Predictors of fibrosis in Asian patients with non‐alcoholic steatohepatitis

Tsang, Steven Woon Choy; Ng, Wing Fung; Wu, Brian Ping Ying; Chow, David Alan; Li, Eric Ting Ho; Wong, Tak Cheung

doi:10.1111/j.1440-1746.2005.04146.x

Cited by 27 publications

(28 citation statements)

References 30 publications

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“…The prevalence of advanced fibrosis in our cohort was only 2.98%. This proportion is smaller than that reported by other Asian studies, 32,33 which would tend to increase the NPV of the noninvasive fibrosis scoring systems examined in the present study. This divergence may have been caused by the low mean BMI of our patients, which was ＜25 kg/m 2 in 67.2% of our cohort.…”

Section: Patient Characteristicscontrasting

confidence: 82%

Validation of P2/MS and Other Noninvasive Fibrosis Scoring Systems in the Korean Population with Nonalcoholic Fatty Liver Disease

Kim

Lee

et al. 2011

Korean J Gastroenterol

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Section: Patient Characteristicscontrasting

confidence: 82%

Validation of P2/MS and Other Noninvasive Fibrosis Scoring Systems in the Korean Population with Nonalcoholic Fatty Liver Disease

Kim

Lee

et al. 2011

Korean J Gastroenterol

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“…The incidence is markedly higher than the 20.3% incidence observed in patients with NAFLD (Gramlich et al, 2004) but is comparable with that found in Northern European young adult alcoholics (38.9%-73.7%; Savolainen et al, 1995), as well as in young Asian adults (57%) with NASH (Tsang et al, 2006). Thus, perisinusoidal fibrosis seems to occur as frequently in older adult cadavers with diverse causes of death as in young adult alcoholics and NASH patients.…”

Section: Discussionsupporting

confidence: 65%

“…We found bridging fibrosis in 30.8% of the elderly cadaveric livers. This incidence is higher than the 10% incidence observed in Asian young adults with NASH or 14.4 % (septal/bridging fibrosis combined) in NAFLD patients, as assessed by histopathology (Gramlich et al, 2004;Tsang et al, 2006). It is also markedly higher than the 2.8% bridging fibrosis reported in French young adults or 6% in European young adult HCV patients coinfected with HIV, as estimated by FibroTest V R (Martín-Carbonero et al, 2009;Poynard et al, 2010).…”

Section: Discussionmentioning

confidence: 79%

Hepatic Steatosis, Fibrosis, and Cancer in Elderly Cadavers

Mak

Kwong

Chu

et al. 2011

The Anatomical Record

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The incidence of hepatic steatosis, fibrosis, and cancer in the elderly population remains unknown. Human cadavers used in anatomy teaching, which come largely from older adults, may provide liver tissue for examining their pathologies. Livers were obtained from 68 cadavers (mean age 82.1 ± 10.4 years) with diverse causes of death in the Anatomy course at Mount Sinai School of Medicine. Paraffin sections were stained with hematoxylin and eosin and Sirius red and evaluated for steatosis, fibrosis, cancer, and lipofuscin. Tissue preservation was graded as good in 38.2% of the embalmed livers, fair in 36.7%, and poor in 25.0%. Steatosis was observed in 35.3% of the livers, central vein fibrosis in 49.2%, perisinusoidal fibrosis in 63.2%, portal tract (PT) fibrosis in 47.0%, septa formation in 44.1%, bridging fibrosis in 30.8%, and cirrhosis in 4.4%. One hepatocellular carcinoma (HCC) and six metastatic tumors were detected. Lobular inflammation occurred in 20.8% of the livers and PT inflammation in 38.8%. Nine livers showed minimal change. Lipofuscin was detected in 60.2% of the livers. Steatosis, fibrosis, and cancer are highly prevalent in elderly cadavers with diverse causes of death. The prevalence of steatosis and fibrosis is consistent with the data in patients with specific liver diseases. Steatosis alongside fibrosis can accelerate the progression of fibrosis to cirrhosis and ultimately HCC. Though not indicated as the primary cause of death, the liver injury may have compromised hepatic functions and enhanced disease susceptibility, thereby exacerbating the health conditions in this elderly population. Anat Rec, 2012. © 2011 Wiley Periodicals, Inc.

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“…Among nearly 1000 morbidly obese subjects undergoing gastrointestinal bariatric surgery in Italy, an aspartate aminotransferase (AST) or ALT level greater than twice the upper limit of normal had a positive predictive value (PPV) for bridging fibrosis of 21% and a negative predictive value (NPV) of 93% [36]. An AST greater than twice the upper limit of normal was also independently predictive of portal or bridging fibrosis in an Asian study of 60 patients with NAFLD [37]. However, other studies have failed to confirm an association between simple aminotransferase levels and degree of fibrosis in patients who have NAFLD [38–40].…”

Section: Serum Markers Of Liver Fibrosis In Nashmentioning

confidence: 99%

Can Nash Be Diagnosed, Graded, and Staged Noninvasively?

Grandison

Angulo

2012

Clinics in Liver Disease

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Synopsis Non-alcoholic bland steatosis and nonalcoholic steatohepatitis (NASH) are stages in the spectrum of nonalcoholic fatty liver disease (NAFLD). NASH may progress to end-stage liver disease with liver-related morbidity and mortality occurring almost exclusively in patients with NASH whose disease had progressed to advanced fibrosis and cirrhosis. Liver biopsy is the only accurate tool available to distinguish between patients with NASH and no NASH and to stage fibrosis which is important for patient counseling and monitoring. Markers of hepatocyte apoptosis such as cytokeratine (CK)-18 measured in plasma hold promise as a non-invasive test for NASH diagnosis. Several scoring systems that combine routine clinical and laboratory variables and some proprietary panels can assist in predicting fibrosis severity. Noninvasive imaging modalities such as ultrasound-based elastography (FibroScan), and particularly magnetic resonance-based elastography (MRE) are reasonably accurate available tools to determine severity of fibrosis in NAFLD, but none of them yet can replace liver biopsy.

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Predictors of fibrosis in Asian patients with non‐alcoholic steatohepatitis

Abstract: Septal fibrosis is common in Asians with NASH. Necroinflammatory grade >or= 2, AST >or= 2 x ULN and DM are independent predictors for septal fibrosis.

Cited by 27 publications

References 30 publications

Validation of P2/MS and Other Noninvasive Fibrosis Scoring Systems in the Korean Population with Nonalcoholic Fatty Liver Disease

Validation of P2/MS and Other Noninvasive Fibrosis Scoring Systems in the Korean Population with Nonalcoholic Fatty Liver Disease

Hepatic Steatosis, Fibrosis, and Cancer in Elderly Cadavers

Can Nash Be Diagnosed, Graded, and Staged Noninvasively?

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