Clinical-liver, pancreas, and biliary tractHepatocyte apoptosis and fas expression are prominent features of human nonalcoholic steatohepatitis☆
Section snippets
Patient population
The study was approved by the Mayo Institutional Review Board, and all patients gave written informed consent for participation in medical research. Demographic, clinical, and laboratory data from 34 untreated consecutive patients with NASH were collected prospectively. All these patients were seen at the Mayo Clinic, Rochester, Minnesota. The diagnosis of NASH was established based on the following criteria: (1) persistent abnormal liver tests for more than 3 months, (2) liver biopsy
Clinical and laboratory features for the NASH population
The main demographic and clinical and laboratory data of the NASH population are summarized in Table 1. Among the 34 patients, 11 (32%) were male and 23 (68%) were female. The mean age at the time of liver biopsy was 46.2 ± 11 years. The mean body mass index (BMI) was 32.5 ± 4.4, with 21 patients having a BMI higher than 30. Four (12%) patients had cirrhosis, all Childs-Turcotte-Pugh class A. Seven (21%) patients had associated type 2 diabetes, with all 7 patients being treated with oral
Discussion
The principal findings of this study relate to the occurrence and significance of apoptosis in NASH. The observations demonstrate the following in NASH as compared with controls: (1) hepatocyte apoptosis is prominent; (2) hepatocytes apoptosis is associated with advanced stages of the disease, implicating a role for hepatocytes apoptosis in disease progression; and (3) Fas expression is enhanced, suggesting a mechanistic role for this death receptor in this disease process. Taken together,
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Supported by grant DK41876 from the National Institute of Health, the Palumbo Foundation, and the Mayo Foundation.