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Glycemic Control Predicts Severity of Hepatocyte Ballooning and Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease

BACKGROUND AND AIMS: Whether glycemic control, as opposed to diabetes status, is associated with the severity of NAFLD is open for study. We aimed to evaluate whether degree of glycemic control in the years preceding liver biopsy predicts the histological severity of NASH. APPROACH AND RESULTS: Usin...

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Autores principales: Alexopoulos, Anastasia‐Stefania, Crowley, Matthew J., Wang, Ying, Moylan, Cynthia A., Guy, Cynthia D., Henao, Ricardo, Piercy, Dawn L., Seymour, Keri A., Sudan, Ranjan, Portenier, Dana D., Diehl, Anna Mae, Coviello, Andrea D., Abdelmalek, Manal F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518519/
https://www.ncbi.nlm.nih.gov/pubmed/33724511
http://dx.doi.org/10.1002/hep.31806
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author Alexopoulos, Anastasia‐Stefania
Crowley, Matthew J.
Wang, Ying
Moylan, Cynthia A.
Guy, Cynthia D.
Henao, Ricardo
Piercy, Dawn L.
Seymour, Keri A.
Sudan, Ranjan
Portenier, Dana D.
Diehl, Anna Mae
Coviello, Andrea D.
Abdelmalek, Manal F.
author_facet Alexopoulos, Anastasia‐Stefania
Crowley, Matthew J.
Wang, Ying
Moylan, Cynthia A.
Guy, Cynthia D.
Henao, Ricardo
Piercy, Dawn L.
Seymour, Keri A.
Sudan, Ranjan
Portenier, Dana D.
Diehl, Anna Mae
Coviello, Andrea D.
Abdelmalek, Manal F.
author_sort Alexopoulos, Anastasia‐Stefania
collection PubMed
description BACKGROUND AND AIMS: Whether glycemic control, as opposed to diabetes status, is associated with the severity of NAFLD is open for study. We aimed to evaluate whether degree of glycemic control in the years preceding liver biopsy predicts the histological severity of NASH. APPROACH AND RESULTS: Using the Duke NAFLD Clinical Database, we examined patients with biopsy‐proven NAFLD/NASH (n = 713) and the association of liver injury with glycemic control as measured by hemoglobin A1c (HbA1c). The study cohort was predominantly female (59%) and White (84%) with median (interquartile range) age of 50 (42, 58) years; 49% had diabetes (n = 348). Generalized linear regression models adjusted for age, sex, race, diabetes, body mass index, and hyperlipidemia were used to assess the association between mean HbA1c over the year preceding liver biopsy and severity of histological features of NAFLD/NASH. Histological features were graded and staged according to the NASH Clinical Research Network system. Group‐based trajectory analysis was used to examine patients with at least three HbA1c (n = 298) measures over 5 years preceding clinically indicated liver biopsy. Higher mean HbA1c was associated with higher grade of steatosis and ballooned hepatocytes, but not lobular inflammation. Every 1% increase in mean HbA1c was associated with 15% higher odds of increased fibrosis stage (OR, 1.15; 95% CI, 1.01, 1.31). As compared with good glycemic control, moderate control was significantly associated with increased severity of ballooned hepatocytes (OR, 1.74; 95% CI, 1.01, 3.01; P = 0.048) and hepatic fibrosis (HF; OR, 4.59; 95% CI, 2.33, 9.06; P < 0.01). CONCLUSIONS: Glycemic control predicts severity of ballooned hepatocytes and HF in NAFLD/NASH, and thus optimizing glycemic control may be a means of modifying risk of NASH‐related fibrosis progression.
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spelling pubmed-85185192021-10-21 Glycemic Control Predicts Severity of Hepatocyte Ballooning and Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease Alexopoulos, Anastasia‐Stefania Crowley, Matthew J. Wang, Ying Moylan, Cynthia A. Guy, Cynthia D. Henao, Ricardo Piercy, Dawn L. Seymour, Keri A. Sudan, Ranjan Portenier, Dana D. Diehl, Anna Mae Coviello, Andrea D. Abdelmalek, Manal F. Hepatology Original Articles BACKGROUND AND AIMS: Whether glycemic control, as opposed to diabetes status, is associated with the severity of NAFLD is open for study. We aimed to evaluate whether degree of glycemic control in the years preceding liver biopsy predicts the histological severity of NASH. APPROACH AND RESULTS: Using the Duke NAFLD Clinical Database, we examined patients with biopsy‐proven NAFLD/NASH (n = 713) and the association of liver injury with glycemic control as measured by hemoglobin A1c (HbA1c). The study cohort was predominantly female (59%) and White (84%) with median (interquartile range) age of 50 (42, 58) years; 49% had diabetes (n = 348). Generalized linear regression models adjusted for age, sex, race, diabetes, body mass index, and hyperlipidemia were used to assess the association between mean HbA1c over the year preceding liver biopsy and severity of histological features of NAFLD/NASH. Histological features were graded and staged according to the NASH Clinical Research Network system. Group‐based trajectory analysis was used to examine patients with at least three HbA1c (n = 298) measures over 5 years preceding clinically indicated liver biopsy. Higher mean HbA1c was associated with higher grade of steatosis and ballooned hepatocytes, but not lobular inflammation. Every 1% increase in mean HbA1c was associated with 15% higher odds of increased fibrosis stage (OR, 1.15; 95% CI, 1.01, 1.31). As compared with good glycemic control, moderate control was significantly associated with increased severity of ballooned hepatocytes (OR, 1.74; 95% CI, 1.01, 3.01; P = 0.048) and hepatic fibrosis (HF; OR, 4.59; 95% CI, 2.33, 9.06; P < 0.01). CONCLUSIONS: Glycemic control predicts severity of ballooned hepatocytes and HF in NAFLD/NASH, and thus optimizing glycemic control may be a means of modifying risk of NASH‐related fibrosis progression. John Wiley and Sons Inc. 2021-06-02 2021-09 /pmc/articles/PMC8518519/ /pubmed/33724511 http://dx.doi.org/10.1002/hep.31806 Text en © 2021 The Authors. Hepatology published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Alexopoulos, Anastasia‐Stefania
Crowley, Matthew J.
Wang, Ying
Moylan, Cynthia A.
Guy, Cynthia D.
Henao, Ricardo
Piercy, Dawn L.
Seymour, Keri A.
Sudan, Ranjan
Portenier, Dana D.
Diehl, Anna Mae
Coviello, Andrea D.
Abdelmalek, Manal F.
Glycemic Control Predicts Severity of Hepatocyte Ballooning and Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease
title Glycemic Control Predicts Severity of Hepatocyte Ballooning and Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease
title_full Glycemic Control Predicts Severity of Hepatocyte Ballooning and Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease
title_fullStr Glycemic Control Predicts Severity of Hepatocyte Ballooning and Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease
title_full_unstemmed Glycemic Control Predicts Severity of Hepatocyte Ballooning and Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease
title_short Glycemic Control Predicts Severity of Hepatocyte Ballooning and Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease
title_sort glycemic control predicts severity of hepatocyte ballooning and hepatic fibrosis in nonalcoholic fatty liver disease
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518519/
https://www.ncbi.nlm.nih.gov/pubmed/33724511
http://dx.doi.org/10.1002/hep.31806
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