Mean platelet volume as a marker of increased cardiovascular risk in patients with nonalcoholic steatohepatitis

Nonalcoholic Fatty Liver Disease (NAFLD); Nonalcoholic Steatohepatitis (NASH); Mean plateletvolume (MPV); Inflammation; Steatosis; Ballooning; Fibrosis; Cardiovascular RiskNonalcoholic fatty liver disease (NAFLD) has emerged as the most common cause ofchronic liver disease in western countries (1). NAFLD is frequently associated with obesity,diabetes, metabolic syndrome, and increased cardiovascular risk. Moreover, patients withthe aggressive form of NAFLD, nonalcoholic steatohepatitis or NASH, may be at higher riskof atherosclerosis than patients with simple steatosis due to increased oxidative stress andsystemic inflammation (2–4). Mean platelet volume (MPV) is a marker of platelet activationand a validated predictor of cardiovascular risk (5). Larger platelets are enzymatically moreactive than small platelets, produce more thromboxane A2, and have an increased propensityto thrombosis (6).The aim of this study was two-fold: first to assess MPV levels in patients with biopsyproven NAFLD, and second to determine the relation between histological features ofNASH and MPV. Our cohort consisted of 100 consecutive patients undergoing liver biopsyfor clinical suspicion of NAFLD. Patients were divided into 3 groups: NASH (n=52), simplesteatosis (n=25), and normal biopsy (n=21). We measured MPV in blood samples collectedat the time of liver biopsy. The mean age was 49.8(± 10.6) years and the mean body massindex was 31.4 (± 4.8) kg/m