Hepatic scar in nonalcoholic steatohepatitis was actively remodeled in advanced fibrosis using data from a cohort of patients with confirmed nonalcoholic fatty liver disease, according to data published in Hepatology.

Marc Hellerstein, MD, PhD, from the Department of Nutritional Sciences and Toxicology at the University of California, and colleagues described a new method to quantify hepatic fibrogenesis flux rates in the liver tissue and noninvasively in blood in 24 participants undergoing diagnostic liver biopsy for suspected nonalcoholic fatty liver disease.

“Direct quantification of the flux rate of collagen synthesis and degradation in the liver may, in principle, predict the likelihood of rapid advancement of fibrotic liver disease,” the study authors wrote. “By monitoring the rate of tracer incorporation into molecules associated with specific disease-related pathways, diagnostic approaches using stable isotope tracers allow for such measurements.”

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The researchers observed a wide range of fractional synthesis rates for liver collagen among patients with hepatitis C and a positive correlation between collagen fractional synthesis rate and histological fibrosis stage, which suggests more extracellular matrix remodeling in more advanced disease.

The study authors found that hepatic collagen fractional synthesis rate in nonalcoholic fatty liver disease increased with advancing liver disease and correlated with hemoglobin A1c. Plasma lumican fractional synthesis rate also showed a significant correlation with hepatic collagen fractional synthesis rate.


  1. Decaris ML, Li KW, Emson CL, Gatmaitan M, et al. Identifying nonalcoholic fatty liver disease patients with active fibrosis by measuring extracellular matrix remodeling rates in tissue and blood. Hepatology. 2016. doi: 10.1002/hep.28860