Dataset Information

Comparison of long-term prognosis between non-obese and obese patients with non-alcoholic fatty liver disease.

ABSTRACT:

Background and aim

Non-alcoholic fatty liver disease (NAFLD) can progress in non-obese patients as in obese patients. Reports on long-term prognosis in non-obese NAFLD patients are controversial. Therefore, we aimed to examine the long-term prognosis of non-obese patients with NAFLD.

Methods

This single-center, retrospective cohort study enrolled biopsy-proven non-obese and obese NAFLD patients between January 2002 and December 2011 and followed them up until 31 March 2021, for death and clinical events (cardiovascular and liver-related events and extrahepatic cancers).

Results

Of the 223 NAFLD patients, 58 (26.0%) were non-obese. Compared with obese patients, they had a lower fibrosis stage (0.8 ± 0.80 vs 1.2 ± 0.91; P = 0.004), milder lobular inflammation (0.9 ± 0.7 vs 1.1 ± 0.7; P = 0.02), and significantly lower serum creatinine, total bilirubin, ferritin, and type IV collagen 7S and higher high-density lipoprotein levels. After a median follow-up of 8.9 years, no significant difference was noted in mortality between the two groups (2 [3.4%] non-obese vs 5 [3.0%] obese; log-rank test, P = 0.63). Twelve patients (20.7%) in the non-obese group and 32 (19.4%) in the obese group had clinical events. Although the obese group had a higher incidence of clinical events during the first 10 years of follow-up, the non-obese group had a higher incidence after that (log-rank test, P = 0.67). The non-obese group had a high incidence of malignancy (9 [15.5%] non-obese vs 14 [8.3%] obese; P = 0.13).

Conclusion

Non-obese NAFLD does not necessarily have a good prognosis, and some cases have a poor prognosis such as extrahepatic cancers. Further validation is required in the future.

SUBMITTER: Iwaki M

PROVIDER: S-EPMC9575321 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Comparison of long-term prognosis between non-obese and obese patients with non-alcoholic fatty liver disease.

Iwaki Michihiro M Kessoku Takaomi T Tanaka Kosuke K Ozaki Anna A Kasai Yuki Y Yamamoto Atsushi A Takahashi Kota K Kobayashi Takashi T Nogami Asako A Honda Yasushi Y Ogawa Yuji Y Imajo Kento K Oyamada Shunsuke S Kobayashi Noritoshi N Aishima Shinichi S Saito Satoru S Nakajima Atsushi A Yoneda Masato M

JGH open : an open access journal of gastroenterology and hepatology 20220824 10

<h4>Background and aim</h4>Non-alcoholic fatty liver disease (NAFLD) can progress in non-obese patients as in obese patients. Reports on long-term prognosis in non-obese NAFLD patients are controversial. Therefore, we aimed to examine the long-term prognosis of non-obese patients with NAFLD.<h4>Methods</h4>This single-center, retrospective cohort study enrolled biopsy-proven non-obese and obese NAFLD patients between January 2002 and December 2011 and followed them up until 31 March 2021, for de ...[more]

PMID: 36262543

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Project description:BackgroundGiven the high prevalence of non-alcoholic fatty liver disease (NAFLD) in obese children, non-invasive markers of disease to date are still limited and worth exploring.ObjectiveThis study aimed to evaluate the association between inflammatory markers and NAFLD in obese children.MethodsWe performed a case-control study in Hunan Children's Hospital from September 2020 to September 2021. Study participants were children with obesity diagnosed with NAFLD by abdominal ultrasound examination. Mean platelet volume (MPV), platelet distribution width (PDW), neutrophil, lymphocyte, monocyte, and platelet counts were extracted from medical records and inflammatory cytokines were measured by enzyme-linked immunosorbent assay (ELISA). Multivariable logistic regression analysis was performed to evaluate the association between inflammatory markers and NAFLD. We also used receiver operating characteristic curve analysis to assess the discriminative ability of inflammatory cytokines for NAFLD.ResultsTwo hundred and sixty-seven obese children were enrolled, including 176 NAFLD patients and 91 simple obesity controls. Multivariable logistic model indicated that increased interleukin (IL)-1β [odds ratio (OR) = 1.15, 95% confidence interval (CI): 1.04-1.27], IL-6 (OR = 1.28, 95% CI: 1.07-1.53), and IL-17 (OR = 1.04, 95% CI: 1.02-1.07) levels were significantly associated with NAFLD. In contrast, we observed non-significant associations for IL-8, IL-12, IL-21, IL-32, tumor necrosis factor-α (TNF-α), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), mean platelet volume (MPV), and platelet distribution width (PDW) with NAFLD. The area under the curves (AUCs) of IL-1β, IL-6, and IL-17 to discriminate obese children with or without NAFLD were 0.94, 0.94, and 0.97, respectively.ConclusionsOur results indicated that IL-1β, IL-6, and IL-17 levels were significantly associated with NAFLD. These inflammatory cytokines may serve as non-invasive markers to determine the development of NAFLD and potentially identify additional avenues for therapeutic intervention.

