RT Journal Article
T1 Definite and indeterminate nonalcoholic steatohepatitis share similar clinical features and prognosis: A longitudinal study of 1893 biopsy-proven nonalcoholic fatty liver disease subjects.
A1 Ampuero, Javier
A1 Aller, Rocio
A1 Gallego-Duran, Rocio
A1 Crespo, Javier
A1 Abad, Javier
A1 Gonzalez-Rodriguez, Agueda
A1 Gomez-Camarero, Judith
A1 Caballeria, Joan
A1 Lo-Iacono, Oreste
A1 Ibañez, Luis
A1 Garcia-Samaniego, Javier
A1 Martin-Mateos, Rosa
A1 Frances, Ruben
A1 Fernandez-Rodriguez, Conrado
A1 Diago, Moises
A1 Soriano, German
A1 Andrade, Raul J
A1 Latorre, Raquel
A1 Jorquera, Francisco
A1 Morillas, Rosa M
A1 Escudero, Desam
A1 Estevez, Pamela
A1 Hernandez-Guerra, Manuel
A1 Augustin, Salvador
A1 Pareja-Megia, Maria Jesus
A1 Banales, Jesus M
A1 Aspichueta, Patricia
A1 Benlloch, Salvador
A1 Rosales, Jose Miguel
A1 Salmeron, Javier
A1 Turnes, Juan
A1 Romero-Gomez, Manuel
A1 HEPAmet Registry, 
K1 ballooning
K1 fatty liver disease
K1 inflammation
K1 metabolic-associated fatty liver disease
K1 natural coursesteatohepatitis
K1 steatosis
AB Histological score systems may not fully capture the essential nonalcoholic steatohepatitis (NASH) features, which is one of the leading causes of screening failure in clinical trials. We assessed the NASH distribution and its components across the fibrosis stages and their impact on the prognosis and their relationship with the concept of metabolic-associated fatty liver disease (MAFLD). Spanish multicenter study including 1893 biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients from HEPAmet registry. NASH was diagnosed by NAS score ≥4 (including steatosis, ballooning and lobular inflammation) and fibrosis by Kleiner score. The presence of MAFLD was determined. Progression to cirrhosis, first episode of decompensated cirrhosis and death were collected during the follow-up (4.7 ± 3.8 years). Fibrosis was F0 34.3% (649/1893), F1 27% (511/1893), F2 16.5% (312/1893), F3 15% (284/1893) and F4 7.2% (137/1893). NASH diagnosis 51.9% (982/1893), and its individual components (severe steatosis, ballooning and lobular inflammation), increased from F0 (33.6%) to F2 (68.6%), and decreased significantly in F4 patients (51.8%) (P = .0001). More than 70% of non-NASH patients showed some inflammatory activity (ballooning or lobular inflammation), showing a similar MAFLD rate than NASH (96.2% [945/982] vs. 95.2% [535/562]) and significantly higher than nonalcoholic fatty liver (NAFL) subjects (89.1% [311/349]) (P  The prevalence of steatohepatitis decreased in advanced liver disease. However, most of these patients showed some inflammatory activity histologically and had metabolic disturbances. These findings should be considered in clinical trials whose main aim is to prevent cirrhosis progression and complications, liver transplant and death.
PB Wiley-Blackwell Publishing Ltd.
SN 1478-3223
YR 2021
FD 2021-08-16
LK http://hdl.handle.net/10668/17630
UL http://hdl.handle.net/10668/17630
LA en
NO Ampuero J, Aller R, Gallego-Durán R, Crespo J, Abad J, González-Rodríguez Á, et al. Definite and indeterminate nonalcoholic steatohepatitis share similar clinical features and prognosis: A longitudinal study of 1893 biopsy-proven nonalcoholic fatty liver disease subjects. Liver Int. 2021 Sep;41(9):2076-2086.
DS RISalud
RD Jun 1, 2025