Presence of alcoholic steatohepatitis, but no selective histological feature, indicates an increased risk of cirrhosis and premature death

Synne Semb; Søren Neermark; Sanne Dam-Larsen; Maria-Benedicte Franzmann; Jens Albrectsen; Thomas Kallemose; Ulrik Becker; Flemming Bendtsen

doi:10.1080/00365521.2016.1203016

Presence of alcoholic steatohepatitis, but no selective histological feature, indicates an increased risk of cirrhosis and premature death

Synne Semb, Søren Neermark, Sanne Dam-Larsen, Maria-Benedicte Franzmann, Jens Albrectsen, Thomas Kallemose, Ulrik Becker, Flemming Bendtsen

Department of Clinical Medicine

1 Citation (Scopus)

Abstract

Objective: The prognostic impact of early stages of histologically confirmed alcoholic liver disease is uncertain. Our aim was to determine the risk of cirrhosis and premature death, and identify prognostic markers, in patients with biopsy-proven alcoholic steatohepatitis – and to compare prognosis in patients with alcoholic pure fatty liver and the general population. Material and methods: Patients with biopsy-proven alcoholic fatty liver disease diagnosed during 1976–1987 were identified. Data were collected from medical records, the Danish National Patient Registry and the Registry of Causes of Death. All biopsies were re-examined and morphological findings assessed. A reference cohort matched for age and gender was created. Cox proportional hazard models adjusted for age and gender were used to analyse differences in mortality and cirrhosis development, as well as the prognostic impact of histological and biochemical parameters. Results: Two hundred and twenty-five patients with fatty liver and 111 with steatohepatitis were followed for median 13 and 9.7 years, respectively. There was a significantly higher risk of developing cirrhosis amongst patients with steatohepatitis compared to both patients with fatty liver (p < 0.001) and the reference cohort (p < 0.001). Mortality was significantly higher in patients with steatohepatitis compared to patients with fatty liver (p = 0.046) and the general population (p < 0.001). No histological or biochemical parameters with prognostic significance for mortality were identified. Conclusion: Presence of steatohepatitis indicates an increased risk of cirrhosis and premature death. However, none of the histological parameters defining steatohepatitis can independently identify patients at risk for premature death.

Original language	English
Book series	Scandinavian Journal of Gastroenterology
Volume	51
Issue number	11
Pages (from-to)	1367-1374
Number of pages	8
ISSN	0036-5521
DOIs	https://doi.org/10.1080/00365521.2016.1203016
Publication status	Published - 1 Nov 2016

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Journal Article

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10.1080/00365521.2016.1203016

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Semb, S., Neermark, S., Dam-Larsen, S., Franzmann, M.-B., Albrectsen, J., Kallemose, T., Becker, U., & Bendtsen, F. (2016). Presence of alcoholic steatohepatitis, but no selective histological feature, indicates an increased risk of cirrhosis and premature death. Scandinavian Journal of Gastroenterology, 51(11), 1367-1374. https://doi.org/10.1080/00365521.2016.1203016

Presence of alcoholic steatohepatitis, but no selective histological feature, indicates an increased risk of cirrhosis and premature death. / Semb, Synne; Neermark, Søren; Dam-Larsen, Sanne et al.
In: Scandinavian Journal of Gastroenterology, Vol. 51, No. 11, 01.11.2016, p. 1367-1374.

Research output: Contribution to journal › Journal article › Research › peer-review

Semb, S, Neermark, S, Dam-Larsen, S, Franzmann, M-B, Albrectsen, J, Kallemose, T, Becker, U & Bendtsen, F 2016, 'Presence of alcoholic steatohepatitis, but no selective histological feature, indicates an increased risk of cirrhosis and premature death', Scandinavian Journal of Gastroenterology, vol. 51, no. 11, pp. 1367-1374. https://doi.org/10.1080/00365521.2016.1203016

