Original articlePancreas, biliary tract, and liverDaily Aspirin Use Associated With Reduced Risk For Fibrosis Progression In Patients With Nonalcoholic Fatty Liver Disease
Section snippets
Study Population
The Massachusetts General Hospital NAFLD Repository is a prospective cohort study of adults older than the age of 18 years with biopsy-confirmed NAFLD. All subjects were referred for clinically indicated liver biopsy from community clinics. More than 90% of biopsies were obtained for persistent unexplained elevation of aminotransferases and/or abnormal hepatic imaging suggesting steatosis and/or fibrosis. This study was approved by the Massachusetts General Hospital Institutional Review Board,
Results
Table 1 describes the baseline characteristics of the full study cohort (n = 361). Compared with non-regular users, daily aspirin users were significantly older (mean, 60 ± 9 years vs 48 ± 14 years; P < .0001) and more likely to have diabetes (46% vs 39%, P = .001), coronary artery disease (21% vs 9%, P < .0001), and to be former smokers (39% vs 25%, P = .011). Mean baseline NFS, APRI, and FIB-4 scores were similar between groups (all P > .05). Among daily aspirin users, the median duration of
Discussion
In a well-phenotyped, prospective population with biopsy-proven NAFLD, daily aspirin use was inversely associated with NAFLD histologic severity and with risk for developing incident advanced fibrosis. Importantly, these findings were consistent in women and men and among patients with paired liver biopsies. We also found this inverse relationship to be duration-dependent, such that risk for developing advanced fibrosis was significantly reduced after at least 2 years of daily aspirin use. In
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Conflicts of interest The authors disclose no conflicts.
Funding Supported by NIH grant K24DK078772 (R.T.C.), NIH grant K23DK099422 (K.E.C.), NIH grant K24DK098311 (A.T.C.), NCI grant R01 CA137178 (A.T.C.), NIH grant 5P30DK046200-25 (T.G.S.), and NIH grant K23DK122104 (T.G.S.). Dr Chung is a Kevin and Polly Maroni MGH Research Scholar. Dr Chan is a Stuart and Suzanne Steele MGH Research Scholar. T.S. is supported by a Clinical and Translational Research Award by the AASLD Foundation. R.M. is supported by a Pinnacle Research Award from the AASLD Foundation.