title: Serum homocysteine levels in patients with nonalcoholic fatty liver disease.
abstract: Background and rational for the study. Nonalcoholic fatty liver disease (NAFLD) is regarded as the hepatic component of insulin resistance (IR) syndrome, but data on serum homocysteine (HCY) are limited. The aim of the study was the evaluation of serum HCY levels in patients with NAFLD. Material and methods.  Thirty-one patients (54 ± 11 years, 8 males) with biopsy-proven NAFLD, 15 with simple nonalcoholic fatty liver (NAFL) and 16 with nonalcoholic steatohepatitis (NASH), and 22 healthy controls (52 ± 9 years, 5 males) matched for gender, age and body mass index (BMI), were recruited. Blood samples for HCY, folate, vitamin B12, insulin and standard biochemical tests were obtained after overnight fasting. Homeostatic model of  assessment-insulin  resistance  (HOMA-IR)  was  calculated.  Results.  There  was  no  difference  in  mean serum HCY levels between controls and NAFLD patients (12.6 ± 4.6 vs. 13.5 ± 2.6 mmol/L, respectively; p = 0.432). Serum folate and vitamin B12 were also similar between the study groups. Mean age, BMI, serum folate and vitamin B12 did not differ between NAFL and NASH patients. However, when compared with NAFL patients, NASH patients had lower mean serum HCY levels (12.3 ± 2.5 vs. 14.7 ± 2.1 mmol/L; p = 0.006). HCY was lower by increasing the grading of fibrosis (p = 0.005), portal inflammation (p = 0.029) and steatosis location (p = 0.021). In logistic regression analysis, HCY independently predicted NASH (p = 0.045) after adjustment for gender, age, BMI, AST, glucose and HOMA-IR. Conclusion. Our data suggest that serum HCY levels are lower in NASH compared with NAFL patients and can independently predict NASH. Serum HCY  might represent another non-invasive marker for the assessment of NAFLD.
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece. stergios@endo.gr
authors.forename: Stergios A
authors.initials: SA
authors.lastname: Polyzos
authors.forename: Jannis
authors.initials: J
authors.lastname: Kountouras
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Patsiaoura
authors.forename: Evangelia
authors.initials: E
authors.lastname: Katsiki
authors.forename: Efthimia
authors.initials: E
authors.lastname: Zafeiriadou
authors.forename: Georgia
authors.initials: G
authors.lastname: Deretzi
authors.forename: Christos
authors.initials: C
authors.lastname: Zavos
authors.forename: Emmanouel
authors.initials: E
authors.lastname: Gavalas
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Katsinelos
authors.forename: Vasileia
authors.initials: V
authors.lastname: Mane
authors.forename: Aristidis
authors.initials: A
authors.lastname: Slavakis
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood; D008099:Liver / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012720:Severity of Illness Index; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D015415:Biomarkers; D007328:Insulin; D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12