Brief Articles
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World J Gastroenterol. Apr 21, 2009; 15(15): 1863-1868
Published online Apr 21, 2009. doi: 10.3748/wjg.15.1863
Non-alcoholic steatohepatitis with normal aminotransferase values
Hüseyin Saadettin Uslusoy, Selim Giray Nak, Macit Gülten, Zeynep Bıyıklı
Hüseyin Saadettin Uslusoy, Selim Giray Nak, Macit Gülten, Department of Gastrenterology, Uludag University Medical School, Bursa 16059, Turkey
Zeynep Bıyıklı, Department of Biostatistics, Ankara University School of Medicine, Ankara 06100, Turkey
Author contributions: Uslusoy HS and Nak SG performed the majority of the sudy; Gülten M provided design of the study, the sources and references in the literature and translations; Bıyıklı Z performed the statistical studies, including data acquisition, analysis and interpretation.
Correspondence to: Hüseyin Saadettin Uslusoy, MD, Department of Gastroenterology, Yozgat State Hospital, Yozgat 66200, Turkey. huslusoy.23@hotmail.com
Telephone: +90-354-2121070
Fax: +90-354-2120923
Received: October 20, 2008
Revised: January 3, 2009
Accepted: January 10, 2009
Published online: April 21, 2009
Abstract

AIM: To investigate the aspects of liver histology in patients with non-alcoholic steatohepatitis (NASH) who had normal aminotransferase levels.

METHODS: Thirty-four patients diagnosed with liver steatosis by ultrasonographic examination participated in the study. We compared all non-alcoholic fatty liver disease and NASH cases, according to aminotransferase level, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio and presence of metabolic syndrome.

RESULTS: Sixteen of 25 patients with high aminotransferase levels were diagnosed with NASH and nine with simple fatty liver according to liver histology. Among the nine patients with normal aminotransferase levels, seven had NASH and two had simple fatty liver. The patients with normal and high liver enzyme levels had almost the same prevalence of NASH and metabolic syndrome. Liver histology did not reveal any difference according to aminotransferase levels and AST/ALT ratio.

CONCLUSION: Aminotransferase levels and AST/ALT ratio do not seem to be reliable predictors for NASH. Despite numerous non-invasive biomarkers, all patients with fatty liver should undergo liver biopsy.

Keywords: Non-alcoholic steatohepatitis; Liver enzymes; Liver histology