Non-alcoholic fatty liver disease causes dissociated changes in metabolic liver functions

被引:28
|
作者
Eriksen, Peter Lykke [1 ]
Sorensen, Michael [1 ]
Gronbaek, Henning [1 ]
Hamilton-Dutoit, Stephen [2 ]
Vilstrup, Hendrik [1 ]
Thomsen, Karen Louise [1 ]
机构
[1] Aarhus Univ Hosp, Dept Hepatol & Gastroenterol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark
[2] Aarhus Univ Hosp, Inst Pathol, Palle Juul Jensens Blvd 99, Aarhus, Denmark
关键词
Non-alcoholic steatohepatitis; Liver function tests; Hepatic elimination; Urea cycle; Aminopyrine; Indocyanine green; GALACTOSE ELIMINATION CAPACITY; BODY-SURFACE AREA; HEPATIC ELIMINATION; INDOCYANINE GREEN; UREA SYNTHESIS; NORMAL-WEIGHT; BREATH TESTS; FIBROSIS; PROGRESSION; STEATOSIS;
D O I
10.1016/j.clinre.2019.01.001
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Non-alcoholic fatty liver disease (NAFLD) is a major health concern affecting 25% of the world's population. It is generally held that a fatty liver does not influence liver function, but quantitative measurements of metabolic liver functions have not been systematically performed. We aimed to study selected hepatocetlular metabolic functions in patients with different stages of NAFLD. Methods: Twenty-five non-diabetic, biopsy-proven NAFLD patients [12 with simple steatosis; 13 with non-alcoholic steatohepatitis (NASH)] and ten healthy controls were included in a cross-sectional study. Hepatocyte cytosolic function was assessed by the galactose elimination capacity (GEC), mitochondrial-cytosolic metabolic capacity by the functional hepatic nitrogen clearance (FHNC), microsomal function by the aminopyrine breath test, and excretory liver function by indocyanine green (ICG) elimination. Results: GEC was 20% higher in NAFLD than in controls [3.15 mmol/min (2.9-3.41) vs. 2.62 (2.32-2.93); P=0.02]. FHNC was 30% lower in NAFLD [23.3 L/h (18.7-28.9) vs. 33.1 (28.9-37.9); P=0.04], more so in simple steatosis [19.1 L/h (13.9-26.2); P=0.003] and non-significantly in NASH [27.9 L/h (20.6-37.8); P=0.19]. Aminopyrine metabolism was 25% lower in simple steatosis [8.9% (7.0-10.7)] and 50% lower in NASH [6.0% (4.5-7.5)] than in controls [11.9% (9.3-12.8)] (P<0.001). KG elimination was intact. Conclusions: The hepatocellular metabolic functions were altered in a manner that was dissociated both by different effects on different liver functions and by different effects of different stages of NAFLD. Thus, NAFLD has widespread consequences for metabolic liver function, even in simple steatosis. (C) 2019 Published by Elsevier Masson SAS.
引用
收藏
页码:551 / 560
页数:10
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