Prognosis of biopsy-confirmed metabolic dysfunction- associated steatotic liver disease: A sub-analysis of the CLIONE study.

Autor:	Iwaki M; Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Fujii H; Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan., Hayashi H; Department of Gastroenterology and Hepatology, Gifu Municipal Hospital, Gifu, Japan., Toyoda H; Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan., Oeda S; Liver Center and Department of Laboratory Medicine, Saga University Hospital, Saga, Japan., Hyogo H; Hyogo Life Care Clinic Hiroshima, Hiroshima, Japan., Kawanaka M; Department of General Internal Medicine2, Kawasaki Medical Center, Kawasaki Medical School, Okayama, Japan., Morishita A; Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan., Munekage K; Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.; Department of Gastroenterology, Kochi Prefectural Hata Kenmin Hospital, Kochi, Japan., Kawata K; Hepatology Division, Department of Internal Medicine II, Hamamatsu University School of Medicine, Shizuoka, Japan., Tsutsumi T; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan., Sawada K; Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan., Maeshiro T; Department of Gastroenterology, Urasoe General Hospital, Okinawa, Japan., Tobita H; Department of Hepatology, Shimane University Hospital, Shimane, Japan., Yoshida Y; Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, Japan., Naito M; Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, Japan., Araki A; Division of Pathology, Shimane University Hospital, Shimane, Japan., Arakaki S; Department of Gastroenterology, Urasoe General Hospital, Okinawa, Japan., Kawaguchi T; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan., Noritake H; Hepatology Division, Department of Internal Medicine II, Hamamatsu University School of Medicine, Shizuoka, Japan., Ono M; Division of Innovative Medicine for Hepatobiliary & Pancreatology, Faculty of Medicine, Kagawa University, Kagawa, Japan., Masaki T; Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan., Yasuda S; Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan., Tomita E; Department of Gastroenterology and Hepatology, Gifu Municipal Hospital, Gifu, Japan., Yoneda M; Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Tokushige A; Department of Clinical Pharmacology and Therapeutics School of Medicine University of the Ryukyus, Okinawa, Japan., Kamada Y; Department of Advanced Metabolic Hepatology, Osaka University, Graduate School of Medicine, Osaka, Japan., Takahashi H; Liver Center, Saga University Hospital, Saga, Japan., Ueda S; Department of Clinical Pharmacology and Therapeutics School of Medicine University of the Ryukyus, Okinawa, Japan., Aishima S; Department of Scientific Pathology Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Sumida Y; Graduate School of Healthcare Management, International University of Healthcare and Welfare, Tokyo, Japan., Nakajima A; Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Okanoue T; Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan.
Jazyk:	angličtina
Zdroj:	Clinical and molecular hepatology [Clin Mol Hepatol] 2024 Apr; Vol. 30 (2), pp. 225-234. Date of Electronic Publication: 2024 Jan 24.
DOI:	10.3350/cmh.2023.0515
Abstrakt:	Background/aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study. Methods: This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD. Results: Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4). Conclusion: Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.
Databáze:	MEDLINE
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