Prevalence and Predictors of Significant Fibrosis Among Subjects with Transient Elastography-Defined Nonalcoholic Fatty Liver Disease

Dig Dis Sci. 2017 Aug;62(8):2150-2158. doi: 10.1007/s10620-017-4592-0. Epub 2017 May 18.

Abstract

Background/aims: Transient elastography (TE) can be used to assess the degree of liver fibrosis and steatosis. We investigated the prevalence and predictors of nonalcoholic fatty liver disease (NAFLD) with or without significant liver fibrosis in the general population.

Methods: A total of 3033 subjects without alcoholic or chronic viral liver diseases who underwent a medical health check-up including TE were recruited from April 2013 to August 2014. TE-defined NAFLD was defined as a controlled attenuation parameter of ≥250 dB/m, and significant liver fibrosis was defined as a liver stiffness (LS) value of ≥8 kPa.

Results: Overall, 1178 (42.9%) subjects had NAFLD. Subjects with NAFLD had significantly higher alanine aminotransferase (ALT) levels and a higher prevalence of parameters related to metabolic syndrome, such as high blood pressure, a high body mass index (BMI), glucose intolerance, and dyslipidemia than did subjects without NAFLD (all P < 0.05). Age, male gender, ALT level, serum albumin, BMI, diabetes, hypertriglyceridemia, and LS values independently showed positive associations with the presence of NAFLD (all P < 0.05). In addition, concomitant significant liver fibrosis was identified in 60 (5.1%) subjects with NAFLD, and its independent predictors were age [odds ratio (OR) 1.054], ALT level (OR 1.019), BMI (OR 1.217), and diabetes (OR 1.987) (all P < 0.05).

Conclusions: We found that the prevalence of subjects with NAFLD was high (42.9%), and 5.1% of them had concomitant significant liver fibrosis. The risk factors found in this study can help identify which subjects with NAFLD are vulnerable to fibrosis progression.

Keywords: Controlled attenuation parameter; Fibrosis; Nonalcoholic fatty liver disease; Steatosis; Transient elastography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alanine Transaminase / blood
  • Body Mass Index
  • Dyslipidemias / complications
  • Elasticity Imaging Techniques / methods
  • Female
  • Glucose Intolerance / complications
  • Humans
  • Hypertension / complications
  • Liver / diagnostic imaging
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / epidemiology*
  • Liver Cirrhosis / etiology*
  • Male
  • Metabolic Syndrome / complications
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / blood
  • Non-alcoholic Fatty Liver Disease / complications*
  • Non-alcoholic Fatty Liver Disease / diagnostic imaging
  • Odds Ratio
  • Prevalence
  • Risk Factors
  • Serum Albumin / analysis
  • Young Adult

Substances

  • Serum Albumin
  • Alanine Transaminase