자료실
비알콜성 지방간질환에서 당뇨병과 간기능(AST/ALT)의 의미
2009.11.10 21:37
Diabetes mellitus and aminotransferase levels are independent predictors of fibrosis in patients with NAFLD.
"Independent Predictors of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease" by Hossain et al.
Abstract:
Background & Aims
Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease. We investigated factors associated with advanced fibrosis in NAFLD.
Methods
The study included 432 patients with histologically proven NAFLD (26.8% with nonalcoholic steatohepatitis [NASH] and 17.4% with moderate-to severe fibrosis). NASH was defined as steatosis, lobular inflammation, and ballooning degeneration with or without Mallory–Denk bodies and/or fibrosis. Fibrosis was classified into 2 groups: those with no or minimal fibrosis and those with moderate-to-severe fibrosis. Groups were compared using Mann–Whitney and chi-square method analyses. A model was constructed using a stepwise bidirectional method; its predictive power was measured using a 10-fold cross-validation technique.
Results
Patients with NASH were more likely to be male (P < .0001); have lower hip-to-waist ratios (P = .03); were less likely to be African American (P = .06); have higher levels of alanine aminotransferase (ALT; P < .0001), aspartate aminotransferase (AST; P < .0001), and serum triglycerides (P = .0154), but lower levels of high-density lipoprotein cholesterol (P < .0001). Patients with moderate-to-severe fibrosis were older (P = .0245); more likely to be male (P = .0189), Caucasian (P = .0382), have diabetes mellitus (P = .0238), and hypertension (P = .0375); and have a lower hip-to-waist ratio (P = .0077) but higher serum AST (P < .0001) and ALT (P < .0001) levels. The multivariate analysis model to predict moderate-to-severe fibrosis included male sex, Caucasian ethnicity, diabetes mellitus, and increased AST and ALT levels (model P value < .0001).
Conclusions
In patients with NAFLD, diabetes mellitus and aminotransferase levels are independent predictors of moderate-to-severe fibrosis. They can be used to identify NAFLD patients at risk for advanced fibrosis.
Read the Full Article.
Hossain N, Afendy A, Stepanova M, et al. Independent Predictors of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Clinical Gastroenterology and Hepatology 2009;7:1224-1229.
Copyright 2009 AGA Institute
Abstract:
Background & Aims
Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease. We investigated factors associated with advanced fibrosis in NAFLD.
Methods
The study included 432 patients with histologically proven NAFLD (26.8% with nonalcoholic steatohepatitis [NASH] and 17.4% with moderate-to severe fibrosis). NASH was defined as steatosis, lobular inflammation, and ballooning degeneration with or without Mallory–Denk bodies and/or fibrosis. Fibrosis was classified into 2 groups: those with no or minimal fibrosis and those with moderate-to-severe fibrosis. Groups were compared using Mann–Whitney and chi-square method analyses. A model was constructed using a stepwise bidirectional method; its predictive power was measured using a 10-fold cross-validation technique.
Results
Patients with NASH were more likely to be male (P < .0001); have lower hip-to-waist ratios (P = .03); were less likely to be African American (P = .06); have higher levels of alanine aminotransferase (ALT; P < .0001), aspartate aminotransferase (AST; P < .0001), and serum triglycerides (P = .0154), but lower levels of high-density lipoprotein cholesterol (P < .0001). Patients with moderate-to-severe fibrosis were older (P = .0245); more likely to be male (P = .0189), Caucasian (P = .0382), have diabetes mellitus (P = .0238), and hypertension (P = .0375); and have a lower hip-to-waist ratio (P = .0077) but higher serum AST (P < .0001) and ALT (P < .0001) levels. The multivariate analysis model to predict moderate-to-severe fibrosis included male sex, Caucasian ethnicity, diabetes mellitus, and increased AST and ALT levels (model P value < .0001).
Conclusions
In patients with NAFLD, diabetes mellitus and aminotransferase levels are independent predictors of moderate-to-severe fibrosis. They can be used to identify NAFLD patients at risk for advanced fibrosis.
Read the Full Article.
Hossain N, Afendy A, Stepanova M, et al. Independent Predictors of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Clinical Gastroenterology and Hepatology 2009;7:1224-1229.
Copyright 2009 AGA Institute
Figure 1. ROC curve for the predictive model of NASH.
Hossain N, Afendy A, Stepanova M, et al. Independent Predictors of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Clinical Gastroenterology and Hepatology 2009;7:1224-1229.
Copyright 2009 AGA Institute
Hossain N, Afendy A, Stepanova M, et al. Independent Predictors of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Clinical Gastroenterology and Hepatology 2009;7:1224-1229.
Copyright 2009 AGA Institute
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