Relationship between presence of MetS and other histological features among adults with non-alcoholic fatty liver disease
| Presence of metabolic syndrome* | Unadjusted† | Adjusted† | ||||
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Histological feature | (N=240) | (N=116) | OR | p Value | OR | p Value |
| Steatosis grade | 0.04 | 0.03 | ||||
| 1: Mild (<33%) (1) | 78 (34%) | 47 (42%) | 1.00 | 1.00 | ||
| 2: Moderate (≥33%) (2) | 79 (34%) | 42 (37%) | 1.13 | 0.64 | 1.12 | 0.66 |
| 3: Severe (≥66%) (3) | 74 (32%) | 24 (21%) | 1.86 | 0.04 | 1.87 | 0.03 |
| Steatosis location | 0.41‡ | 0.35‡ | ||||
| Zone 3 (central) | 103 (43%) | 40 (35%) | 1.00 | 1.00 | ||
| Zone 1 (periportal) | 4 (2%) | 1 (1%) | 1.56 | 0.70 | 1.53 | 0.77 |
| Azonal | 51 (21%) | 30 (26%) | 0.66 | 0.16 | 0.65 | 0.09 |
| Panacinar | 82 (34%) | 45 (39%) | 0.71 | 0.19 | 0.70 | 0.27 |
| Lobular inflammation score (0–3) | 0.26 | 0.25 | ||||
| 0, 1: <2 under 20× mag | 116 (48%) | 49 (42%) | 1.00 | 1.00 | ||
| 2: ≥2–4 under 20× mag | 99 (41%) | 52 (45%) | 0.80 | 0.67 | 0.87 | 0.58 |
| 3: ≥4 under 20× mag | 25 (10%) | 15 (13%) | 0.70 | 0.34 | 0.63 | 0.24 |
| Chronic portal inflammation score (0–2) | 0.01 | 0.15 | ||||
| 0: None | 36 (15%) | 30 (26%) | 1.00 | 1.00 | ||
| 1, 2: Mild/more than mild | 240 (85%) | 86 (74%) | 1.98 | 1.55 | ||
| Ballooning degeneration score (0–2) | 0.53 | 1.00 | ||||
| 0: None | 72 (30%) | 39 (34%) | 1.00 | 1.00 | ||
| 1: Few | 80 (33%) | 37 (32%) | 1.17 | 0.56 | 1.16 | 0.62 |
| 2: Many | 88 (37%) | 40 (35%) | 1.19 | 0.64 | 1.00 | 1.00 |
| Fibrosis stage, categorised (0–4) | 0.82‡ | 0.88‡ | ||||
| 0: None | 64 (27%) | 34 (29%) | 1.00 | 1.00 | ||
| 1A,B,C, 2: Mild/moderate | 125 (52%) | 60 (52%) | 1.20 | 0.54 | 1.09 | 0.78 |
| 3, 4: Bridging/cirrhosis | 50 (21%) | 22 (19%) | 1.09 | 0.77 | 0.94 | 0.84 |
| Fibrosis stage (stage) | 0.76‡ | 0.71‡ | ||||
| 0: None | 64 (27%) | 34 (29%) | 1.00 | 1.00 | ||
| 1A: Mild, zone 3 perisinusoidal | 45 (19%) | 15 (13%) | 1.59 | 0.20 | 1.50 | 0.30 |
| 1B: Moderate, Z3 perisinusoidal | 23 (10%) | 13 (11%) | 0.94 | 0.88 | 0.83 | 0.67 |
| 1C: Portal/periportal only | 11 (5%) | 7 (6%) | 0.83 | 0.73 | 0.73 | 0.58 |
| 2: Zone 3 and periportal | 46 (19%) | 25 (22%) | 0.98 | 0.94 | 0.91 | 0.80 |
| 3: Bridging | 39 (16%) | 15 (13%) | 1.48 | 0.38 | 1.15 | 0.73 |
| 4: Cirrhosis | 11 (5%) | 7 (6%) | 0.83 | 0.73 | 0.56 | 0.32 |
| NASH diagnosis | 0.09 | 0.13 | ||||
| 0: NAFLD, not NASH | 45 (19%) | 30 (26%) | 1.00 | 1.00 | ||
| 1A,B: Possible/borderline‡ | 48 (20%) | 25 (22%) | 1.28 | 0.47 | 1.35 | 0.41 |
| 2: Definite | 147 (61%) | 61 (53%) | 1.61 | 0.09 | 1.58 | 0.13 |
| NAS, mean±SD | 4.67±1.33 | 4.25±1.15 | 1.05 | 0.47 | 1.04 | 0.57 |
| NAFLD activity score | 0.15 | 0.14 | ||||
| <4 | 115 (48%) | 65 (56%) | 1.00 | 1.00 | ||
| ≥5 | 92 (52%) | 51 (44%) | 1.39 | 1.20 | ||
| HC iron grade§: absent | 176 (79%) | 73 (69%) | ||||
| Present | 46 (21%) | 33 (31%) | 0.58 | 0.04 | 0.72 | 0.27 |
| RES iron grade§: none | 165 (74%) | 67 (63%) | ||||
| Mild/>mild | 57 (26%) | 39 (37%) | 0.59 | 0.04 | 0.65 | 0.14 |
*Data are number and per cent (%) in each category except for the NAS.
†ORs and p values (two-sided) determined from logistic (binary) regression of presence of metabolic syndrome in relation to each histological feature. The adjusted model estimates were adjusted for sex, race/ethnicity, age (18–39, 40–59, 60 years or older) and an indicator for obesity (yes vs no). A trend test was used to determine the p value.
‡p Value determined from a Wald test due to the lack of linearity in the estimates.
§HC iron grade: absent=absent or barely discernable (40×), present=barely discernable granules (20×) to discrete granules resolved (4×).
¶Distribution of zone 3 pattern is 43 (18%) and 24 (21%), and of zone 1, periportal pattern is 5 (2%) and 1 (1%), respectively, by MetS and non-MetS groups.
HC, hepatocellular; MetS, metabolic syndrome; NAFLD, non-alcoholic fatty liver disease; NAS, NAFLD Activity Score; NASH, non-alcoholic steatohepatitis; RES, reticuloendothelial system.