PMID- 32087038
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1478-3231 (Electronic)
IS  - 1478-3223 (Linking)
VI  - 40
IP  - 5
DP  - 2020 May
TI  - The amount of liver fat predicts mortality and development of type 2 diabetes in 
      non-alcoholic fatty liver disease.
PG  - 1069-1078
LID - 10.1111/liv.14414 [doi]
AB  - BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is a risk factor for 
      development of type 2 diabetes mellitus (T2DM). We aimed to evaluate whether 
      conventional histological grading of steatosis and accurate quantification of fat 
      content in liver biopsies using stereological point counting (SPC) can predict 
      mortality and future development of T2DM in NAFLD patients. METHODS: 129 patients 
      with biopsy proven NAFLD, enrolled between 1988 and 1992, were re-evaluated on 
      two occasions, after 13.7 (+/-1.5) and 23.2 (+/-6.8) years. In patients accepting to 
      undergo the procedure, repeat liver biopsies were performed on each follow-up and 
      were evaluated with conventional histopathological methodology and SPC. RESULTS: 
      Of the 106 patients without T2DM at baseline, 66 (62%) developed T2DM during a 
      mean follow-up of 23.2 (+/- 6.8) years. Steatosis grade and liver fat measured with 
      SPC independently (adjusted for age, BMI, fibrosis stage) predicted development 
      of T2DM with an aHR of 1.60 per grade and 1.03 for each SPC percentage increase 
      respectively. Overall mortality and development of T2DM was more common in 
      patients with grade 3 steatosis compared to lower grades of steatosis. Liver fat 
      measured with SPC was significant for overall mortality (aHR 1.04). In patients 
      that underwent repeat biopsy, reduction in liver fat measured with SPC was 
      associated with decreased risk of developing T2DM (aHR 0.91 for each SPC 
      percentage decrease). CONCLUSION: Steatosis grade and liver fat measured with SPC 
      predict mortality and the risk of developing T2DM in NAFLD. Reduction in liver 
      fat decreases the risk of developing T2DM.
CI  - (c) 2020 The Authors. Liver International published by John Wiley & Sons Ltd.
FAU - Nasr, Patrik
AU  - Nasr P
AUID- ORCID: 0000-0002-2928-4188
AD  - Department of Gastroenterology and Hepatology, Department of Health, Medicine and 
      Caring Sciences, Linkoping University, Linkoping, Sweden.
FAU - Fredrikson, Mats
AU  - Fredrikson M
AUID- ORCID: 0000-0003-3067-8587
AD  - Forum Ostergotland, Faculty of Medicine and Health Sciences, Linkoping 
      University, Linkoping, Sweden.
AD  - Department of Biomedical and Clinical Sciences, Faculty of Health Sciences, 
      Linkoping University, Linkoping, Sweden.
FAU - Ekstedt, Mattias
AU  - Ekstedt M
AUID- ORCID: 0000-0002-5590-8601
AD  - Department of Gastroenterology and Hepatology, Department of Health, Medicine and 
      Caring Sciences, Linkoping University, Linkoping, Sweden.
FAU - Kechagias, Stergios
AU  - Kechagias S
AUID- ORCID: 0000-0001-7614-739X
AD  - Department of Gastroenterology and Hepatology, Department of Health, Medicine and 
      Caring Sciences, Linkoping University, Linkoping, Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200310
PL  - United States
TA  - Liver Int
JT  - Liver international : official journal of the International Association for the 
      Study of the Liver
JID - 101160857
SB  - IM
CIN - Liver Int. 2020 May;40(5):1016-1017. PMID: 32352234
MH  - Biopsy
MH  - *Diabetes Mellitus, Type 2/complications/pathology
MH  - Humans
MH  - Liver/pathology
MH  - Liver Cirrhosis/pathology
MH  - *Non-alcoholic Fatty Liver Disease/pathology
OTO - NOTNLM
OT  - hepatic steatosis
OT  - quantitative steatosis
OT  - stereological point count
EDAT- 2020/02/23 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/02/23 06:00
PHST- 2019/12/11 00:00 [received]
PHST- 2020/02/18 00:00 [revised]
PHST- 2020/02/19 00:00 [accepted]
PHST- 2020/02/23 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/02/23 06:00 [entrez]
AID - 10.1111/liv.14414 [doi]
PST - ppublish
SO  - Liver Int. 2020 May;40(5):1069-1078. doi: 10.1111/liv.14414. Epub 2020 Mar 10.