title: Liver function breath tests for differentiation of steatohepatitis from simple fatty liver in patients with nonalcoholic Fatty liver disease.
abstract: OBJECTIVE
  We investigated the utility of liver function breath tests [C-Aminopyrine Breath Test (C-ABT), C-Galactose Breath Test (C-GBT)], for the diagnosis of nonalcoholic steatohepatitis (NASH) among nonalcoholic fatty liver disease (NAFLD) patients.
  
  
  BACKGROUND
  Liver biopsy is currently the gold standard for the differentiation between simple fatty liver (NAFL) and NASH in NAFLD patients.
  
  
  METHODS
  Thirty-six patients with histologically proven NAFLD (NAFL:16, NASH:20) underwent C-ABT and C-GBT. The results were expressed as the percentage of administered C dose recovered per hour (%dose/h) and as cumulative percentage of administered C dose recovered over time (%cumulative dose). Histologic lesions were scored according to Brunt and Kleiner's classifications.
  
  
  RESULTS
  C-ABT results correlated inversely with activity grade (r=-0.650, P=0.001), NAFLD activity score (r=-0.473, P=0.026), and fibrosis stage (r=-0.719, P=0.001). Compared with NAFL, NASH patients had significantly lower %dose/h and %cumulative dose at 60, 90, and 120 minutes (always P<0.04) by C-ABT. C-ABT %dose/h and %cumulative dose at 120 minutes could predict the presence of NASH (area under the receiver operating characteristic curve: 0.762 and 0.741, respectively). In contrast, there was no significant association between C-GBT results and any patient characteristic.
  
  
  CONCLUSIONS
  In the NAFLD patients, decreased and delayed liver microsomal function, as assessed by C-ABT, is associated with more severe necroinflammation and fibrosis, whereas C-ABT results at 120 minutes may be helpful for the diagnosis of NASH.
authors: *2nd Department of Internal Medicine, Hippokration General Hospital †Laboratory of Histology & Embryology, Athens University Medical School, Athens, Greece.
authors: George
authors: G
authors: Tribonias
authors: Ekaterini
authors: E
authors: Margariti
authors: Dina
authors: D
authors: Tiniakos
authors: Dimitrios
authors: D
authors: Pectasides
authors: George V
authors: GV
authors: Papatheodoridis
mesh_terms: D000328:Adult; D000368:Aged; D000632:Aminopyrine / Q000032:analysis; D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005690:Galactose / Q000032:analysis; D006801:Humans; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012372:ROC Curve; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D002247:Carbon Isotopes; D000632:Aminopyrine; D005690:Galactose