Project description:Background & aimThere is currently no agreement on the screening strategy for non-alcoholic fatty liver disease (NAFLD) in children at risk. The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) recommends screening for NAFLD using alanine aminotransferase (ALT) in obese/overweight children, while the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommends using both ALT and abdominal ultrasound. The aim of this study was to assess the prevalence of suspected NAFLD in obese children based on the 2 screening strategies.MethodConsecutive overweight/obese children seen at a weight-management program were included. Each child underwent a liver ultrasound and had ALT level measured at first visit. Two screening strategies were compared: the NASPGHAN strategy using ALT ≫2x the gender specific cut-off and the ESPGHAN strategy using elevated ALT ≫45 IU/L and/or fatty liver on ultrasound. Univariate and multivariate analyses were performed to assess predictors of low ALT in individuals with evidence of suspected NAFLD on ultrasound.ResultsOverweight/obese children were included. NAFLD was suspected as follows: 26% based on the NASPGHAN strategy, and 58% based on the ESPGHAN strategy. Fatty liver was present on ultrasound in 53% of our cohort. ALT was ≫2x the gender specific cut-off in only 26% of children with fatty liver on ultrasound. Univariate and multivariate analyses indicated that children with fatty infiltration on ultrasound and low ALT were less likely to have metabolic syndrome, insulin resistance, or hypertriglyceridemia.ConclusionBy relying on ALT values alone to screen for NAFLD, suspected NAFLD might be missed in many children who are at risk. Children with fatty infiltration on ultrasound and low ALT may be less likely to have metabolic syndrome, insulin resistance or hypertriglyceridemia.Lay summaryUsing the combination of elevated alanine aminotransferase and fatty infiltration on ultrasound increases the detection rate of suspected non-alcoholic fatty liver disease in at-risk children. Notably, a significant percentage of children with fatty infiltration on ultrasound have low alanine aminotransferase (≪52/44). Children with fatty infiltration on ultrasound and low alanine aminotransferase may be less likely to have features of the metabolic syndrome.

Project description:IntroductionNon-alcoholic fatty liver disease (NAFLD) in the non-obese population accounts for a large proportion of NAFLD. Atherogenic index of plasma (AIP, defined as the logarithm of the triglyceride/high-density lipoprotein cholesterol ratio.) can provide a stronger reflection of dyslipidemia and studies on the longitudinal association between AIP and NAFLD were limited in non-obese participants, especially in different BMI groups.MethodsWe performed a post-hoc analysis of data obtained from the Dryad data repository (Dryad is a nonprofit open database of medicine.) and explored the predictive value of AIP on the risk of NAFLD among non-obese participants.ResultsThis study included 16173 participants with AIP, of which 2322(14.4%) non-obese participants developed into individuals with NAFLD with the 5-year follow-up examination. The difference between AIP quartiles in the cumulative estimation of new-onset NAFLD was significant, and with increased AIP, the cumulative new-onset NAFLD gradually increased. Participants in higher AIP quartiles had a significantly increased risk of NAFLD. In the fully adjusted model 3, hazard ratios of the new-onset NAFLD for subjects in Q2, Q3, and Q4 of AIP were 2.00 (1.59, 2.53), 2.61 (2.09, 3.72), and 4.49 (3.62, 5.57) respectively. Meanwhile, the trend test for the association between AIP quartiles and the new-onset NAFLD presented that AIP quartile was positively and strongly associated with the new-onset NAFLD (adjusted hazard ratio (95%CI) in Model 3: 1.59 (1.51, 1.67), P<0.001). We found that AIP was also positively and strongly associated with new-onset NAFLD in different sex groups and different age groups in female patients. Moreover, the predictive ability of AIP was no significant difference in different sex groups and different age groups in female patients. In the subgroup analysis, we found that in the low BMI population, the predictive effect of AIP for new-onset NAFLD was expanded by 2-3 times for each quality increase of AIP.ConclusionThis study found that AIP was a strong independent risk factor for new-onset NAFLD among non-obese individuals especially in the low BMI participants, and screening for AIP in this population can be used to prevent future NAFLD.

Project description:BackgroundQuantification of the relationship between hypertension and non-alcoholic fatty liver disease (NAFLD) risk is limited and controversial. This study aimed to investigate the relationship between hypertension and NAFLD in non-obese Chinese and to use different methods to demonstrate that hypertension is an independent risk factor for NAFLD.MethodsOn 16,153 nonobese individuals, a retrospective cohort study was conducted in China to examine the impact of hypertension on incident NAFLD. We compared five methods: multivariable Cox proportional-hazards regression, propensity score-matched (PSM) analysis, propensity score adjustment method (considering the propensity score as a covariate in a multivariable Cox proportional-hazard regression), and two propensity score-based weighted methods-The first one estimated the hypertension effect in the overall study population-inverse probability of treatment weights (IPTW), the other in the hypertensive population-standardized mortality ratio (SMR) weights. We also used a genetic matching (GenMatch) algorithm to match the participants for sensitive analysis.ResultsBetween 2010 and 2014, 16,153 participants met our inclusion criteria, including 2427 (15.03%) with hypertension. A total of 2321 (14.37%) participants developed NAFLD during the median follow-up of 2.98 years. The crude hazard ratio (HR) between hypertension and incident NAFLD was 2.05 (95% confidence interval (CI): 1.87, 2.25). The adjusted HR depended on the different methods, ranging from 1.09 (95% CI: 0.77, 1.23) for the PSM method to 2.24 (95% CI: 2.05, 2.44) for the SMR weighted analysis. Hypertensive participants with high propensity scores had a higher risk of developing NAFLD in the future. Excluding participants with propensity scores <8% yielded comparable hazard ratios with a narrower range, from 1.04 to 1.80. After adjusting for the confounding variables, the relationship also existed in the GenMatch cohort as a sensitivity analysis (HR=1.06, 95% CI 1.01-1.13).ConclusionHypertension is a significant cause of NAFLD in Chinese adults in non-obese Chinese adults, with the hazard ratio ranging from 1.09 to 2.24.

Dataset Information

Comparison of long-term prognosis between non-obese and obese patients with non-alcoholic fatty liver disease.

Background and aim

Methods

Results

Conclusion

Publications

Comparison of long-term prognosis between non-obese and obese patients with non-alcoholic fatty liver disease.

Similar Datasets

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