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Lysosomal acid lipase activity and liver fibrosis in the clinical continuum of non-alcoholic fatty liver disease.

Liver Int.2019 Dec;39(12):2301-2308. doi:10.1111/liv.14206. Epub 2019 Aug 21
Francesco Baratta 1 , Daniele Pastori 2 , Giulia Tozzi 3 , Laura D'Erasmo 2 , Alessia Di Costanzo 2 , Marcello Arca 2 , Evaristo Ettorre 4 , Stefano Ginanni Corradini 5 , Francesco Violi 6 , Francesco Angelico 7 , Maria Del Ben 2
Francesco Baratta 1 , Daniele Pastori 2 , Giulia Tozzi 3 , Laura D'Erasmo 2 , Alessia Di Costanzo 2 , Marcello Arca 2 , Evaristo Ettorre 4 , Stefano Ginanni Corradini 5 , Francesco Violi 6 , Francesco Angelico 7 , Maria Del Ben 2
+ et al

[No authors listed]

Author information
  • 1 Department of Anatomical Sciences, Histological, Legal Medical and Locomotor, Sapienza University of Rome, Rome, Italy.
  • 2 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.
  • 3 Hepatology, Gastroenterology and Nutrition Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.
  • 4 Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy.
  • 5 Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • 6 Mediterranea Cardiocentro, Naples, Italy.
  • 7 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.

摘要


BACKGROUND AND AIMS:Recent evidence showed a reduced activity of the lysosomal acid lipase (LAL) in patients with non-alcoholic fatty liver disease (NAFLD) and cryptogenic cirrhosis (CC). However, the relationship between LAL activity and liver fibrosis has never been investigated. METHODS:Cross-sectional study including 575 outpatients referred for the management of cardio-metabolic and liver disease. The absence of liver fibrosis was defined by a FIB-4 < 1.30 and NAFLD fibrosis score (NFS) <-1.455. LAL activity was measured with dried blood spot technique. RESULTS:Overall, 515 patients had a diagnosis of NAFLD (454 NAFL and 61 biopsy-proven NASH) and 60 of CC. The value of LAL activity progressively decreased from healthy subjects to NAFL/NASH patients to CC (P < .001). LAL activity was reduced by 10% in patients with NAFL, by 20% in NASH and by 50% in CC. The prevalence of CC decreased across the tertiles of LAL activity: 22.2% in the lowest, 4.6% in the intermediate and 0.5% in the highest tertile. In NAFLD patients, 69.9% had a FIB4 < 1.30, and 43.1% a NFS <-1.455. Multivariate logistic regression analysis showed that Log (LAL activity) was associated with FIB-4 < 1.30 (Odds ratio [OR] 2.19 95% confidence interval [CI] 1.33-3.62, P = .002) and NFS < -1.455 (OR 2.43, 95% CI 1.51-3.91, P < .001) after adjustment for confounding factors. CONCLUSIONS:We found a progressive reduction of LAL activity according to liver disease severity. LAL activity was inversely associated with markers of liver fibrosis in patients with NAFLD.

KEYWORDS: NAFLD, cryptogenic cirrhosis, liver fibrosis, lysosomal acid lipase