Patients with nonalcoholic steatohepatitis (NASH) had a higher percentage of steatosis on liver biopsy than patients with nonalcoholic fatty liver disease (NAFLD), according to a study presented at Digestive Disease Week 2022.

The authors wrote this suggests “that early in the disease process fatty deposition may play a more prominent role in disease progression.”

While NAFLD is the most common cause of chronic liver disease in the developed world, there is not a well-established understanding of the prevalence and clinical characteristics of NAFLD and NASH among younger adults. To determine risk factors for development of NASH and NAFLD in patients younger than 50 years of age, the researchers performed a retrospective review of patients aged 18-50 years who had undergone a liver biopsy between 2011 and 2018 at Brooke Army Medical Center in San Antonio, Texas, with histopathologic evidence of NAFLD or NASH. 

Of 339 patients included in the study, 171 were diagnosed with NAFLD and 168 were diagnosed with NASH based on liver biopsy. Compared to NAFLD, NASH was significantly more prevalent among men, and patients with diabetes, hypertension, and hyperlipidemia. Additionally, patients with NASH had significantly higher aspartate aminotransferase, alanine transaminase, and hemoglobin A1c, and lower high-density cholesterol, higher percentage of fat on liver biopsy and steatosis extent. There was no significant difference between the body mass index of patients with NAFLD and NASH.

The study correlated previous data demonstrating that metabolic risk factors are strongly associated with the development of NASH, although the authors noted, “a substantial number of study patients lacked those risk factors. Researchers also confirmed that women have a lower risk of NASH in early life, despite having similar risk factors.

With this study, there is further knowledge into the early factors associated with the development of NASH. The authors also stressed “the importance of early surveillance in patients with risk factors.”

—Allison Casey

Reference:
Gyorffy J, Madden S, Basso J, Davis S, Moralas A. Higher steatosis grade on liver biopsy is a risk factor for NASH in patients younger than 50 years old. Presented at: Digestive Disease Week. May 22, 2022. San Diego, California.