Abstract
Background & Aims Non-alcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease in Western countries. Diagnosis of NASH requires a liver biopsy. We estimated the prevalence of NASH non-invasively in a population-based study using scores validated against liver histology. Methods Clinical characteristics, PNPLA3 genotype at rs738409, and serum cytokeratin 18 fragments were measured in 296 consecutive bariatric surgery patients who underwent a liver biopsy to discover and validate a NASH score ('NASH score'). We also defined the cut-off for NASH for a previously validated NAFLD liver fat score to diagnose NASH in the same cohort ('NASH liver fat score'). Both scores were validated in an Italian cohort comprising of 380, mainly non-bariatric surgery patients, who had undergone a liver biopsy for NASH. The cut-offs were utilized in the Finnish population-based D2D-study involving 2849 subjects (age 45-74 years) to estimate the population prevalence of NASH. Results The final 'NASH Score' model included PNPLA3 genotype, AST and fasting insulin. It predicted NASH with an AUROC 0.774 (0.709, 0.839) in Finns and 0.759 (0.711, 0.807) in Italians (NS). The AUROCs for 'NASH liver fat score' were 0.734 (0.664, 0.805) and 0.737 (0.687, 0.787), respectively. Using 'NASH liver fat score' and 'NASH Score', the prevalences of NASH in the D2D study were 4.2% (95% CI: 3.4, 5.0) and 6.0% (5.0, 6.9%). Sensitivity analysis was performed by taking into account stochastic false-positivity and false-negativity rates in a Bayesian model. This analysis yielded population prevalences of NASH of 3.1% (95% stimulation limits 0.2-6.8%) using 'NASH liver fat score' and 3.6% (0.2-7.7%) using 'NASH Score'. Conclusions The population prevalence of NASH in 45-74 year old Finnish subjects is ∼5%.
| Original language | English |
|---|---|
| Pages (from-to) | 839-846 |
| Number of pages | 8 |
| Journal | Journal of Hepatology |
| Volume | 60 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- Alanine aminotransferase
- Aspartate aminotransferase
- Metabolic syndrome
- Non-alcoholic fatty liver disease
- Non-alcoholic steatohepatitis
- Type 2 diabetes
ASJC Scopus subject areas
- Hepatology
- Medicine(all)
Cite this
A population-based study on the prevalence of NASH using scores validated against liver histology. / Hyysalo, Jenni; Männistö, Ville T.; Zhou, You; Arola, Johanna; Kärjä, Vesa; Leivonen, Marja; Juuti, Anne; Jaser, Nabil; Lallukka, Susanna; Käkelä, Pirjo; Venesmaa, Sari; Simonen, Marko; Saltevo, Juha; Moilanen, Leena; Korpi-Hyövalti, Eeva; Keinänen-Kiukaanniemi, Sirkka; Oksa, Heikki; Orho-Melander, Marju; Valenti, Luca; Fargion, Silvia; Pihlajamäki, Jussi; Peltonen, Markku; Yki-Järvinen, Hannele.
In: Journal of Hepatology, Vol. 60, No. 4, 2014, p. 839-846.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A population-based study on the prevalence of NASH using scores validated against liver histology
AU - Hyysalo, Jenni
AU - Männistö, Ville T.
