dc.creator | Ampuero Herrojo, Javier | es |
dc.creator | Aller, Rocío | es |
dc.creator | Gallego Durán, Rocío | es |
dc.creator | Crespo, Javier | es |
dc.creator | Abad, Javier | es |
dc.creator | Romero Gómez, Manuel | es |
dc.date.accessioned | 2021-12-02T16:10:18Z | |
dc.date.available | 2021-12-02T16:10:18Z | |
dc.date.issued | 2021-04 | |
dc.identifier.citation | Ampuero Herrojo, J., Aller, R., Gallego-Durán, R., Crespo, J., Abad, J. y Romero Gómez, M. (2021). Definite and indeterminate nonalcoholic steatohepatitis share similar clinical features and prognosis: A longitudinal study of 1893 biopsy-proven nonalcoholic fatty liver disease subjects. Liver International, 2021 (41), 2076-2086. | |
dc.identifier.issn | 1478-3223 | es |
dc.identifier.uri | https://hdl.handle.net/11441/127959 | |
dc.description.abstract | Background and Aim: Histological 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).
Methods: Spanish 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).
Results: Fibrosis 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.
Conclusions: The 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. | es |
dc.format | application/pdf | es |
dc.format.extent | 10 p. | es |
dc.language.iso | eng | es |
dc.relation.ispartof | Liver International, 2021 (41), 2076-2086. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Ballooning | es |
dc.subject | Fatty liver disease | es |
dc.subject | Inflammation | es |
dc.subject | Metabolic-associated fatty liver disease | es |
dc.subject | Natural coursesteatohepatitis | es |
dc.subject | Steatosis | es |
dc.title | Definite and indeterminate nonalcoholic steatohepatitis share similar clinical features and prognosis: A longitudinal study of 1893 biopsy-proven nonalcoholic fatty liver disease subjects | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina | es |
dc.relation.publisherversion | https://onlinelibrary.wiley.com/doi/full/10.1111/liv.14898 | es |
dc.identifier.doi | 10.1111/liv.14898 | es |
dc.journaltitle | Liver International | es |
dc.publication.volumen | 41 | es |
dc.publication.issue | 9 | es |
dc.publication.initialPage | 2076 | es |
dc.publication.endPage | 2086 | es |