Subclinical steatohepatitis and advanced liver fibrosis in health examinees with nonalcoholic fatty liver disease (NAFLD) in 10 South Korean cities: A retrospective cross-sectional study

• Published in: PloS one Vol. 16; no. 11; p. e0260477
• Main Authors: Nah, Eun-Hee, Cho, Seon, Park, Hyeran, Noh, Dongwon, Kwon, Eunjoo, Cho, Han-Ik
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.11.2021; Public Library of Science (PLoS)
• Subjects: Abdomen; Adult; Biology and Life Sciences; Biopsy; Body mass index; Cholesterol; Cirrhosis; Cross-Sectional Studies; Diabetes; Diabetes mellitus; Diagnosis; Epidemiology; Fatty liver; Fatty Liver - complications; Fatty Liver - diagnosis; Fatty Liver - epidemiology; Female; Fibrosis; Health promotion; Health risks; Hepatitis; High density lipoprotein; Humans; Liver; Liver cirrhosis; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Liver diseases; Magnetic resonance; Male; Medicine and Health Sciences; Metabolic syndrome; Middle Aged; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Obesity; Regression analysis; Republic of Korea - epidemiology; Research and Analysis Methods; Retrospective Studies; Risk analysis; Risk factors; Steatosis; Stiffness; Triglycerides; Ultrasonic imaging; Republic of Korea; South Korea; United States > US; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0260477

Nonalcoholic steatohepatitis (NASH) has a risk of progressing to cirrhosis. The prevalence of NASH and its associated risk factors in community populations are relatively unknown. This study aimed to determine the prevalence of NASH and advanced liver fibrosis using magnetic resonance elastography (MRE), and determine those risk factors in health examinees with asymptomatic fatty liver. This study consecutively selected subjects who underwent health checkups at 13 health-promotion centers in 10 Korean cities between 2018 and 2020. Hepatic steatosis and stiffness were assessed using ultrasonography and MRE, respectively. Stages of liver stiffness were estimated using MRE with cutoff values for NASH and advanced liver fibrosis of 2.91 and 3.60 kPa, respectively. The overall prevalence of NASH and advanced liver fibrosis in the subjects with fatty liver were 8.35% and 2.04%, respectively. Multivariate logistic regression analysis indicated that central obesity (OR = 5.12, 95% CI = 2.70-9.71), increased triglyceride (OR = 3.29, 95% CI = 1.72-6.29), abnormal liver function test (OR = 3.09, 95% CI = 1.66-5.76) (all P<0.001), and decreased high-density lipoprotein cholesterol (OR = 5.18, 95% CI = 1.78-15.05) (P = 0.003) were associated with NASH. The main risk factor for advanced liver fibrosis was diabetes (OR = 4.46, 95% CI = 1.14-17.48) (P = 0.032). NASH or advanced liver fibrosis is found in one-tenth of health examinees with asymptomatic fatty liver. This suggests that early detection of NASH should be considered to allow early interventions such as lifestyle changes to prevent the adverse effects of NASH and its progression in health examinees with asymptomatic fatty liver.