Predictors for incidence and remission of NAFLD in the general population during a seven-year prospective follow-up

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• 作者：Shira Zelber-Sagi¹ ; ² ; ^&dagger ; ; ^{zelbersagi@bezeqint.net} ; Roni Lotan¹ ; ³ ; ^&dagger ; ; Amir Shlomai¹ ; Muriel Webb¹ ; Gil Harrari² ; Assaf Buch¹ ; ³ ; Dorit Nitzan Kaluski³ ; Zamir Halpern¹ ; ³ ; Ran Oren¹ ; ³
• 关键词：NAFLD ; non-alcoholic fatty liver disease ; NASH ; non-alcoholic steatohepatitis ; HCC ; hepatocellular carcinoma ; HOMA ; homeostasis model assessment ; HRI ; hepato-renal index ; ALT ; alanine aminotransferase ; BMI ; body mass index ; PA ; physical activity
• 刊名：Journal of Hepatology
• 出版年：2012
• 出版时间：May, 2012
• 年：2012
• 卷：56
• 期：5
• 页码：1145-1151
• 全文大小：999 K

文摘

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Background & Aims

Data on the incidence and remission rates of non-alcoholic fatty liver disease (NAFLD) as well as predictive factors are scant. This study aims at evaluating NAFLD¡¯s epidemiology in prospective follow-up of individuals sampled from the general population.

Methods

Evaluation of metabolic parameters and ultrasonographic evidence of NAFLD was performed in 213 subjects, with no known liver disease or history of alcohol abuse. The evaluation was performed at baseline and after a 7-year period by identical protocols.

Results

Of the 147 patients who did not have NAFLD at baseline, 28 (19 % ) were found to have NAFLD at a 7-year follow-up. Baseline BMI, HOMA score, blood cholesterol, triglycerides, leptin levels, and weight gain (5.8 ¡À 6.1 vs. 1.4 ¡À 5.5 kg, p <0.001) were significantly higher and adiponectin was lower among those who developed NAFLD at 7-year follow-up, compared with those who remained NAFLD-free. However, only weight gain and baseline HOMA were independent predictors for the development of NAFLD. Of the 66 patients who were found to have NAFLD at baseline, as many as 24 patients (36.4 % ) had no evidence of NAFLD at 7 years. Weight loss of 2.7 ¡À 5.0 kg was significantly associated with NAFLD remission. Moreover, there was a 75 % remission rate among NAFLD patients who lost 5 % or more from their baseline weight.

Conclusions

Among the general population, weight gain, and baseline insulin resistance are predictors for NAFLD incidence. One third of NAFLD patients may have remission of disease within a 7-year follow-up, mostly depending on modest weight reduction.