TABLE 2.
Overview of studies investigating intestinal permeability using serum zonulin
| Author, Country | Adult Children | NAFLD | Method NAFLD | HC | Method HC | IP test | Main outcome |
|---|---|---|---|---|---|---|---|
| Loffredo et al 2017, Italy 39 | Children |
67 NAFLD ‐ 44NAFL ‐ 23 NASH |
Biopsy NAS 1‐4 NAS ≥ 5 |
72 HC | Not specified | Serum zonulin |
‐ zonulin ↑ in NAFLD vs HC (P = .0001) ‐ Zonulin = in NASH vs NAFL (P = .10) |
| Cakir et al 2017, Turkey 40 | Children | 28 NAFLD | US | 30 HC | Not specified | Serum zonulin | Zonulin ↑ in NAFLD vs HC (P = .049) |
| Pacifico et al 2014, Italy 14 | Children |
40 NAFLD ‐ 15 NAFL ‐ 25 NASH |
Biopsy NAS NASb |
40 HC a | MRI | Serum zonulin | Zonulin ↑ in NAFLD vs HC (P = .009) |
| Hendy et al 2017, Egypt 22 | Adult |
56 NAFLD ‐ 24 NAFL ‐ 32 NASH |
Biopsy NAS 1‐4 NAS ≥ 5 |
20 HC a | Biopsy | Serum zonulin |
‐ zonulin ↑ in NAFLD vs HC (P < .001) ‐ zonulin ↑ in NASH vs NAFL (P < .001) |
| Chwist et al 2014, Poland 13 | Adult |
70 NAFLD ‐ 43 NAFL ‐ 27 NASH |
Biopsy NAS 1‐4 NAS ≥ 5 |
NP | NP | Serum zonulin | zonulin ↑ in NASH vs NAFL (P = .003) |
Abbreviations: NP, not present; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; NAFL, simple steatosis; HC, healthy control; US, ultrasound; IP, intestinal permeability; NAS, NAFLD activity score.
BMI not significantly different between HC vs NAFLD.
Diagnosis based on NAS. All patients with NASH had minimal: steatosis (1‐3), lobular inflammation (1‐3) and ballooning (1‐2).