Clinicopathological study of nonalcoholic fatty liver disease in Japan: the risk factors for fibrosis.
OBJECTIVE
We evaluated patients with nonalcoholic fatty liver disease (NAFLD) and compared the clinical and pathological features to identify the risk factors for NAFLD with severe fibrosis.


METHODS
One hundred and eighty-two patients with biopsy-confirmed NAFLD from various medical centres were recruited into this study.


RESULTS
The variables that were significantly associated with severe steatosis were male gender (mild:severe=36%:53%, P=0.02), younger age (mild:severe=57%:82%, P>0.001) and absence of type 2 diabetes (mild:severe=43%:71%, P>0.001). There was no significant difference in the degree of inflammation among the clinical groups. The variables that were significantly associated with severe fibrosis were female gender (mild:severe=54%:84%, P=0.002), older age (> or = 60 years old) (mild:severe=29%:53%, P=0.020), type 2 diabetes (mild:severe=42%:71%, P=0.020) and hypertension (mild:severe=24%:53%, P=0.002). Although there were more obese patients in the group with severe fibrosis, the association was not statistically significant (mild:severe=67%:78%, P=0.229). The prevalence of high serum triglyceride levels was similar between the two groups. The N (Nippon) score (total number of risk factor) could significantly predict severe fibrosis in NAFLD patients (1.48 +/- 1.14 vs. 2.66 +/- 0.94, P<0.001).


CONCLUSIONS
The N score can be used to predict severe fibrosis in cases of NAFLD.
Miyaaki
Hisamitsu
H
The First Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto, Nagasaki, Japan. miyaaki-hi@umin.ac.jp
Ichikawa
Tatsuki
T
Nakao
Kazuhiko
K
Yatsuhashi
Hiroshi
H
Furukawa
Ryuji
R
Ohba
Kazuo
K
Omagari
Katsuhisa
K
Kusumoto
Yukio
Y
Yanagi
Kenji
K
Inoue
Osami
O
Kinoshita
Noboru
N
Ishibashi
Hiromi
H
Yano
Michitami
M
Eguchi
Katsumi
K
D017677:Age Distribution; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001707:Biopsy, Needle; D018450:Disease Progression; D005234:Fatty Liver / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution
D000410:Alanine Transaminase