Clinicopathological characteristics and risk factors in nonalcoholic steatohepatitis patients with different stages of liver fibrosis

doi:10.4254/wjh.121661

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Hepatol. Jul 27, 2026; 18(7): 121661
Published online Jul 27, 2026. doi: 10.4254/wjh.121661

Table 1 Baseline characteristics, n (%)

	Total (n = 122)	Stage F1 (n = 21)	Stage F2 (n = 86)	Stage F3 (n = 15)	P value
Male	66 (54.1)	11 (52.3)	47 (54.7)	8 (53.3)	0.981
Age (years)	41.6 ± 14.2	42 (30, 57)	39.5 (28, 52)	53 (35, 62)	0.142
BMI (kg/m²)	28.3 ± 3.7	28.3 (26.4, 30.1)	28.13 (25.4, 30.8)	28.7 (25.1, 31)	0.89
Hypertension	39 (32)	9 (42.9)	22 (25.6)	8 (53.3)	0.052
Diabetes	24 (19.7)^a	0 (0)	18 (20.9)	6 (40)	0.009

^aP = 0.001 vs stage F3 group.

BMI: Body mass index.

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Table 2 Comparison of FibroScan results

Variable	Total(n = 122)	Stage F1 (n = 21)	Stage F2 (n = 86)	Stage F3 (n = 15)	P value
LSM (kPa)	8.1 (6.1, 10.2)	5.8 (3.3, 8.3)	8.1 (5, 11.2)^a	12 (5.9, 18.1)^b^,^c	< 0.001
CAP (dB/m)	311.5 ± 34.7	313.9 ± 34.6	312.8 ± 34	300.9 ± 39.2	0.45

^aP = 0.002 vs stage F1 group.

^bP < 0.001 vs stage F1 group.

^cP < 0.001 vs stage F2 group.

LSM: Liver stiffness measurement; CAP: Controlled attenuation parameter.

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Table 3 Comparison of laboratory test results

