RT info:eu-repo/semantics/article
T1 Definite and indeterminate nonalcoholic steatohepatitis share similar clinical features and prognosis: A longitudinal study of 1893 biopsy‐proven nonalcoholic fatty liver disease subjects
A1 Ampuero, Javier
A1 Aller de la Fuente, Rocío
A1 Gallego‐Durán, Rocío
A1 Crespo, Javier
A1 Abad, Javier
A1 González‐Rodríguez, Águeda
A1 Gómez‐Camarero, Judith
A1 Caballería, Joan
A1 Lo Iacono, Oreste
A1 Ibañez, Luis
A1 García‐Samaniego, Javier
A1 Martín‐Mateos, Rosa
A1 Francés, Rubén
A1 Fernández‐Rodríguez, Conrado
A1 Diago, Moisés
A1 Soriano, Germán
A1 Andrade, Raúl J.
A1 Latorre, Raquel
A1 Jorquera, Francisco
A1 Morillas, Rosa M.
A1 Escudero, Desam
A1 Estévez, Pamela
A1 Hernández‐Guerra, Manuel
A1 Augustín, Salvador
A1 Pareja‐Megia, María Jesús
A1 Banales, Jesús M.
A1 Aspichueta, Patricia
A1 Benlloch, Salvador
A1 Rosales, José Miguel
A1 Salmerón, Javier
A1 Turnes, Juan
A1 Romero‐Gómez, Manuel
AB Background and AimHistological score systems may not fully capture the essential nonalcoholic steatohepatitis (NASH) features, which is one of the leading causes of screening failure in clinical trials. We assessed the NASH distribution and its components across the fibrosis stages and their impact on the prognosis and their relationship with the concept of metabolic-associated fatty liver disease (MAFLD).MethodsSpanish multicenter study including 1893 biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients from HEPAmet registry. NASH was diagnosed by NAS score ≥4 (including steatosis, ballooning and lobular inflammation) and fibrosis by Kleiner score. The presence of MAFLD was determined. Progression to cirrhosis, first episode of decompensated cirrhosis and death were collected during the follow-up (4.7 ± 3.8 years).ResultsFibrosis was F0 34.3% (649/1893), F1 27% (511/1893), F2 16.5% (312/1893), F3 15% (284/1893) and F4 7.2% (137/1893). NASH diagnosis 51.9% (982/1893), and its individual components (severe steatosis, ballooning and lobular inflammation), increased from F0 (33.6%) to F2 (68.6%), and decreased significantly in F4 patients (51.8%) (P = .0001). M ore t han 7 0% o f n on-NASH p atients s howed s ome i nflammatory activity (ballooning or lobular inflammation), showing a similar MAFLD rate than NASH (96.2% [945/982] vs. 95.2% [535/562]) and significantly higher than nonalcoholic fatty liver (NAFL) subjects (89.1% [311/349]) (P < .0001). Progression to cirrhosis was similar between NASH (9.5% [51/539]) and indeterminate NASH (7.9% [25/316]), and higher than steatosis (5% [14/263]) (logRank 8.417; P = .015). Death and decompensated cirrhosis were similar between these.ConclusionsThe prevalence of steatohepatitis decreased in advanced liver disease. However, most of these patients showed some inflammatory activity histologically and had metabolic disturbances. These findings should be considered in clinical trials whose main aim is to prevent cirrhosis progression and complications, liver transplant and death.
SN 1478-3223
YR 2021
FD 2021
LK https://uvadoc.uva.es/handle/10324/64578
UL https://uvadoc.uva.es/handle/10324/64578
LA spa
NO Liver International, 2021 (41), 2076-2086., 2021•idus.us.es
DS UVaDOC
RD 20-may-2024