{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:40:11Z","timestamp":1780659611521,"version":"3.54.1"},"reference-count":43,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Non-alcoholic steatohepatitis (NASH), fatty liver disease and fibrosis are associated with diabetes mellitus and obesity. Previous autopsy series have reported prevalence of fatty liver disease to be 11%\u201324%. Recent studies, using imaging and serology, suggest a prevalence of 20%\u201335%, NASH of 5% and advanced fibrosis of 2%\u20133%. We examined the prevalence of NASH and liver fibrosis in a general autopsy population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional study of consecutive, adult, medicolegal autopsies over a 1-year period was conducted. Liver sections were scored for fibrosis, inflammation and steatosis using a modified NASH scoring system. Stepwise logistic regression was used to identify associations between NASH or moderate\/severe fibrosis and several clinicopathological parameters, including postmortem haemoglobin A1c (HbA1c).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 376 cases, 86 (22.9%) were classified as NASH. Prevalence of diabetes mellitus, body mass index (BMI) and postmortem HbA1c were significantly higher in NASH cases (39.5%, 32.3\u2009kg\/m<jats:sup>2<\/jats:sup>and 6.88%) than non-NASH cases (12.1%, 27.0\u2009kg\/m<jats:sup>2<\/jats:sup>and 5.73%). Decedents with moderate\/severe fibrosis (6.9%) had higher prevalence of diabetes, BMI and HbA1c (50%, 31.4\u2009kg\/m<jats:sup>2<\/jats:sup>and 6.7%) compared with those with no\/mild fibrosis (16%, 28\u2009kg\/m<jats:sup>2<\/jats:sup>and 5.9%). HbA1c \u22657% was found to be an independent predictor of NASH (OR 5.11, 95%\u2009CI 2.61 to 9.98) and advanced fibrosis (OR 3.94, 95%\u2009CI 1.63 to 9.53).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>NASH and advanced fibrosis were higher in our general adult autopsy population compared with previously published estimates. This is a large series with histological evaluation showing that HbA1c &gt;7.0% is independently associated with NASH and advanced fibrosis.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jclinpath-2021-207998","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T16:46:23Z","timestamp":1653324383000},"page":"606-611","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Postmortem survey of haemoglobin A1c, non-alcoholic steatohepatitis and liver fibrosis within a general population"],"prefix":"10.1136","volume":"76","author":[{"given":"Kristina-Ana","family":"Klaric","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4173-592X","authenticated-orcid":false,"given":"Jacqueline Louise","family":"Parai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charis Anthea","family":"Kepron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo Eugene","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher Mark","family":"Milroy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"2023081702100955000_76.9.606.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.1997.tb00450.x"},{"key":"2023081702100955000_76.9.606.2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20701"},{"key":"2023081702100955000_76.9.606.3","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i42.5286"},{"key":"2023081702100955000_76.9.606.4","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.11.312"},{"key":"2023081702100955000_76.9.606.5","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1111\/liv.14478","article-title":"What\u2019s in a name? 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