Clinical features and treatment of nonalcoholic fatty liver disease across the Asia Pacific region—the GO ASIA initiative. Issue 6 (14th January 2018)

• Record Type: Journal Article
• Authors: Chan, W.‐K.; Treeprasertsuk, S.; Imajo, K.; Nakajima, A.; Seki, Y.; Kasama, K.; Kakizaki, S.; Fan, J.‐G.; Song, M. J.; Yoon, S. K.; Dan, Y.‐Y.; Lesmana, L.; Ho, K.‐Y.; Goh, K.‐L.; Wong, V. W.‐S.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 47:Issue 6(2018)
• Page Start: 816
• Page End: 825
• Publication Date: 2018-01-14
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.14506
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: Background: The Gut and Obesity Asia (GO ASIA) workgroup was formed to study the relationships between obesity and gastrointestinal diseases in the Asia Pacific region. Aim: To study factors associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis, and medical treatment of biopsy‐proven nonalcoholic fatty liver disease (NAFLD) patients. Methods: Retrospective study of biopsy‐proven NAFLD patients from centres in the GO ASIA Workgroup. Independent factors associated with NASH and with advanced fibrosis on binary logistic regression analyses in a training cohort were used for the development of their corresponding risk score, which were validated in a validation cohort. Results: We included 1008 patients from nine centres across eight countries (NASH 62.9%, advanced fibrosis 17.2%). Independent predictors of NASH were body mass index ≥30 kg/m 2, diabetes mellitus, dyslipidaemia, alanine aminotransferase ≥88 U/L and aspartate aminotransferase ≥38 U/L, constituting the Asia Pacific NASH risk score. A high score has a positive predictive value of 80%‐83% for NASH. Independent predictors of advanced fibrosis were age ≥55 years, diabetes mellitus and platelet count <150 × 10 9 /L, constituting the Asia‐Pacific NAFLD advanced fibrosis risk score. A low score has a negative predictive value of 95%‐96% for advanced fibrosis. Only 1.7% of patients were referred for structured lifestyle program, 4.2% were on vitamin E, and 2.4% were on pioglitazone. Conclusions: More severe liver disease can be suspected or ruled out based on factors identified in this study. Utilisation of structured lifestyle program, vitamin E and pioglitazone was limited despite this being a cohort of biopsy‐proven NAFLD patients with majority of patients having NASH. Abstract : Linked Content This article is linked to Hardy and McPherson and Chan et al papers. To view these articles visit https://doi.org/10.1111/apt.14557 and https://doi.org/10.1111/apt.14572 .