Long term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease

BMC Gastroenterology

Einar S Björnsson³  Sigrun H Lund¹  David E Kleiner⁴  Sylvia O Einarsdottir⁵  Helga Norland³  Jon G Jonasson³  Svanhildur Haflidadottir² 

[1] Centre of Public Health, University of Iceland, Reykjavík, Iceland;Department of Internal Medicine, Section of Gastroenterology and Hepatology, The National University Hospital of Iceland, Hringbraut 11D, 101 Reykjavik, Iceland;Faculty of Medicine, University of Iceland, Reykjavík, Iceland;Laboratory of Pathology, NIH/NCI, Bethesda, MD, USA;Department of Pathology, The National University Hospital, Reykjavík, Iceland

关键词: Mortality;    Prognosis;    Fibrosis;    AFLD;    NAFLD;   

Others  :  1121809
DOI  :  10.1186/1471-230X-14-166

 received in 2014-07-03, accepted in 2014-09-23,  发布年份 2014

【 摘 要 】

Background

Few studies have compared the prognosis and liver-related mortality in patients with NAFLD (nonalcoholic fatty liver disease) and AFLD (alcoholic fatty liver disease). We aimed to investigate the etiology and liver-related mortality of patients with liver biopsy verified fatty liver disease in a population based setting.

Methods

In this retrospective study, all patients who underwent a liver biopsy 1984–2009 at the National University Hospital of Iceland were identified through a computerized pathological database with the code for fatty liver. Only patients with NAFLD and AFLD were included and medical records reviewed. The patients were linked to the Hospital Discharge Register, the Causes of Death Registry and Centre for Addiction Medicine.

Results

A total of 151 had NAFLD and 94 AFLD with median survival of 24 years and 20 years, respectively (p = NS). A total of 10/151 (7%) patients developed cirrhosis in the NAFLD group and 19/94 (20%) in AFLD group (p = 0.03). The most common cause of death in the NAFLD group was cardiovascular disease (48%). Liver disease was the most common cause of death in the AFLD group (36%), whereas liver-related death occurred in 7% of the NAFLD group. The mean liver-related death rate among the general population during the study period was 0.1% of all deaths. There was a significantly worse survival for patients in the AFLD group compared to the NAFLD group after adjusting for gender, calendar year of diagnosis and age at diagnosis (HR 2.16, p = 0.009). The survival for patients with moderate to severe fibrosis was significantly worse than for patients with mild fibrosis after adjusting for gender, calendar year of diagnosis and age at diagnosis (HR 2.09, p = 0.01).

Conclusions

Patients with fatty liver disease showed a markedly higher risk of developing liver-related death compared to the general population. The AFLD group had higher liver-related mortality and had a worse survival than the NAFLD group. Patients with more severe fibrosis at baseline showed a worse survival than patients with none or mild fibrosis at baseline.

【 授权许可】

   
2014 Haflidadottir et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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