Journal
HEPATOLOGY RESEARCH
Volume 24, Issue 4, Pages 429-438Publisher
ELSEVIER SCI IRELAND LTD
DOI: 10.1016/S1386-6346(02)00246-2
Keywords
nonalcoholic steatohepatitis; liver fibrosis; liver cirrhosis; steatohepatitis; Mallory body
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The purpose of this study was to clarify the clinicopathological features of nonalcoholic steatohepatitis (NASH) and identify risk factors for severe hepatic fibrosis. Materials and Methods: Eighty-one patients with biopsy-proven NASH were studied. In all patients, the diagnosis of NASH was established on the basis of following criteria: (1) the presence of steatosis, lobular inflammation, and ballooning degeneration on liver biopsy, (2) intake of less than 20 g of ethanol per week, and (3) appropriate exclusion of other liver diseases. Results: The median age was 54 years (range: 21-82 years) and 41 patients were women (51%). Obesity was present in 58 patients (72%), while 25 patients (31%) had diabetes mellitus and 33 patients (41%) had hyperlipidemia. Histologically, 58 patients (72%) had trivial to moderate fibrosis, 6 patients (7%) had bridging fibrosis, and 17 patients (21%) had established cirrhosis. Multiple logistic regression analysis assessed clinical, laboratory and histological factors showed that the risk factors for fibrosis were a low platelet count (P = 0.0016), a high AST/ALT ratio (P = 0.0229), and the presence of Mallory bodies (P = 0.0209). To exclude factors that were a consequence of liver cirrhosis, variables included in the multiple logistic analysis were age, gender, diabetes, obesity, and hyperlipidemia. This showed that older age (P=0.0037) and the absence of hyperlipidemia (P = 0.0150) were risk factors for fibrosis. Conclusions: We found that a low platelet count, a high AST/ALT ratio, and the presence of Mallory bodies were significant predictors of severe liver fibrosis. (C) 2002 Elsevier Science B.V. All rights reserved.
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