Azonal steatosis correlates with disease severity and poor outcome of nonalcoholic fatty liver disease

作者：Xiao Fei Tong, Xinyan Zhao, Ya Meng Sun, Yi Wen Shi, Min� Li, Xiao Ning Wu, Jing Jie Zhao, Li Ling Yang, Zheng Zhao Lu, Xiao Juan Ou, Ji Dong Jia, Qian Yi Wang, Qian Yi Wang, Hong You · 发表于：Journal of Digestive Diseases · 年份：2023 · DOI：10.1111/1751-2980.13163 · 被引用次数：1 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Liver Diseases and Immunity

OBJECTIVES: In this study we aimed to assess the clinicopathological characteristics and long-term prognosis of patients with nonalcoholic fatty liver disease (NAFLD) having distinct steatosis distribution patterns. METHODS: Clinicopathological data of 238 individuals with biopsy-confirmed NAFLD were collected. Nonalcoholic steatohepatitis-clinical research network (NASH-CRN) and steatosis, activity and fibrosis (SAF)/fatty liver inhibition of progression (FLIP) algorithm were used. Cumulative incidence of liver-related events (LREs) was compared by Kaplan-Meier analysis. Univariate and multivariate logistic regression analyses were used to identify independent predictors for steatosis distribution. RESULTS: Eligible patients were categorized into three groups based on their steatosis distribution, including azonal steatosis (AS) (62 [26.1%]), perivenular steatosis (PVS) (147 [61.8%]), and the pan-acinar steatosis (PAS) groups (29 [12.1%]). There were significantly higher ballooning grade and disease activity (P < 0.05), more severe fibrosis (P < 0.001), and a higher cumulative incidence of LREs (hazard ratio [HR] 8.0, 95% confidence interval [CI] 2.34-27.35, P < 0.0001) in the AS group than in the PVS and PAS groups after a median of 3.6-year follow-up. Multivariate logistic regression analysis revealed age (odds ratio [OR] 1.11, 95% CI 1.06-1.16, P < 0.001) might be independently associated with AS distribution, and PNPLA3 rs738409 CG/GG genotype (OR 3.36, 95% CI 0.98-11.47...