Abstract | BACKGROUND & AIMS: METHODS: This retrospective analysis included patients with nonalcoholic fatty liver disease from a tertiary care center who underwent magnetic resonance imaging proton density fat fraction, magnetic resonance elastography, and laboratory testing within 6 months from 2013 to 2022. Other causes of chronic liver disease were excluded. Hazard ratios between logit MAST and MALO ( ascites, hepatic encephalopathy, or bleeding esophageal varices), liver transplant, HCC, or liver-related death were computed using a Cox proportional hazards regression model. We computed the hazard ratio of MALO or death associated with MAST scores 0.165-0.242 and 0.242-1.000, using MAST scores 0.000-0.165 as the reference group. RESULTS: Among 346 total patients, average age was 58.8 years with 52.9% females and 34.4% with type 2 diabetes. Average alanine aminotransferase was 50.7 IU/L (24.3-60.0 IU/ L), aspartate aminotransferase was 38.05 IU/L (22.00-41.00 IU/L), platelets were 242.9 × 109/L (193.8-290.0 × 109/L), proton density fat fraction was 12.90% (5.90%-18.22%), and liver stiffness on magnetic resonance elastography was 2.75 kPa (2.07-2.90 kPa). Median follow-up was 29.5 months. Fourteen had adverse outcomes, including 10 MALO, 1 HCC, 1 liver transplant, and 2 liver-related deaths. The Cox regression of MAST versus adverse event rate had a hazard ratio of 2.01 (95% confidence interval, 1.59-2.54; P < .0001) for each 1 logit unit increases in MAST. The corresponding Harrell concordance statistic (C statistic) was 0.919 (95% confidence interval, 0.865-0.953). The MAST score ranges of 0.165-0.242 and 0.242-1.0, respectively, had adverse event rate hazard ratio of 7.75 (1.40-42.9; P = .0189) and 22.11 (6.59-74.2; P < .0000) relative to MAST 0-0.165. CONCLUSIONS:
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Authors | Emily Truong, Jeffrey A Gornbein, Ju Dong Yang, Nabil Noureddin, Stephen A Harrison, Naim Alkhouri, Mazen Noureddin |
Journal | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
(Clin Gastroenterol Hepatol)
Vol. 21
Issue 10
Pg. 2570-2577.e1
(09 2023)
ISSN: 1542-7714 [Electronic] United States |
PMID | 36813013
(Publication Type: Journal Article)
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Copyright | Copyright © 2023 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Female
- Humans
- Middle Aged
- Male
- Carcinoma, Hepatocellular
(pathology)
- Non-alcoholic Fatty Liver Disease
(complications, pathology)
- Liver Transplantation
(adverse effects)
- Retrospective Studies
- Diabetes Mellitus, Type 2
(complications)
- Protons
- Liver Neoplasms
(pathology)
- Liver
(diagnostic imaging, pathology)
- Magnetic Resonance Imaging
(methods)
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