Simple noninvasive systems predict long-term outcomes of patients with nonalcoholic fatty liver disease
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Background & aims Some patients with nonalcoholic fatty liver disease (NAFLD) develop liver-related complications and have higher mortality than other patients with NAFLD. We determined the accuracy of simple, noninvasive scoring systems in identification of patients at increased risk for liver-related complications or death.Methods We performed a retrospective, international, multicenter cohort study of 320 patients diagnosed with NAFLD, based on liver biopsy analysis through 2002 and followed through 2011. Patients were assigned to mild-, intermediate-, or high-risk groups based on cutoff values for 2 of the following: NAFLD fibrosis score, aspartate aminotransferase/platelet ratio index, FIB-4 score, and BARD score. Outcomes included liver-related complications and death or liver transplantation. We used multivariate Cox proportional hazard regression analysis to adjust for relevant variables and calculate adjusted hazard ratios (aHRs).Results During a median follow-up period of 104.8 months (range, 3-317 months), 14% of patients developed liver-related events and 13% died or underwent liver transplantation. The aHRs for liver-related events in the intermediate-risk and high-risk groups, compared with the low-risk group, were 7.7 (95% confidence interval [CI]: 1.4-42.7) and 34.2 (95% CI: 6.5-180.1), respectively, based on NAFLD fibrosis score; 8.8 (95% CI: 1.1-67.3) and 20.9 (95% CI: 2.6-165.3) based on the aspartate aminotransferase/platelet ratio index; and 6.2 (95% CI: 1.4-27.2) and 6.6 (95% CI: 1.4-31.1) based on the BARD score. The aHRs for death or liver transplantation in the intermediate-risk and high-risk groups compared with the low-risk group were 4.2 (95% CI: 1.3-13.8) and 9.8 (95% CI: 2.7-35.3), respectively, based on the NAFLD fibrosis scores. Based on aspartate aminotransferase/platelet ratio index and FIB-4 score, only the high-risk group had a greater risk of death or liver transplantation (aHR = 3.1; 95% CI: 1.1-8.4 and aHR = 6.6; 95% CI: 2.3-20.4, respectively).Conclusions Simple noninvasive scoring systems help identify patients with NAFLD who are at increased risk for liver-related complications or death. NAFLD fibrosis score appears to be the best indicator of patients at risk, based on HRs. The results of this study require external validation.
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Six retrospective cohort studies on individuals with biopsy-proven MASLD showed that NFS and FIB-4 predict the occurrence of liver-related events (AUROCs from 0.72 to 0.86) and overall mortality (AUROCs from 0.67 to 0.82), with similar or lower accuracy compared to histology.
“Six retrospective cohort studies on individuals with biopsy-proven MASLD showed that NFS and FIB-4 predict the occurrence of liver-related events (AUROCs from 0.72 to 0.86) and overall mortality (AUROCs from 0.67 to 0.82), 176,177 with a similar or lower accuracy compared to histology.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [176]
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Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., Gordon, D. J., Krauss, R. M., Savage, P. J., Smith, S. C., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.169404 · Cited by 11,961 · see citing works
Design and validation of a histological scoring system for nonalcoholic fatty liver disease†
Kleiner, D. E., Brunt, E. M., Van Natta, M., Behling, C., Contos, M. J., Cummings, O. W., Ferrell, L. D., Liu, Y., Torbenson, M. S., Unalp‐Arida, A., et al. (2005) · Hepatology · doi:10.1002/hep.20701 · Cited by 10,791 · see citing works
Management of Hepatocellular Carcinoma: An Update Δσ
Bruix, J., & Sherman, M. (2011) · Hepatology · doi:10.1002/hep.24199 · Cited by 8,068 · see citing works
Renehan, A. G., Tyson, M., Egger, M., Heller, R. F., & Zwahlen, M. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60269-x · Cited by 5,219 · see citing works
Wai, C.-T., Greenson, J. K., Fontana, R. J., Kalbfleisch, J. D., Marrero, J. A., Conjeevaram, H. S., & Lok, A. S.-F. (2003) · Hepatology · doi:10.1053/jhep.2003.50346 · Cited by 4,406 · see citing works
Angulo, P., Hui, J. M., Marchesini, G., Bugianesi, E., George, J., Farrell, G. C., Enders, F., Saksena, S., Burt, A. D., Bida, J. P., et al. (2007) · Hepatology · doi:10.1002/hep.21496 · Cited by 3,198 · see citing works
Obesity and Cardiovascular Disease
Lavie, C. J., Milani, R. V., & Ventura, H. O. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.12.068 · Cited by 2,326 · see citing works
