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Significant fibrosis predicts new-onset diabetes mellitus and arterial hypertension in patients with NASH

dc.contributor.authorAmpuero, Javier
dc.contributor.authorAller, Rocio
dc.contributor.authorGallego-Duran, Rocio
dc.contributor.authorCrespo, Javier
dc.contributor.authorCalleja, Jose Luis
dc.contributor.authorGarcia-Monzon, Carmelo
dc.contributor.authorGomez-Camarero, Judith
dc.contributor.authorCaballeria, Joan
dc.contributor.authorLo-Iacono, Oreste
dc.contributor.authorIbañez, Luis
dc.contributor.authorGarcia-Samaniego, Javier
dc.contributor.authorAlbillos, Agustin
dc.contributor.authorFrances, Ruben
dc.contributor.authorFernandez-Rodriguez, Conrado
dc.contributor.authorDiago, Moises
dc.contributor.authorSoriano, German
dc.contributor.authorAndrade, Raul J
dc.contributor.authorLatorre, Raquel
dc.contributor.authorJorquera, Francisco
dc.contributor.authorMorillas, Rosa Maria
dc.contributor.authorEscudero, Desamparados
dc.contributor.authorEstevez, Pamela
dc.contributor.authorHernandez-Guerra, Manuel
dc.contributor.authorAugustin, Salvador
dc.contributor.authorBañales, Jesus
dc.contributor.authorAspichueta, Patricia
dc.contributor.authorBenlloch, Salvador
dc.contributor.authorRosales, Jose Miguel
dc.contributor.authorSalmeron, Javier
dc.contributor.authorTurnes, Juan
dc.contributor.authorRomero-Gomez, Manuel
dc.contributor.groupHEPAmet Registry
dc.date.accessioned2023-02-09T09:36:49Z
dc.date.available2023-02-09T09:36:49Z
dc.date.issued2020-03-06
dc.description.abstractNon-alcoholic fatty liver disease ( NAFLD ) could play a catalytic role in the development of metabolic comorbidities, although the magnitude of this effect in metabolically healthy patients with NAFLD remains unclear. We assessed the role of biopsy -proven NAFLD on the risk of developing type 2 diabetes mellitus (T2DM) and other metabolic comorbidities (arterial hypertension [AHT], and dyslipidemia ) in metabolically healthy patients . We included 178 metabolically healthy—defined by the absence of baseline T2DM, AHT, dyslipidemia — patients with biopsy -proven NAFLD from the HEPAmet Registry (N = 1,030). Hepamet fibrosis score (HFS), NAFLD fibrosis score, and Fibrosis -4 were calculated. Follow-up was computed from biopsy to the diagnosis of T2DM, AHT, or dyslipidemia .During a follow-up of 5.6 ± 4.4 years, T2DM occurred in 9% (16/178), AHT in 8.4% (15/178), low HDL in 9.6% (17/178), and hypertriglyceridemia in 23.6% (42/178) of patients . In multivariate analysis , significant fibrosis predicted T2DM and AHT. Independent variables related to T2DM appearance were significant fibrosis (HR 2.95; 95% CI 1.19–7.31; p = 0.019), glucose levels (p = 0.008), age (p = 0.007) and BMI (p = 0.039). AHT was independently linked to significant fibrosis (HR 2.39; 95% CI 1.14–5.10; p = 0.028), age (p = 0.0001), BMI (p = 0.006), glucose (p = 0.021) and platelets (p = 0.050). The annual incidence rate of T2DM was higher in patients with significant fibrosis (4.4 vs. 1.2 cases per 100 person -years), and increased in the presence of obesity , similar to AHT (4.6 vs. 1.1 cases per 100 person -years). HFS >0.12 predicted the risk of T2DM (25% [4/16] vs. HFS <0.12 4.5% [4/88]; logRank 6.658, p = 0.010).Metabolically healthy patients with NAFLD -related significant fibrosis were at greater risk of developing T2DM and AHT. HFS >0.12, but not NAFLD fibrosis score or Fibrosis -4, predicted the occurrence of T2DM.
dc.description.versionSi
dc.identifier.citationAmpuero J, Aller R, Gallego-Durán R, Crespo J, Calleja JL, García-Monzón C, et al. Significant fibrosis predicts new-onset diabetes mellitus and arterial hypertension in patients with NASH. J Hepatol. 2020 Jul;73(1):17-25.
dc.identifier.doi10.1016/j.jhep.2020.02.028
dc.identifier.essn1600-0641
dc.identifier.pmid32147361
dc.identifier.unpaywallURL
dc.identifier.urihttp://hdl.handle.net/10668/15927
dc.issue.number3
dc.journal.titleJournal of hepatology
dc.journal.titleabbreviationJ Hepatol
dc.language.isoen
dc.organizationHospital Universitario San Cecilio
dc.organizationHospital Universitario Virgen de la Victoria
dc.organizationHospital Costa del Sol
dc.organizationInstituto de Investigación Biomédica de Málaga-IBIMA
dc.organizationInstituto de Biomedicina de Sevilla-IBIS
dc.organizationHospital Universitario Virgen del Rocío
dc.page.number17-25
dc.provenanceRealizada la curación de contenido 22/05/2025.
dc.publisherElsevier BV
dc.pubmedtyperesearch article
dc.relation.publisherversionhttps://linkinghub.elsevier.com/retrieve/pii/S0168-8278(20)30127-6
dc.rights.accessRightsRestricted Access
dc.subjectArterial hypertension
dc.subjectDiabetes mellitus
dc.subjectFibrosis
dc.subjectHepamet score
dc.subjectNAFLD
dc.subject.decsEnfermedad del hígado graso no alcohólico
dc.subject.decsFibrosis
dc.subject.decsDislipidemias
dc.subject.decsBiopsia
dc.subject.decsDiabetes Mellitus Tipo 2
dc.subject.decsHipertrigliceridemia
dc.subject.meshDisease Progression
dc.subject.meshFemale
dc.subject.meshIncidence
dc.subject.meshLongitudinal Studies
dc.subject.meshPrognosis
dc.subject.meshNon-alcoholic Fatty Liver Disease
dc.subject.meshLiver Cirrhosis
dc.subject.meshHypertension
dc.subject.meshDyslipidemias
dc.titleSignificant fibrosis predicts new-onset diabetes mellitus and arterial hypertension in patients with NASH
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number73
dspace.entity.typePublication

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