Histological course of nonalcoholic fatty liver disease in Japanese patients: tight glycemic control, rather than weight reduction, ameliorates liver fibrosis.
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.
Hamaguchi
Erika
E
Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan. ttakamura@m-kanazawa.jp
Takamura
Toshinari
T
Sakurai
Masaru
M
Mizukoshi
Eishiro
E
Zen
Yoh
Y
Takeshita
Yumie
Y
Kurita
Seiichiro
S
Arai
Kuniaki
K
Yamashita
Tatsuya
T
Sasaki
Motoko
M
Nakanuma
Yasuni
Y
Kaneko
Shuichi
S
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
D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases; D001786:Blood Glucose; D006442:Glycated Hemoglobin