Evidence map›Paper›PMID 37968251›Full record

SynthesisAlimentary pharmacology & therapeutics2024

Low liver fat in non-alcoholic steatohepatitis-related significant fibrosis and cirrhosis is associated with hepatocellular carcinoma, decompensation and mortality.

Sung Won Lee, Daniel Q Huang, Ricki Bettencourt, Veeral Ajmera, Monica Tincopa, Nabil Noureddin, Maral Amangurbanova, Harris Siddiqi, Egbert Madamba, Abdul M Majzoub and 10 more

Erratum issuedOpen access · bronzeAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Alimentary pharmacology & therapeutics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
4.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 23 citations in OpenAlex.

  1. Article
  2. [Proportion and clinical characteristics of probable metabolic-associated fatty liver disease-related cirrhosis in cryptogenic cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. [Guidelines for the prevention and treatment of metabolic dysfunction-associated (non-alcoholic) fatty liver disease (Version 2024)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024
    Article
  9. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 6 institutions in 5 countries.

Sung Won LeeNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.ORCID 0000-0002-5194-5130
Daniel Q HuangNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.ORCID 0000-0002-5165-5061
Ricki BettencourtNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.
Veeral AjmeraNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.ORCID 0000-0001-5626-0942
Monica TincopaNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.ORCID 0000-0002-9954-8548
Nabil NoureddinNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.
Maral AmangurbanovaNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.
Harris SiddiqiNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.
Egbert MadambaNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.
Abdul M MajzoubEvidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA.
Tarek NayfehEvidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA.
Nobuharu TamakiDepartment of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.ORCID 0000-0003-4634-6616
Namiki IzumiDepartment of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.
Atsushi NakajimaDepartment of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Japan.ORCID 0000-0002-6263-1436
Masato YonedaDepartment of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Japan.
Ramzan IdilmanDepartment of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
Mesut GumussoyDepartment of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
Digdem Kuru OzDepartment of Radiology, Ankara University School of Medicine, Ankara, Turkey.
Ayse ErdenDepartment of Radiology, Ankara University School of Medicine, Ankara, Turkey.
Rohit LoombaNAFLD Research Center, Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, California, USA.ORCID 0000-0002-4845-9991
University of California San Diego · USAnkara University · TRMayo Clinic · USMusashino Red Cross Hospital · JPYokohama City University · JPNational University of Singapore · SG

Funding

UC San Diego Clinical and Translational Research InstituteUL1TR001442 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S, HOGARTH, MICHAEL · 2015 to 2024
$88.3M
Pediatric Trials in Non-Alcoholic Steatohepatitis (NASH)U01DK061734 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI ROHIT LOOMBA · 2002 to 2026
$24.4M
Tissue-specific roles of FXR in CVD and NASHP01HL147835 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LOOMBA, ROHIT · 2020 to 2024
$12.2M
San Diego Digestive Diseases Research CenterP30DK120515 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Bernd G. Schnabl · 2019 to 2026
$10.8M
HIV MASLD Clinical Research Network (HCRN)R01DK121378 · NIDDK · INDIANA UNIVERSITY INDIANAPOLIS · PI NAGA P CHALASANI, ROHIT LOOMBA · 2020 to 2026
$8.7M
QUS Technology for Diagnosis and Grading of Hepatic Steatosis in NAFLDR01DK106419 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LOOMBA, ROHIT, SIRLIN, CLAUDE B · 2015 to 2019
$3.4M
San Diego Cirrhosis Clinical Research NetworkU01DK130190 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI ROHIT LOOMBA · 2021 to 2026
$2.3M
Non-invasive screening of diabetics for advanced fibrosis due to NAFLDR01DK124318 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LOOMBA, ROHIT · 2020 to 2022
$1.7M
A Novel Multimodal Approach to Characterize NAFLD Severity and PrognosisK23DK119460 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI AJMERA, VEERAL HARESH · 2019 to 2023
$1.1M
NCATS NIH HHS 5UL1TR001442NCATS NIH HHS UL1 TR001442NHLBI NIH HHS P01 HL147835NHLBI NIH HHS P01HL147835NIDDK NIH HHS K23 DK119460NIDDK NIH HHS K23DK119460NIDDK NIH HHS P30 DK120515NIDDK NIH HHS P30DK120515NIDDK NIH HHS R01 DK106419NIDDK NIH HHS R01DK106419NIDDK NIH HHS R01 DK121378NIDDK NIH HHS R01DK121378NIDDK NIH HHS R01 DK124318NIDDK NIH HHS R01DK124318NIDDK NIH HHS U01 DK061734NIDDK NIH HHS U01DK061734NIDDK NIH HHS U01 DK130190NIDDK NIH HHS U01DK130190
6 · The paper itself

Abstract

backgroundProgression to cirrhosis in non-alcoholic steatohepatitis (NASH) is associated with a decrease in liver fat. However, the prognostic significance of liver fat content in NASH-related significant fibrosis and cirrhosis is unclear.

aimTo investigate the risk of decompensation, hepatocellular carcinoma (HCC) and mortality stratified by liver fat content in NASH-related significant fibrosis and cirrhosis.

methodsIn this meta-analysis of individual participant data, 456 patients with both magnetic resonance elastography (MRE) and MRI-derived protein density fat fraction (MRI-PDFF) were enrolled, and 296 patients with longitudinal follow-up were analysed. MRE combined with fibrosis-4 (MEFIB-index), and MRI-PDFF were used to measure liver fibrosis and fat, respectively. MEFIB-negative, MEFIB-positive+ MRI-PDFF ≥5% and MEFIB-positive+ MRI-PDFF <5% were defined as no significant liver fibrosis, NASH with significant fibrosis and higher liver fat content, and NASH with significant fibrosis and low liver fat content groups, respectively. The primary outcome was hepatic decompensation, HCC and death.

resultsThe rates of decompensation, HCC and mortality were highest in the NASH with significant fibrosis and low liver fat group (33%, 17% and 17%, respectively), followed by the NASH with significant fibrosis and higher liver fat group (18%, 13% and 13% respectively), and lowest in the no significant fibrosis (MEFIB-negative) group (0%, 1% and 2% respectively). In multivariable-adjusted analysis, low liver fat content was strongly associated (HR = 42.2 [95% CI: 7.5-235.5, p < 0.0001]) with HCC, decompensation and death. Sensitivity analyses for patients with cirrhosis (MRE ≥5 kPa) determined consistent findings.

conclusionsLow liver fat content in patients with burnt-out NASH-related significant fibrosis and cirrhosis is associated with an increase in hepatic decompensation, HCC and mortality.

Indexed as

Carcinoma, HepatocellularElasticity Imaging TechniquesLiver NeoplasmsNon-alcoholic Fatty Liver DiseaseFibrosisHumansLiverLiver CirrhosisMagnetic Resonance Imaging

Identifiers

PMID37968251
PMCPMC10807727
OpenAlexW4388715067

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.