HCD Economics Ltd., The Innovation Centre, Keckwick Lane, Daresbury, Cheshire WA4 4FS, United Kingdom.
HCD Economics Ltd., The Innovation Centre, Keckwick Lane, Daresbury, Cheshire WA4 4FS, United Kingdom.
Gastroenterol Hepatol. 2024 May;47(5):463-472. doi: 10.1016/j.gastrohep.2023.10.005. Epub 2023 Oct 27.
To better understand drivers of disease progression in non-alcoholic steatohepatitis (NASH), we assessed clinical and sociodemographic markers of fibrosis progression in adults with NASH.
Physician-reported patient demographics and clinical characteristics were utilised from the real-world Global Assessment of the Impact of NASH (GAIN) study. Factors associated with likelihood of fibrosis progression since NASH diagnosis were identified using a logistic regression model.
Overall, 2349 patients in Europe from the GAIN study were included; mean age was 54.6 years and 41% were women. Significant covariates included age, years since diagnosis, employment status, fibrosis stage at diagnosis, type 2 diabetes mellitus, hypertension, liver transplant and liver biopsy at diagnosis. Risk of progression was 1.16 (95% confidence interval 1.12-1.20; p<0.001) times higher for each additional year since NASH diagnosis and 5.43 (2.68-11.37; p<0.001) times higher when physicians proposed a liver transplant at diagnosis. Compared with full-time employed patients, risk of progression was 1.77 (1.19-2.60; p=0.004) times higher for unemployed patients and 3.16 (1.30-7.63; p=0.010) times higher for those unable to work due to NASH.
Disease duration, NASH severity and presence of other metabolic comorbidities could help to assess risk of progression in patients with NASH.
为了更好地了解非酒精性脂肪性肝炎（NASH）疾病进展的驱动因素，我们评估了患有 NASH 的成年人纤维化进展的临床和社会人口统计学标志物。
利用来自真实世界全球 NASH 影响评估（GAIN）研究的医生报告的患者人口统计学和临床特征。使用逻辑回归模型确定自 NASH 诊断以来纤维化进展可能性相关的因素。
总体而言，GAIN 研究中纳入了来自欧洲的 2349 名患者；平均年龄为 54.6 岁，41%为女性。显著的协变量包括年龄、自诊断以来的年数、就业状况、诊断时的纤维化分期、2 型糖尿病、高血压、肝移植和诊断时的肝活检。自 NASH 诊断以来每年增加的风险为 1.16（95%置信区间 1.12-1.20；p<0.001），当医生在诊断时建议进行肝移植时，风险增加 5.43（2.68-11.37；p<0.001）。与全职工作的患者相比，失业患者的进展风险高 1.77（1.19-2.60；p=0.004），因 NASH 而无法工作的患者的进展风险高 3.16（1.30-7.63；p=0.010）。
疾病持续时间、NASH 严重程度和其他代谢合并症的存在有助于评估 NASH 患者的进展风险。
