title: Steatosis degree, measured by morphometry, is linked to other liver lesions and metabolic syndrome components in patients with NAFLD.
abstract: OBJECTIVE
  We carried out morphometric measurements of steatosis to evaluate relationships between steatosis degree and other liver lesions or metabolic syndrome components in nonalcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  We developed an algorithm to measure steatosis area. Two hundred and fourteen patients with NAFLD were included in derivation (10) and validation (204) groups. Controls consisted of patients who were steatosis-free (12), patients with chronic hepatitis C (188), and patients with alcoholic chronic liver disease (94).
  
  
  RESULTS
  Accuracy of steatosis area was considered as good or very good in at least 72% of cases by three pathologists. Steatosis areas were as follows: NAFLD = 10.3 ± 9.7%, virus = 2.4 ± 3.1%, alcohol = 7.8 ± 8.2% (P<0.0001). Steatosis area was closely related to steatosis grades in NAFLD (P<0.0001 for linear trend). Steatosis area increased from the fibrosis stage F0 to the fibrosis state F2, then decreased in the stages F3 and F4 (cirrhosis) (P<0.0001 for quadratic trend). Fibrosis was present in an average steatosis area of approximately 4% (defining significant steatosis) and in nonalcoholic steatohepatitis by approximately 8% (defining severe steatosis). Steatosis and fibrosis area increased symmetrically until approximately 10%, then steatosis area decreased to null as average fibrosis area reached 32%. Average fasting glycemia (approximately 92 mg/dl) or triglycerides and BMI plateaued before a steatosis area of approximately 4%, then increased thereafter. Significant steatosis was present in 61.3% of NAFLD versus 20.2% of viral hepatitis (P<0.0001) and in 58.7% of alcoholic liver diseases (P=0.674).
  
  
  CONCLUSIONS
  The average threshold of steatosis area is 4% for the development of fibrosis or metabolic syndrome components and 8% for nonalcoholic steatohepatitis. Steatosis area may contribute to defining the normal range and clinical course of metabolic components.
authors: Department of Hepato-Gastroenterology, University Hospital, Angers, France.
authors: Jérôme
authors: J
authors: Boursier
authors: Julien
authors: J
authors: Chaigneau
authors: Vincent
authors: V
authors: Roullier
authors: Fabrice
authors: F
authors: Lainé
authors: Jeremy
authors: J
authors: Sandrini
authors: Sophie
authors: S
authors: Michalak
authors: Isabelle
authors: I
authors: Hubert
authors: Nina
authors: N
authors: Dib
authors: Frédéric
authors: F
authors: Oberti
authors: Sandrine
authors: S
authors: Bertrais
authors: Gilles
authors: G
authors: Hunault
authors: Yves
authors: Y
authors: Deugnier
authors: Marie Christine
authors: MC
authors: Rousselet
authors: Christine
authors: C
authors: Cavaro-Ménard
authors: Yves
authors: Y
authors: Gallois
authors: Christophe
authors: C
authors: Aubé
authors: Paul
authors: P
authors: Calès
mesh_terms: D000328:Adult; D000465:Algorithms; D001707:Biopsy, Needle; D004812:Epidemiologic Methods; D005234:Fatty Liver / Q000209:etiology / Q000473:pathology*; D005260:Female; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000473:pathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease