Nonalcoholic steatohepatitis may cause severe fibrosis, cirrhosis and hepatocellular carcinoma, however, supporting evidence is based on indirect data.
Few research groups have evaluated the progression of fibrosis by examining results of repeat liver biopsies.
Researchers in Argentina undertook this study in order to assess the rate of fibrosis progression in untreated patients with nonalcoholic steatohepatitis.
106 patients in total were available for the study and out of these, a second liver biopsy was offered to those who had undergone their first biopsy at least 3 years before.
These patients were not given pharmacological therapy.
The samples were all evaluated blindly and variables were compared between patients with (group P) and without (group NP) fibrosis progression.
In total, 22 patients (median age 45 years; 13 women; diabetes in 8, obesity in 10 patients) underwent a second liver biopsy 4.3 years after the first.
The researchers found fibrosis progression in 7 patients in group P (31.8%), and they found no progression in 15 of the patients in group NP.
The group reported no differences between both groups regarding age, gender, diabetes, hyperlipidaemia, ALT levels, AST-to-ALT ratio levels, albumin levels, prothrombin activity, steatosis, or inflammation.
Obesity was found to be sgnificantly more prevalent in group P (86%) than in group NP (27%).
Basal body mass index was higher in group P than group NP. Time between biopsies was no different between groups.
The group concluded that progression of liver fibrosis occurred in a third of nonalcoholic steatohepatitis patients 4.3 years after the first liver biopsy, and obesity and body mass index were the only associated factors with such progression.