The non-invasive ¹³C-methionine breath test detects hepatic mitochondrial dysfunction as a marker of disease activity in non-alcoholic steatohepatitis

• Main Authors: Banasch M, Ellrichmann M, Tannapfel A, Schmidt WE, Goetze O
• Format: Article
• Language: English
• Published: BMC 2012-06-01
• Series: European Journal of Medical Research
• Subjects: ¹³C-methionine breath test; MeBT, NASH
• Online Access: http://www.eurjmedres.com/content/16/6/258

<p>Abstract</p> <p>Introduction</p> <p>Mitochondrial dysfunction plays a central role in the general pathogenesis of non-alcoholic fatty liver disease (NAFLD), increasing the risk of developing steatosis and subsequent hepatocellular inflammation. We aimed to assess hepatic mitochondrial function by a non-invasive ¹³C-methionine breath test (MeBT) in patients with histologically proven NAFLD.</p> <p>Methods</p> <p>118 NAFLD-patients and 18 healthy controls were examined by MeBT. Liver biopsy specimens were evaluated according to the NASH scoring system.</p> <p>Results</p> <p>Higher grades of NASH activity and fibrosis were independently associated with a significant decrease in cumulative ¹³C-exhalation (expressed as cPDR(%)). cPDR_1.5hwas markedly declined in patients with NASH and NASH cirrhosis compared to patients with simple steatosis or borderline diagnosis (cPDR1.5h: 3.24 ± 1.12% and 1.32 ± 0.94% vs. 6.36 ± 0.56% and 4.80 ± 0.88% respectively; p < 0.001). ¹³C-exhalation further declined in the presence of advanced fibrosis which was correlated with NASH activity (r = 0.36). The area under the ROC curve (AUROC) for NASH diagnosis was estimated to be 0.87 in the total cohort and 0.83 in patients with no or mild fibrosis (F0-1).</p> <p>Conclusion</p> <p>The ¹³C-methionine breath test indicates mitochondrial dysfunction in non-alcoholic fatty liver disease and predicts higher stages of disease activity. It may, therefore, be a valuable diagnostic addition for longitudinal monitoring of hepatic (mitochondrial) function in non-alcoholic fatty liver disease.</p>