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

• Published in: Liver international 2008-04, Vol.28 (4), p.519-524
• Main Authors: Miyaaki, Hisamitsu, Ichikawa, Tatsuki, Nakao, Kazuhiko, Yatsuhashi, Hiroshi, Furukawa, Ryuji, Ohba, Kazuo, Omagari, Katsuhisa, Kusumoto, Yukio, Yanagi, Kenji, Inoue, Osami, Kinoshita, Noboru, Ishibashi, Hiromi, Yano, Michitami, Eguchi, Katsumi
• Format: Article
• Language: English
• Subjects: Age Distribution; Aged; Alanine Transaminase - blood; Biopsy, Needle; Disease Progression; Fatty Liver - epidemiology; Fatty Liver - pathology; Fatty Liver - physiopathology; Female; gender; Humans; hypertension; Immunohistochemistry; Incidence; Japan - epidemiology; Liver Cirrhosis - epidemiology; Liver Cirrhosis - pathology; Liver Cirrhosis - physiopathology; liver fibrosis; Liver Function Tests; Male; Middle Aged; non alcoholic fatty liver disease; older age; Predictive Value of Tests; Probability; Prognosis; Retrospective Studies; Risk Assessment; ROC Curve; Severity of Illness Index; Sex Distribution; type 2 diabetes mellitus
• ISSN: 1478-3223; 1478-3231
• DOI: 10.1111/j.1478-3231.2007.01614.x

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 (≥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