Hormonal
In patients with nonalcoholic steatohepatitis (NASH), older age, obesity, and diabetes mellitus are independent predictors of severe liver fibrosis (bridging fibrosis or cirrhosis).
If you have NASH, your risk of severe liver scarring is highest if you are older, obese, or have diabetes. Focus on managing blood sugar and achieving a healthy weight, as these factors drive the scarring process more than the amount of fat in the liver itself. Regular monitoring via biopsy or advanced testing is recommended for this high-risk group.
In multivariate analysis, older age (P < .001), obesity (P < .002), diabetes mellitus (P < .009), and aspartate transaminase/alanine transaminase (AST/ALT) ratio greater than 1 (P < .03) were significant predictors of severe liver fibrosis (bridging/cirrhosis).
Why this rating
Large sample size (n=144) and multivariate analysis controlling for confounders, but observational design.
Source
Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis
Paul Angulo et al. · Hepatology · 1999
DOI 10.1002/hep.510300604
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