Objective:

To compare the prevalence of complete blood count (CBC) abnormalities between patients with clinically diagnosed NASH and matched controls, describe demographic and clinical characteristics of NASH patients with hematological abnormalities, and examine associations with fibrosis scores and other clinical factors.

Key Findings:

• NASH patients had a higher prevalence of any CBC abnormality (35.8% vs. 28.4%) compared to controls, with statistical significance (p < 0.05).
• Thrombocytopenia was significantly more frequent in NASH patients (15.4% vs. 2.5%; p < 0.01).
• Anemia (23.5%), neutropenia (5.4%), and abnormal platelets (18.6%) were more common in older patients, women, and those with diabetes, indicating a need for targeted monitoring.
• Higher FIB-4 scores were associated with increased odds of anemia and abnormal platelets, suggesting a potential predictive role.

Interpretation:

Hematological abnormalities are prevalent in NASH patients and are associated with increased fibrosis risk, suggesting that routine CBC assessments could help identify patients at risk for significant liver disease, thereby enhancing early intervention strategies.

Limitations:

• Study limited to patients with clinically diagnosed NASH, which may not represent all cases, potentially underestimating the prevalence of hematological abnormalities.
• Data derived from a single healthcare system may limit generalizability, necessitating further studies across diverse populations.

Conclusion:

Routine CBC assessments may serve as a simple tool to identify NASH patients at higher risk for clinically significant liver disease.