Long-term follow-up of patients with NAFLD and elevated liver enzymes
Ekstedt, M., Franzén, L. E., Mathiesen, U. L., Thorelius, L., Holmqvist, M., Bodemar, G., & Kechagias, S. (2006) · Hepatology · doi:10.1002/hep.21327 · Cited by 2,302 · see citing works
de Franchis, R. (2010) · Journal of Hepatology · doi:10.1016/j.jhep.2010.06.004 · Cited by 2,291 · see citing works
Schuppan, D., & Afdhal, N. H. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60383-9 · Cited by 2,089 · see citing works
Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis
Angulo, P., Keach, J. C., Batts, K., & Lindor, K. (1999) · Hepatology · doi:10.1002/hep.510300604 · Cited by 1,708 · see citing works
Comparison of Noninvasive Markers of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease
Shah, A. G., Lydecker, A. D., Murray, K. F., Tetri, B., Contos, M. J., & Sanyal, A. J. (2009) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2009.05.033 · Cited by 1,561 · see citing works
Updated definitions of healthy ranges for serum alanine aminotransferase levels
Prati, D., Taioli, E., Zanella, A., Torre, E. D., Butelli, S., Del Vecchio, E., Vianello, L., Zanuso, F., Mozzi, F., Milani, S., et al. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-137-1-200207020-00006 · Cited by 1,445 · see citing works
Musso, G., Gambino, R., Cassader, M., & Pagano, G. (2010) · Annals of Medicine · doi:10.3109/07853890.2010.518623 · Cited by 1,285 · see citing works
Brunt, E. M., Kleiner, D. E., Wilson, L. A., Belt, P., & Neuschwander-Tetri, B. A. (2011) · Hepatology · doi:10.1002/hep.24127 · Cited by 1,251 · see citing works
Cryptogenic Cirrhosis: Clinical Characterization and Risk Factors for Underlying Disease
Caldwell, S. H., Oelsner, D. H., Iezzoni, J. C., Hespenheide, E. E., Battle, E. H., & Driscoll, C. J. (1999) · Hepatology · doi:10.1002/hep.510290347 · Cited by 1,138 · see citing works
Charlton, M., Burns, J. M., Pedersen, R. A., Watt, K. D. S., Heimbach, J. K., & Dierkhising, R. (2011) · Gastroenterology · doi:10.1053/j.gastro.2011.06.061 · Cited by 1,103 · see citing works
Harrison, S. A., Oliver, D., Arnold, H. L., Gogia, S., & Neuschwander‐Tetri, B. A. (2008) · Gut · doi:10.1136/gut.2007.146019 · Cited by 869 · see citing works
Hepatocellular carcinoma in non-alcoholic fatty liver disease: An emerging menace
Baffy, G., Brunt, E. M., & Caldwell, S. H. (2012) · Journal of Hepatology · doi:10.1016/j.jhep.2011.10.027 · Cited by 856 · see citing works
AST/ALT Ratio Predicts Cirrhosis in Patients With Chronic Hepatitis C Virus Infection
Sheth, S. G., Flamm, S. L., Gordon, F. D., & Chopra, S. (1998) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.1998.044_c.x · Cited by 583 · see citing works
Nonalcoholic Fatty Liver Disease: Pathologic Patterns and Biopsy Evaluation in Clinical Research
Kleiner, D. E., & Brunt, E. M. (2012) · Seminars in Liver Disease · doi:10.1055/s-0032-1306421 · Cited by 402 · see citing works
Ryan, C., Johnson, L. A., Germin, B. I., & Marcos, A. (2002) · Liver Transplantation · doi:10.1053/jlts.2002.36740 · Cited by 325 · see citing works
Epidemiology and natural history of non-alcoholic fatty liver disease (NAFLD)
Bellentani, S., & Marino, M. (2009) · Annals of Hepatology · doi:10.1016/s1665-2681(19)31820-4 · Cited by 322 · see citing works
The Role of Ultrasound in the Diagnosis of Hepatic Steatosis in Morbidly Obese Patients
Mottin, C. C., Moretto, M., Padoin, A. V., Swarowsky, A. M., Toneto, M. G., Glock, L., & Repetto, G. (2004) · Obesity Surgery · doi:10.1381/096089204323093408 · Cited by 301 · see citing works
Angulo, P. (2010) · Hepatology · doi:10.1002/hep.23521 · Cited by 232 · see citing works
Liver Transplantation for Nonalcoholic Steatohepatitis
Agopian, V. G., Kaldas, F. M., Hong, J. C., Whittaker, M., Holt, C., Rana, A. A., Zarrinpar, A., Petrowsky, H., Farmer, D. G., Yersiz, H., et al. (2012) · Annals of Surgery · doi:10.1097/sla.0b013e31826b4b7e · Cited by 227 · see citing works
Final results of a long-term, clinical follow-up in fatty liver patients
Dam‐Larsen, S., Becker, U., Franzmann, M., Larsen, K. R., Christoffersen, P., & Bendtsen, F. (2009) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520903171284 · Cited by 187 · see citing works
Afzali, A., Berry, K., & Ioannou, G. N. (2011) · Liver Transplantation · doi:10.1002/lt.22435 · Cited by 135 · see citing works
Prevalence and Indicators of Portal Hypertension in Patients With Nonalcoholic Fatty Liver Disease
Mendes, F. D., Suzuki, A., Sanderson, S. O., Lindor, K. D., & Angulo, P. (2012) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2012.05.008 · Cited by 109 · see citing works
Can Nash Be Diagnosed, Graded, and Staged Noninvasively?