AU - Zhou, You
AU - Arola, Johanna
AU - Kärjä, Vesa
AU - Leivonen, Marja
AU - Juuti, Anne
AU - Jaser, Nabil
AU - Lallukka, Susanna
AU - Käkelä, Pirjo
AU - Venesmaa, Sari
AU - Simonen, Marko
AU - Saltevo, Juha
AU - Moilanen, Leena
AU - Korpi-Hyövalti, Eeva
AU - Keinänen-Kiukaanniemi, Sirkka
AU - Oksa, Heikki
AU - Orho-Melander, Marju
AU - Valenti, Luca
AU - Fargion, Silvia
AU - Pihlajamäki, Jussi
AU - Peltonen, Markku
AU - Yki-Järvinen, Hannele
PY - 2014
Y1 - 2014
N2 - Background & Aims Non-alcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease in Western countries. Diagnosis of NASH requires a liver biopsy. We estimated the prevalence of NASH non-invasively in a population-based study using scores validated against liver histology. Methods Clinical characteristics, PNPLA3 genotype at rs738409, and serum cytokeratin 18 fragments were measured in 296 consecutive bariatric surgery patients who underwent a liver biopsy to discover and validate a NASH score ('NASH score'). We also defined the cut-off for NASH for a previously validated NAFLD liver fat score to diagnose NASH in the same cohort ('NASH liver fat score'). Both scores were validated in an Italian cohort comprising of 380, mainly non-bariatric surgery patients, who had undergone a liver biopsy for NASH. The cut-offs were utilized in the Finnish population-based D2D-study involving 2849 subjects (age 45-74 years) to estimate the population prevalence of NASH. Results The final 'NASH Score' model included PNPLA3 genotype, AST and fasting insulin. It predicted NASH with an AUROC 0.774 (0.709, 0.839) in Finns and 0.759 (0.711, 0.807) in Italians (NS). The AUROCs for 'NASH liver fat score' were 0.734 (0.664, 0.805) and 0.737 (0.687, 0.787), respectively. Using 'NASH liver fat score' and 'NASH Score', the prevalences of NASH in the D2D study were 4.2% (95% CI: 3.4, 5.0) and 6.0% (5.0, 6.9%). Sensitivity analysis was performed by taking into account stochastic false-positivity and false-negativity rates in a Bayesian model. This analysis yielded population prevalences of NASH of 3.1% (95% stimulation limits 0.2-6.8%) using 'NASH liver fat score' and 3.6% (0.2-7.7%) using 'NASH Score'. Conclusions The population prevalence of NASH in 45-74 year old Finnish subjects is ∼5%.
AB - Background & Aims Non-alcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease in Western countries. Diagnosis of NASH requires a liver biopsy. We estimated the prevalence of NASH non-invasively in a population-based study using scores validated against liver histology. Methods Clinical characteristics, PNPLA3 genotype at rs738409, and serum cytokeratin 18 fragments were measured in 296 consecutive bariatric surgery patients who underwent a liver biopsy to discover and validate a NASH score ('NASH score'). We also defined the cut-off for NASH for a previously validated NAFLD liver fat score to diagnose NASH in the same cohort ('NASH liver fat score'). Both scores were validated in an Italian cohort comprising of 380, mainly non-bariatric surgery patients, who had undergone a liver biopsy for NASH. The cut-offs were utilized in the Finnish population-based D2D-study involving 2849 subjects (age 45-74 years) to estimate the population prevalence of NASH. Results The final 'NASH Score' model included PNPLA3 genotype, AST and fasting insulin. It predicted NASH with an AUROC 0.774 (0.709, 0.839) in Finns and 0.759 (0.711, 0.807) in Italians (NS). The AUROCs for 'NASH liver fat score' were 0.734 (0.664, 0.805) and 0.737 (0.687, 0.787), respectively. Using 'NASH liver fat score' and 'NASH Score', the prevalences of NASH in the D2D study were 4.2% (95% CI: 3.4, 5.0) and 6.0% (5.0, 6.9%). Sensitivity analysis was performed by taking into account stochastic false-positivity and false-negativity rates in a Bayesian model. This analysis yielded population prevalences of NASH of 3.1% (95% stimulation limits 0.2-6.8%) using 'NASH liver fat score' and 3.6% (0.2-7.7%) using 'NASH Score'. Conclusions The population prevalence of NASH in 45-74 year old Finnish subjects is ∼5%.
KW - Alanine aminotransferase
KW - Aspartate aminotransferase
KW - Metabolic syndrome
KW - Non-alcoholic fatty liver disease
KW - Non-alcoholic steatohepatitis
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=84896396831&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84896396831&partnerID=8YFLogxK
U2 - 10.1016/j.jhep.2013.12.009
DO - 10.1016/j.jhep.2013.12.009
M3 - Article
C2 - 24333862
AN - SCOPUS:84896396831
VL - 60
SP - 839
EP - 846
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
IS - 4
ER -