Predictive factors of non-alcoholic steatohepatitis: relationship with metabolic syndrome

Non-alcoholic fatty liver disease (NAFLD) has been proposed as the hepatic manifestation of the metabolic syndrom (Ms), with insulin resistance (IR) as the common pathophysiological mechanism.

We included 145 patients with NAFLD proven liver biopsy. NAS-score was employed to grading NAFLD. We determined anthropometric measurements, basal blood pression (BP), biochemical measurements including high lipoprotein cholesterol (HDL-Chol), low-density lipoprotein cholesterol (LDL-Chol), triglycerides and leptin levels, homeostasis model assessment index (HOMA-IR), and abdominal ultrasound scan (US) was performed. Diagnosis of Ms was performed based on ATP III criteria.

Average age was 43.6 + 11.2 years old and the mean body mass index (BMI) was 39 ± 10.7 kg/m2. Sex distribution was: females 66 and males 79. Forty patients (27.5%) presented a NAS score > = 5. Waist circumference (p = 0.007), systolic and diastolic BP (p = 0.002 and p = 0.003 respectively), (HOMA-IR) (p = 5. Independent factors associated to NAS-score > = 5 were Ms and BMI > 30. Leptin levels were higher in patients with advanced fibrosis (≥ F2) compared to patients with mild fibrosis (F0-F1) (75.5 + 50.2 ng/ml vs - 39.7 + 38.4 ng/ml respectively; p = 0.002).

Presence of Ms and obesity (BMI >30) are the principal independent factors associated to NASH (NAS score > = 5). Leptin levels and BMI are higher in patients with advanced fibrosis.