Hepatic Steatosis Is Highly Prevalent but Is Not Correlated With Advanced Fibrosis in Autoimmune Hepatitis: Results Obtained at the Autoimmune Hepatitis Association National Meeting
Bibliographic record
Abstract
Introduction: Obesity and associated steatosis are unfavorable prognostic factors in viral hepatitis. A recent report suggested that coexisting fatty liver disease may adversely affect the natural history of patients with autoimmune hepatitis in a similar fashion. We conducted a study to examine the prevalence of hepatic steatosis in individuals with autoimmune hepatitis. Methods: Vibration-controlled transient elastography (Fibroscan) was offered to patients with autoimmune hepatitis (AIH) at the Autoimmune Hepatitis Association (AIHA) national meeting in June 2017 in Indianapolis. All participants were fasting for 3 hours prior to examination. Based on the NASH CRN criteria for 90% sensitivity, presence of hepatic steatosis was defined as Continuous Attenuation Parameter (CAP) ≥ 263 dB/m and severe hepatic steatosis as CAP score ≥ 274 dB/m. The presence of compensated advanced chronic liver disease (cACLD) was defined as: liver stiffness measurement (LSM) > 15 kPa as highly suggestive, 10-15 kPa) as suggestive and < 10 kPa as unlikely. Results: 221 participants attended the AIHA conference in which 148 (67%) carried the diagnosis of AIH and 73 (33%) were caregivers. In total, 74 (50%) participants with AIH (8% male and 92% female) completed Fibroscan examination. This group had a median age of 48 years (yrs) and BMI 29 kg/m2. The median liver stiffness and CAP scores of all participants was 6.8 kPa and 236 dB/m, respectively. 22 (30%) patients had steatosis whereas 19 (26%) severe steatosis. Individuals with both steatosis and severe steatosis had higher BMI (32.6 kg/m2, 32.9 kg/m2) compared to those without steatosis (26.8 kg/m2, p=0.01). Patients with steatosis (50 yrs) also tended to be older compared to those without steatosis (47 yrs, p=0.09). According to the parameters of cACLD, 11 (15%) individuals were highly suggestive, 12 (16%) were suggestive, and 51 (69%) had no evidence of cACLD. Advanced fibrosis was more likely in participants that were male (67% vs 28%, p=0.07) and had higher BMI (31 kg/m2 vs 27.1 kg/m2, p=0.02). There was no significant correlation between advanced fibrosis and the presence of steatosis (r=0.17, p=0.3) or severe steatosis (r=0.18, p=0.3). Conclusion: In patients with AIH there is high prevalence of any steatosis or severe steatosis, but lack of their correlation with advanced fibrosis argues against a role for steatosis in worsening fibrosis in patients with AIH.946_C Figure 3. Liver Cancer Death Rate946_B Figure 2. GI Fellowships
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".