Grandison, G. A., & Angulo, P. G. (2012) · Clinics in Liver Disease · doi:10.1016/j.cld.2012.05.001 · Cited by 74 · see citing works
Demir, M., Lang, S., Nierhoff, D., Drebber, U., Hardt, A., Wedemeyer, I., Schulte, S., Quasdorff, M., Goeser, T., Töx, U., et al. (2013) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e3182819a89 · Cited by 42 · see citing works
Flagged first, then by citations
1 of the 32 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- [12]Angulo P Long-term mortality in NAFLD: Is liver histology of any prognostic significance? Hepatology 2010 51 373 375 20101746 PMC2945376 Erratum in: Hepatology 2010;51:1868.
- [19]Grandison GA Angulo P Can NASH be diagnoses, graded and staged nonivasively? Clin Liver Dis 2012 16 567 585 22824481 PMC3405360
Cited by
Sorted by citations
Ekstedt, M., Hagström, H., Nasr, P., Fredrikson, M., Stål, P., Kechagias, S., & Hultcrantz, R. (2015) · Hepatology · doi:10.1002/hep.27368 · Cited by 2,287 · see citing works
Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
Estes, C., Anstee, Q. M., Arias, M., Bantel, H., Bellentani, S., Caballería, J., Colombo, M., Craxı̀, A., Crespo, J., Day, C. P., et al. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.05.036 · Cited by 1,986 · see citing works
Berzigotti, A., Tsochatzis, E., Boursier, J., Castera, L., Cazzagon, N., Friedrich-Rust, M., Petta, S., & Thiele, M. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2021.05.025 · Cited by 1,925 · see citing works
(2015) · Journal of Hepatology · doi:10.1016/j.jhep.2015.04.006 · Cited by 1,875 · see citing works
Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease
Castera, L., Friedrich-Rust, M., & Loomba, R. (2019) · Gastroenterology · doi:10.1053/j.gastro.2018.12.036 · Cited by 1,494 · see citing works
McPherson, S., Hardy, T., Henderson, E., Burt, A. D., Day, C. P., & Anstee, Q. M. (2014) · Journal of Hepatology · doi:10.1016/j.jhep.2014.11.034 · Cited by 1,059 · see citing works
Musso, G., Gambino, R., Tabibian, J. H., Ekstedt, M., Kechagias, S., Hamaguchi, M., Hultcrantz, R. W., Hagström, H., Yoon, S. K., Charatcharoenwitthaya, P., et al. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001680 · Cited by 727 · see citing works
Noninvasive biomarkers in NAFLD and NASH — current progress and future promise
Wong, V. W., Adams, L. A., de Lédinghen, V., Wong, G. L., & Sookoian, S. C. (2018) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-018-0014-9 · Cited by 617 · see citing works
Nonalcoholic Fatty Liver Disease: Pathogenesis and Disease Spectrum
Hardy, T., Oakley, F., Anstee, Q. M., & Day, C. P. (2016) · Annual Review of Pathology Mechanisms of Disease · doi:10.1146/annurev-pathol-012615-044224 · Cited by 619 · see citing works
Vilar‐Gómez, E., & Chalasani, N. (2017) · Journal of Hepatology · doi:10.1016/j.jhep.2017.11.013 · Cited by 608 · see citing works
Past, present and future perspectives in nonalcoholic fatty liver disease
Sanyal, A. J. (2019) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-019-0144-8 · Cited by 522 · see citing works
(2024) · Obesity Facts · doi:10.1159/000539371 · Cited by 510 · see citing works
Jarvis, H., Craig, D., Barker, R., Spiers, G., Stow, D., Anstee, Q. M., & Hanratty, B. (2020) · PLoS Medicine · doi:10.1371/journal.pmed.1003100 · Cited by 434 · see citing works
Kwok, R., Tse, Y. ‐., Wong, G. L. ‐., Ha, Y., Lee, A. U., Ngu, M. C., Chan, H. L. ‐., & Wong, V. W. ‐. (2014) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12569 · Cited by 405 · see citing works
Boursier, J., Vergniol, J., Guillet, A., Hiriart, J.-B., Lannes, A., Le Bail, B., Michalak, S., Chermak, F., Bertrais, S., Foucher, J., et al. (2016) · Journal of Hepatology · doi:10.1016/j.jhep.2016.04.023 · Cited by 400 · see citing works
