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The degree of fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) is a key driver of liver disease–related morbidity and mortality. Small, single-center studies show that despite having persistently normal liver enzymes, some patients with NAFLD still present with advanced fibrosis.
To determine how frequently this occurs, and its predictors, researchers analyzed prospectively collected data from 534 adults with biopsy-proven NAFLD. Patients had normal levels (<40 U/L) of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) within 3 months of liver biopsy. Multivariate clinical predictive models were developed for nonalcoholic steatohepatitis (NASH) with stage 2 or 3 fibrosis and cirrhosis.
Results were as follow…