PubMed ID:
23686698
Public Release Type:
Journal
Publication Year: 2013
Affiliation: Division of Gastroenterology and Epidemiology, University of California at San Diego School of Medicine, La Jolla, CA.
DOI:
https://doi.org/10.1002/hep.26465
Authors:
Hoofnagle JH,
Vuppalanchi R,
Kleiner DE,
Kleiner DE,
Nguyen A,
Chalasani N,
Abdelmalek MF,
Ackermann S,
Aouizerat B,
Bambha K,
Bass M,
Bass NM,
Behling C,
Behling C,
Belt P,
Boyett S,
Brancati FL,
Brandt P,
Bringman D,
Brunt EM,
Buie S,
Clark JM,
Collins J,
Colvin R,
Contos MJ,
Corless E,
Cummings OW,
Dasarathy J,
Dasarathy S,
Dasarathy S,
Diehl A,
Donithan M,
Doo E,
Doo EC,
Durelle J,
Ferrell LD,
Fuchs M,
Ghabril M,
Gottfried M,
Green M,
Gu B,
Guy C,
Hameed B,
Hameed B,
Hanna M,
Hassanein T,
Hawkins C,
Hollick R,
Isaacson M,
Jin WK,
Jones A,
Kigongo C,
Killenberg P,
King D,
Klipsch A,
Kowdley KV,
Kwan S,
Lavine JE,
Lavine JE,
Liu YC,
Loomba R,
Loomba R,
Luketic VA,
Lydecker A,
Mann P,
May KP,
McCullough A,
McCullough AJ,
McCullough AJ,
Merriman R,
Merriman R,
Miriel L,
Mooney J,
Morgan A,
NASH CRN,
Nelson J,
Neuschwander-Tetri BA,
Neuschwander-Tetri BA,
Nguyen T,
Noureddin M,
Pabst M,
Pagadala M,
Pan Y,
Park J,
Patton H,
Pierce T,
Piercy D,
Puri P,
Ragozzino L,
Robuck PR,
Rogers N,
Rosenthal M,
Sandhu B,
Sanyal AJ,
Sanyal AJ,
Sargeant C,
Sargent R,
Shaw C,
Sherker A,
Siegner J,
Sirlin C,
Smith M,
Srivastava S,
Stead A,
Steel T,
Sternberg A,
Stewart S,
Subbarao G,
Tandra S,
Thompson J,
Tonascia J,
Unalp-Arida A,
VanNatta M,
Vaughn I,
Vaughn IA,
Wang C,
White M,
Wilson L,
Yates K,
Yates KP,
Yeh M,
Yerian L,
Zein C
Studies:
Nonalcoholic Steatohepatitis Clinical Research Network
The characteristics of nonalcoholic fatty liver disease (NAFLD) in elderly patients are unknown. Therefore, we aimed to examine the differences between elderly and nonelderly patients with NAFLD and to identify determinants of nonalcoholic steatohepatitis (NASH) and advanced fibrosis (bridging fibrosis or cirrhosis) in elderly patients. This is a cross-sectional analysis of adult participants who were prospectively enrolled in the NASH Clinical Research Network studies. Participants were included based on availability of the centrally reviewed liver histology data within 1 year of enrollment, resulting in 61 elderly (age ≥65 years) and 735 nonelderly (18-64 years) participants. The main outcomes were the presence of NASH and advanced fibrosis. Compared to nonelderly patients with NAFLD, elderly patients had a higher prevalence of NASH (56% versus 72%, P = 0.02), and advanced fibrosis (25% versus 44%, P = 0.002). Compared to nonelderly patients with NASH, elderly patients with NASH had higher rates of advanced fibrosis (35% versus 52%, P = 0.03), as well as other features of severe liver disease including the presence of ballooning degeneration, acidophil bodies, megamitochondria, and Mallory-Denk bodies (P ≤ 0.05 for each). In multiple logistic regression analyses, independent determinants of NASH in elderly patients included higher aspartate aminotransferase (AST) (odds ratio [OR] = 1.12, P = 0.007) and lower platelets (OR = 0.98, P = 0.02); and independent determinants of advanced fibrosis included higher AST (OR = 1.08, P = 0.007), lower alanine aminotransferase value (OR = 0.91, P = 0.002), and an increased odds of having low high-density lipoprotein (OR = 8.35, P = 0.02).