Smoking and severity of hepatic fibrosis in nonalcoholic fatty liver disease

• Published in: Journal of hepatology 2011-04, Vol.54 (4), p.753-759
• Main Authors: Zein, Claudia O, Unalp, Aynur, Colvin, Ryan, Liu, Yao-Chang, McCullough, Arthur J
• Format: Article
• Language: English
• Subjects: Adult; Alcohol; Biological and medical sciences; Cohort Studies; Databases, Factual; Diabetes Mellitus, Type 2 - complications; Disease Progression; Fatty Liver - etiology; Fatty Liver - pathology; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver Cirrhosis - etiology; Liver Cirrhosis - pathology; Liver fibrosis; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Multivariate Analysis; Non-alcoholic Fatty Liver Disease; Nonalcoholic fatty liver disease; Other diseases. Semiology; Predictors; Prospective Studies; Risk Factors; Smoking; Smoking - adverse effects; Tobacco, tobacco smoking; Toxicology
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2010.07.040

Background & Aims Although many predictors of disease severity of nonalcoholic fatty liver disease (NAFLD) have been proposed, studies of the potential effects of specific environmental exposures on human NAFLD are lacking. Smoking increases insulin resistance. Given the pathophysiological role of insulin resistance in NAFLD, characterization of the influence of smoking in NAFLD is warranted. The aim of this paper was to study the potential association between cigarette smoking and advanced fibrosis in NAFLD. Methods All adults enrolled in the NASH CRN studies, between October 2004 and February 2008, who had liver biopsies, were included ( n = 1091). Advanced fibrosis was defined as stages 3–4. Analyses were performed. Results Significant bivariate associations were demonstrated between advanced fibrosis and age, gender, ethnicity, diabetes, and smoking history. History of smoking ⩾10 pack-years was more common ( p