title: Histological course of nonalcoholic fatty liver disease in Japanese patients: tight glycemic control, rather than weight reduction, ameliorates liver fibrosis.
abstract: OBJECTIVE
  The goal of this study was to examine whether metabolic abnormalities are responsible for the histological changes observed in Japanese patients with nonalcoholic fatty liver disease (NAFLD) who have undergone serial liver biopsies.
  
  
  METHODS
  In total, 39 patients had undergone consecutive liver biopsies. Changes in their clinical data were analyzed, and biopsy specimens were scored histologically for stage.
  
  
  RESULTS
  The median follow-up time was 2.4 years (range 1.0-8.5). Liver fibrosis had improved in 12 patients (30.7%), progressed in 11 patients (28.2%), and remained unchanged in 16 patients (41%). In a Cox proportional hazard model, decrease in A1C and use of insulin were associated with improvement of liver fibrosis independent of age, sex, and BMI. However, DeltaA1C was more strongly associated with the improvement of liver fibrosis than use of insulin after adjustment for each other (chi(2); 7.97 vs. 4.58, respectively).
  
  
  CONCLUSIONS
  Tight glycemic control may prevent histological progression in Japanese patients with NAFLD.
authors.affiliation: Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan. ttakamura@m-kanazawa.jp
authors.forename: Erika
authors.initials: E
authors.lastname: Hamaguchi
authors.forename: Toshinari
authors.initials: T
authors.lastname: Takamura
authors.forename: Masaru
authors.initials: M
authors.lastname: Sakurai
authors.forename: Eishiro
authors.initials: E
authors.lastname: Mizukoshi
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.forename: Yumie
authors.initials: Y
authors.lastname: Takeshita
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Kurita
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Arai
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamashita
authors.forename: Motoko
authors.initials: M
authors.lastname: Sasaki
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kaneko
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D018450:Disease Progression; D005234:Fatty Liver / Q000097:blood / Q000150:complications / Q000473:pathology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007564:Japan; D008103:Liver Cirrhosis / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015431:Weight Loss
chemical_list: D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases; D001786:Blood Glucose; D006442:Glycated Hemoglobin