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Publications

Journal Article Ahead of print

PubMed: 42899427 DOI: 10.1111/jgh.70837

Clinical Risk Factors for Advanced Fibrosis in Pathology-Proven Steatotic Liver Disease: Emphasis on Nonelder Subjects.

J Gastroenterol Hepatol

Authors: Chen-Te Huang, Shang-Chin Huang, Chia-Lin Kang, Sia-Wang Tang, Hau-Jyun Su, Tung-Hung Su, Tai-Chung Tseng, Shih-Jer Hsu, Chun-Ming Hong, Chen-Hua Liu, Hung-Chih Yang, Pei-Jer Chen, Jia-Horng Kao, Chun-Jen Liu

Affiliations

  • Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University BioMedical Park Hospital, Hsinchu, Taiwan.
  • Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
  • Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
  • Department of Internal Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.
  • Division of Gastroenterology and Hepatology, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan.
  • National Taiwan University Hsin-Chu Hospital, Hsinchu, Taiwan.
  • Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
  • Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
  • Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Abstract

BACKGROUND AND AIM

Steatotic liver disease (SLD) may lead to advanced liver diseases. We aimed to identify clinical risk factors for advanced fibrosis in pathology-proven SLD patients in a hepatitis B virus (HBV) endemic population, with emphasis on nonelder subjects.

METHODS

Adult SLD patients diagnosed via pathology at National Taiwan University Hospital between June 2009 and December 2023 were recruited. Advanced fibrosis was defined as F2 to F4 fibrosis. Patients were stratified by age (< 50 years defined as nonelder), metabolic dysfunction-associated steatotic liver disease (MASLD), and HBV infection. Clinical risk factors for advanced fibrosis and at-risk steatohepatitis were investigated, and the predictive performance of noninvasive scores was examined.

RESULTS

Among 223 pathology-proven SLD patients, older age (odds ratio [OR]: 1.04), alcohol consumption (OR: 5.77), type 2 diabetes mellitus (T2DM) (OR: 2.13), chronic HBV infection (OR: 2.52), and obesity (OR: 2.64) were independent risk factors for advanced fibrosis. In the nonelder subgroup, older age (OR: 1.10) and obesity (OR: 3.75) were significant. In the MASLD subgroup, older age (OR: 1.04), hypertension (OR: 2.31), T2DM (OR: 3.07), and chronic HBV infection (OR: 3.59) remained significant. Obesity (OR: 4.14) was a significant risk factor for at-risk steatohepatitis in the nonelder subgroup. NAFLD fibrosis score had the highest AUROC (0.724) for advanced fibrosis in the entire cohort, while FIB-4 performed best in nonelder subjects.

CONCLUSIONS

Older age, alcohol, T2DM, chronic HBV infection, and obesity were associated with advanced fibrosis. Risk factors and noninvasive score performance varied in nonelder subjects.

MeSH

Liver Diseases, Diabetes Mellitus, Gastroenterology, Fibrosis, Pathology, Liver, Obesity, Risk Factors, Infections, Hepatitis, Diabetes Mellitus, Type 2