지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2013.1
- 수록면
- 120 - 130 (11page)
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초록· 키워드
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Background/Aims: The aims of this study were (1) to identify the useful clinical parameters of noninvasive approach for distinguishing nonalcoholic steatohepatitis (NASH) from nonalcoholic fatty liver disease (NAFLD), and (2) to determine whether the levels of the identified parameters are correlated with the severity of liver injury in patients with NASH.
Methods: One hundred and eight consecutive patients with biopsy-proven NAFLD (age, 39.8±13.5 years, mean±SD;males, 67.6%) were prospectively enrolled from 10 participating centers across Korea.
Results: According to the original criteria for NAFLD subtypes, 67 patients (62.0%) had NASH (defined as steatosis with hepatocellular ballooning and/or Mallory-Denk bodies or fibrosis ≥2). Among those with NAFLD subtype 3 or 4,none had an NAFLD histologic activity score (NAS) below 3 points, 40.3% had a score of 3 or 4 points, and 59.7% had a score >4 points. Fragmented cytokeratin-18 (CK-18) levels were positively correlated with NAS (r=0.401), as well as NAShecomponents such as lobular inflammation (r=0.387) and ballooning (r=0.231). Fragmented CK-18 was also correlated with aspartate aminotransferase (r=0.609), alanine aminotransferase (r=0.588), serum ferritin (r=0.432), and the fibrosis stage (r=0.314). A fragmented CK-18 cutoff level of 235.5 U/L yielded sensitivity, specificity, and positive and negative predictive values of 69.0%, 64.9%, 75.5% (95% CI 62.4–85.1), and 57.1% (95% CI 42.2–70.9), respectively, for the diagnosis of NASH.
Conclusions: Serum fragmented CK-18 levels can be used to distinguish between NASH and NAFL. Further evaluation is required to determine whether the combined measurement of serum CK-18 and ferritin levels improves the diagnostic performance of this distinction. (Clin Mol Hepatol 2013;19:120-130)
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참고문헌 (24)
참고문헌 신청
Adams LA / 2005 / The natural history of nonalcoholic fatty liver disease: a population-based cohort study / Gastroenterology 129 : 113 ~ 121
Ascha MS / 2010 / The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis / Hepatology 51 : 1972 ~ 1978
Assy N / 2005 / Elevated plasma protein C levels correlate with the presence of fatty live
Brunt EM / 1999 / Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions / Am J Gastroenterol 94 : 2467 ~ 2474
Ekstedt M / 2006 / Long-term follow-up of patients with NAFLD and elevated liver enzymes / Hepatology 44 : 865 ~ 873
Ascha MS / 2010 / The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis / Hepatology 51 : 1972 ~ 1978
Assy N / 2005 / Elevated plasma protein C levels correlate with the presence of fatty live
Brunt EM / 1999 / Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions / Am J Gastroenterol 94 : 2467 ~ 2474
Ekstedt M / 2006 / Long-term follow-up of patients with NAFLD and elevated liver enzymes / Hepatology 44 : 865 ~ 873
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