Reduced Lysosomal Acid Lipase Activity in Adult Patients With Non-alcoholic Fatty Liver Disease

AbstractNon-alcoholic fatty liver disease (NAFLD) is characterized by intra-hepatic fat accumulation and mechanisms involved in its pathogenesis are not fully explained. Lysosomal Acid Lipase (LAL) is a key enzyme in lipid metabolism. We investigated its activity in patients with fatty liver.LAL activity (nmol/spot/h) was measured in 100 adult healthy subjects (HS) and in 240 NAFLD patients. A sub-analysis on 35 patients with biopsy-proven non-alcoholic steatohepatitis (NASH) was performed.Median LAL activity was 1.15 (0.95–1.72) in HS. It was significantly reduced in NAFLD [0.78 (0.61–1.01), p<0.001 vs. HS]. A further reduction was observed in the subgroup of NASH [0.67 (0.51–0.77), p<0.001 vs. HS]. Patients with LAL activity below median had higher values of serum total cholesterol (p<0.05) and LDL-c (p<0.05), and increased serum liver enzymes (ALT, p<0.001; AST, p<0.01; GGT, p