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dc.contributor.authorAngulo, Paul
dc.contributor.authorKleiner, David E
dc.contributor.authorDam-Larsen, Sanne
dc.contributor.authorAdams, Leon A
dc.contributor.authorBjornsson, Einar S
dc.contributor.authorCharatcharoenwitthaya, Phunchai
dc.contributor.authorMills, Peter R
dc.contributor.authorKeach, Jill C
dc.contributor.authorLafferty, Heather D
dc.contributor.authorStahler, Alisha
dc.contributor.authorHaflidadottir, Svanhildur
dc.contributor.authorBendtsen, Flemming
dc.date.accessioned2015-09-17T13:18:06Zen
dc.date.available2015-09-17T13:18:06Zen
dc.date.issued2015-08en
dc.date.submitted2015en
dc.identifier.citationGastroenterology 2015, 149 (2):389-397.e10en
dc.identifier.issn1528-0012en
dc.identifier.pmid25935633en
dc.identifier.doi10.1053/j.gastro.2015.04.043en
dc.identifier.urihttp://hdl.handle.net/2336/577432en
dc.descriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the pageen
dc.description.abstractHistologic analysis of liver biopsy specimens allows for grading and staging of nonalcoholic fatty liver disease (NAFLD). We performed a longitudinal study to investigate the long-term prognostic relevance of histologic features for patients with NAFLD.
dc.description.abstractWe performed a retrospective analysis of 619 patients diagnosed with NAFLD from 1975 through 2005 at medical centers in the United States, Europe, and Thailand. Patients underwent laboratory and biopsy analyses, and were examined every 3-12 months after their diagnosis. Outcomes analyzed were overall mortality, liver transplantation, and liver-related events. Cumulative outcomes were compared by log-rank analysis. Cox proportional-hazards regression was used to estimate adjusted hazard ratios (HRs). Time at risk was determined from the date of liver biopsy to the date of outcome or last follow-up examination.
dc.description.abstractOver a median follow-up period of 12.6 years (range, 0.3-35.1 y), 193 of the patients (33.2%) died or underwent liver transplantation. Features of liver biopsies significantly associated with death or liver transplantation included fibrosis stage 1 (HR, 1.88; 95% confidence interval [CI], 1.28-2.77), stage 2 (HR, 2.89; 95% CI, 1.93-4.33), stage 3 (HR, 3.76; 95% CI, 2.40-5.89), and stage 4 (HR, 10.9; 95% CI, 6.06-19.62) compared with stage 0, as well as age (HR, 1.07; 95% CI, 1.05-1.08), diabetes (HR, 1.61; 95% CI, 1.13-2.30), current smoking (HR, 2.62; 95% CI, 1.67-4.10), and statin use (HR, 0.32; 95% CI, 0.14-0.70). Twenty-six patients (4.2%) developed liver-related events; fibrosis stage 3 (HR, 14.2; 95% CI, 3.38-59.68) and stage 4 (HR, 51.5; 95% CI, 9.87-269.2) compared with stage 0, were associated significantly with the events. Patients with fibrosis, regardless of steatohepatitis or NAFLD activity score, had shorter survival times than patients without fibrosis.
dc.description.abstractIn a longitudinal study of patients with NAFLD, fibrosis stage, but no other histologic features of steatohepatitis, were associated independently with long-term overall mortality, liver transplantation, and liver-related events.
dc.description.sponsorshipNational Institute of Health R01 DK82426 National Institutes of Health, National Cancer Instituteen
dc.language.isoenen
dc.publisherW B Saunders Co-Elsevieren
dc.relation.urlhttp://dx.doi.org/ 10.1053/j.gastro.2015.04.043en
dc.rightsArchived with thanks to Gastroenterologyen
dc.subjectLifrarsjúkdómaren
dc.subject.meshNon-alcoholic Fatty Liver Diseaseen
dc.subject.meshPrognosisen
dc.titleLiver Fibrosis, but No Other Histologic Features, Is Associated With Long-term Outcomes of Patients With Nonalcoholic Fatty Liver Disease.en
dc.typeArticleen
dc.contributor.department[ 1 ] Univ Kentucky, Med Ctr, Div Digest Dis & Nutr, Lexington, KY USA [ 2 ] Natl Canc Inst, Pathol Lab, Bethesda, MD 20892 USA [ 3 ] Koege Univ Hosp, Dept Med, Koege, Denmark [ 4 ] Univ Western Australia, Sch Med & Pharmacol, Perth, WA 6009, Australia [ 5 ] Univ Iceland, Natl Univ Hosp, Fac Med, Sect Gastroenterol & Hepatol, Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital     University of Iceland [ 6 ] Mahidol Univ, Siriraj Hosp, Fac Med, Bangkok 10700, Thailand [ 7 ] Gartnavel Royal Hosp, Glasgow, Lanark, Scotland [ 8 ] Mayo Clin, Div Gastroenterol & Hepatol, Rochester, MN USA [ 9 ] Oslo Univ Hosp, Rikshosp, Dept Pediat, Oslo, Norway [ 10 ] Univ Copenhagen, Hvidovre Hosp, Dept Gastroenterol, Copenhagen, Denmark [ 11 ] Univ Copenhagen, Hvidovre Hosp, Fac Hlth Sci, Copenhagen, Denmarken
dc.identifier.journalGastroenterologyen
dc.rights.accessNational Consortium - Landsaðganguren
html.description.abstractHistologic analysis of liver biopsy specimens allows for grading and staging of nonalcoholic fatty liver disease (NAFLD). We performed a longitudinal study to investigate the long-term prognostic relevance of histologic features for patients with NAFLD.
html.description.abstractWe performed a retrospective analysis of 619 patients diagnosed with NAFLD from 1975 through 2005 at medical centers in the United States, Europe, and Thailand. Patients underwent laboratory and biopsy analyses, and were examined every 3-12 months after their diagnosis. Outcomes analyzed were overall mortality, liver transplantation, and liver-related events. Cumulative outcomes were compared by log-rank analysis. Cox proportional-hazards regression was used to estimate adjusted hazard ratios (HRs). Time at risk was determined from the date of liver biopsy to the date of outcome or last follow-up examination.
html.description.abstractOver a median follow-up period of 12.6 years (range, 0.3-35.1 y), 193 of the patients (33.2%) died or underwent liver transplantation. Features of liver biopsies significantly associated with death or liver transplantation included fibrosis stage 1 (HR, 1.88; 95% confidence interval [CI], 1.28-2.77), stage 2 (HR, 2.89; 95% CI, 1.93-4.33), stage 3 (HR, 3.76; 95% CI, 2.40-5.89), and stage 4 (HR, 10.9; 95% CI, 6.06-19.62) compared with stage 0, as well as age (HR, 1.07; 95% CI, 1.05-1.08), diabetes (HR, 1.61; 95% CI, 1.13-2.30), current smoking (HR, 2.62; 95% CI, 1.67-4.10), and statin use (HR, 0.32; 95% CI, 0.14-0.70). Twenty-six patients (4.2%) developed liver-related events; fibrosis stage 3 (HR, 14.2; 95% CI, 3.38-59.68) and stage 4 (HR, 51.5; 95% CI, 9.87-269.2) compared with stage 0, were associated significantly with the events. Patients with fibrosis, regardless of steatohepatitis or NAFLD activity score, had shorter survival times than patients without fibrosis.
html.description.abstractIn a longitudinal study of patients with NAFLD, fibrosis stage, but no other histologic features of steatohepatitis, were associated independently with long-term overall mortality, liver transplantation, and liver-related events.


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