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1. Nineteen-year prognosis in Japanese patients with biopsy-proven nonalcoholic fatty liver disease: Lean versus overweight patients.

Author

Shunji Hirose, Koshi Matsumoto, Masayuki Tatemichi, Kota Tsuruya, Kazuya Anzai, Yoshitaka Arase, Koichi Shiraishi, Michiko Suzuki, Satsuki Ieda, and Tatehiro Kagawa

Subjects
Medicine, Science
Abstract

BackgroundMany studies have investigated the prognosis of nonalcoholic fatty liver disease (NAFLD); however, most studies had a relatively short follow-up. To elucidate the long-term outcome of NAFLD, we conducted a retrospective cohort study of patients with biopsy-proven NAFLD.MethodsWe re-evaluated 6080 patients who underwent liver biopsy from 1975 to 2012 and identified NAFLD patients without other etiologies. With follow-up these patients, we evaluated the outcome-associated factors.ResultsA total of 223 patients were enrolled, 167 (74.9%) was non-alcoholic steatohepatitis (NASH). The median follow-up was 19.5 (0.5-41.0) years and 4248.3 person-years. The risk of type 2 diabetes mellitus (T2DM) and hypertension was 11.7 (95% confidence interval [CI] 8.70-15.6) and 7.99 (95% CI 6.09-10.5) times higher, respectively, in NAFLD patients than in the general population. Twenty-three patients died, 22 of whom had NASH. Major causes of death were extrahepatic malignancy and cardiovascular disease (21.7%) followed by liver-related mortality (13.0%). All-cause mortality was significantly higher in NASH patients than in nonalcoholic fatty liver patients (P = 0.041). In multivariate analysis, older age (hazard ratio [HR] 1.09 [95% CI 1.05-1.14], PConclusionsT2DM was highly prevalent in NAFLD patients and was significantly associated with both all-cause mortality and liver-related events. The lean patients' prognosis wasn't necessarily better than that of overweight patients.

Published
2020
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2. Nineteen-year prognosis in Japanese patients with biopsy-proven nonalcoholic fatty liver disease: Lean versus overweight patients

Author

Kota Tsuruya, Masayuki Tatemichi, Koichi Shiraishi, Michiko Suzuki, Satsuki Ieda, Tatehiro Kagawa, Yoshitaka Arase, Shunji Hirose, Kazuya Anzai, and Koshi Matsumoto

Subjects
Male, Steatosis, Physiology, Biopsy, Cardiovascular Medicine, Pathology and Laboratory Medicine, Gastroenterology, Cytopathology, Medical Conditions, Endocrinology, Non-alcoholic Fatty Liver Disease, Nonalcoholic fatty liver disease, Medicine and Health Sciences, education.field_of_study, Multidisciplinary, medicine.diagnostic_test, Liver Diseases, Hazard ratio, Fatty liver, Middle Aged, Prognosis, Physiological Parameters, Cardiovascular Diseases, Liver biopsy, Medicine, Female, Algorithms, Research Article, Adult, medicine.medical_specialty, Endocrine Disorders, Science, Population, Cardiology, Surgical and Invasive Medical Procedures, Gastroenterology and Hepatology, Thinness, Diagnostic Medicine, Internal medicine, medicine, Diabetes Mellitus, Humans, Mortality, education, Retrospective Studies, business.industry, Body Weight, Biology and Life Sciences, nutritional and metabolic diseases, Retrospective cohort study, Overweight, medicine.disease, Fibrosis, Fatty Liver, Diabetes Mellitus, Type 2, Anatomical Pathology, Metabolic Disorders, Steatohepatitis, business, Body mass index, Developmental Biology
Abstract

Background Many studies have investigated the prognosis of nonalcoholic fatty liver disease (NAFLD); however, most studies had a relatively short follow-up. To elucidate the long-term outcome of NAFLD, we conducted a retrospective cohort study of patients with biopsy-proven NAFLD. Methods We re-evaluated 6080 patients who underwent liver biopsy from 1975 to 2012 and identified NAFLD patients without other etiologies. With follow-up these patients, we evaluated the outcome-associated factors. Results A total of 223 patients were enrolled, 167 (74.9%) was non-alcoholic steatohepatitis (NASH). The median follow-up was 19.5 (0.5–41.0) years and 4248.3 person-years. The risk of type 2 diabetes mellitus (T2DM) and hypertension was 11.7 (95% confidence interval [CI] 8.70–15.6) and 7.99 (95% CI 6.09–10.5) times higher, respectively, in NAFLD patients than in the general population. Twenty-three patients died, 22 of whom had NASH. Major causes of death were extrahepatic malignancy and cardiovascular disease (21.7%) followed by liver-related mortality (13.0%). All-cause mortality was significantly higher in NASH patients than in nonalcoholic fatty liver patients (P = 0.041). In multivariate analysis, older age (hazard ratio [HR] 1.09 [95% CI 1.05–1.14], P Conclusions T2DM was highly prevalent in NAFLD patients and was significantly associated with both all-cause mortality and liver-related events. The lean patients’ prognosis wasn’t necessarily better than that of overweight patients.

Published
2020

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