Low liver fat in non-alcoholic steatohepatitis-related significant fibrosis and cirrhosis is associated with hepatocellular carcinoma, decompensation and mortality
Correction(s) for this article
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Corrigendum
- Volume 59Issue 3Alimentary Pharmacology & Therapeutics
- pages: 427-427
- First Published online: January 2, 2024
Sung Won Lee
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Contribution: Data curation (lead), Formal analysis (equal), Writing - original draft (lead), Writing - review & editing (lead)
Search for more papers by this authorDaniel Q. Huang
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Contribution: Data curation (equal), Writing - original draft (equal), Writing - review & editing (equal)
Search for more papers by this authorRicki Bettencourt
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Contribution: Formal analysis (lead), Writing - review & editing (equal)
Search for more papers by this authorVeeral Ajmera
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorMonica Tincopa
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorNabil Noureddin
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorMaral Amangurbanova
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorHarris Siddiqi
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorEgbert Madamba
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorAbdul M. Majzoub
Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorTarek Nayfeh
Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorNobuharu Tamaki
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorNamiki Izumi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorAtsushi Nakajima
Department of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Japan
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorMasato Yoneda
Department of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Japan
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorRamzan Idilman
Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorMesut Gumussoy
Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorDigdem Kuru Oz
Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorAyse Erden
Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Rohit Loomba
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
Correspondence
Rohit Loomba, NAFLD Research Center, University of California at San Diego, Altman Clinical and Translational Research Institute, 9500 Gilman Drive, La Jolla, CA 92093-0887, USA.
Email: [email protected]
Search for more papers by this authorSung Won Lee
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Contribution: Data curation (lead), Formal analysis (equal), Writing - original draft (lead), Writing - review & editing (lead)
Search for more papers by this authorDaniel Q. Huang
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Contribution: Data curation (equal), Writing - original draft (equal), Writing - review & editing (equal)
Search for more papers by this authorRicki Bettencourt
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Contribution: Formal analysis (lead), Writing - review & editing (equal)
Search for more papers by this authorVeeral Ajmera
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorMonica Tincopa
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorNabil Noureddin
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorMaral Amangurbanova
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorHarris Siddiqi
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorEgbert Madamba
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorAbdul M. Majzoub
Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorTarek Nayfeh
Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorNobuharu Tamaki
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorNamiki Izumi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorAtsushi Nakajima
Department of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Japan
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorMasato Yoneda
Department of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Japan
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorRamzan Idilman
Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorMesut Gumussoy
Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorDigdem Kuru Oz
Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorAyse Erden
Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Rohit Loomba
NAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA
Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
Correspondence
Rohit Loomba, NAFLD Research Center, University of California at San Diego, Altman Clinical and Translational Research Institute, 9500 Gilman Drive, La Jolla, CA 92093-0887, USA.
Email: [email protected]
Search for more papers by this authorThe Handling Editor for this article was Dr Vincent Wong, and it was accepted for publication after full peer-review.
Summary
Background
Progression to cirrhosis in non-alcoholic steatohepatitis (NASH) is associated with a decrease in liver fat. However, the prognostic significance of liver fat content in NASH-related significant fibrosis and cirrhosis is unclear.
Aim
To investigate the risk of decompensation, hepatocellular carcinoma (HCC) and mortality stratified by liver fat content in NASH-related significant fibrosis and cirrhosis.
Methods
In this meta-analysis of individual participant data, 456 patients with both magnetic resonance elastography (MRE) and MRI-derived protein density fat fraction (MRI-PDFF) were enrolled, and 296 patients with longitudinal follow-up were analysed. MRE combined with fibrosis-4 (MEFIB-index), and MRI-PDFF were used to measure liver fibrosis and fat, respectively. MEFIB-negative, MEFIB-positive+ MRI-PDFF ≥5% and MEFIB-positive+ MRI-PDFF <5% were defined as no significant liver fibrosis, NASH with significant fibrosis and higher liver fat content, and NASH with significant fibrosis and low liver fat content groups, respectively. The primary outcome was hepatic decompensation, HCC and death.
Results
The rates of decompensation, HCC and mortality were highest in the NASH with significant fibrosis and low liver fat group (33%, 17% and 17%, respectively), followed by the NASH with significant fibrosis and higher liver fat group (18%, 13% and 13% respectively), and lowest in the no significant fibrosis (MEFIB-negative) group (0%, 1% and 2% respectively). In multivariable-adjusted analysis, low liver fat content was strongly associated (HR = 42.2 [95% CI: 7.5–235.5, p < 0.0001]) with HCC, decompensation and death. Sensitivity analyses for patients with cirrhosis (MRE ≥5 kPa) determined consistent findings.
Conclusions
Low liver fat content in patients with burnt-out NASH-related significant fibrosis and cirrhosis is associated with an increase in hepatic decompensation, HCC and mortality.
Supporting Information
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| apt17783-sup-0001-FigureS1.tiffTIFF image, 138.2 KB |
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| apt17783-sup-0002-TableS1.docxWord 2007 document , 19.4 KB |
Table S1. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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