Heritability of Hepatic Fibrosis and Steatosis Based on a Prospective Twin Study
Loomba, R. S., Schork, N. J., Chen, C., Bettencourt, R., Bhatt, A., Ang, B., Nguyen, P., Hernandez, C., Richards, L., Salotti, J., et al. (2015) · Gastroenterology · doi:10.1053/j.gastro.2015.08.011 · Cited by 388 · see citing works
Management of NAFLD: a stage-based approach
Rinella, M. E., & Sanyal, A. J. (2016) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2016.3 · Cited by 388 · see citing works
Lee, J., Vali, Y., Boursier, J., Spijker, R., Anstee, Q. M., Bossuyt, P. M., & Zafarmand, M. H. (2020) · Liver International · doi:10.1111/liv.14669 · Cited by 385 · see citing works
Sanyal, A. J., Friedman, S. L., McCullough, A. J., & Dimick‐Santos, L. (2014) · Hepatology · doi:10.1002/hep.27678 · Cited by 355 · see citing works
Mantovani, A., Zaza, G., Byrne, C. D., Lonardo, A., Zoppini, G., Bonora, E., & Targher, G. (2017) · Metabolism · doi:10.1016/j.metabol.2017.11.003 · Cited by 348 · see citing works
Advances in non-invasive assessment of hepatic fibrosis
Loomba, R. S., & Adams, L. A. (2020) · Gut · doi:10.1136/gutjnl-2018-317593 · Cited by 351 · see citing works
Lee, Y., Jung, K. S., Kim, S. U., Yoon, H.-J., Yun, Y., Lee, B., Kang, E. S., Han, K., Lee, H. C., & Soo, B. (2015) · Journal of Hepatology · doi:10.1016/j.jhep.2015.02.051 · Cited by 342 · see citing works
Sberna, A.-L., Bouillet, B., Rouland, A., Brindisi, M., Nguyen, A., Mouillot, T., Duvillard, L., Denimal, D., Loffroy, R., Vergès, B. L., et al. (2017) · Diabetic Medicine · doi:10.1111/dme.13565 · Cited by 322 · see citing works
Kanwal, F., Kramer, J. R., Li, L., Dai, J., Natarajan, Y., Yu, X., Asch, S. M., & El‐Serag, H. B. (2020) · Hepatology · doi:10.1002/hep.31014 · Cited by 319 · see citing works
Spengler, E. K., & Loomba, R. S. (2015) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2015.06.013 · Cited by 285 · see citing works
Petroff, D., Blank, V., Newsome, P. N., Shalimar, Voican, C. S., Thiele, M., de Lédinghen, V., Baumeler, S., Chan, W. K., Perlemuter, G., et al. (2021) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(20)30357-5 · Cited by 268 · see citing works
Liver fibrosis scores predict liver disease mortality in the United States population
Ünalp–Arida, A., & Ruhl, C. E. (2017) · Hepatology · doi:10.1002/hep.29113 · Cited by 261 · see citing works
Yan, J., Yao, B., Kuang, H., Yang, X., Huang, Q., Hong, T., Li, Y., Dou, J., Yang, W., Qin, G., et al. (2019) · Hepatology · doi:10.1002/hep.30320 · Cited by 260 · see citing works
Kabbany, M. N., Selvakumar, P. K. C., Watt, K. D. S., López, R., Akras, Z., Zein, N. N., Carey, W., & Alkhouri, N. (2017) · The American Journal of Gastroenterology · doi:10.1038/ajg.2017.5 · Cited by 241 · see citing works
Boursier, J., Hagström, H., Ekstedt, M., Moreau, C., Bonacci, M., Cure, S., Ampuero, J., Nasr, P., Tallab, L., Canivet, C. M., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2021.12.031 · Cited by 206 · see citing works
Non-alcoholic fatty liver disease: What the clinician needs to know
Machado, M. V. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i36.12956 · Cited by 209 · see citing works
NAFLD and Chronic Kidney Disease
Marcuccilli, M. E., & Chonchol, M. (2016) · International Journal of Molecular Sciences · doi:10.3390/ijms17040562 · Cited by 200 · see citing works
Nonalcoholic fatty liver disease: Evolving paradigms
Lonardo, A., Nascimbeni, F., Maurantonio, M., Marrazzo, A., Rinaldi, L., & Adinolfi, L. E. (2017) · World Journal of Gastroenterology · doi:10.3748/wjg.v23.i36.6571 · Cited by 197 · see citing works
