{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T04:16:42Z","timestamp":1768709802927,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,10,16]],"date-time":"2014-10-16T00:00:00Z","timestamp":1413417600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Malaysian Society of Gastroenterology and Hepatology","award":["-"],"award-info":[{"award-number":["-"]}]},{"name":"University of Malaya Research Grant","award":["RG536-13HTM"],"award-info":[{"award-number":["RG536-13HTM"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To perform a follow\u2010up study on non\u2010alcoholic fatty liver disease (<jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>) patients in our previous study using paired liver biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who were included in our previous study on <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> and agreed to receive a repeat liver biopsy were included in the study. Their clinical characteristics, laboratory examination results and histological analysis on the repeat liver biopsied specimens were prospectively collected and compared with those in the previous study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 35 patients (mean age 47.5\u2009\u00b1\u200910.9 years, male 40.0%) were analyzed. The mean interval between the liver biopsies was 6.4\u2009\u00b1\u20090.8 years. <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> activity score (<jats:styled-content style=\"fixed-case\">NAS<\/jats:styled-content>) worsened in 13, remained unchanged in 9 and ameliorated in 13. Fibrosis worsened in 18 and remained unchanged in 17. Two patients who were confirmed with cirrhosis at baseline developed decompensated cirrhosis. On multivariate analysis, elevated serum aspartate aminotransferase (<jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content>) (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 10.74, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.00\u2013115.86, <jats:italic>P<\/jats:italic>\u2009=\u20090.050) and \u03b3\u2010glutamyl transpeptidase (\u03b3\u2010<jats:styled-content style=\"fixed-case\">GT<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 16.10, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.30\u2013198.90, <jats:italic>P<\/jats:italic>\u2009=\u20090.030) at follow\u2010up were associated with worsened <jats:styled-content style=\"fixed-case\">NAS<\/jats:styled-content>. Patients with borderline <jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content> at baseline were more likely to have worsened <jats:styled-content style=\"fixed-case\">NAS<\/jats:styled-content> at follow\u2010up than those with definite <jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 12.67, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.29\u201370.02, <jats:italic>P<\/jats:italic>\u2009=\u20090.004). However, both groups had a similar likelihood of having worsened fibrosis at follow\u2010up. No plausible factors were found to be associated with worsened fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> patients with persistently elevated serum <jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content> and \u03b3\u2010<jats:styled-content style=\"fixed-case\">GT<\/jats:styled-content> levels during follow\u2010up should be suspected of having worsened <jats:styled-content style=\"fixed-case\">NAS<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content> patients can have significant disease progression over a relatively short period of time and fibrosis might be irreversible without specific interventions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.12175","type":"journal-article","created":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T09:47:55Z","timestamp":1406195275000},"page":"545-552","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Progression of liver disease in non\u2010alcoholic fatty liver disease: A prospective clinicopathological follow\u2010up study"],"prefix":"10.1111","volume":"15","author":[{"given":"Wah\u2010Kheong","family":"Chan","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Unit Gastrointestinal Endoscopy Unit Department of Medicine University of Malaya  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Normiha Hilmi","family":"Ida","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit Gastrointestinal Endoscopy Unit Department of Medicine University of Malaya  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phaik\u2010Leng","family":"Cheah","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine University of Malaya  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khean\u2010Lee","family":"Goh","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit Gastrointestinal Endoscopy Unit Department of Medicine University of Malaya  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,10,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-012-9384-1"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-012-9359-2"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12204"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2010.518623"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.03.019"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-9573.2007.00286.x"},{"key":"e_1_2_6_8_1","unstructured":"GoddardE.Estimating alcohol consumption from survey data: updated method of converting volumes to units. 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