Clinical and histological features of non‐alcoholic fatty liver disease in Hong Kong Chinese

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Abstract
Summary: Background: Non‐alcoholic fatty liver disease is prevalent in affluent countries and is a cause of cirrhosis and possibly hepatocellular carcinoma.Aim: To examine the clinical and histological features of biopsy‐proven non‐alcoholic fatty liver disease and investigate the predictors of severe histological disease in Chinese patients.Methods: Electronic records of all patients (n = 247) who underwent liver biopsy between 1996 and 2003 in our hospital were retrieved. Patients who had histological features of non‐alcoholic fatty liver disease were identified. The demographic, clinical, laboratory and histological (Brunt's criteria) parameters of these patients were analysed.Results: Forty‐two patients had histology‐proven non‐alcoholic fatty liver disease. The median age was 47 years (range 23–69). All except one patient had features of metabolic syndrome. The median alanine aminotransferase was 93 (range 24–270) IU/L. Thirty‐six (85.7%) patients had steatohepatitis and 11 (26.1%) also had fibrosis. Only one patient had stage 3 fibrosis. The presence of diabetes mellitus predicted higher grade steatohepatitis and fibrosis (P = 0.019) whereas alanine aminotransferase level had no correlation with histological severity of steatohepatitis. After a median follow‐up of 42 months, no patient developed hepatic decompensation.Conclusions: Most Chinese patients with non‐alcoholic fatty liver disease had features of the metabolic syndrome. Histological activity was generally mild. Diabetes mellitus was the most important predictor of severe histological disease.