Association of Histologic Disease Activity With Progression of Nonalcoholic Fatty Liver Disease

Key Points Question In patients with nonalcoholic fatty liver disease who are not undergoing specific therapeutic interventions, what factors are associated with progression and regression of hepatic fibrosis? Findings In this cohort study of 446 patients, high baseline nonalcoholic fatty liver disease activity score and changes in the score were associated with concordant changes in fibrosis. Weight gain, high baseline aspartate aminotransferase level, and increases in the aspartate aminotransferase level were associated with fibrosis progression. Meaning These data may support the use of therapeutics targeting disease activity in nonalcoholic steatohepatitis and the use of short-term changes in the nonalcoholic fatty liver disease activity score as an end point in such clinical trials; in clinical practice, weight gain and an increasing aspartate aminotransferase level should increase suspicion of increasing fibrosis.