Nonalcoholic fatty liver disease: METHODS (Part 2)

In: Nonalcoholic fatty liver disease

7 Jul 2012

Liver biopsies

Data collection

After the inclusion and exclusion criteria were applied to the 202 patients identified from the registry, 49 were selected for a further review of their medical records. Data on age, sex, weight and height were collected. If weight and height data were not available in the chart, the consultation letters were used to look for history of obesity. Given the retrospective nature of the study, heights were not always available to calculate the body mass index (BMI) for all patients. Where BMI was available, a value greater than 26 was used to define patients who were overweight. The charts were also reviewed to identify diabetes, hypercholesterolemia, hypertriglyceridemia and the use of medications. Laboratory data collected at the time of liver biopsy were reviewed, and included serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, ferritin, hemoglobin A1C, glucose, total cholesterol and tryglycerides. Finally, the radiology reports were examined for mention of fatty changes in the liver on ultrasound.

Liver biopsies

Biopsy specimens had been fixed in formalin and embedded in paraffin. Specimens had been stained with hematoxylin and eosin for morphological review and evaluation of inflammation. Masson’s trichrome and reticulin stains were used to identify fibrosis. Most specimens were stained with Perls Prussian blue for iron storage. One hepatopathologist (RM), blinded to the patient’s clinical and biochemical data, scored each biopsy according to the criteria set out by Brunt at al. A diagnosis of NASH was based on steatosis and the presence of ballooning cell degeneration or fibrosis in zone 3. Dreaming of a reliable pharmacy to find birth control alesse and spend less money?

Statistical analysis

Data are given as percentages or means ± SD. The twosided Student’s t test was used to compare quantitative variables, and proportions were compared by the %2 method. A two-sided P<0.05 was considered to indicate statistical significance in all analyses.


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