Primary biliary cirrhosis is more severe in overweight patients

Mia Híndi, Cynthia Levy, Claudia A. Couto, Pablo Bejarano, Flavia Mendes

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

GOALS: We sought to determine whether features of metabolic syndrome (MS) and histologic features of nonalcoholic steatohepatitis (NASH) are associated with increased fibrosis in patients with primary biliary cirrhosis (PBC). BACKGROUNDS: PBC is a chronic, progressive cholestatic disease. MS is strongly associated with NASH and fibrosis progression in some liver diseases. STUDY: Patients with PBC seen consecutively at the University of Miami between 1985 and 2008 who had antimitochondrial antibody positivity and a liver biopsy performed at this center at the time of diagnosis were identified. Demographics, clinical features, and biochemical parameters were collected. All liver biopsies were reviewed by a single blinded pathologist for features of NASH, PBC, and fibrosis. The impact of NASH and features of MS on liver biopsy findings were analyzed. RESULTS: Forty-nine patients [median age 51 (34 to 78) years, 98% females] were enrolled. Higher degree of steatosis, severe inflammatory grade, and severe biliary duct damage were each associated with advanced fibrosis (P<0.0001). Regarding MS, only overweight status [body mass index (BMI) ≥25] was associated with nonalcoholic fatty liver activity score (NAS) ≥5 (P<0.0001), biliary duct damage (P<0.0001), and advanced fibrosis (71% vs. 32%, P=0.007). Patients with NAS≥5 had more severe fibrosis (14/15, 96% vs. 11/34, 44%; P=0.0001) and more severe biliary duct damage (13/15, 87% vs. 3/34, 9%; P=<0.0001). CONCLUSIONS: NASH and BMI≥25 are associated with severe biliary duct damage and fibrosis in patients with PBC. BMI could become a useful noninvasive tool to predict advanced fibrosis in PBC.

Original languageEnglish
JournalJournal of Clinical Gastroenterology
Volume47
Issue number3
DOIs
StatePublished - Mar 1 2013

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Biliary Liver Cirrhosis
Fibrosis
Biopsy
Liver
Body Mass Index
Non-alcoholic Fatty Liver Disease
Liver Diseases
Demography
Antibodies

Keywords

  • metabolic syndrome
  • nonalcoholic fatty liver disease
  • overweight
  • primary biliary cirrhosis
  • steatosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Primary biliary cirrhosis is more severe in overweight patients. / Híndi, Mia; Levy, Cynthia; Couto, Claudia A.; Bejarano, Pablo; Mendes, Flavia.

In: Journal of Clinical Gastroenterology, Vol. 47, No. 3, 01.03.2013.

Research output: Contribution to journalArticle

Híndi, Mia ; Levy, Cynthia ; Couto, Claudia A. ; Bejarano, Pablo ; Mendes, Flavia. / Primary biliary cirrhosis is more severe in overweight patients. In: Journal of Clinical Gastroenterology. 2013 ; Vol. 47, No. 3.
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abstract = "GOALS: We sought to determine whether features of metabolic syndrome (MS) and histologic features of nonalcoholic steatohepatitis (NASH) are associated with increased fibrosis in patients with primary biliary cirrhosis (PBC). BACKGROUNDS: PBC is a chronic, progressive cholestatic disease. MS is strongly associated with NASH and fibrosis progression in some liver diseases. STUDY: Patients with PBC seen consecutively at the University of Miami between 1985 and 2008 who had antimitochondrial antibody positivity and a liver biopsy performed at this center at the time of diagnosis were identified. Demographics, clinical features, and biochemical parameters were collected. All liver biopsies were reviewed by a single blinded pathologist for features of NASH, PBC, and fibrosis. The impact of NASH and features of MS on liver biopsy findings were analyzed. RESULTS: Forty-nine patients [median age 51 (34 to 78) years, 98{\%} females] were enrolled. Higher degree of steatosis, severe inflammatory grade, and severe biliary duct damage were each associated with advanced fibrosis (P<0.0001). Regarding MS, only overweight status [body mass index (BMI) ≥25] was associated with nonalcoholic fatty liver activity score (NAS) ≥5 (P<0.0001), biliary duct damage (P<0.0001), and advanced fibrosis (71{\%} vs. 32{\%}, P=0.007). Patients with NAS≥5 had more severe fibrosis (14/15, 96{\%} vs. 11/34, 44{\%}; P=0.0001) and more severe biliary duct damage (13/15, 87{\%} vs. 3/34, 9{\%}; P=<0.0001). CONCLUSIONS: NASH and BMI≥25 are associated with severe biliary duct damage and fibrosis in patients with PBC. BMI could become a useful noninvasive tool to predict advanced fibrosis in PBC.",
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N2 - GOALS: We sought to determine whether features of metabolic syndrome (MS) and histologic features of nonalcoholic steatohepatitis (NASH) are associated with increased fibrosis in patients with primary biliary cirrhosis (PBC). BACKGROUNDS: PBC is a chronic, progressive cholestatic disease. MS is strongly associated with NASH and fibrosis progression in some liver diseases. STUDY: Patients with PBC seen consecutively at the University of Miami between 1985 and 2008 who had antimitochondrial antibody positivity and a liver biopsy performed at this center at the time of diagnosis were identified. Demographics, clinical features, and biochemical parameters were collected. All liver biopsies were reviewed by a single blinded pathologist for features of NASH, PBC, and fibrosis. The impact of NASH and features of MS on liver biopsy findings were analyzed. RESULTS: Forty-nine patients [median age 51 (34 to 78) years, 98% females] were enrolled. Higher degree of steatosis, severe inflammatory grade, and severe biliary duct damage were each associated with advanced fibrosis (P<0.0001). Regarding MS, only overweight status [body mass index (BMI) ≥25] was associated with nonalcoholic fatty liver activity score (NAS) ≥5 (P<0.0001), biliary duct damage (P<0.0001), and advanced fibrosis (71% vs. 32%, P=0.007). Patients with NAS≥5 had more severe fibrosis (14/15, 96% vs. 11/34, 44%; P=0.0001) and more severe biliary duct damage (13/15, 87% vs. 3/34, 9%; P=<0.0001). CONCLUSIONS: NASH and BMI≥25 are associated with severe biliary duct damage and fibrosis in patients with PBC. BMI could become a useful noninvasive tool to predict advanced fibrosis in PBC.

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