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Collagen proportionate area is an independent predictor of long-term outcome in patients with non-alcoholic fatty liver disease.
- Source :
-
Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2019 May; Vol. 49 (9), pp. 1214-1222. Date of Electronic Publication: 2019 Mar 18. - Publication Year :
- 2019
-
Abstract
- Background: Collagen proportionate area (CPA) measurement is a technique that quantifies fibrous tissue in liver biopsies by measuring the amount of collagen deposition as a proportion of the total biopsy area. CPA predicts clinical outcomes in patients with HCV and can sub-classify cirrhosis.<br />Aim: To test the ability of CPA to quantify fibrosis and predict clinical outcomes in patients with NAFLD.<br />Methods: We assessed consecutive patients with biopsy-proven NAFLD from three European centres. Clinical and laboratory data were collected at baseline and at the time of the last clinical follow-up or death. CPA was performed at two different objective magnifications, whole biopsy macro and ×4 objective magnification, named standard (SM) and high (HM) magnification respectively. The correlation between CPA and liver stiffness was assessed in a sub-group of patients.<br />Results: Of 437 patients, 32 (7.3%) decompensated and/or died from liver-related causes during a median follow-up of 103 months. CPA correlated with liver stiffness and liver fibrosis stage across the whole spectrum of fibrosis. HM CPA was significantly higher than SM CPA in stages F0-F3 but similar in cirrhosis, reflecting a higher ability to capture pericellular/perisinusoidal fibrosis at early stages. Age at baseline (HR: 1.04, 95% CI: 1.01-1.08), HM CPA (HR: 1.04 per 1% increase, 95% CI: 1.01-1.08) and presence of advanced fibrosis (HR: 15.4, 95% CI: 5.02-47.84) were independent predictors of liver-related clinical outcomes at standard and competing risk multivariate Cox-regression analysis.<br />Conclusions: CPA accurately measures fibrosis and is an independent predictor of clinical outcomes in NAFLD; hence it merits further evaluation as a surrogate endpoint in clinical trials.<br /> (© 2019 John Wiley & Sons Ltd.)
- Subjects :
- Adult
Aged
Biomarkers analysis
Biomarkers metabolism
Biopsy
Collagen analysis
Female
Follow-Up Studies
Greece epidemiology
Humans
Liver chemistry
Liver pathology
Liver Cirrhosis diagnosis
Liver Cirrhosis metabolism
Liver Cirrhosis mortality
Liver Cirrhosis therapy
Liver Transplantation
Longitudinal Studies
Male
Middle Aged
Non-alcoholic Fatty Liver Disease metabolism
Non-alcoholic Fatty Liver Disease mortality
Non-alcoholic Fatty Liver Disease therapy
Prognosis
Retrospective Studies
Sweden epidemiology
Treatment Outcome
United Kingdom epidemiology
Collagen metabolism
Liver metabolism
Non-alcoholic Fatty Liver Disease diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2036
- Volume :
- 49
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Alimentary pharmacology & therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 30882933
- Full Text :
- https://doi.org/10.1111/apt.15219