Clinicopathological study of nonalcoholic fatty liver disease in Japan: the risk factors for fibrosis

Hisamitsu Miyaaki, Tatsuki Ichikawa, Kazuhiko Nakao, Hiroshi Yatsuhashi, Ryuji Furukawa, Kazuo Ohba, Katsuhisa Omagari, Yukio Kusumoto, Kenji Yanagi, Osami Inoue, Noboru Kinoshita, Hiromi Ishibashi, Michitami Yano, Katsumi Eguchi
Liver International: Official Journal of the International Association for the Study of the Liver 2008, 28 (4): 519-24

BACKGROUND/AIMS: We evaluated patients with nonalcoholic fatty liver disease (NAFLD) and compared the clinical and pathological features to identify the risk factors for NAFLD with severe fibrosis.

METHODS: One hundred and eighty-two patients with biopsy-confirmed NAFLD from various medical centres were recruited into this study.

RESULTS: The variables that were significantly associated with severe steatosis were male gender (mild:severe=36%:53%, P=0.02), younger age (mild:severe=57%:82%, P>0.001) and absence of type 2 diabetes (mild:severe=43%:71%, P>0.001). There was no significant difference in the degree of inflammation among the clinical groups. The variables that were significantly associated with severe fibrosis were female gender (mild:severe=54%:84%, P=0.002), older age (> or = 60 years old) (mild:severe=29%:53%, P=0.020), type 2 diabetes (mild:severe=42%:71%, P=0.020) and hypertension (mild:severe=24%:53%, P=0.002). Although there were more obese patients in the group with severe fibrosis, the association was not statistically significant (mild:severe=67%:78%, P=0.229). The prevalence of high serum triglyceride levels was similar between the two groups. The N (Nippon) score (total number of risk factor) could significantly predict severe fibrosis in NAFLD patients (1.48 +/- 1.14 vs. 2.66 +/- 0.94, P<0.001).

CONCLUSIONS: The N score can be used to predict severe fibrosis in cases of NAFLD.

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