forename: Naga
authors.initials: N
authors.lastname: Chalasani
mesh_terms: D003710:Demography; D005227:Fatty Acids / Q000032:analysis; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008099:Liver / Q000737:chemistry* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014280:Triglycerides / Q000032:analysis
chemical_list: D005227:Fatty Acids; D014280:Triglycerides