Variable	Total (n = 122)	Stage F1 (n = 21)	Stage F2 (n = 86)	Stage F3 (n = 15)	P value
ALT (U/L)	85 (53.4, 141.7)	70.2 (39, 121)	85.5 (55.7, 143.5)	93.2 (59, 158.3)	0.351
AST (U/L)	49.5 (36.2, 76)	47 (29.1, 66.9)^a	49 (36.2, 71.5)	80 (43.9, 100.4)	0.031
ALP (U/L)	76.1 (63, 89.3)	71(58, 89.6)	77.3 (63.9, 88)	86 (54.9, 98.4)	0.498
GGT (U/L)	70.4 (46.8, 105.2)	72 (39, 115.2)	70.4 (46, 106.1)	70 (58, 97.5)	0.9
ALB (g/L)	47.6 (45.5, 49.8)	47.5 (44.7, 49)	47.8 (46, 50.3)^b	45.5 (42.2, 47.9)	0.008
TBA (µmol/L)	3.2 (2, 5.3)	3 (2, 6)	3 (2, 5)	4 (3, 6)	0.367
TP (g/L)	75.5 ± 5.1	75.2 ± 5.9	75.9 ± 4.7	73.2 ± 5.9	0.163
TBIL (µmol/L)	14 (11.6, 17.4)	14 (10.5, 18.7)	13.4 (11.5, 17.2)	15.2 (13.1, 18.8)	0.241
DBIL (µmol/L)	2.9 (1.9, 4.5)	2.4 (1.7, 6.2)	3 (1.7, 4.4)	2.4 (1.9, 4.7)	0.972
IBIL (μmol/L)	11 (8.8, 13.2)	11.1 (7.6, 14.2)	10.8 (8.8, 12.5)	12.8 (10, 13.5)	0.251
BUN (g/L)	4.5 (3.9, 5.2)	6.6 (3.9, 5)	4.5 (3.8, 5.2)	4.9 (4.2, 5.9)	0.195
CRE (µmol/L)	62.9 ± 14.4	62.6 ± 13.8	62.6 ± 14.0	65.5 ± 18.3	0.766
UA (µmol/L)	375 (334.4, 466)	379 (346.8, 490.5)	375 (320.9, 462.6)	374 (363, 491)	0.646
eGFR (mL/minute/1.73 m²)	110.8 ± 13.7	110.6 ± 14.3	113.3 ± 12.1^c	102.5 ± 18.6	0.036
FPG (mmol/L)	5.9 (5.5, 6.7)	5.7 (5.4, 6.2)	6 (5.5, 6.8)	6.2 (5.3, 6.9)	0.169
TC (mmol/L)	5.4 ± 1.2	5.2 ± 1.3	5.4 ± 1.2	6.0 ± 1.3	0.159
TG (mmol/L)	1.8 (1.4, 2.5)	1.9 (1.7, 3)	1.8 (1.3, 2.4)	1.9 (1.5, 2.5)	0.231
HDL (mmol/L)	1.3 ± 0.3	1.3 ± 0.3	1.3 ± 0.3	1.3 ± 0.2	0.599
LDL (mmol/L)	3.3 ± 1	2.9 ± 0.9^d	3.3 ± 0.9	3.8 ± 1	0.034
Glo (%)	15.3 (13.8, 16.8)	15.7 (13.8, 16.5)	15.1 (13.9, 17.1)	15.2 (12.8, 17.4)	0.942
IgG (g/L)	11.95 (10.31, 14.14)	11.8 (9.44, 14.07)	12.33 (10.68, 14.28)	11.2 (10, 13.45)	0.29
IgM (g/L)	0.95 (0.69, 1.19)	0.97 (0.73, 1.18)	0.9 (0.66, 1.17)	1.13 (0.73, 1.72)	0.267
IgA (g/L)	2.43 (1.81, 3.21)	2.32 (1.83, 3.11)	2.5 (1.82, 3.18)	2.23 (1.54, 3.49)	0.949
WBC (10⁹/L)	6.3 ± 1.5	6.3 ± 1.6	6.3 ± 1.5	6.5 ± 1.2	0.856
RBC (10¹²/L)	4.91 (4.59, 5.29)	4.84 (4.47, 5.12)	4.95 (4.59, 5.36)	4.88 (4.56, 5.29)	0.351
Hb (g/L)	146 ± 14.6	144 ± 10.7	146.9 ± 15.7	145.9 ± 12.4	0.72
PLT (10⁹/L)	248 ± 65	247.6 ± 78.6	252.2 ± 66.0	224.7 ± 31.1	0.309
PT (s)	11.1 (10.6, 12.53)	12.1 (10.4, 12.95)	11.1 (10.6, 11.95)	11.6 (10.8, 13)	0.272

^aP = 0.03 vs stage F3 group.

^bP = 0.002 vs stage F3 group.

^cP = 0.03 vs stage F3 group.

^dP = 0.031 vs stage F3 group.

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transferase; ALB: Albumin; TBA: Total bile acids; TP: Total protein; TBIL: Total bilirubin; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; BUN: Blood urea nitrogen; CRE: Creatinine; UA: Uric acid; eGFR: Estimated glomerular filtration rate; FPG: Fasting plasma glucose; TC: Total cholesterol; TG: Triglycerides; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; Glo: Globulin; IgG: Immunoglobulin G; IgM: Immunoglobulin M; IgA: Immunoglobulin A; WBC: White blood cell; RBC: Red blood cell; Hb: Hemoglobin; PLT: Platelets; PT: Prothrombin time.

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Table 4 Comparison of histological features

Variable	Total (n = 122)	Stage F1 (n = 21)	Stage F2 (n = 86)	Stage F3 (n = 15)	P value
Steatosis, n					0.035^a
Grade 1	11	2	9	0
Grade 2	55	15	34	6
Grade 3	56	4	43	9
Lobular inflammation, n					< 0.001^b^,^c
Grade 1	27	10	16	1
Grade 2	87	11	66	10
Grade 3	8	0	4	4
Ballooning degeneration, n					0.223
Grade 1	41	5	33	3
Grade 2	81	16	53	12

^aP = 0.049 stage F3 vs stage F1 group.

