Abstract：
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: Disease duration, NASH severity and presence of other metabolic comorbidities could help to assess risk of progression in patients with NASH.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: Disease duration, NASH severity and presence of other metabolic comorbidities could help to assess risk of progression in patients with NASH.
摘要：
目的：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NASH成人纤维化进展的临床和社会人口统计学标志物.
方法：医生报告的患者人口统计学和临床特征来自真实世界的NASH影响全球评估（GAIN）研究。使用逻辑回归模型鉴定了自NASH诊断以来与纤维化进展的可能性相关的因素。
结果：总体而言，纳入了来自GAIN研究的2349名欧洲患者；平均年龄为54.6岁，41%为女性。重要的协变量包括年龄，诊断多年来，就业状况,诊断时的纤维化阶段，2型糖尿病,高血压,诊断时的肝移植和肝活检。自NASH诊断以来，每增加一年，进展风险为1.16（95％置信区间1.12-1.20；p<0.001）倍，当医生在诊断时提出肝移植时，进展风险为5.43（2.68-11.37；p<0.001）倍。与全职就业患者相比，失业患者的进展风险为1.77(1.19-2.60;p=0.004)倍,NASH导致无法工作的患者的进展风险为3.16(1.30-7.63;p=0.010)倍.
结论：疾病持续时间，NASH严重程度和其他代谢合并症的存在可能有助于评估NASH患者的进展风险。
方法：医生报告的患者人口统计学和临床特征来自真实世界的NASH影响全球评估（GAIN）研究。使用逻辑回归模型鉴定了自NASH诊断以来与纤维化进展的可能性相关的因素。
结果：总体而言，纳入了来自GAIN研究的2349名欧洲患者；平均年龄为54.6岁，41%为女性。重要的协变量包括年龄，诊断多年来，就业状况,诊断时的纤维化阶段，2型糖尿病,高血压,诊断时的肝移植和肝活检。自NASH诊断以来，每增加一年，进展风险为1.16（95％置信区间1.12-1.20；p<0.001）倍，当医生在诊断时提出肝移植时，进展风险为5.43（2.68-11.37；p<0.001）倍。与全职就业患者相比，失业患者的进展风险为1.77(1.19-2.60;p=0.004)倍,NASH导致无法工作的患者的进展风险为3.16(1.30-7.63;p=0.010)倍.
结论：疾病持续时间，NASH严重程度和其他代谢合并症的存在可能有助于评估NASH患者的进展风险。
