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Obesity-related non-alcoholic steatohepatitis and TGF-β1 serum levels in relation to morbid obesity

Ricardo N Sepúlveda-Flores, Lucio Vera-Cabrera, Juan P. Flores-Gutiérrez, Héctor Maldonado-Garza, Ricardo Salinas-Garza, Pablo Zorrilla-Blanco, Francisco J Bosques-Padilla

Abstract

Non-alcoholic steatohepatitis (NASH) can vary from mild hepatic inflammation and steatosis to cirrhosis, and is most frequently associated with obesity, Type 2 diabetes mellitus, hypertension, and the female gender. The prevalence of fatty liver and NASH in the general population is 20% and 3%, respectively. In Western countries, 15–20% of the population is obese and 74–90% of them exhibit fatty changes in liver biopsies. We assessed the prevalence of NASH in morbidly obese patients and evaluated serum TGF-β1 concentrations in different stages of liver fibrosis. Thirty-five obese patients were evaluated, nine male and 26 female. Their mean body mass index (BMI) was 43.62 ± 7.92 kg/m2. Liver biopsies were evaluated by light microscopy; graded and staged according to Brunt’s system. Serum obtained from patients was used to detect TGF- β1 concentrations by an ELISA method. Serum alanine transaminase (ALT) levels were elevated in four of the patients and the mean level was 49.98 ± 94.7 (8–65 IU/L). NASH was diagnosed in 32 (91%) of the biopsies, and the most common pattern seen was mixed, predominantly macrovesicular steatosis. Some degree of fibrosis was seen in 34 (97%) of the biopsies and 22 (63%) were at stage 2 (range 1–3). Serum concentrations of TGF-β1 had no relationship with the stages of fibrosis. In conclusion, NASH and fibrosis are common in our obese patients, as observed in other studies. TGF-β1 may play a key role in liver fibrogenesis.

Key words. Obesity, Non-alcoholic steatohepatitis, Hepatic fibrosis, Steatosis

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The Official Journal of the Mexican Association of Hepatology, the Latin-American Association for the Study of the Liver and the Canadian Association for the Study of the Liver

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