Clinical and sociodemographic determinants of disease progression in patients with nonalcoholic steatohepatitis in the United States.
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Date
2021
Authors
Ruiz-Casas, Leonardo
Pedra, Gabriel
Shaikh, Anum
Franks, Bethany
Dhillon, Harpal
Fernandes, João Diogo da Rocha
Mangla, Kamal Kant
Augusto, Margarida
Schattenberg, Jörn M
Romero-Gómez, Manuel
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Abstract
One fifth of patients with nonalcoholic fatty liver disease (NAFLD) may progress to nonalcoholic steatohepatitis (NASH), which can increase the risk of cirrhosis, cancer, and death. To date, reported predictors of NASH progression have been heterogeneous.We identified determinants of fibrosis progression in patients with NASH in the United States using physician-reported data from the real-world Global Assessment of the Impact of NASH (GAIN) study, including demographics and clinical characteristics, NASH diagnostic information, fibrosis stage, comorbidities, and treatment. We developed a logistic regression model to assess the likelihood of fibrosis progression since diagnosis, controlling for sociodemographic and clinical variables. An iterative nested model selection approach using likelihood ratio test determined the final model.A total of 989 patients from the GAIN US cohort were included; 46% were women, 58% had biopsy-proven NAFLD, and 74% had fibrosis stage F0-F2 at diagnosis. The final multivariable model included age, years since diagnosis, sex, employment status, smoking status, obesity, fibrosis stage, diagnostic biopsy, Vitamin E, and liver transplant proposed at diagnosis. Odds of progression were 17% higher (odds ratio, 1.17 [95% CI: 1.11-1.23]; P
Description
MeSH Terms
Aged
Biopsy
Disease Progression
Female
Fibrosis
Humans
Liver
Liver Cirrhosis
Male
Middle Aged
Non-alcoholic Fatty Liver Disease
Obesity
Social Determinants of Health
United States
Biopsy
Disease Progression
Female
Fibrosis
Humans
Liver
Liver Cirrhosis
Male
Middle Aged
Non-alcoholic Fatty Liver Disease
Obesity
Social Determinants of Health
United States