|
KMID : 1040620240300020225
|
|
Clinical and Molecular Hepatology
2024 Volume.30 No. 2 p.225 ~ p.234
|
|
|
Prognosis of biopsy-confirmed metabolic dysfunction- associated steatotic liver disease: A sub-analysis of the CLIONE study
|
|
Michihiro Iwaki
Hideki Fujii
Hideki Hayashi
Hidenori Toyoda
Satoshi Oeda
Hideyuki Hyogo
Miwa Kawanaka
Asahiro Morishita
Kensuke Munekage
Kazuhito Kawata
Tsubasa Tsutsumi
Koji Sawada
Tatsuji Maeshiro
Hiroshi Tobita
Yuichi Yoshida
Masafumi Naito
Asuka Araki
Shingo Arakaki
Takumi Kawaguchi
Hidenao Noritake
Masafumi Ono
Tsutomu Masaki
Satoshi Yasuda
Eiichi Tomita
Masato Yoneda
Akihiro Tokushige
Yoshihiro Kamada
Hirokazu Takahashi
Shinichiro Ueda
Shinichi Aishima
Yoshio Sumida
Atsushi Nakajima
Takeshi Okanoue
|
|
|
Abstract
|
|
|
Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study.
Methods: This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD.
Results: Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4).
Conclusions: Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.
|
|
|
KEYWORD
|
|
|
Prognosis, Steatotic liver disease, Liver biopsy
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|