Evidence map›Paper›PMID 33724511›Full record

ArticleHepatology (Baltimore, Md.)2021

Glycemic Control Predicts Severity of Hepatocyte Ballooning and Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease.

Anastasia-Stefania Alexopoulos, Matthew J Crowley, Ying Wang, Cynthia A Moylan, Cynthia D Guy, Ricardo Henao, Dawn L Piercy, Keri A Seymour, Ranjan Sudan, Dana D Portenier and 3 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Hepatology (Baltimore, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 2 pooled it
13.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 2 syntheses or guidelines pooled it, 122 citations in OpenAlex.

  1. Pooled it
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  8. Article
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  10. The dynamic spectrum of steatotic liver disease: the global perspective.Nature reviews. Gastroenterology & hepatology · 2026
    Review
  11. Impact of sleeve gastrectomy on the course of metabolic associated fatty liver disease.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Observational
  12. Review
  13. Article
  14. Tetrandrine, a Major Alkaloid FromFood science & nutrition · 2026
    Article
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  18. Article
  19. Review
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Anastasia-Stefania AlexopoulosDivision of Endocrinology, Department of Medicine, Duke University, Durham,, NC.
Matthew J CrowleyDivision of Endocrinology, Department of Medicine, Duke University, Durham,, NC.
Ying WangDivision of Gastroenterology, Department of Medicine, Duke University, Durham,, NC.
Cynthia A MoylanDivision of Gastroenterology, Department of Medicine, Duke University, Durham,, NC.
Cynthia D GuyDepartment of Pathology, Duke University, Durham, NC.
Ricardo HenaoDivision of Biostatistics and Bioinformatics, Duke University, Durham, NC.
Dawn L PiercyDivision of Gastroenterology, Department of Medicine, Duke University, Durham,, NC.
Keri A SeymourDivision of Metabolic Surgery, Department of Surgery, Duke University, Durham, NC.ORCID 0000-0002-2735-0786
Ranjan SudanDivision of Metabolic Surgery, Department of Surgery, Duke University, Durham, NC.
Dana D PortenierDivision of Metabolic Surgery, Department of Surgery, Duke University, Durham, NC.
Anna Mae DiehlDivision of Gastroenterology, Department of Medicine, Duke University, Durham,, NC.
Andrea D Coviello *Division of Endocrinology, Department of Medicine, Duke University, Durham,, NC.
Manal F Abdelmalek *Division of Gastroenterology, Department of Medicine, Duke University, Durham,, NC.ORCID 0000-0002-5001-8618
Duke University · US

Funding

Pathogenesis, prognosis, and treatment of NAFLD patientsU01DK061713 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI ANNA MAE ELIZABETH DIEHL · 2002 to 2026
$10.3M
Endocrinology and Metabolism Training ProgramT32DK007012 · NIDDK · DUKE UNIVERSITY · PI DAVID A. D'ALESSIO · 1986 to 2026
$6.8M
NIDDK NIH HHS T32 DK007012NIDDK NIH HHS U01 DK061713
6 · The paper itself

Abstract

BACKGROUND AND

aimsWhether glycemic control, as opposed to diabetes status, is associated with the severity of NAFLD is open for study. We aimed to evaluate whether degree of glycemic control in the years preceding liver biopsy predicts the histological severity of NASH. APPROACH AND

resultsUsing the Duke NAFLD Clinical Database, we examined patients with biopsy-proven NAFLD/NASH (n = 713) and the association of liver injury with glycemic control as measured by hemoglobin A1c (HbA1c). The study cohort was predominantly female (59%) and White (84%) with median (interquartile range) age of 50 (42, 58) years; 49% had diabetes (n = 348). Generalized linear regression models adjusted for age, sex, race, diabetes, body mass index, and hyperlipidemia were used to assess the association between mean HbA1c over the year preceding liver biopsy and severity of histological features of NAFLD/NASH. Histological features were graded and staged according to the NASH Clinical Research Network system. Group-based trajectory analysis was used to examine patients with at least three HbA1c (n = 298) measures over 5 years preceding clinically indicated liver biopsy. Higher mean HbA1c was associated with higher grade of steatosis and ballooned hepatocytes, but not lobular inflammation. Every 1% increase in mean HbA1c was associated with 15% higher odds of increased fibrosis stage (OR, 1.15; 95% CI, 1.01, 1.31). As compared with good glycemic control, moderate control was significantly associated with increased severity of ballooned hepatocytes (OR, 1.74; 95% CI, 1.01, 3.01; P = 0.048) and hepatic fibrosis (HF; OR, 4.59; 95% CI, 2.33, 9.06; P < 0.01).

conclusionsGlycemic control predicts severity of ballooned hepatocytes and HF in NAFLD/NASH, and thus optimizing glycemic control may be a means of modifying risk of NASH-related fibrosis progression.

Indexed as

AdultBlood GlucoseDiabetes MellitusFemaleGlycated HemoglobinGlycemic ControlHepatocytesHumansHypoglycemic AgentsLiver CirrhosisMaleMiddle AgedNon-alcoholic Fatty Liver DiseaseSeverity of Illness IndexBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic Agents

Identifiers

PMID33724511
PMCPMC8518519
OpenAlexW3137131423

What Socratic holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.