Younes, R., Caviglia, G. P., Govaere, O., Rosso, C., Armandi, A., Sanavia, T., Pennisi, G., Liguori, A., Francione, P., Gallego-Durán, R., et al. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2021.05.008 · Cited by 196 · see citing works
Hagström, H., Talbäck, M., Andreasson, A., Walldius, G., & Hammar, N. (2020) · Gastroenterology · doi:10.1053/j.gastro.2019.09.008 · Cited by 182 · see citing works
Simon, T. G., Henson, J., Osganian, S., Masia, R., Chan, A. T., Chung, R. T., & Corey, K. E. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2019.04.061 · Cited by 180 · see citing works
Yu, M., Lin, C., Liu, C., Yang, S.-H., Tseng, Y.-L., & Wu, C. (2017) · Gastroenterology · doi:10.1053/j.gastro.2017.07.001 · Cited by 176 · see citing works
Biomarkers in Nonalcoholic Fatty Liver Disease
Neuman, M. G., Cohen, L. B., & Nanau, R. M. (2014) · Canadian Journal of Gastroenterology and Hepatology · doi:10.1155/2014/757929 · Cited by 172 · see citing works
Serra‐Burriel, M., Juanola, A., Serra-Burriel, F., Thiele, M. S., Graupera, I., Pose, E., Pera, G., Grgurević, I., Caballería, L., Piano, S. S., et al. (2023) · The Lancet · doi:10.1016/s0140-6736(23)01174-1 · Cited by 176 · see citing works
Karlas, T., Petroff, D., Garnov, N., Böhm, S. K., Tenckhoff, H., Wittekind, C., Wiese, M., Schiefke, I., Linder, N., Schaudinn, A., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0091987 · Cited by 169 · see citing works
Chang, Y., Cho, Y. K., Kim, Y., Sung, E., Ahn, J., Jung, H., Yun, K. E., Shin, H. C., & Ryu, S. (2018) · Hepatology · doi:10.1002/hep.30170 · Cited by 162 · see citing works
Rinella, M. E., Dufour, J.-F., Anstee, Q. M., Goodman, Z., Younossi, Z., Harrison, S. A., Loomba, R., Sanyal, A. J., Bonacci, M., Trylesinski, A., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2021.10.029 · Cited by 164 · see citing works
Stal, P. I. (2015) · World Journal of Gastroenterology · doi:10.3748/wjg.v21.i39.11077 · Cited by 159 · see citing works
Yang, B.-L., Wu, W.-C., Fang, K., Wang, Y., Huo, T., Huang, Y., Yang, H., Su, C., Lin, H.-C., Lee, F., et al. (2015) · PLoS ONE · doi:10.1371/journal.pone.0120443 · Cited by 158 · see citing works
Non-Alcoholic Fatty Liver Disease
Weiß, J., Rau, M., & Geier, A. (2014) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2014.0447 · Cited by 155 · see citing works
Fibrosis Assessment in Nonalcoholic Fatty Liver Disease (NAFLD) in 2016
Kaswala, D. H., Lai, M., & Afdhal, N. H. (2016) · Digestive Diseases and Sciences · doi:10.1007/s10620-016-4079-4 · Cited by 155 · see citing works
Becker, P. P., Rau, M., Schmitt, J., Malsch, C., Hammer, C., Bantel, H., Müllhaupt, B., & Geier, A. (2015) · PLoS ONE · doi:10.1371/journal.pone.0142661 · Cited by 154 · see citing works
Current and Future Burden of Chronic Nonmalignant Liver Disease
Udompap, P., Kim, D., & Kim, W. R. (2015) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2015.08.015 · Cited by 150 · see citing works
Rasmussen, D. N., Thiele, M. S., Johansen, S., Kjærgaard, M., Lindvig, K. P., Israelsen, M. E., Antonsen, S., Detlefsen, S., Krag, A. A., Anastasiadou, E., et al. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2021.05.037 · Cited by 150 · see citing works
Noninvasive assessment of liver fibrosis in NAFLD
Sanyal, A. J., Castera, L., & Wong, V. W.-S. (2023) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2023.03.042 · Cited by 157 · see citing works
Nonalcoholic Fatty Liver Disease
Bril, F., & Cusi, K. J. (2016) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2016.06.005 · Cited by 152 · see citing works
Effects of resveratrol and other polyphenols in hepatic steatosis
Aguirre, L. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i23.7366 · Cited by 143 · see citing works
