Non-alcoholic steatohepatitis and influence of age and gender on histopathologic findings.
OBJECTIVE
To characterize the histopathologic specifications of non-alcoholic steatohepatitis (NASH) according to age and gender.


METHODS
An analytical cross-sectional study was conducted in two private gastroenterology clinics on biopsy proven patients suffering from NASH. Biopsy histopathologic findings as well as demographic and laboratory data of the patients at the time of biopsy were gathered retrospectively from clinical records. The grading and staging of histopathologic findings were performed according to the Brunt method after reevaluation of the slides by a pathologist. Patients were divided into two groups according to age (below and above 55 years). Mean quantitative grade of all pathologic findings were also calculated according to Brunt scoring values.


RESULTS
A total number of 77 NASH patients, consisting of 58 males (75.3%) and 19 (24.7%) females with a mean age of 41.99 +/- 11.80 years (range, 18-70 years), were enrolled. The mean age (48.72 +/- 13.99 years vs 39.74 +/- 10.16 years, P = 0.004) and aspartate aminotransferase level (75.11 +/- 29.68 U/L vs 52.78 +/- 25.00 U/L, P = 0.002) was significantly higher in female patients. Mean quantitative grade of hepatosteatosis was significantly higher in females (2.00 +/- 0.82 vs 1.59 +/- 0.68, P = 0.031) compared to males. Fifty four percent (34/65) of young patients had mild hepatosteatosis (Grade I) while only one patient (11.2%) in the older group had grade I hepatosteatosis. Patients aged > or = 55 had significantly more severe hepatosteatosis (Grade III) (44.4% vs 9.5%, P = 0.007) and the mean quantitative grade of hepatosteatosis was significantly higher among them (2.33 +/- 0.71 vs 1.56 +/- 0.67, P = 0.002). Multivariate analysis after omitting the confounding role of age revealed a higher grade of hepatosteatosis in female patients (P = 0.010).


CONCLUSIONS
These findings point toward the possible influence of age in the severity of steatohepatitis, portal and lobar inflammation in patients suffering from NASH while gender independently might contribute to the level of steatohepatitis.
Daryani
Nargess Ebrahimi
NE
Department of Gastroenterology and Hepatology, Tehran University of Medical Sciences, Tehran 19686-13113, Iran.
Daryani
Nasser Ebrahimi
NE
Alavian
Seyed Moayed
SM
Zare
Ali
A
Fereshtehnejad
Seyed-Mohammad
SM
Keramati
Mohammad Reza
MR
Pashaei
Mohammad Reza
MR
Habibollahi
Peiman
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000473:pathology*; D001706:Biopsy; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000473:pathology*; D005260:Female; D006801:Humans; D007492:Iran; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012727:Sex Characteristics; D012737:Sex Factors; D055815:Young Adult
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