Systemic and adipose tissue inflammation in NASH: correlations with histopathological aspects

Vol. 62 No. 2, 2021

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Elena Simona Micu, Anca Maria Amzolini, Anca Barau Abu-Alhija, Mircea Catalin Fortofoiu, Ionela Mihaela Vladu, Diana Clenciu, Adina Mitrea, Stelian Stefanita Mogoanta, Anda Elena Crisan, Octavian Ion Predescu, Mirela Radu

Introduction: Non-alcoholic steatohepatitis (NASH) is a progressive form of liver steatosis that involves a risk of progression towards fibrosis, cirrhosis, and end-stage liver disease. Low-grade inflammation is recognized to be involved in non-alcoholic fatty liver disease (NAFLD) pathogeny. Additionally, adipose tissue dysfunction plays an important role in the development of metabolic diseases. Patients, Materials and Methods: We conducted a study on 68 patients with liver steatosis confirmed through liver biopsy during the surgery. In all the patients, we recorded anthropometric parameters and we performed blood tests for systemic inflammation [high-sensitivity C-reactive protein (hs-CRP), fibrinogen] and serum adipokines related to adipose tissue inflammation (leptin, adiponectin). Additional to histopathological examination, we also performed the immunohistochemical study of inflammatory mononuclear cells. Results: The 68 patients had a mean age of 56.57+/-4.94 years old, had a mean value of hs-CRP of 2.30+/-0.91 mg/L, a mean value of leptin of 14.02+/-17.02 ng/mL and a mean value of adiponectin of 7.54+/-0.38 mg/L. In all the cases studied by liver biopsy, the steatosis exceeded 5% of hepatocytes, but the frequency of NASH was 26.47%. Cluster of differentiation (CD)45-positive, CD4-positive, and CD8-positive T-lymphocytes predominated in the studied cases. We obtained a statistically significant high association between definite NASH and the values of hs-CRP, serum adiponectin and leptin/adiponectin ratio (p<0.0001). Conclusions: Systemic and adipose tissue inflammation was statistically significant associated with histological lesions of steatosis and NASH, suggesting that the determination of hs-CRP and serum adipokines in dynamics in patients with NAFLD is predictive for the progression of the disease.

Corresponding author: Anca Maria Amzolini, University Assistant, MD, PhD; e-mails: anca.amzolini@umfcv.ro, amzolinianca@yahoo.com; Octavian Ion Predescu, Lecturer, MD, PhD; e-mail: octavian_predescu@yahoo.com

DOI: 10.47162/RJME.62.2.17 Download PDF
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