Ekstedt, M., Nasr, P., & Kechagias, S. (2017) · Current Hepatology Reports · doi:10.1007/s11901-017-0378-2 · Cited by 141 · see citing works
Nonalcoholic fatty liver disease burden – Saudi Arabia and United Arab Emirates, 2017–2030
Alswat, K., Aljumah, A. A., Sanai, F. M., Abaalkhail, F. A., Alghamdi, M., Hamoudi, W. A., Khathlan, A. A., Quraishi, H. A., Rifai, A. A., Zaabi, M. A., et al. (2018) · Saudi Journal of Gastroenterology · doi:10.4103/sjg.sjg_122_18 · Cited by 141 · see citing works
The Epidemiology, Risk Profiling and Diagnostic Challenges of Nonalcoholic Fatty Liver Disease
Iqbal, U., Perumpail, B. J., Akhtar, D. H., Kim, D., & Ahmed, A. (2019) · Medicines · doi:10.3390/medicines6010041 · Cited by 137 · see citing works
Progression and Natural History of Nonalcoholic Fatty Liver Disease in Adults
Marengo, A., Jouness, R. I. K., & Bugianesi, E. (2015) · Clinics in Liver Disease · doi:10.1016/j.cld.2015.10.010 · Cited by 136 · see citing works
Golovaty, I., Tien, P. C., Price, J. C., Sheira, L. A., Seligman, H. K., & Weiser, S. D. (2019) · Journal of Nutrition · doi:10.1093/jn/nxz212 · Cited by 136 · see citing works
Dang, K., Hirode, G., Singal, A. K., Sundaram, V., & Wong, R. J. (2019) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000000380 · Cited by 135 · see citing works
Trivedi, P. J., Bruns, T., Cheung, A., Li, K.-K., Kittler, C., Kumagi, T., Shah, H., Corbett, C., Al-Harthy, N., Acarsu, U., et al. (2014) · Journal of Hepatology · doi:10.1016/j.jhep.2014.01.029 · Cited by 132 · see citing works
Hagström, H., Nasr, P., Ekstedt, M., Stål, P., Hultcrantz, R., & Kechagias, S. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2018.11.030 · Cited by 132 · see citing works
Athyros, V. G., Τζιόμαλος, Κ., Katsiki, N., Doumas, M. N., Karagiannis, A. I., & Mikhailidis, D. P. (2015) · World Journal of Gastroenterology · doi:10.3748/wjg.v21.i22.6820 · Cited by 131 · see citing works
Non-alcoholic fatty liver disease and the interface between primary and secondary care
Tsochatzis, E. A., & Newsome, P. N. (2018) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(18)30077-3 · Cited by 130 · see citing works
Vodkin, I., Valasek, M. A., Bettencourt, R., Cachay, E. R., & Loomba, R. S. (2014) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13052 · Cited by 129 · see citing works
for the Japan Study Group of Non-Alcoholic Fatty Liver Disease (JSG-NAFLD), Ishiba, H., Sumida, Y., Tanaka, S., Yoneda, M., Hyogo, H., Ono, M., Fujii, H., Eguchi, Y., Suzuki, Y., et al. (2018) · Journal of Gastroenterology · doi:10.1007/s00535-018-1474-y · Cited by 130 · see citing works
Lessons from Epidemiology: The Burden of Liver Disease
Rowe, I. A. C. (2017) · Digestive Diseases · doi:10.1159/000456580 · Cited by 126 · see citing works
Biopsy and Noninvasive Methods to Assess Progression of Nonalcoholic Fatty Liver Disease
Bédossa, P., & Patel, K. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.03.008 · Cited by 123 · see citing works
Bertot, L. C., Jeffrey, G. P., de Boer, B., MacQuillan, G. C., Garas, G., Chin, J., Huang, Y., & Adams, L. A. (2018) · Liver International · doi:10.1111/liv.13739 · Cited by 121 · see citing works
Shili‐Masmoudi, S., Wong, G. L., Hiriart, J., Liu, K., Chermak, F., Shu, S. S., Foucher, J., Tse, Y., Bernard, P., Yip, T. C., et al. (2019) · Liver International · doi:10.1111/liv.14301 · Cited by 117 · see citing works
Hafliðadóttir, S., Jonasson, J. G., Norland, H., Einarsdottir, S., Kleiner, D. E., Lund, S. H., & Bjornsson, E. S. (2014) · BMC Gastroenterology · doi:10.1186/1471-230x-14-166 · Cited by 114 · see citing works
Nonalcoholic fatty liver disease and type 2 diabetes: where do Diabetologists stand?
