Liver histology is associated with long-term clinical outcomes in patients with metabolic dysfunction-associated steatohepatitis.

Autor:	Younossi ZM; Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia, USA.; The Global NASH Council, Washington, District of Columbia, USA., Mangla KK; Novo Nordisk A/S, Søborg, Denmark., Berentzen TL; Novo Nordisk A/S, Søborg, Denmark., Grau K; Novo Nordisk A/S, Søborg, Denmark., Kjær MS; Novo Nordisk A/S, Søborg, Denmark., Ladelund S; Novo Nordisk A/S, Søborg, Denmark., Nitze LM; Novo Nordisk A/S, Søborg, Denmark., Coolbaugh C; Nashville Biosciences, Nashville, Tennessee, USA., Hsu CY; Nashville Biosciences, Nashville, Tennessee, USA., Hagström H; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.; Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden.
Jazyk:	angličtina
Zdroj:	Hepatology communications [Hepatol Commun] 2024 May 10; Vol. 8 (6). Date of Electronic Publication: 2024 May 10 (Print Publication: 2024).
DOI:	10.1097/HC9.0000000000000423
Abstrakt:	Background: Few studies have examined the risk of long-term clinical outcomes in patients with metabolic dysfunction-associated steatohepatitis in relation to liver histology. We aimed to study this using a real-world cohort. Methods: Adults (N = 702) recorded on Vanderbilt University Medical Center's Synthetic Derivative database (1984-2021) with evidence of metabolic dysfunction-associated steatohepatitis on liver biopsy were followed from the first biopsy until the first clinical event or last database entry (median: 4.7 y). Risks of cirrhosis (N = 650), other noncirrhotic liver-related (N = 702) and cardiovascular-related outcomes (N = 660), and mortality due to liver, cardiovascular, or cancer events (N = 660) were determined as a function of baseline histology (fibrosis stage [F], lobular inflammation grade [LI], hepatocyte ballooning grade [HB], and steatosis score) adjusting for sex, age, diabetes, and weight-loss surgery. Results: Cirrhosis risk was reduced for lower versus higher fibrosis stage (HR: F0-1 vs. F3: 0.22 [95% CI: 0.12-0.42]), LI1 versus LI2-3 (0.42 [0.19-0.97]), and HB1 versus HB2 (0.20 [0.08-0.50]). Lower fibrosis stage was associated with significantly lower risks of liver-related outcomes versus F4 cirrhosis (eg, F0-1: 0.12 [0.05-0.25]), whereas no differences were seen across baseline lobular inflammation, hepatocyte ballooning, and steatosis grades/scores. Lower versus higher lobular inflammation grade was associated with lower risks for liver-related outcomes in patients with weight-loss surgery. There was a trend for lower risks for cardiovascular-related and any long-term outcomes with lower versus higher fibrosis stage. Conclusions: Fibrosis stage and lobular inflammation and hepatocyte ballooning grades predict the risk of long-term outcomes, supporting the use of these histological features as potential surrogate markers of disease progression or clinical outcomes. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.)
Databáze:	MEDLINE
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