Low levels of Lysosomal Acid Lipase (LAL) activity increases necroinflammation in adult patients with biopsy-proven metabolic associated fatty liver disease - 11/11/21
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Highlights |
• | Metabolic associated fatty liver disease (MAFLD), a new terminology for non-alcoholic fatty liver disease (NAFLD). |
• | Lysosomal acid lipase (LAL) is an enzyme that plays a pivotal role in lipid homeostasis. |
• | Reduced LAL-activity is associated with increased necroinflammatory activity in patients with biopsy-proven MAFLD. |
• | Reduced LAL-activity is associated with severity of the NAFLD activity score (NAS) in patients with biopsy-proven MAFLD. |
Abstract |
Introduction and objective |
Metabolic associated fatty liver disease (MAFLD), characterized by intra-hepatic fat accumulation, will soon be the leading cause of end-stage liver disease. Lysosomal Acid Lipase (LAL) is a key enzyme in lipid metabolism. We investigated its activity in patients with biopsy-proven MAFLD.
Methods |
Prospective cross-sectional study in patients with biopsy-proven MAFLD. Blood LAL-activity (pmol/punch/h) was measured with dried blood spot extracts using Lalistat 2. Demographic, clinical, and laboratory data were collected.
Results |
101 adult patients were recruited. Among them, 11.9% had a diagnosis of MAFLD without steatohepatitis and 88.1% had MAFLD with steatohepatitis. The median of LAL-activity in patients with MAFLD was 76.8 pmol/punch/h. MAFLD patients with steatohepatitis showed an increase in gamma-glutamyl transferase (p = 0.042), insulin (p = 0.001), homeostatic model assessment for insulin resistance (HOMA-IR, p = 0.001) and advanced liver fibrosis (p < 0.001), compared to cases of MAFLD without steatohepatitis. There was no statistical difference in LAL-activity between the cases (p = 0.296). When considering LAL-activity above and below 77 pmol/punch/h as a cut-off value, patients with reduced LAL-activity had a significant increase in necroinflammatory activity according to the METAVIR score (p = 0.040), and NAFLD activity score (NAS, p = 0.031) compared to cases with higher LAL-activity.
Conclusion |
Our findings suggest that reduced LAL-activity is associated with increased necroinflammatory activity and severity of the NAS. A better knowledge of the role of LAL may provide new insights into the pathogenesis and progression of MAFLD.
Le texte complet de cet article est disponible en PDF.Abbreviations : BMI, CP, DBS, FIB-4, GGT, HCC, HOMA-IR, INR, LAL, NAFLD, NAS, NFS, MAFLD, MELD
Keywords : Lysosomal acid lipase, Metabolic associated fatty liver disease, Metabolic syndrome, Steatohepatitis
Plan
Vol 45 - N° 6
Article 101638- novembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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