Tomah, S., Alkhouri, N., & Hamdy, O. (2020) · Clinical Diabetes and Endocrinology · doi:10.1186/s40842-020-00097-1 · Cited by 117 · see citing works
Loomba, R., Huang, D. Q., Sanyal, A. J., Anstee, Q. M., Trauner, M., Lawitz, E. J., Ding, D., Ma, L., Jia, C., Billin, A., et al. (2023) · Gut · doi:10.1136/gutjnl-2022-327777 · Cited by 110 · see citing works
Aller, R., Fernández‐Rodríguez, C., Iacono, O. L., Bañares, R., Abad, J., Carrión, J. A., García‐Monzón, C., Caballería, J., Berenguer, M., Rodríguez‐Perálvarez, M., et al. (2018) · Gastroenterología y Hepatología · doi:10.1016/j.gastrohep.2017.12.003 · Cited by 108 · see citing works
Aspirin use is associated with lower indices of liver fibrosis among adults in the United States
Jiang, Z. G., Feldbrügge, L., Tapper, E. B., Popov, Y. V., Ghaziani, T., Afdhal, N. H., Robson, S. C., & Mukamal, K. J. (2016) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13515 · Cited by 106 · see citing works
Nonalcoholic fatty liver disease – current status and future directions
Demir, M., Lang, S., & Steffen, H. (2015) · Journal of Digestive Diseases · doi:10.1111/1751-2980.12291 · Cited by 105 · see citing works
Insights into Nonalcoholic Fatty-Liver Disease Heterogeneity
Arrese, M. A., Arab, J. P., Francisco Barrera, M., Kaufmann, B. K., Valenti, L. V. C., & Feldstein, A. E. (2021) · Seminars in Liver Disease · doi:10.1055/s-0041-1730927 · Cited by 104 · see citing works
Barbosa, J. V., Milligan, S. C., Frick, A., Broestl, J., Younossi, Z. M., Afdhal, N. H., & Lai, M. (2022) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001606 · Cited by 101 · see citing works
Sebastiani, G., Alshaalan, R., Wong, P. Y. N., Rubino, M., Salman, A., Metrakos, P. P., Deschênes, M., & Ghali, P. (2015) · PLoS ONE · doi:10.1371/journal.pone.0128774 · Cited by 99 · see citing works
Panahi, Y., Kianpour, P., Mohtashami, R., Atkin, S. L., Butler, A. E., Jafari, R., Badeli, R., & Sahebkar, A. (2018) · Phytotherapy Research · doi:10.1002/ptr.6073 · Cited by 95 · see citing works
Fibrosis‐4 Index as an Independent Predictor of Mortality and Liver‐Related Outcomes in NAFLD
Barbosa, J. V., Milligan, S. C., Frick, A., Broestl, J., Younossi, Z. M., Afdhal, N. H., & Lai, M. (2021) · Hepatology Communications · doi:10.1002/hep4.1841 · Cited by 94 · see citing works
QUAPAS: An Adaptation of the QUADAS-2 Tool to Assess Prognostic Accuracy Studies
Lee, J., Mulder, F. I., Leeflang, M., Wolff, R. F., Whiting, P. F., & Bossuyt, P. M. (2022) · Annals of Internal Medicine · doi:10.7326/m22-0276 · Cited by 93 · see citing works
Lai, M., & Afdhal, N. H. (2019) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2019.02.002 · Cited by 92 · see citing works
From the origin of NASH to the future of metabolic fatty liver disease
Geier, A., TINIAKOS, D. G., Denk, H., & Trauner, M. A. (2021) · Gut · doi:10.1136/gutjnl-2020-323202 · Cited by 90 · see citing works
Alkhouri, N., Mansoor, S., Giammaria, P., Liccardo, D., López, R., & Nobili, V. (2014) · PLoS ONE · doi:10.1371/journal.pone.0104558 · Cited by 89 · see citing works
Xu, X., Jiang, L., Wu, C., Pan, L., Lou, Z., Peng, C., Dong, Y., & Ruan, B. (2021) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2021.07.013 · Cited by 88 · see citing works
Crossan, C., Majumdar, A., Srivastava, A., Thorburn, D., Rosenberg, W. M., Pinzani, M., Longworth, L., & Tsochatzis, E. A. (2019) · Liver International · doi:10.1111/liv.14198 · Cited by 87 · see citing works
Irvine, K. M., Wockner, L. F., Shanker, M., Fagan, K. J., Horsfall, L. U., Fletcher, L. M., Ungerer, J. P. J., Pretorius, C. J., Miller, G. C., Clouston, A. D., et al. (2015) · Liver International · doi:10.1111/liv.12896 · Cited by 86 · see citing works
