Histological Course of Nonalcoholic Fatty Liver Disease in Japanese Patients
Tight glycemic control, rather than weight reduction, ameliorates liver fibrosis
- Erika Hamaguchi, MD, PHD1,
- Toshinari Takamura, MD, PHD1,
- Masaru Sakurai, MD, PHD2,
- Eishiro Mizukoshi, MD, PHD3,
- Yoh Zen, MD, PHD4,
- Yumie Takeshita, MD, PHD1,
- Seiichiro Kurita, MD, PHD1,
- Kuniaki Arai, MD, PHD3,
- Tatsuya Yamashita, MD, PHD3,
- Motoko Sasaki, MD, PHD5,
- Yasuni Nakanuma, MD, PHD5 and
- Shuichi Kaneko, MD, PHD3
- 1Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan;
- 2Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan;
- 3Department of Gastroenterology, Kanazawa University Hospital, Ishikawa, Japan;
- 4Division of Pathology, Kanazawa University Hospital, Ishikawa, Japan;
- 5Department of Human Pathology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan.
- Corresponding author: Toshinari Takamura, ttakamura{at}m-kanazawa.jp.
Abstract
OBJECTIVE The goal of this study was to examine whether metabolic abnormalities are responsible for the histological changes observed in Japanese patients with nonalcoholic fatty liver disease (NAFLD) who have undergone serial liver biopsies.
RESEARCH DESIGN AND METHODS In total, 39 patients had undergone consecutive liver biopsies. Changes in their clinical data were analyzed, and biopsy specimens were scored histologically for stage.
RESULTS The median follow-up time was 2.4 years (range 1.0–8.5). Liver fibrosis had improved in 12 patients (30.7%), progressed in 11 patients (28.2%), and remained unchanged in 16 patients (41%). In a Cox proportional hazard model, decrease in A1C and use of insulin were associated with improvement of liver fibrosis independent of age, sex, and BMI. However, ΔA1C was more strongly associated with the improvement of liver fibrosis than use of insulin after adjustment for each other (χ2; 7.97 vs. 4.58, respectively).
CONCLUSIONS Tight glycemic control may prevent histological progression in Japanese patients with NAFLD.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received February 8, 2009.
- Accepted October 20, 2009.
- © 2010 by the American Diabetes Association.
