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dc.contributor.authorAmpuero, Javier-
dc.contributor.authorAller, Rocío-
dc.contributor.authorGallego-Durán, Rocío-
dc.contributor.authorCrespo García, Javier-
dc.contributor.authorCalleja, José Luis-
dc.contributor.authorGarcía-Monzón, Carmelo-
dc.contributor.authorGómez-Camarero, Judith-
dc.contributor.authorCaballería, Juan-
dc.contributor.authorLo lacono, Oreste-
dc.contributor.authorIbáñez, Luis-
dc.contributor.authorGarcía-Samaniego, Javier-
dc.contributor.authorAlbillos, Agustín-
dc.contributor.authorFrancés, Rubén-
dc.contributor.authorFernández-Rodríguez, Conrado M.-
dc.contributor.authorDiago, Moisés-
dc.contributor.authorSoriano, Germán-
dc.contributor.authorAndrade, Raúl J.-
dc.contributor.authorLatorre, Raquel-
dc.contributor.authorJorquera, Francisco-
dc.contributor.authorMorillas, Rosa María-
dc.contributor.authorEscudero, Desamparados-
dc.contributor.authorEstévez, Pamela-
dc.contributor.authorHernández-Guerra, Manuel-
dc.contributor.authorAugustín, Salvador-
dc.contributor.authorBanales, Jesus M.-
dc.contributor.authorAspichueta, Patricia-
dc.contributor.authorBenlloch, Salvador-
dc.contributor.authorRosales-Zábal, José Miguel-
dc.contributor.authorSalmerón, Javier-
dc.contributor.authorTurnes, Juan-
dc.contributor.authorRomero-Gómez, Manuel-
dc.identifierdoi: 10.1016/j.jhep.2020.02.028-
dc.identifierissn: 0168-8278-
dc.identifier.citationJournal of Hepatology 73(1): 17-25 (2020)-
dc.description.abstract[Background & Aims] Non-alcoholic fatty liver disease (NAFLD) could play a catalytic role in the development of metabolic comorbidities, although the magnitude of this effect in metabolically healthy patients with NAFLD remains unclear. We assessed the role of biopsy-proven NAFLD on the risk of developing type 2 diabetes mellitus (T2DM) and other metabolic comorbidities (arterial hypertension [AHT], and dyslipidemia) in metabolically healthy patients.-
dc.description.abstract[Methods] We included 178 metabolically healthy—defined by the absence of baseline T2DM, AHT, dyslipidemia—patients with biopsy-proven NAFLD from the HEPAmet Registry (N = 1,030). Hepamet fibrosis score (HFS), NAFLD fibrosis score, and Fibrosis-4 were calculated. Follow-up was computed from biopsy to the diagnosis of T2DM, AHT, or dyslipidemia.-
dc.description.abstract[Results] During a follow-up of 5.6 ± 4.4 years, T2DM occurred in 9% (16/178), AHT in 8.4% (15/178), low HDL in 9.6% (17/178), and hypertriglyceridemia in 23.6% (42/178) of patients. In multivariate analysis, significant fibrosis predicted T2DM and AHT. Independent variables related to T2DM appearance were significant fibrosis (HR 2.95; 95% CI 1.19–7.31; p = 0.019), glucose levels (p = 0.008), age (p = 0.007) and BMI (p = 0.039). AHT was independently linked to significant fibrosis (HR 2.39; 95% CI 1.14–5.10; p = 0.028), age (p = 0.0001), BMI (p = 0.006), glucose (p = 0.021) and platelets (p = 0.050). The annual incidence rate of T2DM was higher in patients with significant fibrosis (4.4 vs. 1.2 cases per 100 person-years), and increased in the presence of obesity, similar to AHT (4.6 vs. 1.1 cases per 100 person-years). HFS >0.12 predicted the risk of T2DM (25% [4/16] vs. HFS <0.12 4.5% [4/88]; logRank 6.658, p = 0.010).-
dc.description.abstract[Conclusion] Metabolically healthy patients with NAFLD-related significant fibrosis were at greater risk of developing T2DM and AHT. HFS >0.12, but not NAFLD fibrosis score or Fibrosis-4, predicted the occurrence of T2DM.-
dc.description.abstract[Lay summary] Patients with biopsy-proven non-alcoholic fatty liver disease and significant fibrosis were at risk of developing type 2 diabetes mellitus and arterial hypertension. The risk of metabolic outcomes in patients with significant fibrosis was increased in the presence of obesity. In addition to liver biopsy, patients at intermediate-to-high risk of significant fibrosis by Hepamet fibrosis score were at risk of type 2 diabetes mellitus.-
dc.description.sponsorshipThis project has been partially funded by the “Consejería de Salud de la Junta de Andalucía” (PI-0075-2014), the “Spanish Ministry of Economy, Innovation and Competition, Instituto de Salud Carlos III” (PI19/01404, PI16/01842 and PI17/00535) and “Gilead” (GLD19/00100).-
dc.subjectHepamet score-
dc.subjectDiabetes mellitus-
dc.subjectArterial hypertension-
dc.titleSignificant fibrosis predicts new-onset diabetes mellitus and arterial hypertension in patients with NASH-
dc.contributor.funderJunta de Andalucía-
dc.contributor.funderMinisterio de Economía y Competitividad (España)-
dc.contributor.funderInstituto de Salud Carlos III-
dc.contributor.funderGilead Sciences-
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