Biopsy Proven Fibrosis in Non-Alcoholic Fatty Liver Disease: An Analysis of Risk Factors

Pattnaik, Kaumudee; Bhuyan, Pallavi; Singh, Ayaskanta; Singh, Shivaram Prasad; Nath, Preetam; Kar, Sanjib; Misra, Bijay; Rath, Jayashree

doi:10.1016/j.jceh.2017.12.008

Cited by 4 publications

(1 citation statement)

References 25 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among patients with NAFLD, 40-68% of patients had progressed to definite biopsy-confirmed NASH and 20% of patients had borderline NASH. In Indian patients, biopsy-proven NASH has been found in >60% of patients and advanced fibrosis (≥F3) in 29-35% of patients [17][18][19].…”

Section: Nafld and Nash Burden: Global And Indiamentioning

confidence: 99%

Non-alcoholic Steatohepatitis in Asians: Current Perspectives and Future Directions

Choudhuri¹,

Shah²,

Sharma³

et al. 2023

Cureus

View full text Add to dashboard Cite

Non-alcoholic steatohepatitis (NASH) is a subset of non-alcoholic fatty liver disease (NAFLD), which, apart from excess fat in the liver, may be characterised by some level of inflammatory infiltration and fibrogenesis, occasionally progressing to liver cirrhosis or hepatocellular carcinoma (HCC). The objective of the current review is to elucidate the rising prevalence, the role of microbiome and genetics in pathogenesis, diagnostic challenges, and novel treatment alternatives for NASH. Newer diagnostic techniques are being developed since using liver biopsy in a larger population is not a reasonable option and is primarily restricted to clinical research, at least in developing countries. Besides these technical challenges, another important factor leading to deviation from guideline practice is the lack of health insurance coverage in countries like India. It leads to reluctance on the part of physicians and patients to delay required tests to curb out-ofpocket expenditure. There is no cure for NASH, with liver transplantation remaining the last option for those who progress to end-stage liver disease (ESLD) or are detected with early-stage HCC. Thus, lifestyle modification remains the only viable option for many, but compliance and long-term adherence remain major challenges. In obese individuals, bariatric surgery and weight reduction have shown favourable results. In patients with less severe obesity, endoscopic bariatric metabolic therapies (EBMT) are rapidly emerging as less invasive therapies. However, access and acceptability remain poor for these weight reduction methods. Therefore, intense research is being conducted for potential newer drug classes with several agents currently in phase II or III of clinical development. Some of these have demonstrated promising results, such as a reduction in hepatic fat content, and attenuation of fibrosis with an acceptable tolerability profile in phase II studies. The developments in the management of NASH have been fairly encouraging. Further well-designed long-term prospective studies should be undertaken to generate evidence with definitive results.

show abstract

Section: Nafld and Nash Burden: Global And Indiamentioning

confidence: 99%

Non-alcoholic Steatohepatitis in Asians: Current Perspectives and Future Directions

Choudhuri¹,

Shah²,

Sharma³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

Liver Stiffness Values in Persons with Normal Histology

Sharma

Choudhary²,

Dhampalwar³

et al. 2023

Journal of Clinical and Experimental Hepatology

View full text Add to dashboard Cite

The Clinical and Histological Characteristics of Patients with Biopsy-Proven Non-alcoholic Fatty Liver Disease in the Absence of Insulin Resistance

Demirtaş¹

2020

Hepatology Forum

View full text Add to dashboard Cite

Background and Aim Non-alcoholic fatty liver disease (NAFLD) is closely associated with insulin resistance (IR). While a minority of patients with NAFLD does not have evidence of IR, no detailed characterization of this specific phenotype is currently available. This study was undertaken to investigate the clinical and histological characteristics of this patient group. Materials and Methods We retrospectively reviewed the clinical records of 263 patients with biopsy-proven NAFLD. IR was defined by a Homeostatic Model Assessment of IR (HOMA-IR) score >2.73. The histological diagnosis of non-alcoholic steatohepatitis (NASH) was performed using 1) the steatosis, activity and fibrosis score and 2) the NASH Clinical Research Network (NASH CRN) criteria. Significant fibrosis was defined by the presence of a histological fibrosis score higher than F≥2. Patients with and without evidence of IR were compared concerning clinical, laboratory, and histological characteristics. Results Of the 263 patients with biopsy-proven NAFLD, 53 (20.2%) patients had no evidence of IR. Patients without IR were younger [IR (-): 42 (22–65) years versus IR (+): 49 (22−71) years, p=0.001] and had a higher prevalence of men [IR (-): 39 (73.6%) versus IR (+): 113 (53.8%), p=0.009]. Moreover, they were characterized by a lower body mass index [IR (-): 30.06±3.61 kg/m 2 versus IR (+): 33.19±5.06 kg/m 2 , p=0.000] and lower frequencies of metabolic risk factors–including the metabolic syndrome, diabetes, hypertension, hyperlipidemia, and lower waist/hip circumference. Liver histology was generally less severe in patients without IR; specifically, they showed a lower prevalence of NASH [IR (-): 38 (71.7%) versus IR (+): 190 (90.5%), p=0.000] and significant fibrosis [IR (-): 9 (17.0%) versus IR (+): 106 (50.5%), p=0.000] than did patients with IR. Multivariate analysis identified obesity [odds ratio (OR): 9.321, 95% confidence interval (CI): 1.031−84.261, p<0.05] and an international normalized ratio >1.1 (OR: 10.116, 95% CI: 1.325−77.225, p<0.05) as independent predictors of significant fibrosis in patients with NAFLD and no IR. Conclusion Patients with NAFLD and no IR has less severe liver histology than patients with IR. However, obesity appears to be independently associated with significant fibrosis in this patient group.

show abstract

Biopsy Proven Fibrosis in Non-Alcoholic Fatty Liver Disease: An Analysis of Risk Factors

Cited by 4 publications

References 25 publications

Non-alcoholic Steatohepatitis in Asians: Current Perspectives and Future Directions

Non-alcoholic Steatohepatitis in Asians: Current Perspectives and Future Directions

Liver Stiffness Values in Persons with Normal Histology

The Clinical and Histological Characteristics of Patients with Biopsy-Proven Non-alcoholic Fatty Liver Disease in the Absence of Insulin Resistance

Contact Info

Product

Resources

About