5, 17 All data used in these analyses were obtained within 6 months of liver biopsy. The following variables were analyzed: demographic features (e.g., age at enrollment [years], gender, race [white or other], and ethnicity [Hispanic/Latino]); family history, clinical selleck inhibitor data (e.g., waist circumference, body mass index [BMI] (kg/m2), diastolic blood pressure [BP], and systolic BP); laboratory measures (e.g., triglyceride [Tg], high-density lipoprotein [HDL], and fasting serum glucose levels); and presence of diabetes. Diabetes status was
based upon previous history of diabetes according to patient/physician report (and/or use of medications to treat diabetes and/or fasting plasma glucose >125 mg/dL or a 2-hour glucose >200 mg/dL during an oral glucose tolerance test during the baseline visit). To determine whether the association between family history of diabetes and advanced histology in NAFLD is
mediated by prediabetes, the cohort was further classified into prediabetic and normoglycemic participants. Prediabetes was defined as fasting glucose between 100 and 125 mg/dL or glycated hemoglobin (hemoglobin A1c; HbA1c) between 5.7% and 6.4%; normoglycemia was defined as fasting glucose <100 mg/dL and HbA1c <5.7%. Patients with discordant results (e.g., glucose <100 mg/dL and HbA1c >6.4% or patients without diagnosis of diabetes, but with discordant one-time laboratory values) were set to missing (N = 22). Family history of a condition or disease was self-reported to be present in a first-degree CHIR-99021 in vivo relative click here (i.e., parent, sibling, or child). The presence of patatin-like phospholipase domain-containing protein 3 (PNPLA3) rs738409 G allele was determined for each
patient, as previously described,18 and included in the analysis. Liver biopsy slides stained with hematoxylin and eosin and Masson’s trichrome were reviewed and scored centrally by the NASH CRN pathology committee, as previously reported.19 Central pathology committee pathologists reviewed biopsies without any knowledge of the local pathology readings or clinical or laboratory values of patients in the study.19, 20 Fibrosis was graded based on Brunt’s modified classification: 0 = no fibrosis; 1a = mild, zone 3 perisinusoidal fibrosis (requires trichrome); 1b = moderate, zone 3 perisinusoidal fibrosis (does not require trichrome); 1c = portal/periportal fibrosis; 2 = zone 3 perisinusoidal or periportal fibrosis or both; 3 = bridging fibrosis; and 4 = cirrhosis.19-22 Advanced fibrosis was defined as stages 3 and 4 and compared with mild or no fibrosis (stages 0-2). Any fibrosis was defined as stages 1-4 and compared with no fibrosis (stage 0). Diagnosis of NASH was classified as either definite NASH or suspicious for NASH (i.e., borderline NASH) based upon central pathology reading, as previously defined,19, 20 and compared with no NASH. These categories were defined before conducting statistical analyses.