Unconjugated hyperbilirubinemia is inversely associated with non-alcoholic steatohepatitis (NASH)
Alimentary Pharmacology and Therapeutics, 05/21/2012
Clinical Article
Hjelkrem M et al. – Unconjugated hyperbilirubinemia is inversely associated with the histopathological severity of liver damage in non–alcoholic fatty liver disease.
Methods- This was a retrospective analysis involving adult patients from a tertiary medical centre undergoing liver biopsy to evaluate suspected NAFLD or NASH and a control group without NAFLD based on normal liver ultrasound, labs and history.
- Identification of unconjugated hyperbilirubinemia was based on the presence of predominantly unconjugated bilirubin ≥1.0 mg/dL (17.1 μmol/L) while fasting, in the absence of haemolytic disease or other hepatic function alteration.
- Six–hundred and forty–one patients were included.
- Unconjugated hyperbilirubinemia was inversely associated with NASH (OR 16.1, 95% CI 3.7–70.8 P < 0.001).
- Of the patients without NAFLD (133 patients), 13 (9.8%) had unconjugated hyperbilirubinemia (range 1.0–1.8, mean 1.4).
- Of the patients with NAFLD without NASH (285 patients), 32 (11.2%) had unconjugated hyperbilirubinemia (range 1.0–3.0, mean 1.4).
- Of the patients with NASH (223 patients), three (1.3%) had unconjugated hyperbilirubinemia (1.0, 1.1, 1.4).



