Brief Article
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World J Gastroenterol. Sep 7, 2010; 16(33): 4169-4175
Published online Sep 7, 2010. doi: 10.3748/wjg.v16.i33.4169
Non-alcoholic steatohepatitis and influence of age and gender on histopathologic findings
Nargess Ebrahimi Daryani, Nasser Ebrahimi Daryani, Seyed Moayed Alavian, Ali Zare, Seyed-Mohammad Fereshtehnejad, Mohammad Reza Keramati, Mohammad Reza Pashaei, Peiman Habibollahi
Nargess Ebrahimi Daryani, Nasser Ebrahimi Daryani, Mohammad Reza Pashaei, Peiman Habibollahi, Department of Gastroenterology and Hepatology, Tehran University of Medical Sciences, Tehran 9686-13113, Iran
Seyed Moayed Alavian, Center for Gastroenterology and Liver Disease, Baqiatallah University of Medicine and Tehran Hepatitis Center, Tehran 9686-13113, Iran
Ali Zare, Department of Pathology, Firouzgar Hospital, Iran University of Medical Sciences, Tehran 9686-13113, Iran
Seyed-Mohammad Fereshtehnejad, Gastrointestinal & Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran 9686-13113, Iran
Mohammad Reza Keramati, Department of Surgery, Iran University of Medical Sciences, Tehran 9686-13113, Iran
Author contributions: All authors contributed equally to this work.
Correspondence to: Nasser Ebrahimi Daryani, MD, Professor of Gastroenterology, Department of Gastroenterology and Hepatology, Tehran University of Medical Sciences, Tehran 19686-13113, Iran. nebrahim@tums.ac.ir
Telephone: +98-21-88799446 Fax: +98-21-88799840
Received: February 10, 2010
Revised: April 7, 2010
Accepted: April 14, 2010
Published online: September 7, 2010
Abstract

AIM: To characterize the histopathologic specifications of non-alcoholic steatohepatitis (NASH) according to age and gender.

METHODS: An analytical cross-sectional study was conducted in two private gastroenterology clinics on biopsy proven patients suffering from NASH. Biopsy histopathologic findings as well as demographic and laboratory data of the patients at the time of biopsy were gathered retrospectively from clinical records. The grading and staging of histopathologic findings were performed according to the Brunt method after reevaluation of the slides by a pathologist. Patients were divided into two groups according to age (below and above 55 years). Mean quantitative grade of all pathologic findings were also calculated according to Brunt scoring values.

RESULTS: A total number of 77 NASH patients, consisting of 58 males (75.3%) and 19 (24.7%) females with a mean age of 41.99 ± 11.80 years (range, 18-70 years), were enrolled. The mean age (48.72 ± 13.99 years vs 39.74 ± 10.16 years, P = 0.004) and aspartate aminotransferase level (75.11 ± 29.68 U/L vs 52.78 ± 25.00 U/L, P = 0.002) was significantly higher in female patients. Mean quantitative grade of hepatosteatosis was significantly higher in females (2.00 ± 0.82 vs 1.59 ± 0.68, P = 0.031) compared to males. Fifty four percent (34/65) of young patients had mild hepatosteatosis (Grade I) while only one patient (11.2%) in the older group had grade I hepatosteatosis. Patients aged ≥ 55 had significantly more severe hepatosteatosis (Grade III) (44.4% vs 9.5%, P = 0.007) and the mean quantitative grade of hepatosteatosis was significantly higher among them (2.33 ± 0.71 vs 1.56 ± 0.67, P = 0.002). Multivariate analysis after omitting the confounding role of age revealed a higher grade of hepatosteatosis in female patients (P = 0.010).

CONCLUSION: These findings point toward the possible influence of age in the severity of steatohepatitis, portal and lobar inflammation in patients suffering from NASH while gender independently might contribute to the level of steatohepatitis.

Keywords: Non-alcoholic steatohepatitis, Age, Gender, Histopathologic findings