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, 52 (3), 894-903

The Association of Genetic Variability in Patatin-Like Phospholipase Domain-Containing Protein 3 (PNPLA3) With Histological Severity of Nonalcoholic Fatty Liver Disease

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The Association of Genetic Variability in Patatin-Like Phospholipase Domain-Containing Protein 3 (PNPLA3) With Histological Severity of Nonalcoholic Fatty Liver Disease

Yaron Rotman et al. Hepatology.

Abstract

Genome-wide association studies identified single-nucleotide polymorphisms (SNPs) that are associated with increased hepatic fat or elevated liver enzymes, presumably reflecting nonalcoholic fatty liver disease (NAFLD). To investigate whether these SNPs are associated with histological severity of NAFLD, 1117 (894 adults/223 children) individuals enrolled in the Nonalcoholic Steatohepatitis (NASH) Clinical Research Network and National Institutes of Health Clinical Center studies with histologically confirmed NAFLD were genotyped for six SNPs that are associated with hepatic fat or liver enzymes in genome-wide association studies. In adults, three SNPs on chromosome 22 showed associations with histological parameters of NASH. After adjustment for age, sex, diabetes, and alcohol consumption, the minor allele of rs738409 C/G, a nonsynonymous coding SNP in the patatin-like phospholipase domain-containing protein 3 (PNPLA3) (adiponutrin) gene encoding an Ile148Met change, was associated with steatosis (P = 0.03), portal inflammation (P = 2.5 x 10(-4)), lobular inflammation (P = 0.005), Mallory-Denk bodies (P = 0.015), NAFLD activity score (NAS, P = 0.004), and fibrosis (P = 7.7 x 10(-6)). Two other SNPs in the same region demonstrated similar associations. Three SNPs on chromosome 10 near the CHUK (conserved helix-loop-helix ubiquitous kinase) gene were independently associated with fibrosis (P = 0.010). In children, no SNP was associated with histological severity. However, the rs738409 G allele was associated with younger age at the time of biopsy in multivariate analysis (P = 0.045).

Conclusion: In this large cohort of histologically proven NAFLD, we confirm the association of the rs738409 G allele with steatosis and describe its association with histological severity. In pediatric patients, the high-risk rs738409 G allele is associated with an earlier presentation of disease. We also describe a hitherto unknown association between SNPs at a chromosome 10 locus and the severity of NASH fibrosis.

Figures

Figure 1
Figure 1
PNPLA3 rs738409 genotype association with histolgical attributes: (a) Association with steatosis in a dominant pattern (λ=0.79, median λbootstrap=0.80, 55% of λbootstrap values classified as dominant) (b) Lobular inflammation, dominant pattern (λ=0.99, median λbootstrap=0.99, 90% classified as dominant) (c) Presence of Mallory-Denk bodies , dominant pattern (λ=0.93, median λbootstrap=0.91, 71% classified as dominant) (d) Fibrosis scores, additive hereditary pattern (λ=0.43, median λbootstrap=0.42, 57% classified as additive). Error bars denote standard error of the mean.
Figure 1
Figure 1
PNPLA3 rs738409 genotype association with histolgical attributes: (a) Association with steatosis in a dominant pattern (λ=0.79, median λbootstrap=0.80, 55% of λbootstrap values classified as dominant) (b) Lobular inflammation, dominant pattern (λ=0.99, median λbootstrap=0.99, 90% classified as dominant) (c) Presence of Mallory-Denk bodies , dominant pattern (λ=0.93, median λbootstrap=0.91, 71% classified as dominant) (d) Fibrosis scores, additive hereditary pattern (λ=0.43, median λbootstrap=0.42, 57% classified as additive). Error bars denote standard error of the mean.
Figure 1
Figure 1
PNPLA3 rs738409 genotype association with histolgical attributes: (a) Association with steatosis in a dominant pattern (λ=0.79, median λbootstrap=0.80, 55% of λbootstrap values classified as dominant) (b) Lobular inflammation, dominant pattern (λ=0.99, median λbootstrap=0.99, 90% classified as dominant) (c) Presence of Mallory-Denk bodies , dominant pattern (λ=0.93, median λbootstrap=0.91, 71% classified as dominant) (d) Fibrosis scores, additive hereditary pattern (λ=0.43, median λbootstrap=0.42, 57% classified as additive). Error bars denote standard error of the mean.
Figure 1
Figure 1
PNPLA3 rs738409 genotype association with histolgical attributes: (a) Association with steatosis in a dominant pattern (λ=0.79, median λbootstrap=0.80, 55% of λbootstrap values classified as dominant) (b) Lobular inflammation, dominant pattern (λ=0.99, median λbootstrap=0.99, 90% classified as dominant) (c) Presence of Mallory-Denk bodies , dominant pattern (λ=0.93, median λbootstrap=0.91, 71% classified as dominant) (d) Fibrosis scores, additive hereditary pattern (λ=0.43, median λbootstrap=0.42, 57% classified as additive). Error bars denote standard error of the mean.
Figure 2
Figure 2
Association of rs738409 genotype with age at time of the biopsy in pediatric patients. (a) Average age at biopsy according to rs738409 genotype. (b) Frequency of rs738409 G allele according to age at time of biopsy. Error bars denote standard error of the mean.
Figure 2
Figure 2
Association of rs738409 genotype with age at time of the biopsy in pediatric patients. (a) Average age at biopsy according to rs738409 genotype. (b) Frequency of rs738409 G allele according to age at time of biopsy. Error bars denote standard error of the mean.

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