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abstract = "Objective: The prognostic impact of early stages of histologically confirmed alcoholic liver disease is uncertain. Our aim was to determine the risk of cirrhosis and premature death, and identify prognostic markers, in patients with biopsy-proven alcoholic steatohepatitis – and to compare prognosis in patients with alcoholic pure fatty liver and the general population. Material and methods: Patients with biopsy-proven alcoholic fatty liver disease diagnosed during 1976–1987 were identified. Data were collected from medical records, the Danish National Patient Registry and the Registry of Causes of Death. All biopsies were re-examined and morphological findings assessed. A reference cohort matched for age and gender was created. Cox proportional hazard models adjusted for age and gender were used to analyse differences in mortality and cirrhosis development, as well as the prognostic impact of histological and biochemical parameters. Results: Two hundred and twenty-five patients with fatty liver and 111 with steatohepatitis were followed for median 13 and 9.7 years, respectively. There was a significantly higher risk of developing cirrhosis amongst patients with steatohepatitis compared to both patients with fatty liver (p < 0.001) and the reference cohort (p < 0.001). Mortality was significantly higher in patients with steatohepatitis compared to patients with fatty liver (p = 0.046) and the general population (p < 0.001). No histological or biochemical parameters with prognostic significance for mortality were identified. Conclusion: Presence of steatohepatitis indicates an increased risk of cirrhosis and premature death. However, none of the histological parameters defining steatohepatitis can independently identify patients at risk for premature death.",

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T1 - Presence of alcoholic steatohepatitis, but no selective histological feature, indicates an increased risk of cirrhosis and premature death

AU - Semb, Synne

AU - Neermark, Søren

AU - Dam-Larsen, Sanne

AU - Franzmann, Maria-Benedicte

AU - Albrectsen, Jens

AU - Kallemose, Thomas

AU - Becker, Ulrik

AU - Bendtsen, Flemming

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N2 - Objective: The prognostic impact of early stages of histologically confirmed alcoholic liver disease is uncertain. Our aim was to determine the risk of cirrhosis and premature death, and identify prognostic markers, in patients with biopsy-proven alcoholic steatohepatitis – and to compare prognosis in patients with alcoholic pure fatty liver and the general population. Material and methods: Patients with biopsy-proven alcoholic fatty liver disease diagnosed during 1976–1987 were identified. Data were collected from medical records, the Danish National Patient Registry and the Registry of Causes of Death. All biopsies were re-examined and morphological findings assessed. A reference cohort matched for age and gender was created. Cox proportional hazard models adjusted for age and gender were used to analyse differences in mortality and cirrhosis development, as well as the prognostic impact of histological and biochemical parameters. Results: Two hundred and twenty-five patients with fatty liver and 111 with steatohepatitis were followed for median 13 and 9.7 years, respectively. There was a significantly higher risk of developing cirrhosis amongst patients with steatohepatitis compared to both patients with fatty liver (p < 0.001) and the reference cohort (p < 0.001). Mortality was significantly higher in patients with steatohepatitis compared to patients with fatty liver (p = 0.046) and the general population (p < 0.001). No histological or biochemical parameters with prognostic significance for mortality were identified. Conclusion: Presence of steatohepatitis indicates an increased risk of cirrhosis and premature death. However, none of the histological parameters defining steatohepatitis can independently identify patients at risk for premature death.

AB - Objective: The prognostic impact of early stages of histologically confirmed alcoholic liver disease is uncertain. Our aim was to determine the risk of cirrhosis and premature death, and identify prognostic markers, in patients with biopsy-proven alcoholic steatohepatitis – and to compare prognosis in patients with alcoholic pure fatty liver and the general population. Material and methods: Patients with biopsy-proven alcoholic fatty liver disease diagnosed during 1976–1987 were identified. Data were collected from medical records, the Danish National Patient Registry and the Registry of Causes of Death. All biopsies were re-examined and morphological findings assessed. A reference cohort matched for age and gender was created. Cox proportional hazard models adjusted for age and gender were used to analyse differences in mortality and cirrhosis development, as well as the prognostic impact of histological and biochemical parameters. Results: Two hundred and twenty-five patients with fatty liver and 111 with steatohepatitis were followed for median 13 and 9.7 years, respectively. There was a significantly higher risk of developing cirrhosis amongst patients with steatohepatitis compared to both patients with fatty liver (p < 0.001) and the reference cohort (p < 0.001). Mortality was significantly higher in patients with steatohepatitis compared to patients with fatty liver (p = 0.046) and the general population (p < 0.001). No histological or biochemical parameters with prognostic significance for mortality were identified. Conclusion: Presence of steatohepatitis indicates an increased risk of cirrhosis and premature death. However, none of the histological parameters defining steatohepatitis can independently identify patients at risk for premature death.

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JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

IS - 11

ER -

Presence of alcoholic steatohepatitis, but no selective histological feature, indicates an increased risk of cirrhosis and premature death

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