Weng, S. F., Kai, J., Guha, I. N., & Qureshi, N. (2015) · Open Heart · doi:10.1136/openhrt-2015-000272 · Cited by 86 · see citing works
Review article: the prevention and reversal of hepatic fibrosis in autoimmune hepatitis
Czaja, A. J. (2014) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12592 · Cited by 86 · see citing works
Castéra, L., Chan, H. L., Chan, Y., Arrese, M. A., & Han, K. (2015) · Cited by 83 · see citing works
Castéra, L. (2018) · Liver International · doi:10.1111/liv.13658 · Cited by 83 · see citing works
Kim, D., Kim, W. K., Adejumo, A., Cholankeril, G. T., Tighe, S. P., Wong, R. J., Gonzalez, S. A., Harrison, S. A., Younossi, Z. M., & Ahmed, A. (2019) · Hepatology International · doi:10.1007/s12072-018-09926-z · Cited by 81 · see citing works
Chen, Q., Li, Q., Li, D., Chen, X., Liu, Z., Hu, G., Wang, J., & Ling, W. (2020) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2020.03.010 · Cited by 81 · see citing works
Non-invasive methods for the diagnosis of nonalcoholic fatty liver disease
Papagianni, M. (2015) · World Journal of Hepatology · doi:10.4254/wjh.v7.i4.638 · Cited by 80 · see citing works
Bhat, M., Tazari, M., & Sebastiani, G. (2017) · PLoS ONE · doi:10.1371/journal.pone.0185192 · Cited by 79 · see citing works
Ewid, M., Sherif, H. M., Allihimy, A. S., Alharbi, S. A., Aldrewesh, D. A., Alkuraydis, S. A., & Abazid, R. M. (2020) · BMC Research Notes · doi:10.1186/s13104-020-05031-3 · Cited by 78 · see citing works
Kim, D., Vazquez‐Montesino, L. M., Escober, J. A., Fernandes, C. T., Cholankeril, G. T., Loomba, R. S., Harrison, S. A., Younossi, Z. M., & Ahmed, A. (2020) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000000654 · Cited by 78 · see citing works
McPherson, S., Armstrong, M. J., Cobbold, J. F., Corless, L., Anstee, Q. M., Aspinall, R., Barclay, S. T., Brennan, P. N., Cacciottolo, T. M., Goldin, R. D., et al. (2022) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(22)00061-9 · Cited by 77 · see citing works
Önnerhag, K., Hartman, H., Nilsson, P. M., & Lindgren, S. C. (2019) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.2019.1583366 · Cited by 76 · see citing works
- Authors
- Angulo, P., Bugianesi, E., Bjornsson, E. S., Charatcharoenwitthaya, P., Mills, P. R., Barrera, F., Haflidadottir, S., Day, C. P., & George, J.
- Affiliations
- University of Kentucky HealthCare (US)
- University of Turin (IT)
- National University Hospital of Iceland (IS)
- Siriraj Hospital (TH)
- Gartnavel General Hospital (GB)
- Newcastle University (GB)
- The University of Sydney (AU)
- Corresponding author
- Angulo, Paul
- ORCID
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 145
- Issue
- 4
- Pages
- 782-789.e4
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC3931256
- OpenAlex
- W2129639561
- Cited by
- 502
- References
- 32
- Citations by year
- 2026: 7 · 2025: 29 · 2024: 31 · 2023: 32 · 2022: 46 · 2021: 60 · 2020: 49 · 2019: 40 · 2018: 39 · 2017: 35 · 2016: 36 · 2015: 49 · 2014: 45 · 2013: 4
- FWCI
- 32.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Institutes of Health (R01 DK82426)
- Seventh Framework Programme (HEALTH-F2-2009-241762)
- National Health and Medical Research Council (1049857, 632630)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- non-alcoholic fatty liver disease, NAFLD fibrosis score, FIB-4, BARD score, liver complications, mortality, liver transplantation, disease progression, prognosis, liver fibrosis, risk stratification, prognostic accuracy
- MeSH terms
- Adult, Fatty Liver, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Cohort Studies, Kaplan-Meier Estimate, Non-alcoholic Fatty Liver Disease
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