Table 4

Liver histology, immunohistochemistry and immunofluorescence of study population (n=80), grouped according to the presence and severity of OSAS

ParameterNon-OSAS subjects (n=28)OSAS subjects (n=52)p Value
OSAS versus non- OSAS
Mild OSAS (n=29)Severe OSAS (n=23)p Value
mild versus severe OSAS
NASH n (%)2 (7%)47 (90%)<0.00124 (83%)*23 (100%)*0.105
Steatosis score1.7±0.52.5±0.6<0.0012.3±0.4*2.7±0.5*0.007
Lobular inflammatory score1.1±0.61.8±0.5<0.0011.5±0.4†1.8±0.5*0.026
Ballooning score0.8±0.51.3±0.6<0.0011.1±0.3†1.4±0.4*0.001
NAS3.6±0.85.5±1.1<0.0014.7±1.0*5.8±0.9*<0.001
Fibrosis stage1.1±0.61.5±0.70.0091.3±0.61.7±0.6‡0.027
Subjects with fibrosis stage n (%)
 010 (32%)0%<0.0010 (0%)0%0.673
 113 (43%)22 (44%)0.90622 (76%)0%<0.001
  1a0%0%0.8510%0%0.673
  1b5 (18%)5 (12%)0.4785 (17%)0%0.097
  1c8 (32%)17 (29%)0.89917 (59%)0%<0.001
 25 (14%)27 (54%)0.0067 (24%)20 (87%)‡<0.001
 30%3 (6%)0.6120 (%)3 (13%)0.160
 40%0%0.9990%0%0.978
Fibrosis any stage n (%)18 (64%)52 (100%)<0.00129 (100%)23 (100%)0.987
Portal fibrosis n (%)13 (46%)44 (85%)<0.00124 (83%)20 (87%)0.942
Significant (F≥2) fibrosis n (%)5 (18%)30 (58%)0.0017 (24%)23 (100%)‡*<0.001
Hepatocytes
 Cell-cycle arrest index§4.68±3.9811.01±6.04<0.0018.97±6.13†15.01±8.11*0.004
 Apoptotic index§6.71±6.5412.50±7.14<0.0019.01±4.58†16.58±6.13<0.001
 Adiponectin-positive hepatocytes (%)23.5±10.38.5±5.5<0.00112.4±5.1†5.8±3.9*<0.001
 Resistin-positive hepatocytes (%)20.1±12.815.9±13.40.20715.8±12.113.9±13.50.704
 TLR-4-positive hepatocytes (%)¶41.6±7.463.3±14.8<0.00159.1±11.3*69.8±6.1*<0.001
Kupffer cells
  n-Kupffer cells¶8.0±3.411.2±3.7<0.00110.7±2.5‡*12.7±1.9*0.003
 TLR-4-positive Kupffer cells
  n-cells3.1±2.46.6±2.8<0.0015.7±2.8†7.2±1.9*0.033
  % cells36.9±15.457.4±13.1<0.00150.1±12.1†65.4±9.1*<0.001
HSCs
 n-HSCs¶5.0±1.46.4±1.6<0.0016.0±1.6‡*7.1±1.7†0.020
 TLR-4-positive HSCs
  n-HSC1.4±0.63.1±1.1<0.0012.4±0.7‡*3.7±0.9*<0.0010
  % HSCs27.1±10.548.4±11.1<0.00140.1±10.5†52.1±11.4*<0.001
HPCs
 n-HPCs**37.1±8.744.1±8.90.00140.0±8.2‡*46.7±8.1†0.005
 Adiponectin-positive
  n HPCs5.2±3.03.3±2.10.001 3.8±1.7†2.8±1.2*0.021
  % HPCs13.9±8.27.5±5.7<0.0019.5±5.1†6.4±4.9*0.031
 Resistin-positive
  n HPCs8.5±3.08.9±4.10.6519.0±3.89.5±4.00.647
  % HPCs23.0±8.520.2±10.40.46322.5±9.720.4±8.90.425
Intermediate hepatocytes (% patients)0%11 (21%)0.0232 (7%)9 (39%)‡*0.034
  • Data are reported as mean±SD, unless otherwise specified. Differences were considered statistically significant at p<0.05. Statistically significant differences are highlighted in bold.

  • *p<0.0001 versus non-OSAS subjects.

  • †p<0.01 versus non-OSAS subjects.

  • ‡p<0.05 versus non-OSAS subjects.

  • §At least 30 lobular fields at ×40 magnification were analysed (1000 hepatocytes) for each section.

  • ¶Mean count in five different fields at a magnification of ×20 under light microscopy.

  • **Cells per HPF, that is, at a magnification of ×20 under light microscopy.

  • HPC, hepatic progenitor cells; HPF, high-power field; HSC, hepatic stellate cells; NAFLD, non-alcoholic fatty liver disease; NAS, NAFLD activity score; NASH, non-alcoholic steatohepatitis; OSAS, obstructive sleep apnoea syndrome; TLR-4, toll-like receptor-4.