Histological progression of non‐alcoholic fatty liver disease in Chinese patients

Abstract

Summary Background : Non‐alcoholic fatty liver disease is an important cause of chronic hepatitis and cryptogenic cirrhosis. The natural history of non‐alcoholic fatty liver disease is not well understood especially in Asian populations. Aim : To investigate the histological progression in Chinese patients with biopsy‐proven non‐alcoholic fatty liver disease. Methods : Chinese patients who had liver biopsy at least 3 years ago and confirmed to have non‐alcoholic fatty liver disease were invited for a second liver biopsy. Clinical and laboratory parameters related to their liver function and metabolic syndrome were recorded and analysed. Liver biopsies were scored for the degree of steatosis, necroinflammation and fibrosis. Correlation coefficients were calculated to assess the association between changes in histological scores and metabolic parameters. Results : Seventeen patients who had been followed up for a median period of 6.1 (range: 3.8–8.0) years underwent a second liver biopsy. Nine (53%) patients had progressive disease with worsening of fibrosis score. No statistically significant correlation was found between the changes in histological scores and metabolic parameters. Seven patients developed hypertension or diabetes mellitus during the period of follow‐up. Conclusions : Non‐alcoholic fatty liver disease is a progressive disease in Chinese patients as in their Caucasian counterparts. Diagnosis of non‐alcoholic fatty liver disease may predate development of new components of metabolic syndrome.

Natural history of nonalcoholic fatty liver disease: A prospective follow‐up study with serial biopsies

“…There are few paired biopsy studies with approximately 520 patients in total,7, 8, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 and all but two studies have a median follow‐up time of less than 7 years (range, 3.0‐7.0 years). Albeit, some studies only include patients with NASH, the rate of fibrosis progression does not seem to be affected by the presence of steatohepatitis.…”

“…NAFLD is a slowly progressive disease,11 and most follow‐up studies have too short a follow‐up time to assess fibrosis progression 24. Fibrosis progression is seen in 27%‐52% of patients7, 8, 19, 21, 22, 24 over a mean of 3.0‐13.8 years of follow‐up, with the majority of patients with NAFLD having static or regressive fibrosis. Baseline variables predicting fibrosis progression have been hard to determine.…”

Dietary and physical activity patterns in children with fatty liver

“…Although NASH is known to progress to cirrhosis in 10-15% (Adams et al, 2005;Schwimmer et al, 2006), simple steatosis is regarded as benign. Accumulating data suggest that 1-2% of patients with simple steatosis will progress to cirrhosis (Hui et al, 2005). Thus, fatty liver severe enough to be identified sonographically deserves attention, at least in children.…”

Metabolic and histological features of non‐alcoholic fatty liver disease patients with different serum alanine aminotransferase levels

“…4,5 When paired biopsies are performed, 30% to 50% of NAFLD patients have histological progression with time. [6][7][8] Alanine aminotransferase (ALT) is an enzyme found abundantly in the cytosol of hepatocytes. 9 Serum ALT level is commonly used to reflect hepatic inflammation and injury in patients with chronic liver disease.…”