Glycogenosis is common in nonalcoholic fatty liver disease and is independently associated with ballooning, but lower steatosis and lower fibrosis

Abstract

Background/Aims: Glycogen synthesis and storage are normal hepatocyte functions. However, glycogenosis, defined as excess hepatocyte glycogen visible by routine H&E light microscopy, has not been well characterized in nonalcoholic fatty liver disease (NAFLD). Methods: Glycogenosis in NAFLD liver biopsies was graded as “none”, “focal” (in <50% of hepatocytes), or “diffuse” (in ≥50% of hepatocytes). Clinical and pathological variables associated with glycogenosis were assessed. 2047 liver biopsies were prospectively analysed. Results: In adults and children, any glycogenosis was present in 54% of cases; diffuse glycogenosis was noted in approximately 1/3 of cases. On multiple logistic regression analysis, adults with glycogenosis tended to be older (P =.003), female (P =.04), have higher serum glucose (P =.01), and use insulin (P =.02). Adults tended to have lower steatosis scores (P =.006) and lower fibrosis stages (P =.005); however, unexpectedly, they also tended to have more hepatocyte injury including ballooning (P =.003). On multiple logistic regression analysis, paediatric patients with glycogenosis were more likely to be Hispanic (P =.03), have lower body weight (P =.002), elevated triglycerides (P =.001), and a higher fasting glucose (P =.007). Paediatric patients with glycogenosis also had less steatosis (P