Gastro Hep Advances (Jan 2024)
Clinical Characteristics of Steatotic Liver Disease Categories in a Large Cohort of Japanese Health Checkup Participants
- Yoshihiro Kamada,
- Hideki Fujii,
- Yuichiro Suzuki,
- Koji Sawada,
- Miwa Tatsuta,
- Tatsuji Maeshiro,
- Hiroshi Tobita,
- Tsubasa Tsutsumi,
- Takemi Akahane,
- Chitomi Hasebe,
- Miwa Kawanaka,
- Takaomi Kessoku,
- Yuichiro Eguchi,
- Hayashi Syokita,
- Atsushi Nakajima,
- Tomoari Kamada,
- Hitoshi Yoshiji,
- Takumi Kawaguchi,
- Hiroshi Sakugawa,
- Asahiro Morishita,
- Tsutomu Masaki,
- Takumi Ohmura,
- Toshio Watanabe,
- Yoshioki Yoda,
- Nobuyuki Enomoto,
- Masafumi Ono,
- Kanako Fuyama,
- Kazufumi Okada,
- Naoki Nishimoto,
- Yoichi M. Ito,
- Hirokazu Takahashi,
- Yoshio Sumida
Affiliations
- Yoshihiro Kamada
- Department of Advanced Metabolic Hepatology, Osaka University Graduate School of Medicine 1-7, Suita, Osaka, Japan
- Hideki Fujii
- Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Osaka, Japan; Correspondence: Address correspondence to: Hideki Fujii, MD, PhD, Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahimachi, Abeno, Osaka 545–8585, Japan.
- Yuichiro Suzuki
- Department of Gastroenterology and Hepatology, Faculty of Medicine, University of Yamanashi, Chuo-shi, Yamanashi, Japan
- Koji Sawada
- Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa-city, Hokkaido, Japan
- Miwa Tatsuta
- Department of Gastroenterology, KKR Takamatsu Hospital 4-18 Tenjinmae, Takamatsu, Kagawa, Japan
- Tatsuji Maeshiro
- First Department of Internal Medicine, University of the Ryukyus Hospital, Nakagami, Okinawa, Japan
- Hiroshi Tobita
- Department of Hepatology, Shimane University Hospital, Izumo, Shimane, Japan
- Tsubasa Tsutsumi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Takemi Akahane
- Department of Gastroenterology, Nara Medical University, Kashihara, Nara, Japan
- Chitomi Hasebe
- Department of Gastroenterology, Japanese Red Cross Asahikawa Hospital, Asahikawa-city, Hokkaido, Japan
- Miwa Kawanaka
- Department of General Internal Medicine 2, Kawasaki Medical Center, Kawasaki Medical School, Kita, Okayama, Japan
- Takaomi Kessoku
- Kanagawa Dental University Yokohama Clinic, Yokohama, Kanagawa, Japan; Department of Palliative Medicine and Gastroenterology, International University Health and Welfare Narita Hospital, Narita-shi, Chiba, Japan; Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
- Yuichiro Eguchi
- Loco Medical General Institute, Ogi, Saga, Japan
- Hayashi Syokita
- Department of Gastroenterology, Northern OKINAWA Medical Center, Nago, Okinawa, Japan
- Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
- Tomoari Kamada
- Department of Health Care Medicine, Kawasaki Medical School, Kita, Okayama, Japan
- Hitoshi Yoshiji
- Department of Gastroenterology, Nara Medical University, Kashihara, Nara, Japan
- Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Hiroshi Sakugawa
- Department of Gastroenterology, Heartlife Hospital, Nakagami, Okinawa, Japan
- Asahiro Morishita
- Faculty of Medicine, Department of Gastroenterology and Neurology, Kagawa University, Kita-gun, Kagawa, Japan
- Tsutomu Masaki
- Faculty of Medicine, Department of Gastroenterology and Neurology, Kagawa University, Kita-gun, Kagawa, Japan
- Takumi Ohmura
- Department of Health Care, Asahikawa-Kosei General Hospital, Asahikawa, Hokkaido, Japan
- Toshio Watanabe
- Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Osaka, Japan
- Yoshioki Yoda
- JA Yamanashi Koseiren Health Care Center, Kofu, Yamanashi, Japan
- Nobuyuki Enomoto
- Department of Gastroenterology and Hepatology, Faculty of Medicine, University of Yamanashi, Chuo-shi, Yamanashi, Japan
- Masafumi Ono
- Division of Innovative Medicine for Hepatobiliary and Pancreatology, Faculty of Medicine, Kagawa University, Mikicho, Kagawa, Japan
- Kanako Fuyama
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
- Kazufumi Okada
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
- Naoki Nishimoto
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
- Yoichi M. Ito
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
- Hirokazu Takahashi
- Liver Center, Saga University Hospital, Saga, Saga, Japan
- Yoshio Sumida
- Graduate School of Healthcare Management, International University of Healthcare and Welfare, Minatoku, Tokyo, Japan
- Journal volume & issue
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Vol. 3,
no. 8
pp. 1148 – 1156
Abstract
Background and Aims: The clinical characteristics and risk factors involved in the development of liver fibrosis in the subtypes of steatotic liver disease (SLD) remain unknown. We examined the clinical characteristics of SLD subtypes using a large Japanese cohort. Methods: We performed a cross-sectional analysis (total n = 108,446). In this cohort, SLD was diagnosed by ultrasonography. Individuals with none of the cardiometabolic risk factors were excluded. Results: According to their nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) status based on the database, participants with cardiometabolic criteria were allocated to the MASLD, MASLD with increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD) with metabolic dysfunction groups. Of 30,857 subjects with SLD, 21,488 (69.6%) had NAFLD, and 20,922 (67.8%) had MASLD. There were few differences in the clinical characteristics between NAFLD and MASLD. After adjustment for clinical variables, we found that male patients with MetALD [odds ratio (OR) 2.26; 95% confidence interval (CI) 1.87–2.84] and ALD with metabolic dysfunction (OR 3.92; 95% CI 2.85–5.39) had a significantly higher risk for advanced liver fibrosis (diagnosed by Fibrosis-4 (FIB-4) index >2.67) compared to those with MASLD. In female patients with ALD, metabolic dysfunction (OR 5.80; 95% CI 2.51–13.4) and systemic blood pressure of ≥130 mmHg were significant risk factors for high FIB-4 (males: OR 3.38, 95% CI 2.51–4.55; females: OR 4.34, 95% CI 2.66–7.07, P < .001). Conclusion: Alcohol intake and systolic blood pressure are independent contributors to liver fibrosis progression assessed by FIB-4 in SLD.
