title: Abnormal glucose tolerance is a predictor of steatohepatitis and fibrosis in patients with non-alcoholic fatty liver disease.
abstract: OBJECTIVE
  The majority of patients with non-alcoholic fatty liver disease (NAFLD) have simple steatosis. A minority, however, present with non-alcoholic steatohepatitis (NASH), a condition that can lead to advanced fibrosis and cirrhosis. The frequencies of NASH and fibrosis among patients with NAFLD and sustained elevation of liver function tests (LFT) are uncertain. Our aim was to estimate these frequencies. We characterize a population with NAFLD, with special emphasis on insulin resistance and the metabolic syndrome, and study possible predictors for different stages of the disease.
  
  
  METHODS
  All referred patients with sustained elevation of LFT, radiological evidence or clinical suspicion of fatty liver, and absence of other liver disease, were invited to participate in our study in the period June 2002 to December 2004.
  
  
  RESULTS
  Of 129 patients who met the inclusion criteria, 88 underwent liver biopsy. NAFLD was verified in 83 of them. Among these patients, 59 (71%) had the metabolic syndrome, 41 (49%) had NASH and 36 (43%) had fibrosis. Abnormal glucose tolerance (T2DM or impaired glucose tolerance) was the only independent risk factor for NASH (OR: 3.14; 95% CI: 1.20-8.23). Independent predictors for fibrosis were abnormal glucose tolerance (OR: 3.83; 95% CI: 1.29-11.40) and body mass index (OR: 1.20; 95% CI: 1.06-1.36) per kg/m2.
  
  
  CONCLUSIONS
  Both NASH and fibrosis are frequently present among patients with NAFLD and sustained elevation of LFT. The probability of these potentially progressive stages of NAFLD increases with the presence of abnormal glucose tolerance.
authors.affiliation: Department of Gastroenterology, Ullevål University Hospital, Oslo, Norway. j.w.haukeland@medisin.uio.no
authors.forename: John Willy
authors.initials: JW
authors.lastname: Haukeland
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Konopski
authors.forename: Paul
authors.initials: P
authors.lastname: Linnestad
authors.forename: Shafiullah
authors.initials: S
authors.lastname: Azimy
authors.forename: Else
authors.initials: E
authors.lastname: Marit Løberg
authors.forename: Terese
authors.initials: T
authors.lastname: Haaland
authors.forename: Kåre
authors.initials: K
authors.lastname: Birkeland
authors.forename: Kristian
authors.initials: K
authors.lastname: Bjøro
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood* / Q000473:pathology; D005260:Female; D005951:Glucose Tolerance Test; D006505:Hepatitis / Q000097:blood / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008103:Liver Cirrhosis / Q000097:blood / Q000209:etiology* / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
chemical_list: D001786:Blood Glucose