Age, obesity, and diabetes mellitus remain independent predictors of the degree of fibrosis in nonalcoholic steatohepatitis (NASH). The relative risk for fibrosis adjusted for sex also increases the grade of Perls stain. 

A study investigated if the risk factors for fibrosis in alcohol-induced liver disease as the same as NASH. 

The study enrolled 268 alcoholic patients with negative hepatitis B virus and hepatitis C virus serology for liver biopsy. Fibrosis was assessed semiquantitatively by assigning scores between 0 to 8. Perls staining was utilized to evaluate Liver iron overload and was assigned grades in 4 classes. Multivariate regression with partial correlation analysis was utilized to estimate the variability of fibrosis score based on 7 variables: 

• Sex, 
• Age, 
• Body mass index (BMI) in the year before the hospitalization at the asymptomatic phase, 
• Daily alcohol intake history of the last 5 years, 
• Total duration of alcohol abuse, 
• Perls grade, and 
• Blood glucose level. 

The observations were as follows-

• Multivariate regression analysis showed fibrosis score to be positively associated with age, BMI, female sex, Perls grade, and blood glucose level. 
• These 7 variables accounted for 20% of the variability of the fibrosis score.

In conclusion, after adjustment for daily alcohol intake and total duration of alcohol abuse, other independent risk factors for fibrosis in alcohol-induced liver disease are BMI, Perls grade, and blood glucose. Thus management must consider their implication.

Source- Hepatology, 2002;35(3):635-638. https://doi.org/10.1053/jhep.2002.31782.