title: Presence and extent of estrogen receptor-alpha expression in patients with simple steatosis and NASH.
abstract: Loss of estrogen receptor-alpha (ER-α) in the liver is associated with hepatic steatosis and inflammation. We conducted a study in order to investigate the presence and extent of ER-α expression in NASH, and its relationship with histological findings. Fifty-four patients with histologically confirmed NASH, 12 patients with simple steatosis (SS), and 6 patients with normal liver tissue (NLT) were included. NASH activity score and fibrosis score were calculated according to biopsy findings. Liver biopsy specimens were immunohistochemically stained for ER-α expression. Nuclear ER-α expression percentage (staining index) was calculated. Mean staining index was significantly different across the NASH, SS, and NLT groups (6.3±9.9 vs. 22.1±26.4 vs. 44.2±24.8, respectively, p<0.001 for all comparisons). Staining index was significantly higher in women than in men (19.4±22.2 vs. 7.9±15.3, respectively, p=0.003). Staining index negatively correlated with serum ALT (r=-0.240; p=0.04), fasting plasma glucose (r=-0.261; p=0.027), and fibrosis score (r=-0.312; p=0.011). As a conclusion, hepatic nuclear ER-α expression percentage (staining index) is lower in patients with NASH when compared to SS and NLT groups. Staining index is negatively correlated with serum ALT levels, plasma glucose, and fibrosis score. Further studies are required to clarify the significance of ER-α expression in NASH.
authors.affiliation: Ufuk University Hospital, Department of Gastroenterology, Faculty of Medicine, 06520 Balgat, Ankara, Turkey. gcanbaloglu@gmail.com
authors.forename: Gulbanu
authors.initials: G
authors.lastname: Erkan
authors.forename: Guldal
authors.initials: G
authors.lastname: Yilmaz
authors.forename: Ceyla
authors.initials: C
authors.lastname: Konca Degertekin
authors.forename: Gulen
authors.initials: G
authors.lastname: Akyol
authors.forename: Seren
authors.initials: S
authors.lastname: Ozenirler
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D002467:Cell Nucleus / Q000737:chemistry; D016009:Chi-Square Distribution; D015536:Down-Regulation; D047628:Estrogen Receptor alpha / Q000032:analysis*; D005215:Fasting / Q000097:blood; D005234:Fatty Liver / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000737:chemistry* / Q000473:pathology; D008103:Liver Cirrhosis / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D011237:Predictive Value of Tests; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; C506487:ESR1 protein, human; D047628:Estrogen Receptor alpha; D000410:Alanine Transaminase
keywords: Estrogen receptor-alpha; Nonalcoholic steatohepatitis; Simple steatosis