Prevalence and risk factors for biopsy‐proven non‐alcoholic fatty liver disease and non‐alcoholic steatohepatitis in a prospective cohort of adult patients with gallstones. (5th March 2015)

• Record Type: Journal Article
• Authors: García‐Monzón, Carmelo; Vargas‐Castrillón, Javier; Porrero, José Luís; Alonso, María Teresa; Bonachía, Oscar; Castillo, María José; Marcos, Alberto; Quirós, Esther; Ramos, Beatriz; Sánchez‐Cabezudo, Carlos; Villar, Sol; Sáez, Alicia; Rodríguez de Cía, Javier; del Pozo, Elvira; Vega‐Piris, Lorena; Soto‐Fernández, Susana; Lo Iacono, Oreste; Miquilena‐Colina, María Eugenia
• Is Part Of: Liver international. Volume 35:Number 8(2015:Aug.)
• Page Start: 1983
• Page End: 1991
• Publication Date: 2015-03-05
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12813
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12813-abs-0001"> <title>Abstract</title> <sec id="liv12813-sec-0001" sec-type="section"> <title>Background & Aims</title> <p>Relationship between gallstones and non‐alcoholic fatty liver disease (NAFLD), and largely non‐alcoholic steatohepatitis (NASH), is uncertain.</p> </sec> <sec id="liv12813-sec-0002" sec-type="section"> <title>Aim</title> <p>To determine the prevalence, non‐invasive fibrosis markers profile and risk factors for biopsy‐proven NAFLD and NASH among patients with gallstones.</p> </sec> <sec id="liv12813-sec-0003" sec-type="section"> <title>Methods</title> <p>Anthropometric and laboratory evaluation, an abdominal ultrasound and a liver biopsy were performed to 215 consecutive patients with gallstones referred for cholecystectomy.</p> </sec> <sec id="liv12813-sec-0004" sec-type="section"> <title>Results</title> <p>Prevalence of NASH was 10.2% whereas that of simple steatosis (SS) was 41.4%. In the cohort of NAFLD patients, negative predictive values for advanced fibrosis of FIB‐4 and NAFLD fibrosis score were 96 and 95% respectively. Gallstone patients with NASH had a higher mean homeostatic model assessment (HOMA) score than those with SS (<italic>P </italic>=<italic> </italic>0.015). Noteworthy, NASH was 2.5‐fold more frequent in patients with gallstones who had metabolic syndrome than in those who did not (<italic>P </italic><<italic> </italic>0.001). Fatty liver on ultrasound was observed in 90.9% of gallstone patients with NASH compared with 61.8% of those with SS (<italic>P </italic>=<italic> </italic>0.044). Using multivariate logistic regression, increased HOMA score (OR, 3.47; 95% CI, 1.41–8.52; <italic>P </italic>=<italic> </italic>0.007) and fatty liver on ultrasound (OR, 23.27; 95% CI, 4.15–130.55; <italic>P </italic><<italic> </italic>0.001) were the only factors independently associated with NASH.</p> </sec> <sec id="liv12813-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Prevalence of NASH among patients with gallstones is lower than estimated previously, but NASH is frequent particularly in those patients with concurrent metabolic syndrome. The combination of an increased HOMA score with fatty liver on ultrasound has a good accuracy for predicting NASH in patients with gallstones.</p> </sec> </abstract>