^bP = 0.0018 stage F2 vs stage F1 group.

^cP < 0.001 stage F3 vs stage F1 group.

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Table 5 Pathological validation of liver stiffness measurement diagnostic efficacy

Pathological staging	LSM-F1 (n = 59)	LSM-F2 (n = 43)	LSM-F3 (n = 18)	LSM-F4 (n = 2)	Total
Path-F1 (n = 21)	17	3	1	0	21
Path-F2 (n = 86)	39	36	11	0	86
Path-F3 (n = 15)	3	4	6	2	15
Total	59	43	18	2	122

Kappa value = 0.206. P = 0.001. LSM: Liver stiffness measurement.

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Table 6 Comparison of clinical and histological features according to liver stiffness measurement accuracy

Variable		Concordant group (n = 59)	Discordant group (n = 63)	P value
BMI (kg/m²)		27.9 ± 3.2	28.6 ± 4.1	0.105
CAP (dB/m)		312.6 ± 30.1	310.5 ± 38.7	0.167
Steatosis, n	Grade 1	3	8	0.298
	Grade 2	27	28
	Grade 3	29	27
Lobular inflammation, n	Grade 1	16	11	0.097
	Grade 2	41	46
	Grade 3	2	6
Ballooning degeneration, n	Grade 1	23	18	0.226
Ballooning degeneration, n	Grade 2	36	45

LSM: Liver stiffness measurement; CAP: Controlled attenuation parameter.

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Table 7 Diagnostic performance of liver stiffness measurement

	AUROC (95%CI)	Optimal cut-off (kPa)	Sensitivity (%)	Specificity (%)	Youden index
≥ F2	0.761 (0.653-0.870)	6.45	78.21	71.42	0.496
≥ F3	0.829 (0.718-0.94)	9.75	80	81.31	0.613

AUROC: Area under the receiver operating characteristic curve; CI: Confidence interval.

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Table 8 Ordered logistic regression results

	Univariate analysis		Multivariate analysis
Variables	OR (95%CI)	P value	OR (95%CI)	P value
Male	1.034 (0.48, 2.232)	0.931
Age	1.012 (0.986, 1.04)	0.36
BMI	1.013 (0.914, 1.122)	0.81
Hypertension	1.306 (0.582, 2.93)	0.52
Diabetes	4.358 (1.589, 11.953)	0.004	3.76 (1.30, 10.84)	0.014
FPG	1.16 (0.93, 1.45)	0.186
AST	1.012 (1.002, 1.021)	0.021
LDL	1.706 (1.134, 2.565)	0.01	1.52 (1.10, 2.34)	0.049

BMI: Body mass index; CI: Confidence interval; OR: Odds ratio; FPG: Fasting plasma glucose; AST: Aspartate aminotransferase; LDL: Low-density lipoprotein.

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Citation: Pan PY, Zheng WW, Guo YQ, Liu YG, Zhang XJ, Wu YY, Li JZ, Qi JG, Wang CY. Clinicopathological characteristics and risk factors in nonalcoholic steatohepatitis patients with different stages of liver fibrosis. World J Hepatol 2026; 18(7): 121661
URL: https://www.wjgnet.com/1948-5182/full/v18/i7/121661.htm
DOI: https://dx.doi.org/10.4254/wjh.121661

Pan PY, Zheng WW, Guo YQ, Liu YG, Zhang XJ, Wu YY, Li JZ, Qi JG, Wang CY. Clinicopathological characteristics and risk factors in nonalcoholic steatohepatitis patients with different stages of liver fibrosis. World J Hepatol 2026; 18(7): 121661 [DOI: 10.4254/wjh.121661]

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