Long-Term Follow-Up of Patients With Nonalcoholic Fatty Liver
| Autor: | Manirath K. Srishord, Zobair M. Younossi, Yun Fang, Nila Rafiq, Chunhong Bai, Arthur J. McCullough, Terry Gramlich |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Biopsy digestive system National Death Index Gastroenterology Coronary artery disease Risk Factors Internal medicine Nonalcoholic fatty liver disease Humans Medicine Hepatology business.industry Proportional hazards model Fatty liver nutritional and metabolic diseases Middle Aged medicine.disease digestive system diseases Fatty Liver Cohort Disease Progression Female Steatosis business Body mass index Follow-Up Studies |
| Zdroj: | Clinical Gastroenterology and Hepatology. 7:234-238 |
| ISSN: | 1542-3565 |
| DOI: | 10.1016/j.cgh.2008.11.005 |
| Popis: | Nonalcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of conditions ranging from simple hepatic steatosis to nonalcoholic steatohepatitis (NASH) convincingly. NASH is the only subtype of NAFLD that has been shown to progress relatively, although these findings were reported from studies with short follow-up periods. We assessed the long-term outcomes of a NAFLD cohort.Patients with NAFLD established by biopsy were identified in databases and categorized as NASH or non-NASH. Mortality data and causes of death were obtained from National Death Index Plus. The nonparametric Kaplan-Meier method with log-rank test and multivariate analyses with a Cox proportional hazard model were used to compare different NAFLD subtypes and to identify independent predictors of overall and liver-related mortality.Of 173 NAFLD patients (age at biopsy, 50.2 +/- 14.5 y; 39.9% male; 80.8% Caucasian; 28.9% with type II diabetes), 72 (41.6%) had NASH and 101 (58.4%) had non-NASH NAFLD. Over the follow-up period, the most common causes of death were coronary artery disease, malignancy, and liver-related death. Although overall mortality did not differ between the NAFLD subtypes, liver-related mortality was higher in patients with NASH (P.05). Independent predictors of liver-related mortality included histologic NASH, type II diabetes, older age at biopsy, lower albumin levels, and increased levels of alkaline phosphatase (P.05).This long-term follow-up evaluation of NAFLD patients confirms that NASH patients have increased liver-related mortality compared with non-NASH patients. In addition, patients with NAFLD and type II diabetes are especially at risk for liver-related mortality. |
| Databáze: | OpenAIRE |
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