Factores analíticos, antropométricos y dietéticos asociados al desarrollo de fibrosis en pacientes con enfermedad por hígado graso no alcohólico

  1. Sara Gómez de La Cuesta 1
  2. Rocío Aller de la Fuente 1
  3. Carla Tafur Sánchez 1
  4. Olatz Izaola Jáuregui 1
  5. María Concepción García Sánchez 1
  6. Natalia Mora Cuadrado 1
  7. José Manuel González Hernández 1
  8. Daniel Antonio de Luis Román 1
  1. 1 Hospital Universitario de Valladolid
    info

    Hospital Universitario de Valladolid

    Valladolid, España

    ROR https://ror.org/04fffmj41

Journal:
Revista Española de Enfermedades Digestivas

ISSN: 2340-416,  1130-0108

Year of publication: 2018

Volume: 110

Issue: 5

Pages: 292-298

Type: Article

DOI: 10.17235/REED.2018.5118/2017 DIALNET GOOGLE SCHOLAR

More publications in: Revista Española de Enfermedades Digestivas

Abstract

Background: a prolonged non-alcoholic steatohepatitis (NASH) condition can lead to advanced stages of liver disease and the development of hepatocellular carcinoma. Aim: to evaluate analytical, anthropometric and dietary factors associated with the presence of fibrosis as this is the factor that most influences survival and evolution. Methods: seventy-six patients with liver biopsy-diagnosed non-alcoholic fatty liver disease (NAFLD) were included. Biopsies were scored considering the NASH criteria of Kleiner. Analytical, anthropometric and dietary (survey) parameters were obtained. NAFLD-FS is a non-invasive fibrosis index and was assessed for each patient. Leptin, adiponectin, resistin and TNF-alpha serum levels were determined. Results: fifty-six patients were male (73.7%) and the mean age was 44.5 ± 11.3 years of age (19-68). Thirty-nine (51.3%) (F1-F2: 84.6%; F3-4: 15.4%) patients had fibrosis in the liver biopsy. Seventeen females (85%) had fibrosis versus 22 males (39%), which was statistically significant by univariate analysis (p < 0.01). Patients with advanced fibrosis were older, with lower platelet counts, lower serum albumin, greater homeostatic model assessment insulin resistance (HOMA-IR), lower dietary lipids percentage, higher serum leptin levels and higher NAFLD Fibrosis Score (NAFLD-FS) values. This index had a negative predictive value of 98% and a positive predictive value of 60% for the detection of fibrosis. Variables independently associated with fibrosis (logistic regression) included male gender (protective factor) (0.09, 95% CI 0.01-0.7; p < 0.05) and HOMA-IR (1.7, 95% CI, 1.03-2.79; p < 0.05). Conclusions: gender and HOMA-IR were the only independent factors associated with fibrosis. NAFLD-FS could be considered as an accurate scoring system to rule out advanced fibrosis.

Data source: Dialnet