Hepatology International

, Volume 6, Issue 1, pp 379–385

Clinical significance of serum autoantibodies in patients with NAFLD: results from the nonalcoholic steatohepatitis clinical research network


    • Indiana University School of Medicine
  • Robert J. Gould
    • Centre for Liver Disease, Virginia Mason Medical Centre
  • Laura A. Wilson
    • Department of EpidemiologyJohns Hopkins Bloomberg School of Public Health
  • Aynur Unalp-Arida
    • Department of EpidemiologyJohns Hopkins Bloomberg School of Public Health
  • Oscar W. Cummings
    • Indiana University School of Medicine
  • Naga Chalasani
    • Indiana University School of Medicine
  • Kris V. Kowdley
    • Centre for Liver Disease, Virginia Mason Medical Centre
  • Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN)
Original Article

DOI: 10.1007/s12072-011-9277-8

Cite this article as:
Vuppalanchi, R., Gould, R.J., Wilson, L.A. et al. Hepatol Int (2012) 6: 379. doi:10.1007/s12072-011-9277-8



Some studies have suggested that autoantibodies might define a subcategory and phenotype of nonalcoholic fatty liver disease (NAFLD) associated with advanced histological features. We evaluated the relationship between the presence of serum autoantibodies and liver histology in a large cohort of well-characterized patients with NAFLD.


A total of 864 NAFLD patients participating in two prospective multicentre clinical studies underwent testing for serum autoantibodies within 24 months of a liver biopsy. Liver histology was compared between the patients with and without ANA ≥ 1:160 or ASMA ≥ 1:40 or both.


Autoantibodies were present in 182 patients (21%). There was no difference in age, gender, race, body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR), or history of diabetes between the two groups. Biopsies in subjects with autoantibodies were less likely to have moderate-to-severe steatosis (i.e., >33%) compared to controls (57.1 vs. 43.0%, P value = 0.0006). Lobular inflammation (46.7 vs. 47.5%), ballooning degeneration (38.5 vs. 42.5%), and advanced fibrosis (33.2 vs. 29.3%) were not different between the two groups. Histologic evidence of ‘definite’ NASH did not differ significantly between the two groups (55.5 vs. 58.9%). After adjusting for age, gender, BMI, race, and diabetes, the presence of autoantibodies was independently associated with lower prevalence of moderate-to-severe steatosis [odds ratio (OR), 0.58; 95% confidence interval (CI), 0.41–0.82; P = 0.01].


Autoantibodies are frequently positive in NAFLD in the absence of autoimmune hepatitis and their occurrence is not associated with more advanced histologic features.


AutoantibodiesNASHNAFLDLiver histology



Nonalcoholic fatty liver disease


Nonalcoholic steatohepatitis


Pioglitazone versus Vitamin E versus Placebo for the treatment of non diabetic patients with NASH

Supplementary material

12072_2011_9277_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 kb)

Copyright information

© Asian Pacific Association for the Study of the Liver 2011