Histological and histochemical features of liver and lung tissue in patients with nonalcoholic steatohepatitis and obesity depending on the presence of comorbid chronic obstructive pulmonary disease

Abstract

Objective – to establish the pathomorphological features of liver and lung tissue of patients with non-alcoholic steatohepatitis (NASH) and obesity depending on comorbidity with chronic obstructive pulmonary disease (COPD). The study used autopsy material of 13 cases of NASH and class I obesity (Group 1), 14 cases of NASH, class I obesity with comorbid COPD of stage II-III (Group 2). For comparison, we used the autopsy material of 12 patients with isolated COPD of stage II-III (Group 3), as well as 11 practically healthy individuals (PHI), whose death was caused by polytrauma or traumatic brain injury or sudden coronary death. The groups were randomized by age, sex, and class of obesity. The average age of patients was 59.3±3.21. In Group 2 there was a maximum percentage of hepatocytes in the state of steatosis (1.9 times more than in Group 1, p<0.05), 1.6 times more hepatocytes in the state of fatty necrosis compared with NASH, p<0.05), oncosis (2.1 times, p<0.05), as well as lipofuscinosis (3.1 times more than in case of NASH with obesity, p<0.05). The combined course of obesity, NASH and COPD contributed to a significant increase in the number of lipocytes in the lungs (29.6 times, p<0.05) compared with isolated COPD, as well as a probable increase in their diameter (1.8 times, p<0.05). In the comorbid course of NASH, obesity and COPD, more intense histological and histochemical changes were observed, indicating more significant dysmetabolic disorders and the role of COPD in the activity of the inflammatory process in the liver, namely a higher % of steatosis in hepatocytes. Accumulation of adipocytes was observed in the lungs in this combined pathology, which probably indicates the aggravating effect of NASH and obesity on the course of COPD.