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 language | English |
|---|---|
| Journal | Journal of Clinical Gastroenterology |
| Volume | 47 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2013 |
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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 journal › Article
}
TY - JOUR
T1 - Primary biliary cirrhosis is more severe in overweight patients
AU - Híndi, Mia
AU - Levy, Cynthia
AU - Couto, Claudia A.
AU - Bejarano, Pablo
AU - Mendes, Flavia
PY - 2013/3/1
Y1 - 2013/3/1
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.
AB - 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.
KW - metabolic syndrome
KW - nonalcoholic fatty liver disease
KW - overweight
KW - primary biliary cirrhosis
KW - steatosis
UR - http://www.scopus.com/inward/record.url?scp=84873989614&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873989614&partnerID=8YFLogxK
U2 - 10.1097/MCG.0b013e318261e659
DO - 10.1097/MCG.0b013e318261e659
M3 - Article
C2 - 23059407
AN - SCOPUS:84873989614
VL - 47
JO - Journal of Clinical Gastroenterology
JF - Journal of Clinical Gastroenterology
SN - 0192-0790
IS - 3
ER -