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Spleen dimensions are inversely associated with lysosomal acid lipase activity in patients with non-alcoholic fatty liver disease

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Abstract

Fatty liver and splenomegaly are typical features of genetic lysosomal acid lipase (LAL) deficiency. No data in adult patients with non-genetic reduction of LAL activity are available. We investigate the association between spleen dimensions and LAL activity in non-alcoholic fatty liver disease (NAFLD) patients, in whom a reduced LAL activity has been reported. We include 425 consecutive patients who underwent abdominal ultrasound to evaluate hepatic steatosis and spleen dimensions. LAL activity was measured with dried blood spot method (Lalistat2). NAFLD was present in 74.1% of screened patients. Higher median spleen longitudinal diameter (10.6 vs. 9.9 cm; p < 0.001) and spleen area (SA) (32.7 vs. 27.7 cm2; p < 0.001), together with a higher and proportion of splenomegaly (17.8 vs. 5.5%, p = 0.001), are present in patients with NAFLD compared to those without. In NAFLD patients, median LAL activity is 0.9 nmol/spot/h. LAL activity is lower in 56 patients with splenomegaly, as compared to those without (p = 0.009). At multivariable logistic regression analysis, age (above median, OR 0.344; p = 0.003), LAL activity (below median, OR 2.206, p = 0.028), and platelets (OR 0.101, p = 0.002) are significantly associated with splenomegaly. NAFLD patients disclose a relatively high prevalence of spleen enlargement and splenomegaly, which are significantly associated with a reduced LAL activity, suggesting that LAL may contribute to spleen enlargement in this setting.

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Acknowledgements

The authors wish to thank nurses Daniela Salzano and Monica Brancorsini for their skilful cooperation.

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Author notes

  1. Licia Polimeni and Daniele Pastori have contributed equally to this work.

Authors and Affiliations

  1. Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy

    Licia Polimeni, Daniele Pastori, Francesco Baratta, Marta Novo, Francesco Violi & Maria Del Ben

  2. Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University, Rome, Italy

    Daniele Pastori & Francesco Baratta

  3. Unit for Neuromuscular and Neurodegenerative Diseases, Children’s Hospital and Research Institute “Bambino Gesù”, Rome, Italy

    Giulia Tozzi

  4. Department of Cardiovascular, Respiratory Nephrologic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy

    Roberto Vicinanza, Giovanni Troisi & Gaetano Pannitteri

  5. Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I Hospital, “La Sapienza” University, Rome, Italy

    Fabrizio Ceci

  6. Department of Surgical Sciences, Sapienza University, Rome, Italy

    Laura Scardella

  7. Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy

    Francesco Angelico

Authors
  1. Licia Polimeni
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  11. Francesco Violi
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Corresponding author

Correspondence to Daniele Pastori.

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The authors have not disclosed any potential conflict of interest.

Statement of human and animal rights

The study was conducted according to the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments. The study did not involved animals.

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Each patient provided written informed consent at baseline.

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Polimeni, L., Pastori, D., Baratta, F. et al. Spleen dimensions are inversely associated with lysosomal acid lipase activity in patients with non-alcoholic fatty liver disease. Intern Emerg Med 12, 1159–1165 (2017). https://doi.org/10.1007/s11739-017-1746-1

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